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  • Things that Students Forget

    OK, this got inspired by trailerparkmedic's thread in CoC on her classmate who forgot her access card in clinic.

    As a nursing instructor (I usually post about my hospice job), one of the things I teach my students is employability skills and accountability. There are certain things that you just have to bring with you to the hospital for clinic.

    If you don't have these things, you really can't do the work, and you risk being sent home by your instructor (me) to get them.

    Some common examples of things students forget to bring with them include:

    Stethoscopes: it's really hard to listen to lung, heart, and bowel sounds, or take a manual blood pressure, without one.

    Blood pressure cuffs: our students are required to buy their own. Every blood pressure they take (unless the patient is on every 15 minute vitals) must be a manual, not using the automated machines. It's a real skill, and we emphasize the students perfecting it. Some of our clinic sites have wall mounted cuffs, but they're often not calibrated right. Some do not have wall mounted cuffs. So they're supposed to bring their own.

    Student ID badge: All of the hospitals require this. Putting your name on a piece of tape on your shirt is not acceptable.

    Black pen: Most documentation is computerized, but the few things that are not are required to be written in black ink.

    Drug book: Some of my students rely on the online resource on the hospital's intranet. It's not a great resource, and they often find they can't answer questions about a drug.

    Bandage scissors: It's amazing the myriad number of uses this has. But most importantly, it's hard to work with some kinds of dressings without them.

    Penlight: Usually used to check pupils. Sometimes used to examine body parts that are deep in shadow (like rectums).

    Those are the most common examples. But I've had a few twists on this lately.

    Last rotation, a student forgot his shoes. Sounds counter-intuitive, I know. But on some of our rotations, students come to the hospital in street clothes, and change into uniform on-site per hospital policy. He ended up buying a new pair because it was quicker than going home.

    So I mention this during clinic orientation for the new rotation. Turns out, word had gotten around and there was some snickering at his expense. So what happens on the very first clinic day?

    A student forgot her uniform (but she did remember her shoes).
    They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

  • #2
    Why is it, in some professions that require serious knowledge, study, and practice, that people doing them cannot handle the simplest of normal human being tasks?
    Last edited by Duncan MacLeod; 03-23-2011, 05:17 PM.
    There Can Be Only One

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    • #3
      Quoth Panacea View Post
      A student forgot her uniform (but she did remember her shoes).
      I want nurse Bare!
      I am not an a**hole. I am a hemorrhoid. I irritate a**holes!
      Procrastination: Forward planning to insure there is something to do tomorrow.
      Derails threads faster than a pocket nuke.

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      • #4
        Quoth Panacea View Post
        Stethoscopes: it's really hard to listen to lung, heart, and bowel sounds, or take a manual blood pressure, without one.
        I take it you don't keep spares in a fridge on-site?

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        • #5
          Wouldn't they just have all those things in a bag ready to go to work? But really, how do you forget your uniform?!

          Thank - you for making them use the manual BP cuffs. They really are a learned skill, but much more accurate.

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          • #6
            Student ID badge: All of the hospitals require this. Putting your name on a piece of tape on your shirt is not acceptable.
            panacea, i get this image of this particular genius putting their head to the chest and abdomen to catch those sounds...and giggle madly.

            wherever these guys/gals end up working, i want to stay as clear away from them as possible...like 1000 miles away.
            look! it's ghengis khan!
            Sorry, but while I can do many things, extracting heads from anuses isn't one of them. (so sayeth the irv)

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            • #7
              Quoth dalesys View Post
              I want nurse Bare!
              That was my first thought too. I'm quite sure, if in hospital, I would feel a lot more alert if one of my nurses weren't wearing anything.

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              • #8
                Quoth dalesys View Post
                Quoth Panacea
                A student forgot her uniform (but she did remember her shoes).
                I want nurse Bare!
                What an excellent way to revive people!

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                • #9
                  Quoth auntiem View Post
                  Wouldn't they just have all those things in a bag ready to go to work? But really, how do you forget your uniform?!
                  My university has a really great Nursing program, but the hospital requires the students wear White or Navy Scrubs. Only one colour, and solid. My friend works as a Floor Aid when she is home for breaks, and has much NICER scrubs. Sometimes she takes the wrong ones to clinical.
                  Hinakiba777- Student of Divinity-Always trying to get laid.

