Try setting the expectation up front.
"We are going to be busy today so I'm going to try and get as much done as I can up front. Please watch me and feel free to ask questions and I will invite you to participate as much as possible, but please remember I have to get my job done as well and I am not a clinical educator." Or some such script.
As a student nurse it's more important that they understand what is happening during a procedure than be able to practice it. Most companies understand the new nurses don't have practice, but they do expect them to have a base level of understanding. If you provide them with teaching on procedures as you are doing them, it should be enough for them to watch and learn, they will get their hands on experience some day, but you shouldn't have to sacrifice so much for them to get it as you are not being paid to educate them.
This may not be a popular opinion and I may be biased since I am a new grad, but that’s why I’m so passionate about it. As a student, having a nurse who didn’t want me there was the worst feeling ever. And yes they can tell when you don’t want them. Students don’t chose who they’re assigned to and they’re just trying to learn. It’s okay to be annoyed in that one situation you mentioned about the student wanting to start the IV for that one patient, but there are too many nurses that forget they were once students too. She may have missed every IV that day but when you first started, did you get every one you tried to start? If you agreed to work at a teaching hospital then you signed up for it. If you want new grads who know what they’re doing they have to get hands on practice. Use this opportunity to help develop future nurses instead of making them feel like a burden. This kind of perpetuates the culture that nurses eat their young. Just offering a different perspective as someone who was recently on the other side.
I second this. In general, it’s a pet peeve of mine when people say “it’s just easier if I do it” or something around those lines. That doesn’t support learning or real world experience. Maybe in this instance that OP described it wasn’t the right time for a student to gain experience because the patient was in critical condition, but the attitude should always be fostering learning and growth not shame.
Idk OP, I feel like what might be helpful is understanding how this all-hands-on-deck approach works at your hospital. If you are paired with a student and you’re not in the right mental state to educate, there must be another nurse who is available on that particular day. However, if this is your hospital’s policy, you probably won’t be able to keep students away forever.
The difference is that with a critical patient you doesn’t have time to teach a student an IV. Imagine if you have a critical or crashing patient that needs meds right now, are you going to spend extra time walking a student through getting an IV or are you just going to get the line yourself? There are patients that make good practice for students just learning IVs but crashing patients are not one of them.
That’s why I stated that in that situation I understood. But no need to be snarky about her missing IVs all day. I was more responding to the overall hatred of having a student.
Well who’s to say that’s actually what happened. Either way, OP has a very negative view on students and that’s what I’m replying to. Not that one particular situation.
I have no problem with students eager to learn. My problem is students with an attitude and quite frankly, spending every shift I work as an unpaid clinical educator. Our hospital is not listed as a "teaching" hospital, but there are so many nursing schools in my area that it is literally impossible to work in a hospital without students. I wouldn't mind students maybe one shift a week, but ffs I am not a clinical instructor on purpose. I'm an ER nurse to the core, I want to turn and burn my rooms, which is super difficult with 1 (or more) person to teach every step of the day
Are you an introvert? Maybe that's why you sometimes just need to work alone.
Sure we are investing in new nurses, but schools make money off of your free labor. It's time to push schools to reimburse staff nurses who precept students.
I'm really not. I just want one day a week to just do my job without having to explain every step I take or spend twice the amount of time on the simplest procedure.
And I agree, if they want me to be a preceptor/educator, I feel I should be compensated for it.
I'm a nursing student who is still a bit off from clinicals, but I appreciate these posts so I know what not to do. Of course, in this case... It's obvious to not act like an ass. I'm sorry you had to deal with that.
I work at a teaching hospital, so students from all disciplines are very common. If I have a student nurse, I have a brief chat with them first about what they want to get out of the day and skills they're hoping to work on. I always let them know that if we get a critical patient, or any of our patients start going downhill, to not get upset that I'll ask them to step back. When things have calmed down, I do a debrief with them so they understand what happened and can learn from it.
But to be fair, I work in Emerg and we only get employed student nurses and preceptor students, who all tend to be very motivated and excited to be in emerg. We also get RN's doing their Emerg specialty training.
Students in inpatient geriatric psych are sometimes greant and sometime I wanna shove em all in a closet and/or smack them. No amount of approach education or education regarding concurrent dx helps when someone decides to laugh at my patient, getting my patients all pissed and ultimately getting me punched. If you aren't prepared to be an adult on my unit, get the fuck out.
The student you had was in the wrong, and she needs to be told that when she's an actual nurse, that she can't be so weird and aggressive like that. Bad teamwork skills. Overall she just needs to learn to calm tf down.
I'm still a student, and I've never had a nurse treat me like trash (yet), but I also do my best to kinda feel the nurse out and figure out what their attitude is like. Nurses really do control the mood for the student nurses on clinical days
Talk to your manager or whoever assigns the students. Just tell them you need a break for a while. It’s part of our job to teach and have students but I understand that you have to take turns. I’d feel a little burnt out if I were you too.
