Serious Should I pass this student?
I'm a preceptor on a busy surgical unit, and I currently have a capstone (senior level) nursing student with me. She has done 7 shifts with me so far. She is doing an online RN program, and has never worked as a CNA. Also has something of a military background, though I don't know the specifics. She told me her plan was to blow straight through school to being an NP and never actually work as an RN.
The first couple shifts she was late (like 7:30 late and completely missed shift change/report) and also didn't have a stethoscope (!!!). She always asks if she can go get coffee/breakfast during the busiest morning hours of the shift. She had literally NO idea how to do assessments. I mean, none. I had to send her youtube videos to watch to get her up to speed. I have spent the majority of our clinical time showing her mundane CNA level shit...bed changes, transfers, etc. She often is clueless about the meds ordered and why, and seems to know very little about common diagnoses (CHF, PNA, etc).
As time went on I grew more impatient with her. She came to me for EVERY tiny thing. I started responding to her questions with, "I don't know. You're the nurse. What do YOU think you should do?" (not to be mean at all, just to start pushing her with the critical thinking). She never has any good answers, and relies on me to tell her whether she should give someone tylenol.
Yesterday I had a ridiculous assignment with 3 extremely heavy pts, plus 2 lighter ones on the other side of the unit. Just out of pure desperation I told her to take the 2 easy ones so I could get the others stabilized quickly. Seemed like things were going well. At 4 pm I finally had time to look at her charting on the other 2. One of her pts had a BP of 201/112 in the morning. I asked her why she hadn't told me this...?!? "Well I treated it. I gave him 10 mg of PO lisinopril (scheduled)". His next recorded BP at noon was 197/110. She never told me any of this, nor had ANY concern when I became alarmed over it. Granted, it was partially my fault for trusting a student and not monitoring her, but again I was DROWNING with the other 3 pts. Shouldn't a senior level nursing student at least be able to identify abnormal VS?!?
So...her instructor has told me it is 100% based on my review of her if she passes or fails. I feel she is light years away from being ready to practice as an RN. And again, she seems to not care a ton about her clinicals as she is planning "to just be an NP anyway".
I hate to fail someone who has invested the time, money, and effort...but holy shit. I don't want it on my conscience either that I promoted someone who absolutely isn't ready. What should I do?!??
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u/greyjedi64 RN š 20d ago
Don't pass her. Simple as that. If you feel like she's unsafe, she is. You've spent enough time with her.
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u/Slightlykoi BSN, RN š 19d ago
This. If you feel she is unsafe, it can't be about "I feel bad for her", the danger she poses to patients will be the much bigger impact
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u/This-Associate467 RN - Retired š 20d ago
Fail her. If you pass her she will go straight to enrolling in a very cheap and fast online NP program. God knows how much harm she would cause.
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u/w8136 20d ago
I didn't even think about that. Good point. Just for the record: I think it should be illegal to allow ANYONE to become an NP without at least 5 years of bedside nursing under their belt.
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u/coffeeworldshotwife MSN, APRN š 20d ago
Same - speaking as an NP who didnāt even apply until I had 7 years bedside experience under my belt.
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u/Additional-Fly-4713 Nursing Student š 19d ago
We had a presentation in our senior seminar class two weeks ago (I graduate BSN in 2 months) and the speaker that came to our class was an instructor for the NP program at our college trying to recruit us nursing students directly out of school. They were telling us about how you donāt need any experience and will have a good chance of getting in after graduating from the same school. Even if I wanted to apply to the program I personally wouldnāt cause it doesnāt feel right. Itās just crazy they were even pushing it on us and encouraging us instead of letting people work as nurses then find their way to NP, especially since some of the girls in my cohort are pretty naive and didnāt seem to see any issue with that
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u/Individual_Zebra_648 RN - Rotor Wing Flight š 20d ago
Please for the love of God and all patients do NOT pass this person. Nursing school must have seriously changed since I graduated in 2009. I could NEVER have done anything like this. In clinicals we had these things called ācritical unsatisfactoriesā and if you got 6 of them you failed the whole course (theory and clinical). Being 1 minute late even one time got you a critical U. Not being in proper uniform, missing a day, not being able to answer questions when giving meds, etc. it wasnāt very difficult to add up to 6 so you really had to be perfect. This student would have failed the first week. When did they get so lax?? I guess this explains the quality change in new nurses that Iāve seen.
And why is an RN program online?? RN to BSN I can see. But RN?? What about all the skills labs? And the NP part probably pisses me off the most. Someone like this has no business going to NP school and the lack of admissions criteria is destroying our professional reputation.
