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.
I have to agree with some of the posters who said theres not much of a difference between allowing a student nurse (with supervision, of course) do something and an actual RN with no experience with something (i.e one poster mentioned inserting an NG tube). Unless you ask, you have no idea what that RN has done and hasnt. Heck, sometimes I think I'd rather have a student, because they most likely would have an instructor present to watch them!
That being said, I can also say that I would be a little apprehensive about letting SOMEONE (SN or RN) with little or no experience start an IV on me, but I probably wouldnt mind, because i have a high pain threshold and because Ive been in that position myself. As for a foley, Ive only had one inserted in myself before, and I was anesthetized at the time, so I have no idea how much it would hurt, but I probably would let a SN do it, if the RN or instructor was there.
Now, I also agree with the posters who said that they wouldnt allow some of the students in their class to perform procedures on them. There are a few in my class that I would be terrified if I has them as a student nurse (or actual nurse). Problem is, for me at least, is that it would be difficult to determine (as the pt) who is one of "those" students. That brings back the memory of a student (who is no longer in our program, but not because she did this) who thought they were d/c'ing a heplock and actually pulled out a pts PICC line...yikes!
Personally, I also find it a little odd that many nurses are hesitant to allow a student to perform a procedure on them, because EVERYONE had to start somewhere...but that is your own decision as the pt and I would respect that if someone refused to have me perform something.
Just about any procedure would be okay with me.... The SN would be supervised, afterall, I'M a nurse! A nurse that graduated having never starting and IV or inserting a Foley (or and NG) for that matter. It does happen and having RN behind your name is not and indication of competency. I wouldn't let any nurses start administering drugs willy nilly without me asking questions, so I'd be sure to confirm the SN knew (or felt like s/he knew)what was going on.
Oh, I simply do not care. Everyone has to learn at some point and time in their life. I appreicate the patients that allowed me to learn on them while in school so I didn't have to be the RN that said.....I've been an RN for 2 years and never got to do that.
And for the poster that was suprised about IV's and Foleys. I started TWO IV's during NS, yes, that's right....just 2. And I never inserted a Foley during NS, only at work as a tech.
I think we all need to understand that there are times that certain cases just aren't "teaching cases." Like the poster whose child was in critical care and had finally had her fill of students; we need to be respectful of that. There are times that pts. are too overwhelmed or sick to care about accommodating the learning needs of a student. There will be other opportunities. It's not personal.
so.. you wouldnt let a me do an ng tube insert...? so i go my whole student time never doing one because people like you say no. i walk into your room with the rn behind my name, say i have been an rn for.. 2 years.. and have never done an ng tube (but you are oblivious to this) and.. you let me ng you...?? how are students supposed to learn? practicing on a mannequin for an ng feels nothing like a real person, so dont go there.
please try to remember during your practice that patients have the right to refuse care from anyone if they aren't comfortable with the person delivering the care and they do not need the attitude i sense from this post if they refuse. they do not owe you your education simply because they are in the hospital, and that also applies to nurses who are patients. just because they have been students doesn't mean that they have to be different than patients who aren't nurses.
if you are a 2 year rn, and you have never placed an ng tube, please walk into that room with another licensed nurse, rn or lvn, and tell me what you are doing and why you have someone with you. let me choose who sinks the tube. i'm actually probably going to let you do it and trust you more because you were honest with me. if you're nervous, and you make a mistake, and i find out later that you've never sunk a tube, trust me, you'll hear my opinion and so will your supervisors.
that being said; if i was a patient in my own hospital, i would let students perform about any procedure because i know most of the instructors. if i was in a hospital i'm not familiar with because i got hurt or sick on a hockey road trip, i really probably wouldn't want a student unless it was for assessment and po meds only. there's too much to deal with in a strange place.
I wouldn't let ANYONE give me a foley unless I was sedated or at least numbed in some way. I got one in highschool because I had not gone in almost 2 whole days and they did it to "get things going". Hurt like a blepity blep.
I would - and have - let both nursing and med students "practice" on me. In fact, I will more often than not ask if there are students around that need practice with their skills to care for me.
I have NEVER had a problem with a student.
I'm going in for surgery in mid April, and I welcome any student to participate in my care or observation of my care/surgery.
