Clinicals and nurses

[txemt]

All rght guys, this past weekend I finished my last ER clinicals for the semester ( new semester starts in like 3 weeks). On Sat. I worked with a nurse who had been in the field for 30+ yrs. Good nurse, he asked me what I felt comfortable doing and the let me go to work ie: iv insertion, im injections etc. I worked my butt off. I was happy, Sun. when I come in I notice they're not letting me do as many procedures, doing lots of grunt work ie: UCG, changing beds etc. I work and don't complain, later in the day I'm told by a nurse that the reason for the grunt duty is due to the fact that a nurse overheard another nurses' conversation about what paramedic students can and can't do and stopped the students from being able to do anything but basic stuff, ie: bandaging, etc. so the question I guess is what's the point of going to the ER to learn if they won't teach you due to one nurses' bad attitude toward students? On a saide note, the nurse bitching was an LVN and the nurse I had worked with who wanted to teach me was an RN.

I think that they miss the point that having a student there can make their lives EASIER.

[Just Plain Ruff]

Here we go again.

performing skills is important but the so called "grunt work" as you put it is also part of the deal.

Not to be harsh but you have to NIP that "I don't do grunt work" attitude in the bud. Every medic here did grunt work in their clinicals and most if not all had to prove themselves to the nurses before they got to do any of the cool stuff. I know of many medics who didn't get to do a lot of challenging skills because they had that attitude. I know of a lot of medics also who were able to do many many things becuase they proved themselves and a part of that is doing the "Grunt work". When nurses see you are willing to get dirty and do the work that they do everyday such as change linens and clean up "poop" then they will gradually bring you into the good stuff.

The nurse who changed the rules should be re-educated and told what medics can and cannot do but unfortunately you are at their hospital and they make the rules and it is also not your place to do the reeducating.

I can tell you that you are going to have to do grunt work at your job as a medic such as Cleaning the truck, changing linens and cleaning the station house.

So, go to clinicals, do what they ask of you and I am sure that you will prove to them that you know more than just the basics and you will soon be starting IV's and stuff before you know it.

**** On a side note - have you brought this up to your instructor and made him/her aware of these new restrictions or are you just here venting?

**** on another side note, I have had hundreds of students precept and learn under me and the ones who got to do the exciting and fun things were the ones who helped make my day easier. And YES, you are there to make the nurses Jobs easier.

[txemt]

Our instructor was informed. This is more of a venting thing since it didn't involve me directly. I do not have a problem with the day to day routine stuff. I have wiped asses, walked more miles than I can count to the lab and held kiddos down so the lab tech could draw blood, none of this is a problem for me although through the grapevine I heard other students bitching and complaining about things that where beneth them.

The problem really was the one LVN, she's been a pain the ass before. She's in RN school and she really just has that whole holier than thou attitude. no problem, I just go where they tell me to go and do what they ask if I'm capable

[Just Plain Ruff]

TX I love that attitude. It's a great one to have. I understand becuase when I was in my first clinical or two I also was relegated to the "Grunt work" yet I did it cause I knew I had to. I proved myself to the nurses and they proved to me that they would let me do more and more fun stuff.

It just took a shift or two. If you can show them you are willing to do the grunt stuff then they are more willing to show you good stuff. Imagine, changing sheets, cleaning up patients and the like makes a nurses day and it lets them get their paperwork done faster and then they can go home faster. It's a win win situation

Keep up the great attitude and you will do wonderful.

[Ace844]

I had a similar situation in one of my clinical rotations as well. I did the 'scut,' and kept my mouth shut..until it got to the point where I was delivering interdept. mail and messages-belongings from nurse to nurse in addition to everything else. Then i went to my program director with the issue and after he suffered a major hypertensive crisis, he straightened it out. Another thing that helped is I worked with the docs as much as possible and once they got comfortable with my abilities and knowledge, they would turn to me instead of the nurse and say..Why don't you go ahead and do the ETI, Cric, ...... It didn't take long before the nurses smartened up, and started to play along as well. Another thing you should be aware of is the fact that when its any nurse vs. you in a disagreement or whatever, your the outsider and the nurses will band together even if they dont agree with or like the nursing party involved, just my .02, and HLO, food for thought,

ACE844

[PrissyEMT]

I absolutely love the RN's in the ED where I do my clinicals. They don't hesitate in the least to let us practice our skills... they've told us that having us there doing clinicals actually makes their jobs easier. Granted, we still do a lot of grunt work, but I think that's part of the whole "you scratch my back & I'll scratch yours" philosophy. I figure if I take the initiative to do the not so fun parts of being in the ED, then they're more likely to let me do the fun stuff... and so far, that's more than paid off. I agree txemt- I'll do anything they ask of me as long as I'm capable of doing it. That way when all's said & done, I know I've made the most of my clinical hours.

[chbare]

Unfortunately, medicine can attract type A people with all kinds of personality flaws. I have seen nurses as well as other providers develop a condescending attitude toward students. We should never forget where we came from. It is too bad that these people are able to ruin a clinical experience for a student. This is my take on students. As an RN I am responsible and held accountable for the actions of my co workers and students. I have no problem with students, however, I have been told I am a little harder than other nurses. If a students is going to perform a procedure or give a med, I will quiz them and require them to convince me that they know how the med works and what problems to expect regarding the med/procedure. This is to ensure that they know what they are doing and to ensure that the patient does not receive poor care. For example, if you are going to give a patient toradol, you will have to tell me more than "it is for pain." I want some basic patient history to include allergies and will want you to tell me how the medicine is thought to work and common problems associated with giving this med. I also make sure to keep close and available while the student is performing a procedure. As far as grunt work goes, I do not believe that students should have to do this kind of stuff. (help with grunt work but not do it all) If one of my patients is incontinent I may ask a student to help me, but it is my job to clean my patient up. Just my take on students.

Take care,

chbare.

[txemt]

There are a lot of different types in the hospital where I did my clinicals. Most where extremly helpful. There was one doctor, who loved to quiz me, which I thought was great. We discussed cases and how to handle them in the field as oposed to the hospital setting. I had another DR. who would sit at the desk and ask me to sit down and tell him what I learned.

[NREMT-Basic]

At the risk of getting blasted yet again, the purpose of a student doing clinicals is not to make the nurses lives easier. The purposed of clinicals is for doctors and nurses to teach you what you need to know and then supervise you doing it. When I was in clinicals and was asked to fetch coffee of make copies, i went to the nearest phone and called my instructor who promptly let the ED know what I was there for and that I was no a gopher.

"Learn one, do one, teach one."

[JPINFV]

While I agree that a person doing clinicals (certified first responder [do they even have clinicals?] through med students) are not there to make anyone's job easier. They are there to learn.

Now, we need to ask ourselves what actions are educational. Sure, anytime a student gets to practice their skills (assessments, especially, but also things like injections, IV starts, etc) and use their education (interpeting their assessments, picking treatments, etc) is educational and useful. What about the other things? Is helping clean up a patient helpful? Sure, especially if the person is lacking clinical experience (especially emt-Bs), because you learn that there is no privacy sphere in medicine. How about running labs? Can be, take a few seconds to talk to the lab techs and get a feel for what their part of patient care is (even if it is indirect patient care). Is getting coffee useful? Generally no.

Finally, we need to ask ourselves if it is worthwild to complain about doing scut work? As a general rule, probably not. So you get a cuff of coffee? So what? Get the cup and get back. Sometimes it is better to just go with the flow then to get everyone against you. Of course, excessive scut is a problem.