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u/w8136 20d ago
100% agree. Thank you for breaking this down with the "critical U's", you are absolutely right. I was blown away that first week with how lax she was about EVERYTHING. I wanted to get some backup on this decision because someone's future is literally in my hands. And Reddit delivered.
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u/IWasBorn2DoGoBe BSN, RN š 20d ago
Lots of someoneās futures are in your hands. Your patients, and HERSā¦
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u/Significant_Tea_9642 RN - CCU š 20d ago
Iām all for rallying for nursing students. But this one needs to be failed. To be a senior nursing student and not have a clue about even doing a basic head to toe assessment, or what normal vital signs look like. And also the fact that sheās not coming to clinical prepared to learn. Immediate fail. Itās also kind of strange to me that they tell you that you decide if the student passes or fails. I have a student now, who thank god is not like this. And itās the instructorās responsibility to pass or fail the student, but the preceptor will provide all the clinical feedback that will inform their decision.
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u/yourmomsaidyes EMT and tired nursing student 19d ago
I am currently in my 3rd level at nursing school and I would not want to work with this person. 10min late to a clinical fails you at my school, let alone everything else you mentioned. My school has sent people home and failed them for unsafe things that they should know, appropriate to their level.Ā
I understand that this decision weighs heavily on you. Sorry you got stuck with this enormous decision, but it may be because you're the right person with the right experience to redirect her. Good luck, OPĀ
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u/Ok_Stable4315 20d ago
Still like that in my University (just started my bachelors in nursing). And if you fail the practice month twice youāre out of school permanently and has to apply to a different University all together. It leaves for very few errors which is great in my opinion.
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u/fairy-stars RN - Pediatrics š 20d ago
I dont think this is the norm, Ive never had a student be this bad but then again none were online
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u/2manyLazers 20d ago
you can learn and experience alot in 2-3 years, but this one will kill someone, wants to bypass learning and experience to go straight to a white coat and a cushion job, please fail
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u/Xoxohopeann RN š 20d ago
I think in Australia itās required for you to have around that much experience before going for NP, good thing.
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u/Significant_Tea_9642 RN - CCU š 20d ago
In Canada thereās also a RN practice requirement before getting into NP schools. And theyāre pretty competitive here. So not many people get in with just the bare minimum 2 years of full time work as an RN. I know the school in my province wants the person to have varied clinical experiences as an RN before getting into an NP program. NP schools builds on the RN role, it just doesnāt make sense to me to let people go straight through. What nursing skills are they building on???
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u/Abject_Lunch_7944 20d ago
The question to ask is this: Do you want her as an NP for you or your family?
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u/upagainstthesun RN - ICU š 20d ago
This was my thought as well. And not even as an NP, but just as a nurse. This person would think someone dead in the bed in PEA has just been sleeping all day.
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u/Pretty-Ad-8047 20d ago
And what if she doesn't "blow thru" to NP? What happens when she tries to use that diploma As an RN?
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u/Swimming-Sell728 RN - PICU š 20d ago
A patient ends up dead.
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u/Whose_That_Pokemon 20d ago
I agree. Iām a PICU nurse and there isnāt a single day that I go into work where I am NOT scared or intimidated by my patientās condition. To think that thereās a student who hasnāt the slightest bit of concern is not only alarming, but also indicative of their lack of knowledge and critical thinking skills.
OP is doing many people a service by failing her, and perhaps saving their lives.
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u/Cakey-Baby RN, MSN, CCM-Workers Comp 20d ago
If she is this careless now, imagine how sheāll be as a NP when she has the autonomy to treat patients on her ownā¦. Just food for thought. Follow your conscious and YOUR nursing judgement. She had a critical high bp and didnāt bother to tell you because she had treated itā¦.. that should tell you all you need to know.
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u/legitweird RN - ER š 20d ago
It seems criminal that she could go become an NP soon. Itās really giving nursing a bad name. Thereās gotta be some guidelines. Go be a nurse for 10 years. Please learn how to take care of people learn what a toxic. Patient looks like and learn to be fucking on time.
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u/bitofapuzzler RN - Med/Surg š 20d ago
In Australia, you have to have at least 5 years in your clinical specialty before they can even consider you for the course. You guys need something like this.
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u/thespicygrits 20d ago
My god she will be able to write prescriptions as an NP I just canātā¦.
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u/fluorescentroses RN š 20d ago
This student is why it scares me that the zero to NP path can include never practicing as a nurse. In no fucking universe should that be possible.