The only thing I have issues with is IV starts - simply because my veins are very hard to find, and vasospasm with IV starts. My last procedure, it took 4 sticks with 22g angios, to get my IV started. The anesthesiologist tried 2x and failed, one RN tried 1x and failed, before another RN finally succeeded.
Note, I said "issues with IV starts" - I wouldn't say no to a student to try, but I would not expect them to succeed at it either, with me. I would let them practice on me.
I have allowed new RN's to practice IV starts and blood draws on me. In fact, I will talk them right through it. You have to learn somehow!!!
I have also talked med students, EMT students, and nursing students through procedures as well. I LOVE having a student with me, and teaching. I only wish that the nursing program would allow the students to do more hands on in L&D.
I wouldn't let ANYONE give me a foley unless I was sedated or at least numbed in some way. I got one in highschool because I had not gone in almost 2 whole days and they did it to "get things going". Hurt like a blepity blep.
Me too. When I had an NST done I asked the OB nurse what to expect when I came in for my section. She told me to insist that the foley be inserted in the OR when I was numb. I'm glad I followed her suggestion because I didn't think about a foley. I try to be as gentle as I can when inserting one but so many people have discomfort with it that the idea of getting one myself makes me nervous.
please try to remember during your practice that patients have the right to refuse care from anyone if they aren't comfortable with the person delivering the care and they do not need the attitude i sense from this post if they refuse. they do not owe you your education simply because they are in the hospital, and that also applies to nurses who are patients. just because they have been students doesn't mean that they have to be different than patients who aren't nurses.
if you are a 2 year rn, and you have never placed an ng tube, please walk into that room with another licensed nurse, rn or lvn, and tell me what you are doing and why you have someone with you. let me choose who sinks the tube. i'm actually probably going to let you do it and trust you more because you were honest with me. if you're nervous, and you make a mistake, and i find out later that you've never sunk a tube, trust me, you'll hear my opinion and so will your supervisors.
that being said; if i was a patient in my own hospital, i would let students perform about any procedure because i know most of the instructors. if i was in a hospital i'm not familiar with because i got hurt or sick on a hockey road trip, i really probably wouldn't want a student unless it was for assessment and po meds only. there's too much to deal with in a strange place.
no-"attitude"- more like -"disbelief"- that just because a person has rn behind their name makes them automatically better at an ng tube insert than a student. i am not allowed to do any invasive procedure without my instructor, same cannot be said for an rn.
everyone has to start somewhere, and if students are never allowed to do something when all the "experienced" rns retire you are going to have a bunch of nurses who dont know how to do anything.
Specializes in ICU, CCU, Trauma, neuro, Geriatrics.
I have allowed students to start IVs, insert foleys and give IM and sub-q but not IVP. I am not sure about NG insertion but maybe with a good teacher at their side. Hang premix IVs including antibiotics after showing me they checked the orders and I agreed to the treatment. Actually show me you have a clue about what you are doing and I will probably allow one attempt on most things.
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TraumaGirl1018
56 Posts
I have to agree with some of the posters who said theres not much of a difference between allowing a student nurse (with supervision, of course) do something and an actual RN with no experience with something (i.e one poster mentioned inserting an NG tube). Unless you ask, you have no idea what that RN has done and hasnt. Heck, sometimes I think I'd rather have a student, because they most likely would have an instructor present to watch them!
That being said, I can also say that I would be a little apprehensive about letting SOMEONE (SN or RN) with little or no experience start an IV on me, but I probably wouldnt mind, because i have a high pain threshold and because Ive been in that position myself. As for a foley, Ive only had one inserted in myself before, and I was anesthetized at the time, so I have no idea how much it would hurt, but I probably would let a SN do it, if the RN or instructor was there.
Now, I also agree with the posters who said that they wouldnt allow some of the students in their class to perform procedures on them. There are a few in my class that I would be terrified if I has them as a student nurse (or actual nurse). Problem is, for me at least, is that it would be difficult to determine (as the pt) who is one of "those" students. That brings back the memory of a student (who is no longer in our program, but not because she did this) who thought they were d/c'ing a heplock and actually pulled out a pts PICC line...yikes!
Personally, I also find it a little odd that many nurses are hesitant to allow a student to perform a procedure on them, because EVERYONE had to start somewhere...but that is your own decision as the pt and I would respect that if someone refused to have me perform something.