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.

[muffie, RN]

i'm brave

pretty well anything

i was green once , along time ago , in a place far far away

[Ruby Vee, BSN]

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.

whoa, there, moongirl. you're coming on pretty strong.

the patient has the right to decide who does what to her. if the patient doesn't want a student nurse inserting an ng, the student nurse doesn't insert the ng on that patient. there are plenty of opportunities to insert ngs out there, but sometimes you need to go outside your comfort zone and ask the nurse with the intubated, sedated patient if it's ok to insert their ng tube for them. most times, you'll get a "yes, thank you" and some instruction on the procedure.

i think sometimes healthcare workers are the worst patients -- we know too much. and if a healthcare worker who is a patient doesn't want a student or an inexperienced rn or an intern or anyone who lacks confidence, lacks compassion or lacks experience touching their body, that's their right.

[TazziRN, RN]

practicing on a mannequin for an NG feels NOTHING like a real person, so dont go there.

It may feel nothing like a real person but the techinque can be practiced. Same thing with learning IV starts on a mannequin. I would be more willing to let a student try an IV on me that has perfected her technique on a dummy arm than one who hasn't even tied a tourniquet before.

[moongirl]

It may feel nothing like a real person but the techinque can be practiced. Same thing with learning IV starts on a mannequin. I would be more willing to let a student try an IV on me that has perfected her technique on a dummy arm than one who hasn't even tied a tourniquet before.

for sure! cept that dummy arm felt nothing like a real arm and a real IV start.. an I am proud to say I got my first IV start on the first try.. however, the NG tube is a gruesome story.. techinque certainly can be practiced in lab, but the mannequin doesnt choke, gag, vomit or scream like a banshee getting both arms cut off with a dull steak knife (my exp with NG tube insert) and this was lidocaine in the nose too- !!!!!!!!!

and certainly everyone has the right to refuse a student, my comment was to nurses refusing students... who did they practice on when it was THEIR first time.. that was my point :)

[TazziRN, RN]

I'm not talking about how different the dummy feels than a real person, but getting the technique itself down can make all the difference in the world: how to hold the equipment, where to put your hands, how to secure the catheter and NG tube without making the pt feel like she wants to strangle you because you're yanking her head from side to side trying to reach the tape.

The first time I had a chance to give an IM as a student, I almost panicked. I went into the school lab and practiced on a dummy until I got the movements down, then did it on a live pt with no problem. Yes, it felt different but I was less nervous and I knew how to hold things.

[moongirl]

I'm not talking about how different the dummy feels than a real person, but getting the technique itself down can make all the difference in the world: how to hold the equipment, where to put your hands, how to secure the catheter and NG tube without making the pt feel like she wants to strangle you because you're yanking her head from side to side trying to reach the tape.

The first time I had a chance to give an IM as a student, I almost panicked. I went into the school lab and practiced on a dummy until I got the movements down, then did it on a live pt with no problem. Yes, it felt different but I was less nervous and I knew how to hold things.

I had all the proper equipment, knew how to measure, told the pt step by step what would be done, was confident, relaxed as I had practiced soooo much in lab then it was a scene from a Stephen King movie one she felt that tube hit the back of her throat! they need to make mannequins that fight back.. lol

[TazziRN, RN]

I had all the proper equipment, knew how to measure, told the pt step by step what would be done, was confident, relaxed as I had practiced soooo much in lab then it was a scene from a Stephen King movie one she felt that tube hit the back of her throat! they need to make mannequins that fight back.. lol

And that could happen to anyone, including nurses to drop tube after tube over several years without a problem, until the Child of Satan shows up!

[Megsd, BSN, RN]

As a patient, it would probably depend on the procedure and how comfortable I felt with that particular student.

As a student (currently) I have bowed out of doing two IV starts because I just couldn't see or feel anything. I felt like I got the experience, at least, of looking and feeling, but I just felt like it would be pin the tail on the donkey to try and start it. I feel that even as hungry as I am for learning opportunities, there is a line between starting an IV I feel confident about (or at least feel I have a chance at) versus just sticking the patient because I'm a student and it's okay if I miss.

Turns out, in both cases where I bowed out and my RN did the IV start, they missed multiple times and had to call in IV therapy.

[nuangel1, BSN, RN]

i believe students need to learn and within reason with their instructor i would let them do most everything .if they hurt me after few attempts i would ask them to stop .but i would even with a seasoned nurse.i would draw the line on med students and gyn exam .no audience there for me.md only and nurse.i also believe each pt has a right to refuse a student med or nurse .i also never placed a foley iv or ngt as a student.

[AirforceRN, RN]

and if a healthcare worker who is a patient doesn't want a student or an inexperienced rn or an intern or anyone who lacks confidence, lacks compassion or lacks experience touching their body, that's their right.

just a question here...are patients (who are healthcare workers or not) allowed to refuse a nurses care in order to get another nurse? obviously if an issue has arisen (the nurse called the patient a fat cow or something) that is one situation, but what about "you don't look very experienced, i want somebody else?" not only would i be upset about this, but i would probably say, "the other nurses are very busy, you're stuck with me." i don't work in a barbershop, you get who you get...am i way off base with this?

[TazziRN, RN]

You have to have a good reason for it. You can't just refuse a nurse because you like another better. And any pt can refuse to be cared for by a student.

[crissrn27, RN]

Hi all, just wanted to say to the last two op's that you can refuse any nurse, doctor, or any other healthcare professional that you want to for any reason you want to. You don't need a "good reason" or any reason at all. It is your body and your health care, isn't it? That being said, I don't think a patient has the right to say "no I don't want sue, I want mary" and be able to get mary. Mary might not be there or might have her max load or might not want to deal with that jerk that night, lol. Anyway, wanted to add my .02 on this. BTW, I have never have refused care from any nurse, and a couple of times I wish I had, but have 99% of the time recieved good care from the nursing students I have had.