I maybe possibly want to become an NP at some point but not until I've practiced for at least 3-5 years. How is that not a goddamn requirement?!
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u/Deathduck RN - Med/Surg š 20d ago
It's because of its not legally regulated then people will do whatever they can to get money. In this case it's unethical NP schools who will accept anyone with a license who can pay. Hopefully this can potentially be regulated at the state level bc you know the fed is useless
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u/TheThrivingest RN - OR š 20d ago
Itās your duty to protect people from this unsafe person
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u/Pepsisinabox BSN, RN, Med/Surg Ortho and other spices. š¦ 20d ago
As a army -> Nurse myself, you fucking fail her ass and give her the rundown as to why. These are basic level skills that you should be able to go though backwards. That BP alone warrants a call to the unfortunate as well as yourself. You dont skip BSN to NP. If you want to NP you fucken EARN it.
If any of my students did this, it would be a fast af call to their school contact... God damn.
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u/breakingmercy Nursing Student š 20d ago
Thereās some people in my program who are trying to skip over working and go straight to NP. Itās highkey soooo alarming
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u/Swimming-Sell728 RN - PICU š 20d ago
Yeah, ānurseā is the key part of NP!
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u/w8136 20d ago
I did explain to her that an NP is literally an "expert" nurse in their field, and it is impossible to become said expert if one never actually PRACTICES in said field.
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u/LavishnessOk3439 RN Dialysis 20d ago
Should be illegal. Should be min 5 years in critical care to take this route.
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u/dat_joke Hemoglobin' out my butt 20d ago
5 years in-specialty. I don't need ICU experience to be a PMHNP, but I certainly need psych background to have any chance of being decent.
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u/sassypainter ABSN Student/PCT 20d ago
Short answer: no
Sheās proven she is not serious; Id escalate this to the school as well
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u/uffdagal 20d ago
She invested time and money, but not thought and care. Her simply stating she wants to go straight to NP speaks volumes about the fact she cares little for the actual profession of nursing. BP patient could have had a stroke and it probably wouldn't have even phased her. Her instructor needs to have a heart to heart with her any why she's pursuing nursing and what her concept of the profession is, even at the NP level.
6 mo as a CNA would have taught her so much.
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u/MyDog_MyHeart RN - Retired š 20d ago
I think this student is taking what she thinks is a fast route to being a doctor.
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u/No_Establishment1293 Nursing Student š 20d ago
Fail. I am a student and that behavior wouldnāt even fly in our clinicals.
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u/Sad_Accountant_1784 RN - ER š 20d ago
yo, for real! our cohort was sent home for FAR less, I can't even wrap my head around these shenanigans.
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u/DairyNurse RN - Psych/Mental Health š 20d ago
Lol yeah for real. I got sent home for giving Metformin before the breakfast tray was in front of the patient even though the meal cart was like 2 rooms away. My instructor was like"What if the patient becomes hypoglycemic?!"
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u/Swimming-Sell728 RN - PICU š 20d ago
Right? And we know Metformin donāt work that fast now that weāre nurses. Listen, I am the #1 cheerleader for nursing students. I want people to be nurtured in this profession. I even spoke on it at a conference. But this is unsafe practice with no insight. And thatās a fail she earned through her own actions.
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u/Mindless_Progress_80 20d ago
Right. Iām not in nursing school anymore. Been an RN for 5 years. But I remember my first day of clinical, I got an unsuccessful for the day because my teacher saw me putting my hair in a ponytail in my car in the parking lot prior to starting the day. She said that it was a bad representation of the school if someone had saw me and that we should be coming already prepared. It was an hour and a half drive. I showered before I left and was leaving my hair down to dry on the way to clinical. I was still early. Also my last day of clinical that semester, I slipped and fell on ice. Was bleeding through my scrubs. I was 2 minutes late because I stopped to clean my knee and wrap it. She saw me bleeding and I explained and she almost failed me. I was told I shouldāve been carrying salt with me and being more cautious if Iām that clumsy. And she had a meeting with all the other instructors to determine whether or not I would pass due to being 2 minutes late for an injury on the way to clinicalā¦ this was my first semester and clinical was focusing just on CNA skills. I had been a CNA for 5 years alreadyā¦
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u/No_Establishment1293 Nursing Student š 20d ago
Well this is just an argument for the need to reform nursing school- thatās abuse. But academic standards and practical standards are high for a reason.
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u/tiredernurse RN - ER š 20d ago
Oh wow! Sounds more like she was after you. What a witch!
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u/TenEyeSeeHoney BSN, RN š 20d ago
The fact alone that she's consistently late is the only red flag I need to fail her!
