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.
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.