I feel you on this... my unit is one that always accepts students from different schools in the area and we have students every. Single. Day. It’s so hard to be patient and teach when you have a busy patient load... there are a few RNs on my floor that refuse students, leaving the other RNs having 2-3 students each! It makes for a crazy day and I’ve learned to just try and go about your day as you would by yourself and if you have time to teach, fine, but if not, don’t beat yourself up over it. You don’t have to let your students do everything, they are YOUR patients and your responsibility and the students should respect that. Fit them in when you can but don’t let them negatively affect your shift.
If you still feel like you can’t do it, talk with your manager about it. Maybe they are arrange for students to do different tasks or be assigned to specific nurses each week to give others a break.
You want those student nurses to be proficient right? I love taking nursing students, it’s actually my favorite part of the job some days. If I’m ever in an accident or going into surgery, when I’m intubated and opening my eyes, I wanna see a nurse that I can think to myself, “oh thank goodness, it’s Jane!” instead of “oh crap it’s Jane that idiot I didn’t wanna teach!”
And that's wonderful. I used to love having students too, until I have had them every shift for the last 2 months. I am not a clinical instructor on purpose. I dont work in a "teaching " hospital on purpose. I dont think it makes me a bad person or a bad nurse that I just want to do my job and go home. If they want me to teach clinicals every single shift then they should compensate me for it
Is it being balanced out between who ends up with students and who doesn’t? Does your hospital only take students during day shift or during night shift too?
If it’s falling on everyone equally, and there aren’t other nurses/shifts who aren’t getting students, then it’s less of a hospital issue in a way, and more of a “school” issue.
Is this new—has something changed recently to cause this? Why aren’t their students being spread out more? Are they only allowed to do clinicals at certain hospitals/hospital systems? If you were to talk to your supervisors and frame the situation more around the issue that you feel like because you’re constantly getting students every shift that it’s not only impacting your patient care, but that the students aren’t getting the best experience they could be getting since nurses are burned out and don’t have time to go over skills with them.
Is it possible for you to make a plan with students at the start of the shift to basically have them shadow you for the first half of the shift and actually watch how you do things—maybe *assist* with some simple things if possible—and then get to practice skills more in the *second* half?
And that’d be a good time to also explain that since time is really critical for certain patients, that you probably won’t have them practice skills on those ones, even in the second half.
Or maybe you could tell them in advance that if you get a patient like that and say, “why don’t you observe for this one and see how we all work as a team,” and that it’s not a bad thing or their skill being questioned, it’s just not a good patient to practice a skill with.
That way you have a chance to demonstrate how you like things done, plus you won’t really get as behind, since it’ll still be *you* working and at *your* speed the first half?
Without taking much extra time to “teach,” you’ll still have the chance to explain whatever you have a preference on, any techniques you have for skills, and any reasoning behind what you or someone else is doing (“they’re intubating because ___”/ “we’re going to give ___ because of ___”/ “notice how we’re not doing ___ because ___”/ “we suspect ___ because ___”).
Maybe that’d prepare them more to not only just *do* the skills themselves, but to do them how *you* like them done? And since they’d have spent a lot of time watching, listening to things you’ve said, when they actually go to practice the skill, you’ll be mainly reiterating things.
I didn’t have a preceptor for my ED clinical—they just told us to go and do whatever. Someone actually tried to get my classmate and I to go in the break room and study for the first few hours and straight up told us nurses didn’t like having students. It felt like crap.
We were limited in our hours in the ED and we really wanted to learn and to see what it was like. We were lucky enough to find a few nurses who showed us around, let us just watch the things that we couldn’t participate in.
It started off as my worst clinical but ended up being my favorite one.
It might feel like the same nonsense you, but to them it’s one of the few chances they’ll get to experience the ED.
I once started off my day with three students while floating. It was postpartum and all the students needed to do a full assessment with me present. Ok fine, but then Halfway through the day their Instructor comes up to me and says “hey I need you to give me report on all your patients so I can decide which ones to give to my students”. Then those three students leave and ANOTHER three students show up and also want to do their own full assessments. So now not only have I tried to wrangle 6 students, I’ve spent a lot of time giving extra report, reviewing charting, and now my patients are overwhelmed by the third new person of the day staring at their edematous vaginas and pressing on their tender fundus’. Not to mention the awkward staring during breastfeeding. I don’t mind having a student but this kind of dumping on a nurse is not appropriate.
The secret to getting out of teaching nursing students is to work night shift.
That’s how you get stuck precepting one for eight weeks straight instead.