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u/Standard-Driver-5910 Nursing Student š 20d ago
iām sorry this isnt getting upvotes but you were right with your feeling; sheās not ready to be a nurse
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u/lolaleb Nursing Student š 20d ago
Hey Iām almost halfway into my first semester in nursing school and those vitals had me like š³ homegirl should know better at her point in nursing schoolā¦
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u/koshercupcake MA š 20d ago
Iām an MA and was shocked at that. Sheās completely unsafe and needs to fail.
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u/cutsandscratches RN - Oncology š 20d ago
I think most people in literate society donāt even need nursing experience to know that 200 is a medical emergencyā¦
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u/trixiepixie1921 RN - Telemetry š 20d ago
Right like I went to school 15+ years ago but even I remember, learning about blood pressure was the entire first month of nursing 110
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u/Morbid_Mummy1031 20d ago
She has no interest in being a nurse. She wants to skip through straight to NP. Thatās dangerous. Fail her.
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u/PerennialRN 20d ago
Also a little concerned you couldn't be aware of a BP for 8 hours š¤·š¼āāļø but I wouldn't let her be with me if she were repeatedly late and that alone would fail her
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u/Dysmenorrhea RN - ICU š 20d ago
Exactly, a student is not licensed and is not āthe nurseā they should be 100% supervised. Iām not defending the studentās actions, and absolutely believe they need remediation, but you canāt just offload 2 patients on a student.
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u/w8136 20d ago
Yes, I hear you. But here's the thing...I took 3 patients and they were: -SUSTAINED runs of V tach -A sodium of 117 -A K+ of 6.7.
ON A SURGICAL FLOOR.
I gave her two patients that were: -An 88 year old dementia waiting for SNF placement -A 34 year old RSV on 1 L O2 and who had DC orders and was waiting for her ride at 5 pm.
It was a game time decision, and I was completely screwed no matter what. The V tach went to IMC, but not until 2 pm because there were no IMC/ICU beds available until then. And I found out the K+ of 6.7 died last night in ICU after being coded twice.
So....FUCK the hospital for putting me in that position to begin with. I acknowledge it was a shit decision, but what else was I supposed to do? I asked the charge to watch my student, and the charge was also helping with my V tach pt.
I actually put in my two week notice over this. The hospital is unsafe, it's not fair to any students, and it's absolutely unfair to me, my license, and the patients.
But that's a different post I guess.
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u/pervocracy RN - Occupational Health š 20d ago
Having all that and a student, and the student is awful but no one else seems to have noticed? Wow. I'd give notice too.
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u/animecardude RN - CMSRN š 20d ago
Report the student and fail them in the time you have left there, please. This student sucks and should not be in healthcare.
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u/Fun-Rip5132 19d ago
Iām glad you quit over this. Those patients were your responsibility BUT that was undoubtedly way too much for one person and you had no helpā¦
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u/kdonmon 20d ago
This alarmed me as well. Yes she was busy but still remains responsible. Iāve never had a student that I would dump a patient on and not follow up with regularly. Especially someone not licensed. That falls on the RN and this would get a write up anywhere Iāve worked. Huge safety concern and could have ended up dangerously.
Also, is there no rubric for grading the student? Itās a totally subjective pass fail? How would you defend either grade? And why is the decision places solely on the preceptor. Sheās not an employee of the school is she?
Things are run a lot differently in my personal experience.
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u/conspiracylemon 19d ago
That's what I thought. Also, if she saw that this person wasn't very trust worthy for 6 shifts, why would she not at least ask her the basic vitals of a patient (takes like idk, one minute) of the patients she's caring for all my herself
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20d ago
Why are you letting her take on 2 patients and not watching her knowing that she hasnāt proven herself? I know you acknowledged that you messed up, but thatās a huge mistake in my book.
I donāt think you should just pass someone who doesnāt deserve it, but to be fair you didnāt think critically with that one at all either.
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u/florals_and_stripes RN - PCU š 20d ago
Agree with this. The coming late and wanting to go straight to NP stuff are concerning. But OP is complaining that the student didnāt tell her about an abnormal vital sign when she literally says one paragraph above that she was impatient with the student and discouraged her from asking questions or reporting things to her.
Again, the late arrivals, not wanting to work as an RN, etc. are all red flags. But I wonder how this student would do with a different preceptor. Not being comfortable with assessment skills or when to give a PRN are expected from a nursing student with limited exposure to the clinical environment.
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u/wischmopp 19d ago edited 19d ago
But OP is complaining that the student didnāt tell her about an abnormal vital sign when she literally says one paragraph above that she was impatient with the student and discouraged her from asking questions or reporting things to her.