                  Annoying student=I pay tuition here so I pay your salary!
                  Desk Worker=I pay tuition here, too. So I guess I pay myself.

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                  • #10
                    Quoth Panacea View Post
                    Stethoscopes: it's really hard to listen to lung, heart, and bowel sounds, or take a manual blood pressure, without one.
                    I'm just curious, why is a stethoscope necessary to take blood pressure manually?
                    Aliterate : A person who is capable of reading but unwilling to do so.

                    "A man who does not read has no advantage over a man who cannot" - Mark Twain

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                    • #11
                      Most nurses I know that use one for that shove the cold metal bit half-under the cuff, right on top of the other side of your elbow...the more medically inclined will be able to explain this better.
                      My Guide to Oblivion

                      "I resent the implication that I've gone mad, Sprocket."

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                      • #12
                        Quoth infinitemonkies View Post
                        I'm just curious, why is a stethoscope necessary to take blood pressure manually?
                        Taking a blood pressure manually is a 2-step process. The heart has two types of pump, which we'll call here, for simplicity "lub" and "dub".

                        Lub is the action of the heart pushing blood out through the arteries, and thus is the higher pressure. Dub is the action of blood returning to the heart via the veins, and thus is lower pressure.

                        To measure a blood pressure manually, you pump the cuff until you hear no blood moving (no lub or dub sounds). Then you slowly loosen the cuff until you hear them, the lub first, and then until you hear both lub and dub. The pressure readings on the cuff when each set of sounds becomes audible is the pressure inside that set of vessels.
                        Dealer hits... 21. Table loses.

                        This happens more often than most people want to believe.

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                        • #13
                          Quoth Mikkel View Post
                          That was my first thought too. I'm quite sure, if in hospital, I would feel a lot more alert if one of my nurses weren't wearing anything.
                          Or they have a heart-attack

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                          • #14
                            Quoth infinitemonkies View Post
                            I'm just curious, why is a stethoscope necessary to take blood pressure manually?
                            Tuxian did a good job of explaining it By listening to the sounds we can determine the systolic pressure (pressure in the circulatory system when the heart has contracted to pump blood) and the diastolic (when the heart is at rest). Changes in those pressures is a warning of a problem.

                            Quoth auntiem View Post
                            Wouldn't they just have all those things in a bag ready to go to work? But really, how do you forget your uniform?!

                            Thank - you for making them use the manual BP cuffs. They really are a learned skill, but much more accurate.
                            You're welcome. I do tell students to keep their clinic stuff in a bag . . . it's what I do myself.

                            I had a student last night who had a discrepancy between her reading and what the techs were getting with an automatic cuff (hers was high, techs was normal). She wanted to know why, and said, "Now I know how to take a blood pressure!" (she was bragging).

                            So I got MY manual cuff and took the patient's BP . . . and my reading was inline with the tech's. Then I had her take MY blood pressure as I listened with my stethoscope. Her systolic was way off.

                            That's OK . . . we've ID'd a problem and she's going to go to the open lab for practice and remediation. Like I said it's a learned skill. And I praised her for bringing the issue to my attention. She could have been RIGHT and the staff was missing a problem . . . the machines aren't as accurate as a manual pressure. I made a point of telling her that . . . she did the right thing by coming to me.

                            Quoth chainedbarista View Post
                            panacea, i get this image of this particular genius putting their head to the chest and abdomen to catch those sounds...and giggle madly.

                            wherever these guys/gals end up working, i want to stay as clear away from them as possible...like 1000 miles away.
                            By the time I'm done with them, they will be light years away from where they are now skills wise. I'm a hard ass, and I see EVERYTHING. My students often tell me how scared they were to come to my class, how hard I was on them during class, and how glad they were when it was over because they learn so much

                            Quoth Argus View Post
                            I take it you don't keep spares in a fridge on-site?
                            No, too inconvenient. We keep a can of liquid nitrogen at the nurse's station . . . a quick squirt, and it's cold enough to shock a heart back to life.
                            They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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                            • #15
                              Quoth Duncan MacLeod View Post
                              Why is it, in some professions that require serious knowledge, study, and practice, that people doing them cannot handle the simplest of normal human being tasks?
                              Being book smart does not equal having common sense.
                              Unseen but seeing
                              oh dear, now they're masquerading as sane-KiaKat
                              There isn't enough interpretive dance in the workplace these days-Irv
                              3rd shift needs love, too
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