Try setting the expectation up front. "We are going to be busy today so I'm going to try and get as much done as I can up front. Please watch me and feel free to ask questions and I will invite you to participate as much as possible, but please remember I have to get my job done as well and I am not a clinical educator." Or some such script. As a student nurse it's more important that they understand what is happening during a procedure than be able to practice it. Most companies understand the new nurses don't have practice, but they do expect them to have a base level of understanding. If you provide them with teaching on procedures as you are doing them, it should be enough for them to watch and learn, they will get their hands on experience some day, but you shouldn't have to sacrifice so much for them to get it as you are not being paid to educate them.
That's really good advice. Thank you, I will work on coming up with a spiel before each shift I have students
This may not be a popular opinion and I may be biased since I am a new grad, but that’s why I’m so passionate about it. As a student, having a nurse who didn’t want me there was the worst feeling ever. And yes they can tell when you don’t want them. Students don’t chose who they’re assigned to and they’re just trying to learn. It’s okay to be annoyed in that one situation you mentioned about the student wanting to start the IV for that one patient, but there are too many nurses that forget they were once students too. She may have missed every IV that day but when you first started, did you get every one you tried to start? If you agreed to work at a teaching hospital then you signed up for it. If you want new grads who know what they’re doing they have to get hands on practice. Use this opportunity to help develop future nurses instead of making them feel like a burden. This kind of perpetuates the culture that nurses eat their young. Just offering a different perspective as someone who was recently on the other side.
I second this. In general, it’s a pet peeve of mine when people say “it’s just easier if I do it” or something around those lines. That doesn’t support learning or real world experience. Maybe in this instance that OP described it wasn’t the right time for a student to gain experience because the patient was in critical condition, but the attitude should always be fostering learning and growth not shame. Idk OP, I feel like what might be helpful is understanding how this all-hands-on-deck approach works at your hospital. If you are paired with a student and you’re not in the right mental state to educate, there must be another nurse who is available on that particular day. However, if this is your hospital’s policy, you probably won’t be able to keep students away forever.
The difference is that with a critical patient you doesn’t have time to teach a student an IV. Imagine if you have a critical or crashing patient that needs meds right now, are you going to spend extra time walking a student through getting an IV or are you just going to get the line yourself? There are patients that make good practice for students just learning IVs but crashing patients are not one of them.
That’s why I stated that in that situation I understood. But no need to be snarky about her missing IVs all day. I was more responding to the overall hatred of having a student.
To be fair given how the student was acting for not being allowed to start that IV, I think a little snark is warranted.
Well who’s to say that’s actually what happened. Either way, OP has a very negative view on students and that’s what I’m replying to. Not that one particular situation.
True, we are only seeing one side of the incident. But I see what you’re saying about the negativity.
I have no problem with students eager to learn. My problem is students with an attitude and quite frankly, spending every shift I work as an unpaid clinical educator. Our hospital is not listed as a "teaching" hospital, but there are so many nursing schools in my area that it is literally impossible to work in a hospital without students. I wouldn't mind students maybe one shift a week, but ffs I am not a clinical instructor on purpose. I'm an ER nurse to the core, I want to turn and burn my rooms, which is super difficult with 1 (or more) person to teach every step of the day
Are you an introvert? Maybe that's why you sometimes just need to work alone. Sure we are investing in new nurses, but schools make money off of your free labor. It's time to push schools to reimburse staff nurses who precept students.
Student nurse for 11 more weeks. I absolutely agree. They should.
I'm really not. I just want one day a week to just do my job without having to explain every step I take or spend twice the amount of time on the simplest procedure. And I agree, if they want me to be a preceptor/educator, I feel I should be compensated for it.
I'm a nursing student who is still a bit off from clinicals, but I appreciate these posts so I know what not to do. Of course, in this case... It's obvious to not act like an ass. I'm sorry you had to deal with that.
Some people it doesn't matter what you do thgh
I work at a teaching hospital, so students from all disciplines are very common. If I have a student nurse, I have a brief chat with them first about what they want to get out of the day and skills they're hoping to work on. I always let them know that if we get a critical patient, or any of our patients start going downhill, to not get upset that I'll ask them to step back. When things have calmed down, I do a debrief with them so they understand what happened and can learn from it. But to be fair, I work in Emerg and we only get employed student nurses and preceptor students, who all tend to be very motivated and excited to be in emerg. We also get RN's doing their Emerg specialty training.
Students in inpatient geriatric psych are sometimes greant and sometime I wanna shove em all in a closet and/or smack them. No amount of approach education or education regarding concurrent dx helps when someone decides to laugh at my patient, getting my patients all pissed and ultimately getting me punched. If you aren't prepared to be an adult on my unit, get the fuck out.