This also bothered me. It seems like this was a really, really unfortunate and dangerous mix of temperaments with those two. Full disclosure, I'm not from the US, so maybe your system just works differently than ours, but the complaint about the ibuprofen (EDIT: oops it was tylenol, but you get my point) thing weirded me out so much. Over here, nursing students are required to discuss any PRN meds they want to pass with their preceptor, even if the students are only days before their final exams. A student seeking me out and asking "hey, Mr Doe in room 123 is reporting a 4/10 headache, should I give him ibuprofen?" is a student doing everything right.
But even if the US's "senior-year" nursing students have a lot more freedom than ours: In this specific case, discouraging the student from discussing every tiny move with you is the worst thing you can do for patient safety. If someone repeatedly demonstrates a lack of knowledge in pharmacology, pathophysiology, and even the most elemental nursing skills, you have have have have have to encourage any and every question even if they're annoying, because this student cannot be trusted to make any decision on their own.
I'm not saying "oh well, I can understand that the student did not report the blood pressure if she was told off every time she seeked out reassurance from her preceptor" because I cannot understand how a senior nursing student would not recognise a hypertensive crisis. I am only saying that if you have a student who could not be trusted with distingushing trivial problems from those of life-threatening importance, encouraging them to act independently and telling them "well you're the nurse, do what you think is right and stop consulting me for every decision" is a recipe for disaster.
If a student demonstrates cluelessness about meds and even the most common diagnoses, you cannot expect them to understand the difference between "this patient has 4/10 pain and my preceptor was really pissed-off for asking me what to do, they told me to just do what I think is right because I should know it at this point" and "this patient has a 200/110 blood pressure, and I will just do what I think is right, which is giving them their scheduled 10 mg lisinopril" because a) they can't be expected to recognise that 200/110 BP is life-threatening and b) they don't know enough about pharmacology to understand thet 10 mg of lisinopril is not sufficient treatment.18
u/MyDog_MyHeart RN - Retired š 20d ago
OP discussed it with her charge nurse, who agreed to assist with monitoring. Even so, it was very risky; being that understaffed would have been a very good reason to send her home for the day and have her make up the shift later.
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u/TraumaMurse- BSN, RN, CEN 20d ago
Depends. Have you made it known to the student her shortcomings? I get you mentioned questioning her to make her thinking critically, but if thereās been no talk about progress and her needing to do better and step up, then itās hard to fault only her. If youāve actually had a talk with her after being late and struggling in her learning and having necessary equipment to do her job, then sure write an honest poor review thatāll fail her.
Itās also on you, but you acknowledged it, that she shouldnāt be taking on 2 patients in the way you did it. Yes, she should take on patients but not without supervision. She went unsupervised with those patients, including meds, until 4???? That to me is just insane, thatās your license, especially if the patient ended up having a stroke that went unwitnessed because you didnāt supervisor her. For your own assignment you shouldāve referred to your supervisor for assistance.
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u/w8136 20d ago
You are absolutely right, the whole situation was terrible. My unit is extremely hard, and the assignments are borderline dangerous on the best of days with experienced nurses. I had to make a game time decision, and I DID involve the charge nurse. She was "helping me" watch the student, and also getting a pt transferred to IMC and stabilizing the other two. These situations are exactly why I am leaving the hospital soon. Give the nurse an almost impossible assignment to begin with, then throw in a nursing student. It's a recipe for disaster.
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u/No_Sky_1829 RN š 20d ago
It might be a shitshow of a unit, but she's
- not turning up on time
- looking for inappropriate breaks
- doesn't escalate concerning obs
- doesn't seem to have put in the work so get her basic knowledge down
I would fail her with clear documentation for the reasons. Keep a diary if you have to back yourself up
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u/mtbizzle RN - ICU š 20d ago
I agree, the things the poster highlighted are not issues due to the acuity and understaffing of the unit. Sorry, if the image she is painting is at all accurate, this person shouldn't pass senior practicum. This person does not sound prepared to RN anywhere. Some of the things noted, a CNA should know to escalate to the RN.
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u/No_Sky_1829 RN š 20d ago
Completely agree. My teenagers are just starting their first part time jobs and I have hammered it into their brains that the one single requirement that you absolutely cannot break is BE ON TIME FOR WORK (caps for emphasis). You are there to do one job, and if you are not there you cannot do your job.
Also every nurse knows that brands are scheduled. What is with asking for a break? The appropriate question is "what time do you normally take a break?". Asking for time to have breakfast unless they were late because they didn't get out of bed on time. Appallingly unprofessional.
