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.
About 3/4 of my pts. in clinicals were nurses or aides. At first, I thought my instructors assigned me to them because I needed extra help. Later, I began to suspect they thought their ailing colleagues needed a laugh. Either way, it worked out. I got a lot of useful advice, and I'm sure watching me fumble around and sweat was pretty amusing. Didn't get to do much that was very invasive in school, though.
My two IV starts in school went very well. Actually, the first was a bit messy, because I started it right-handed. That was fine until I tried to put the hub on. Starting IVs was problematic once I was on my own, though. I had to start one on a pt who was an EMT, and she actually used a napkin to mop my brow as I stuck her. (My theory, then and now, is that you have to miss a hundred sticks to get good at it. Happily, it's taking a lot longer to miss the last thirty than it did the first thirty...)
I like to believe I'd be as generous toward students as my patients were with me. The point may be moot, though. After my last hospitalization, I took an oath that if I ever came back, they'd have to carry me in. No such thing as a "walk-in emergency." So I like to believe I'd be in no condition to object to a student, if I ever have to return to that living nightmare, again. (I had a spider bite. I got IV antibiotics q8h x 6 doses. If they had kept me a third day, I'd have been on suicide precautions. The hot compresses were nice, though.)
I think I would allow them to do any procedure as long as the nursing instructor was there by their side to make sure they didn't screw up. Have things changed or doesn't the instructors observe and walk you through procedures anymore? I graduated in 1996, so its been a while.
Just yesterday I was allowed by my instructor to Straight cath a male patient of another student. Said student REFUSED to do it, so I jumped right on in. I kept sterile technique, and did quite a good job according to my instructor AND the patient. Either way, tube down a member isnt going to be a day at the beach
Its rare we get to do that out of the ER so I was very very glad that I got to practice a skill like that on a real patient.
Maybe I will be the odd man out here BUT...24 years ago I was a student nurse...and where would I be today if patients THEn had said 'no you can't do that on me/to me'...
We all have to learn and be patient while others are learning. Who is not to say that that student nurse isn't better at such and such procedure than an older nurse?
We need good nurses and people who want to be nurses need all the guidance and help they can get. We have to 'take care of our young' and help them the way WE seasoned nurses had someone help us...
This is a great topic, although I find it a bit lopsided due to the fact that we are all health care professionals. As a nursing student now I would totally understand if a patient that happened to be a nurse said no. Having done many IVs, foleys and NGs we know that they can be uncomfortable and that experience generally brings less pain. Luckily for us students, most patients are unaware what a foley is supposed to feel like, or that an NG can be a real "tickler" at times. I tell all my patients that a foley insertion is going to be uncomfortable and that I'm going to poke them with a big stick before I start an IV. It just lets them know what thy are in store for.
i've let new nurses practice iv's on me. though, i did make her use a 20g instead of an 18g (we usually use 18's in l&d).
i've only been in the hospital for having babies. didnt have a student nurse last time. had a med student check out my perineum. didnt mind that, but i did mind when in the room, my crotch up in the air, they asked him if he liked OB and he said no!
i suppose i wouldn't let a student do something to me that i'd never had done before. why? i am a very anxious person and the anxiety of having something new done would be bad enough, i'd want teh nurse focused on me, not on instructing the student!
generally, probably yes, but only with supervision. depends on teh student, too, though.
i've only been in the hospital for having babies. didnt have a student nurse last time. had a med student check out my perineum. didnt mind that, but i did mind when in the room, my crotch up in the air, they asked him if he liked OB and he said no!
Everything except arterial sticks but I would put a limit on IV starts. I would let them try 3 times after that, get the RN. They have to learn and I truly understand that. If I couldn't have done any of the stuff to learn What kind of a nurse would I be today.
Open to anything pretty much, as long as their instructor is present.
kinda have to agree here. I mean they have to learn on someone...
When I was in nursing school (17 yrs ago) I went to the Public Health Dept for BC pills. Looking back, I guess it was a student (or really new nurse) trying to draw blood on me. She didn't even try in my AC, instead she poked me below the AC on my forearms. I was too "green" to realize she was doing it wrong. For the next few clinicals my instructor made me wear long sleeves to cover up the huge bruises because I looked like a junkie.
:lol2:
nursemike, ASN, RN
1 Article; 2,362 Posts
About 3/4 of my pts. in clinicals were nurses or aides. At first, I thought my instructors assigned me to them because I needed extra help. Later, I began to suspect they thought their ailing colleagues needed a laugh. Either way, it worked out. I got a lot of useful advice, and I'm sure watching me fumble around and sweat was pretty amusing. Didn't get to do much that was very invasive in school, though.
My two IV starts in school went very well. Actually, the first was a bit messy, because I started it right-handed. That was fine until I tried to put the hub on. Starting IVs was problematic once I was on my own, though. I had to start one on a pt who was an EMT, and she actually used a napkin to mop my brow as I stuck her. (My theory, then and now, is that you have to miss a hundred sticks to get good at it. Happily, it's taking a lot longer to miss the last thirty than it did the first thirty...)
I like to believe I'd be as generous toward students as my patients were with me. The point may be moot, though. After my last hospitalization, I took an oath that if I ever came back, they'd have to carry me in. No such thing as a "walk-in emergency." So I like to believe I'd be in no condition to object to a student, if I ever have to return to that living nightmare, again. (I had a spider bite. I got IV antibiotics q8h x 6 doses. If they had kept me a third day, I'd have been on suicide precautions. The hot compresses were nice, though.)