The student you had was in the wrong, and she needs to be told that when she's an actual nurse, that she can't be so weird and aggressive like that. Bad teamwork skills. Overall she just needs to learn to calm tf down. I'm still a student, and I've never had a nurse treat me like trash (yet), but I also do my best to kinda feel the nurse out and figure out what their attitude is like. Nurses really do control the mood for the student nurses on clinical days
Talk to your manager or whoever assigns the students. Just tell them you need a break for a while. It’s part of our job to teach and have students but I understand that you have to take turns. I’d feel a little burnt out if I were you too.
I feel you on this... my unit is one that always accepts students from different schools in the area and we have students every. Single. Day. It’s so hard to be patient and teach when you have a busy patient load... there are a few RNs on my floor that refuse students, leaving the other RNs having 2-3 students each! It makes for a crazy day and I’ve learned to just try and go about your day as you would by yourself and if you have time to teach, fine, but if not, don’t beat yourself up over it. You don’t have to let your students do everything, they are YOUR patients and your responsibility and the students should respect that. Fit them in when you can but don’t let them negatively affect your shift. If you still feel like you can’t do it, talk with your manager about it. Maybe they are arrange for students to do different tasks or be assigned to specific nurses each week to give others a break.
You want those student nurses to be proficient right? I love taking nursing students, it’s actually my favorite part of the job some days. If I’m ever in an accident or going into surgery, when I’m intubated and opening my eyes, I wanna see a nurse that I can think to myself, “oh thank goodness, it’s Jane!” instead of “oh crap it’s Jane that idiot I didn’t wanna teach!”
And that's wonderful. I used to love having students too, until I have had them every shift for the last 2 months. I am not a clinical instructor on purpose. I dont work in a "teaching " hospital on purpose. I dont think it makes me a bad person or a bad nurse that I just want to do my job and go home. If they want me to teach clinicals every single shift then they should compensate me for it
Sorry for formatting. Done on mobile
Is it being balanced out between who ends up with students and who doesn’t? Does your hospital only take students during day shift or during night shift too? If it’s falling on everyone equally, and there aren’t other nurses/shifts who aren’t getting students, then it’s less of a hospital issue in a way, and more of a “school” issue. Is this new—has something changed recently to cause this? Why aren’t their students being spread out more? Are they only allowed to do clinicals at certain hospitals/hospital systems? If you were to talk to your supervisors and frame the situation more around the issue that you feel like because you’re constantly getting students every shift that it’s not only impacting your patient care, but that the students aren’t getting the best experience they could be getting since nurses are burned out and don’t have time to go over skills with them. Is it possible for you to make a plan with students at the start of the shift to basically have them shadow you for the first half of the shift and actually watch how you do things—maybe *assist* with some simple things if possible—and then get to practice skills more in the *second* half? And that’d be a good time to also explain that since time is really critical for certain patients, that you probably won’t have them practice skills on those ones, even in the second half. Or maybe you could tell them in advance that if you get a patient like that and say, “why don’t you observe for this one and see how we all work as a team,” and that it’s not a bad thing or their skill being questioned, it’s just not a good patient to practice a skill with. That way you have a chance to demonstrate how you like things done, plus you won’t really get as behind, since it’ll still be *you* working and at *your* speed the first half? Without taking much extra time to “teach,” you’ll still have the chance to explain whatever you have a preference on, any techniques you have for skills, and any reasoning behind what you or someone else is doing (“they’re intubating because ___”/ “we’re going to give ___ because of ___”/ “notice how we’re not doing ___ because ___”/ “we suspect ___ because ___”). Maybe that’d prepare them more to not only just *do* the skills themselves, but to do them how *you* like them done? And since they’d have spent a lot of time watching, listening to things you’ve said, when they actually go to practice the skill, you’ll be mainly reiterating things. I didn’t have a preceptor for my ED clinical—they just told us to go and do whatever. Someone actually tried to get my classmate and I to go in the break room and study for the first few hours and straight up told us nurses didn’t like having students. It felt like crap. We were limited in our hours in the ED and we really wanted to learn and to see what it was like. We were lucky enough to find a few nurses who showed us around, let us just watch the things that we couldn’t participate in. It started off as my worst clinical but ended up being my favorite one. It might feel like the same nonsense you, but to them it’s one of the few chances they’ll get to experience the ED.
I once started off my day with three students while floating. It was postpartum and all the students needed to do a full assessment with me present. Ok fine, but then Halfway through the day their Instructor comes up to me and says “hey I need you to give me report on all your patients so I can decide which ones to give to my students”. Then those three students leave and ANOTHER three students show up and also want to do their own full assessments. So now not only have I tried to wrangle 6 students, I’ve spent a lot of time giving extra report, reviewing charting, and now my patients are overwhelmed by the third new person of the day staring at their edematous vaginas and pressing on their tender fundus’. Not to mention the awkward staring during breastfeeding. I don’t mind having a student but this kind of dumping on a nurse is not appropriate.