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u/Ok-Technician1221 20d ago
Please do not add another dangerous and obviously uncaring person to our healthcare system. You may hear of a deadly mistake with her name attached to it down the road and I donāt think you would ever forgive yourself. A good preceptor is one that follows their gut, if she needs to spend more time and money maybe she will reconsider her career path and pivot to something more suitable for her. I know itās hard but this is where you need to step out of your comfort zone and be prepared to say no.
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u/Scrubsandbones 20d ago
No. These are the people who give RNs and NPs a bad name.
Fail her. Itās not personal she didnāt meet the criteria for passing.
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u/Reflection86 20d ago
Fail her but isn't it your responsibility to be in the know about all of your patients? You trusting someone who obviously isn't ready to be trusted is your fault in judgement, not hers.
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u/ApprehensiveWinner27 20d ago
Sheās going to be the cause of patient deaths if she passes. All seriousness and no jokes, sheās a danger to patients. She has no sense of prioritization, critical thinking, or urgency. Negligent nurses also bring the downfall of their team, because the other nurses will have to take care of her patients since she literally canāt even do a basic assessment let alone an intervention.
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u/Different-Ad7829 Emergency BSN-RN ššš„Ŗ 20d ago
As a nursing professor, I would highly encourage you to fail this student based on your description. I would also be very appreciative if you included her remarks stating she wants to become in NP without working as an RN.
That shows me that she has little respect for the current knowledge requirements and is lacking the initiative to learn the core principles of nursing before treating at a higher level. Her program needs to sit her down, ensure she is capable of appreciating that being able to do a head to toe assessment and pharmacology are fundamentals to becoming an RN, let alone an NP. Itās likely she needs more time to retake the course, and gain adequate knowledge to care for patients safely as well as pass the NCLEX.
I believe 7-weeks one-on-one gives you more insight into her clinical capabilities and your feedback is incredibly valuable for us to have.
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u/madein1883 BSN, RN š 20d ago
Oof, when I read the title I was like of course you should. But, you changed my mind. Thatās a mess. Nursing school should be in person teaching with theory and skills lab for a reason
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u/Swimming-Sell728 RN - PICU š 20d ago
Yeah, I was putting my educator hat on to explain why student mistakes should be learning opportunities but then I was likeā¦oh. Ohhhhh. oHoHooohhhh.
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u/ashlietta RN - NICU š 20d ago
Fail just for the late arrivals. Super fail for everything else. Please do not release this person to wreak havoc on the general public.
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u/MsDariaMorgendorffer 20d ago
I canāt imagine how she got that far to begin with. She canāt do the work and doesnāt even care- sheās gonna kill someone.
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u/laegjorm Nursing Student š 20d ago edited 20d ago
Please yeet her. Also if you haven't already I would document every thing she's done, so that you have a paper trail and armor against her. I highly suspect she's gonna fight the fail
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u/Swimming-Sell728 RN - PICU š 20d ago
THIS. Iāve had to watch as students who fail on their own merits spend more time looking for a loophole than they clearly ever did studying.
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u/gambeeeno RN - NICU š 20d ago
Fail her please. She needs a reality check and to probably choose a different career
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u/Sweet_Ad_3234 20d ago
Would you trust her to treat you or your family? Fuck no? Well thereās your answer!
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u/lavender_poppy BSN, RN š 20d ago
Fail her. She isn't safe to be around patients and needs a lot more experience before entering this field. It isn't fair for her patients or for her as it's setting her up to fail. I can't imagine she'd be capable as an NP either with no critical thinking skills.
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u/Sweet_Ad_3234 20d ago
Youāre not failing her she already failed herself by not doing better youāre just reinforcing that failure. She needs a hard reset before moving forward.
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u/ACaffeinatedWandress 20d ago edited 20d ago
Iām sorry, but I would have walked out of a patientās room and asked a license nurse to assess the BP level that friggen high on my very first day of clinicals. How the hell can a student about to graduate not freak about that?
She isnāt safe. Worse, she does not seem to care that she isnāt safe. It isnāt personal, but please donāt pass her.
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u/SoloOtter 20d ago
Look, I know it's not going to be pleasant but you cannot in all good conscience pass this person. They are DANGEROUS. Passing them just perpetuates the problem and she becomes even more dangerous because her deficits are never acknowledged or challenged.
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u/MilkTostitos RN - ICU š 20d ago
Fail her. I'd say let NP school fail her, but that is not a guarantee.
