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 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.
That's what I meant by needing a good reason. A good reason could be as simple as "I can't stand that nurse" or "She hurts me when she changes my dressing", but there has to be a reason.
I'm a bad pt. I've learned 1 thing from all my trips to the ER for uncontrollable allergic reactions. I question everything!!!!!! They have to pass the quiz before they touch, I don't care if I'm turning into a smurf they still have to pass!!!!!
I went to the ER back in 2005 with c/o N&V and the inability to hold fluids down for over 12 hours. At that point I realized I may need IV fluids. When they took me back they asked if I would let a student try and start the IV, sure why not? I have a high pain tolerance and beautiful veins. She took 3 tries, but on the third try it was a beautiful stick. They asked if I was sure I would allow a 3rd try, and I said yes.
There is not anything I would not allow a student nurse to try, as long as THEY felt comfortable.
Ok I am the RN who has never allowed student nurses for myself nor my family. Sorry Charlie but practice somewhere else. If we are in the hospital for whatever reason the last thing I want is trial and error while someone hones skills. Yes, I realize we all started somewhere but as for me no thanks I will pass. Flame on if you feel it necessary:smokin:
As a fairly new grad just off orientation -- I find this thread very amusing. My skills as a student nurse are't really much better as a new grad nurse...only I don't have someone looking over me while I practice said skills as I would have as a student nurse.
I'd let a student do anything to me if I were alert and oriented. I would quiz them about what drug they are giving and how they were going to give it. I'd give them a chance to anything, but I'd quiz them and watch carefully. While foleys are not comfortable, I've had a few and I wouldn't mind a student trying...I'd supervise. NG tubes the same. I think I got a pretty good skill set of skills while in nursing school, 24 years ago. We had a lab, and I think one mannequin back then, but even the mannequin was plastic and couldn't have "invasive procedures" done to it. At my first nursing job, I worked Peds. We had a 15 year old that had severe Chron's disease and was a FTT. The orders were for her to get tube feedings for 12 hours at night. Both patient and mother adamantly refused a feeding tube, so we had to put small 14 french NG tubes in her and change every so often. The patient wanted to go home, but MD was not satisfied with her weight so MD made an agreement with patient that if she would leave NG tube in she could go home. She lived about 4 hours away from our large teaching hospital. MD orders were to teach patient/caregiver to insert NG tube, assess placement, and give tube feedings over 12 hours each night. We had some goals to meet. Patient was reluctant at first to learn, but she really wanted to go home and go back to school. She did not want the tube in her nose during the day at school. Finally we had a "come to Jesus" talk about how were we going to get this done. I told patient that I would help her learn and she agreed. First she cried, then she was mad, and I decided that if we made a game out of it maybe she would learn. So I said..."I know, let's me and you race and see who can get our tubes down faster." She agreed. I gathered the supplies for me and for her. We talked through the procedure, and it was "ready, set, go"... I gagged more than she did and she got hers down first. Mind you we had done this to her many times, and it was my FIRST NG tube. We succeeded in getting the job done, she got to go home. Six months later when they went to the clinic they came up to the floor to visit me. They could not thank me enough for helping her, and she had met goal weight and got to DC her tube feedings. So yeah, I'd let anyone try...it has to be done. If you can tell me how you are going to do it and I think you're doing a fair job, I'm game. Everyone has to learn sometime. If I'm unconscious then what do I know anyway? Have at it!
And as a Home Health nurse it's my job to teach patients and cg to do many procedures. Deep wound packing, IV therapy, shots etc. If we teach lay people with no education to do this stuff at home, what's the big deal about having a student do it in the hospital?
Ok I am the RN who has never allowed student nurses for myself nor my family. Sorry Charlie but practice somewhere else. If we are in the hospital for whatever reason the last thing I want is trial and error while someone hones skills. Yes, I realize we all started somewhere but as for me no thanks I will pass. Flame on if you feel it necessary:smokin:
All procedures short of surgery should be practiced on their fellow classmates.
Also, making med students submit to "intimate" procedures such as caths & other "nudity required" exams / procedures by their classmates will allow to the student to undertstand what the pt is going through, and might help instill sensitivity to the pts modesty, having now been naked infront of (relative) strangers themselves.
And... if the student doesn't do it right and causes a bit of pain / minor injury, there's less likely to be a lawsuit from an irate pt.
TazziRN, RN
6,487 Posts
That's what I meant by needing a good reason. A good reason could be as simple as "I can't stand that nurse" or "She hurts me when she changes my dressing", but there has to be a reason.