YOU as a Pt-what would you allow a student nurse to do?

[KellNY]

I had mentioned in another thread that I wouldn't allow a student nurse to attempt insertion of a foley on me (unless I'd been anesthetized prior).

So that got me thinking....

What would I and what wouldn't I allow a student nurse to do for me?

Here's my personal thoughts

I WOULD allow:

Vitals

Venipuncture

PO meds dispensed and IVPB meds to be hung (and main fluid bag changed/hung)

*SC or IM meds administered

EKG

SLIV/HLIV flush

D/C IV or SL/HL IV

Foley emptying and flushing (if RN with SN for flush)

Unchecked assessments for lung sounds, bowel sounds, DTRs etc (as in, SN can do it, as long as RN there to assess and verify)

I WOULD NOT allow:

Catheterization

IV insertion

*SC or IM meds administered

IVP meds

NG tube insertion

*I listed SC and IM under both categories. If SN had experience giving injections, well, then shoot away. But if not, sorry. I've seen way too many students get scared or try to be nice, etc, and push the needle in so slowly, push the med too fast into the tissue, not feel comfortable with location and hit a bone, etc.

I know I'm leaving lots of stuff out--haven't slept in over 36hrs, so brain ain't what she could be right now, yk?

What about you all? Where are you willing to aid the learning process and where do you draw the line(for you personally-not your kids/family)?

***We're assuming these are not emergency situations. ie, I'd let a student venipuncture me, but not if it were for STAT Mag levels because they think I have MagTox, or T&S because I'm bleeding, etc.

Can't wait to see your answers.

[Sacred eagle]

There is a section of the form thatasks you if you want non-teach,that includes nursing students,residents, etc. Actually a good idea.

[Purple_Scrubs, BSN, RN]

And everyone has their own orifice to check if you want to feel normal tonus.

Not quite sure why, but this really tickled my funny bone today

[anotherone, BSN, RN]

I would let some of the students I see perform procedures liek caths etc on me before many of my coworkers with 10 years+ experience...................... all thsoe years doing things wrong. but i know these nurses and their skills. other people have nothing to go by but that he/she is a nurse vs student.

[anotherone, BSN, RN]

Everyone does realize that your nurse may be just as great at IV starts of foleys as the students right? I have seen many many many "Experienced " nurses miss both, than someone comes in and misses again. and again. One time we had 2 experienced nurses try to insert a foley in a massively obese female that could barely move ( anyone with any experience knows the logistical difficulty in this). i had the least experience by far both putting in foleys and in nursing and finally i decided to try, the pt let me, and i got it in. it was some sort of fluke i am sure. lol.

[Brekka, ADN, RN]

Personally I'd let a SN practice pretty much anything on me. As long as their instructor knows and they are cleared to practice the procedure, they can try and do whatever needs to be done. If it's a known painful or uncomfortable procedure, it will hurt whether it's a student or a nurse with 5 years experience. In fact, I'm fairly certain (personal opinions) that a student nurse is more likely to practice by the book than an experienced nurse who has had time and opportunity to adopt shortcuts or bad habits.

It would depend on the student. A confident, intelligent go-getter: Knock yourself out. A hesitant, nervous student - nothing invasive.

I'm more of the latter than the former, and while I did know what I was doing I tended to take an extra minute or two to complete my mental checks and sort out my thoughts. From what I've seen from my fellow classmates, those that were overly confident and headstrong in their skills seemed to make more mistakes. I have no problem with the quiet, timid students, as I know they're actually thinking about what they're going to do instead of doing and then following up with an "oops!"

[Picklefreak]

I think it's funny that several people have said they would let students do anything but a foley. I'll bet most students are more conscientious about sterility than a lot of experienced nurses.

[Cul2]

It seems to me that, for some at least, this issue is at heart about trust, honesty, oversight and supervision. Some may

just firmly be against having any student nurse or doctor work on them. But most people, I really believe, are open to it if,

and I repeat, if they believe people are being honest with them, if they see there there is oversight and supervision, and if they feel safe. Much depends upon the demeanor of the student. If they appear confident, fine. If they're too nervous, not fine. But, frankly, once trust has been lost, it's extremely difficult to get it back. How many have by chance found out a student was working on them without being told? How many felt deceived? Now, you can say all you want about signing consent forms with that fine print written in legalese. That may be a "legal" standard, but it's not a human one. Patients must be asked if students can work on them, and be introduced to the students -- even better, have the student approach the patient and ask permission to work on them. That represents respect. If this doesn't sit well with some, then work on models or standardized patients.

[canned_bread]

I understand that... but they have to to learn. And if they are being watched by someone to ensure proper practice I would be okay with it. That being said, I am about to have surgery tomorrow in a teaching hospital, and I'm worried it's going to be done by a registrar lol!

[Old.Timer]

On my last Csection- I was a new nurse (less than 2 months) and I was willing to have a student to the usual IV insertion vitals- whatever- Of course there were no students because it was August. HOWEVER when I got to the OR it turned out that my CRNA was a student- that was so scary for me. I am afraid of being paralyzed and whether or not that is a possibility I am not sure. I did let him do it- he was a nice guy- been an ICU nurse for 10 years and had done many procedures. The CRNA that was precepting him was sitting over in the corner reading a paper while the student was working on me. I know this because my sister was like "Who's the guy reading the newspaper?" This was my second section- and I felt more tugging and freaked out a lot more= but I think this was because I had seen several in nursing school and I was more aware of risks etc. In fact after they delivered the baby I asked for some versed- but I apparently did not get any because I remember everything after that.

I did let the student I am precepting this semester start an IV on me.

I apologize if I am repeating what anyone else has said since I have not read the thread. There are very few things that I would not let a student do if they appear knowledgeable, adequately prepared and appropriately supervised for the task.

A CRNA student only being monitored by another CRNA would be a deal breaker for me. Unless there was additional oversight by a board certified anesthesiologist who has reviewed my case, has been introduced to me , and is in close physical proximityduring the case, I would refuse. That is the norm when a CRNA is handling a case and I would expect it to be the same in the case of a student.

[FLmomof5]

I have had student nurses handle things for me as a patient. In fact, I was a post-partum patient and a male student nurse came in. He sheepishly told me that he was a SN and needed to do an assessment on me. I said, OK.....he then stated that he needed to check my episiotomy and I told him OK on that too. He suddenly looked relieved that I would allow him to do all those "private" things without an issue. He did a good job and protected my privacy as best he could. I am sure he is a good nurse now.

I have ROPES for veins and the stand up huge and never move and that is without a tourniquet!!! I have no problem in letting SN's or student phlebotomists practice on me. In my 50 yrs, only 1 person has ever missed a vein. Poor navy nurse trainee was embarrased that he missed. I simply told him to try again! The regular nurses tried to step in and I pointed out that he needs to learn and I have great veins for him to practice on...so let him try again. He didn't miss on the second attempt at IV insertion. He smiled so big when he got it the second time!

Never had a SN attempt a foley. I have had foley's and straight caths....and never felt them. I guess that I wouldn't have a problem with a SN attempting one. Females are much tougher to get and everyone needs to get experience. At least, I am VERY flexible (used to by a gymnast) and I only weigh 122, so there is no fat to get in the way. My first foley was on a 300 lb female who had hip issues and couldn't "spread" very well. It took 1 other nurse and a tech to help so we could find the location for insertion!