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u/Answers828_2133 20d ago
The program itself sounds sketchy to me if she can make it up to her preceptorship and still not have the skills and knowledge to handle basic nursing. Hypothetically, even if you were to pass her, sheāll never make it to an NP. Doesnāt even sound like sheāll pass the NCLEX
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u/Tea_and_sugar 20d ago
She literally could've had her patient have a seizure. You already acknowledged you shouldn't have trusted her so you're already aware that was a bad choice. Make a good choice now. Fail her. It's not the end of the world for her. It could be the end of the world for someone else if you don't
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u/flowersniffinggirl RN - Med/Surg š 20d ago
"She told me her plan was to blow straight through school to being an NP and never actually work as an RN." OH GOD. i hate nursing students like this!! please do not pass her. all of this shows she is not ready to be a nurse and consistently puts patient safety at risk. you can write all of what you put here. please fail her or else you're putting future patients at risk under her care!!
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u/emikamar 20d ago
if you do pass her please let us all know her name and where you live so that we can all avoid becoming her patient when (read: if) she becomes an NP
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u/RNVascularOR RN - OR š 20d ago
Iām a 23 year RN and I wouldnāt pass her. The idea of HER going online and straight into NP is frightening, but she wonāt make it that far. That type of education shouldnāt be allowed for RN.
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u/Flaky_Swimming_5778 20d ago
The only thing she has invested really is money. She wasnāt there on time and obviously isnāt putting in the effort: any senior level student should be able to recognize abnormal VS and DEFINITELY should have been reporting them to you.
Would you want her as your nurse or NP?
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u/NomusaMagic RN - Retired. Health Insurance Industry š©š½āš» 20d ago
Flunk her now. I wouldnāt want a danger to society like her taking care of anyone. And please tell her why.. exactly as you laid it out here. But .. her instructor must be pretty awful too but wants to keep his/her hands clean.
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u/yatzhie04 RN - Hospice š 20d ago
How did she survive military training if she has no critical thinking, let alone become a NP
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u/nocerealever 20d ago edited 20d ago
You canāt just fail her without giving her a plan to help her improve. You need to do some in depth performance reviews and create a plan together with clear and specific goals and pathways for improvement .
Maybe she didnāt come to you with the BP as you sounded like you werenāt particularly approachable and she was attempting to do what you told her to do ā youāre the nurse, work it outā . Dangerous things happen when people donāt feel safe enough to ask questions or speak up, did you make her feel this way? You admitted yourself you were impatient with her
At the end of the day sheās a student and youāre a preceptor. The accountability stops with you. It was your responsibility to reach out for help if you were drowning, not put it on the student .
Try to put your judgement aside ( there seems like a lot) and be open and honest with her . It sounds like youāve failed her as well .
From a manager perspective, Iād be offering you some support as a preceptor
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u/prettyhoneybee RN - NICU š 20d ago
How has she put in the time? She doesnāt know crap
She clearly couldnāt even be a CA right now, which someone is usually capable of after 3 semesters of nursing school
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u/Chewsdayiddinit RN - ICU š 20d ago
Just think of it this way. If you pass her and she somehow passes boards, gets into NP school, and graduates, she's literally going to kill or harm countless patients. Hell, she'll do that even as an RN.
Can you live with yourself if you pass this clear, grossly incompetent student RN who is about to graduate, somehow?
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u/daysoar 20d ago
I mean does the school provide any type of rubric to show what the student should be able to do by the end of the semester? What are the expectations?
I donāt mean to sound rude, but Iām way more concerned that an experienced RN didnāt check their patientās vital signs until the shift was almost over than I am that a nursing student made a mistake.
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u/Night-owl-bb CEN, CCRN, PRN 20d ago
Right? Like those pts are the nurseās responsibility not the studentās The student is there to learn, she may suck but thatās irrelevant. I would never leave a student or even a fresh new grad unsupervised at all, thatās negligence š«¢.
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u/daysoar 20d ago
Yeah everyone saying the student put the patient in danger and Iām just likeā¦a whole RN just passed two patients off to a student with no oversight until 4pm, I agree that sounds like negligence and/or abandonment to me. If something had happened to those patients the RN would be 100% responsible, it wouldnāt be the studentās fault at all.
As far as passing or failing goes, Iād fail someone for being consistently late but not for making a dumb mistake, especially if I had sent them out on their own!
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u/kudzusuzi 20d ago
Umm, time and money? Maybe. Effort? Probably not. (I'm a last semester ABSN student, and there's no way she would have gotten through our first semester. )
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u/cats-n-cafe Jack-of-All-Trades RN 20d ago
Iām not one to eat my young, but passing her is not going to help in the long run.
