Slightly Used Posts: Poo Free

A repost of one of my (IMHO) better entries in the past year, to mark the first year of this weblog. First posted November 2009.

No more poo:

Student nurses are rejecting essential elements of bedside care because they feel it is not a worthwhile learning experience, research published by Nursing Times has found.

The research found widespread conflict between student nurses and qualified staff over the tasks students should do on placement.

Tasks normally carried out by HCAs, such as making tea, washing patients and cleaning, were not seen as valuable learning opportunities for student nurses keen to gain experience with more technical roles like administering drugs.

As a result, many senior nurses feel that students are qualifying with significant gaps in their basic skills. One interview participant said: “I sometimes feel in despair that by the time students have qualified, they still haven’t gained some of the practicalities and common sense – things like time management, basic assessment skills – that we would have been doing on our first round.”

One student was reported to have told a staff nurse: “I keep being asked to do things which won’t help me learn – clear up poo, mop up blood, give patients tea and toast. I realised that I needed to more focused to learn, and I don’t do those sorts of things now. [The full study is here.]

I’m actually with the students on this. There are few things going on here. One is the perpetual nostalgia that nurses have for the good old days, when men were men and nurses were nurses, and we were trained by battle-axe old-school-types who flogged us students daily with used foley catheters before we walked home uphill in a blinding snowstorm to work all night on 45-page-long care plans. And that somehow produced wonderful, thoroughly trained nurses, unlike today’s crop of know-nothings. So say a lot of you, including many of my own colleagues.

Oh honey. I have a newsflash for you. We weren’t that good, or well trained, and we fumbled around just like today’s new grads. I know. I was one of you.

And then there is a notion that since we went through all that crap that Hilda Harridan RN made us do, the current generation needs to “pay its dues” too. Though it escapes me how making nursing student go through their paces like we did will make them better nurses.

From the times I walked the floor as a clinical educator, I spent a great of time defending my students from the sort of crazy, useless busywork that the ward staff seemed determined to make them do. Staff believed they were free, exploitable labour. The manager of one of units told me, “They will be great help for the nurses.” She grew shocked and angry when I suggested they weren’t peons or gophers, and accused me of not teaching the students proper “teamwork”. This in her eyes seemed to mean making the students do the pissy things no one else wanted to do. My students, in fact, were not there to fluff pillows, cart patients to x-ray, boil the kettle, organize the bedsides, take specimens to the lab or any of the innumerable trivial tasks that can consume your average med-surg floor.

They were there to learn.

And I still don’t see how making a cuppa for the dear in 6 or running that routine R&M downstairs will help nursing students in time management or pharmacology — which seems to be the prevailing attitude in clinical areas. Good nursing skills come from hours of doing patient assessments, developing advocacy skills and learning to think critically.

And frankly, I would much rather have a nurse at the bedside with amazing critical thinking and communication skills than one who can effectively wipe the poo from my bum.

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  1. #1 by The Nerdy Nurse on Wednesday 08 September 2010 - 2005

    While I agree that nursing students are often ‘used’ to complete seaminly meaniale tasks. In my nursing school experiences I often was told to feed patients, clean crap, change linens, take v/s. and so on. However, I was also allowed the privledge to be a part charting assessments, admininister medications, starting IVs, changing dressings, and educating patients. I use all of these things on a daily basis, and you know what? Sometimes I clean more poop than I start IVs or administer medication. If there are 25 patients, 6 nurses, and 1 tech… well the tech can’t/shouldn’t change every bed, give every bath, or be expected to run theirselves ragged.
    I also agree with the aspect of “paying dues”. It is a huge responsibility we take on when we walk into those hospital doors and take on our patients. Its a responsibility that I did not fully realize until well after I was a nurse. When I was in school I would sometimes be puzzeled and feel used when I was asked to do “meanial” things, but in restrospect I realize that ALL of these things are vital to goo patient care.
    Would I rather have a good critical thinker or poo off of me? Depends on the setting. If I’m 24, and in a trauma, Critical thinker all the way… If I’m 77 and a medical patient, give me a poo cleaner!

  2. #2 by NNR on Thursday 09 September 2010 - 1016

    Agree overall but have to add that I worked as a CNA in school and recommend that as a supplemental learning experience. I see new RNs who DON’T know how to wipe poo or give baths or transfer, and those are skills nurses still need.

    • #3 by torontoemerg on Friday 10 September 2010 - 1155

      I tend to agree with this. Basic nursing skills are basic for a reason. However I’m not clear how many bedbaths need to happen until a student becomes proficient.b

  3. #4 by Tammy on Thursday 09 September 2010 - 1450

    I am a Personal Support Worker, you know the people refered too as the ones who wipe the poo. I found your blog offensive and wrong. Nurses SHOULD learn to make a cup of tea and actually TALK to their patients rather than sit around and “document”.

    PSWs are the front line workers, we make YOU nurses look good. How dare this be written! If there weren’t PSWs, nurses just might have to stoop to our level and administer bedside care. Oh no for you!

    But Watch out because no more will PSWs be called Professional Sh*t Wipers. We now have a professional association, we will become regulated, we are just as important as ANY nurse. We are the first on the scene and the last to leave. WE are the workers the families know best. Get it right.

    I find this blog disgraceful. It’s no wonderful PSWs and Nurses cannot work together as a team. When we should, because the only difference between PSW and many nurses is MEDS. That’s it.

    • #5 by torontoemerg on Friday 10 September 2010 - 1153

      Nothing like a little poo to get people all hot and bothered.

      I’m having trouble thinking of a nice way to respond to this, without validating your obvious (and misplaced) discontent with nurses. Evidently, you actually haven’t read much of this blog. So thanks for writing, and I do hope you continue reading.

      Also, I’m thinking of adding a sidebar, to document the epithets thrown at me. So far, I have “emotional”, “posturing”, “shrill”, and now, “disgraceful”. Thanks!

  4. #6 by Mary on Monday 12 September 2011 - 1515

    I work in ER – 3 RN’s – no LPN’s, PCA’s – ie:no suport staff. We have a ward clerk 8-4 – after that – nada. So I DO clean poo, make tea and toast, change stretchers, restock shelves, answer the phone, take people to CT, get charts together, bring samples to the lab etc etc. That’s the way it is. I would prefer to spend my time doing more RN oriented tasks – but alas – apparently our management has yet to see the light. And – at times – getting an 84yr old patient tea and toast, and remaking their stretcher is just as helpful to them as a dose of pain meds – really.

  5. #7 by Mary on Monday 12 September 2011 - 1518

    I read this blog again – and HAVE to say – any student nurse who is preceptored in our ER – LEARNS how to do all those tasks I just mentioned. Whether he/she likes it – well – that’s not the issue. Safe shifts everyone!

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