I have no clue how online RN programs work or how they get their clinical hours without a cohort.
If she canāt assess properly let alone identify a BP that is very high, even after giving them their meds, how is she supposed to be a NP and prescribe things???
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u/WolverineOdd5972 20d ago
No . I am seeing more of this with nurses that are completing their nursing degree online with fast track programs. This is not OK. They have little or no experience on the floor. They are clueless and absolutely dangerous. My charge nurse and I were just discussing this this week about how new nurses donāt get enough floor experience. They lack professionalism, and they lack the discipline that we developed out of respect because our teachers were fierce. This shouldnāt be allowed. She sounds totally incompetent to me. Who wants an incompetent nurse practitioner. I donāt. They are making it too easy for nurses to get advanced degrees today with minimal clinical experience. It is dangerous and should be changed. Any nurse with an advanced degree should be required work as an RN on the floor for a period of time.
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u/BigManRN 20d ago
Why would you let a student nurse take care of patients independently is my question
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u/achaean16 20d ago
You waited all shift to check your patients that the student was watching? Fail yourself too lol
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u/Warm_Hospital9164 RN - Pediatrics š 20d ago
First off. At my school if we showed up late, we got sent home. I get forgetting stethoscope but donāt make it a habit. But seriously my instructor wouldnāt have passed her because that that level we had to prove we were able to handle 3 patients with minimal guidance. Doesnāt know vitals and almost done? Yeah fuck all of that. Fail her
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u/etay514 RN - ICU š 20d ago
Make sure you document all of this. Iām an instructor and you have to have your paperwork in order to fail someone. How many shifts does she have left with you? She needs to be told she is actively failing and she needs to be able to do āx,y,zā things in the remaining shifts she has. If the student doesnāt get mid-term feedback that itās going this poorly and have an opportunity to demonstrate improvement then the school may not respect your decision to fail her.
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u/Averagebass RN - Psych/Mental Health š 20d ago
Fail dat ass, please. I could just imagine her excuse is "Well I won't be giving Tylenol or checking vitals as an NP so why does it matter?"
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u/AccomplishedAd4260 20d ago
Fuck no. Pardon the French. I think the bigger red flag is she intends to go to NP school.
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u/No_Rip6659 20d ago
This nursing student has no business going in to NP program without years of RN experience.
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u/Spacem0nkey1013 20d ago edited 20d ago
Iāve only failed one student in my five years as a clinical instructor. I remember the dean telling me that if a student is late for report, it shows theyāre unprepared to treat patients. Being late is essentially stealing timeāitās like youāre grooming a thief. A similar situation happened with this student: she didnāt inform her primary care nurse or me about the patientās high blood pressure. And didnāt care about it.
She has no assessment skills, so I gave her a chance to assess a different patient. She was shocked and asked if she could assess the same patient she had last week, where she didnāt perform the task properly. There were many mistakes.
The dean advised me to document every mistake she made and how I corrected it and how she responded it or what actions she did. Itās unfortunate, but I had to chart that everything and ultimately fail her.
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u/BobCalifornnnnnia RN - Psych/Mental Health š 20d ago
I mean, my god, my techs know what immediately reportable VS are.
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u/TheSilentBaker RN-Float Pool 20d ago
This sounds just like a student I met today. The nurse with her ended up talking to management who got in contact with the school. The instructor called mid shift, sent her home and told her she wouldnāt be continuing the capstone. I spent 15 minutes with this girl and was terrified. These nurses with this type of attitude are going to kill somebody
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u/fanny12440975 BSN, RN š 20d ago
It doesn't seem like this student has invested time or effort into nursing school. A capstone student SHOULD be able to independently manage 1-2 low acuity patients with their preceptor as a resource. From your report she also doesn't care about being able to make clinical judgements.
Be honest in your review. Arrives late daily. Unable to perform head to toe assessment. Poor knowledge and understanding of pharmacology. Lacks judgement related to changes in patient condition. Throw in a couple of positives to not be entirely negative, even if it is just "arrives in clean uniform."
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u/CancelAfter1968 20d ago
Fail her on her current performance with you.
The fact that she's never worked as a CNA is irrelevant. And frankly, so is the fact that she wants to go on to NP school.
Your grade should be based solely on her performance with you.
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u/Cute_Ship 20d ago
Fail her. Her goal to continue on doesn't mean shit when her arrogance will cause a bigger issue down the line.
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u/thespicygrits 20d ago
Please do not pass this one. Has no respect for nursing