Making it real for students

I have my first Capstone student, and last night was just her second shift with me. She has no medical experience, even as a CNA, so we are learning everything from the ground up, including how to steer hospital beds. She is an agreeable, smart, quick-to-learn nontraditional student, and that works in both of our favors; I am able to use most of what I know from orienting new nurses to guide her.


I have drawn the short straw and gotten the most jacked up, hostile, weird patient situations I think I've ever had. We've had some really sick patients, and we wanted those. But I walked in to a buzz saw a few times, and they were the kind of interactions that really bother me. The kind where a patient finds your buttons and pushes them all so you want to cry and run out of the room (mine involve "you're a mean, awful person and a bad nurse" when I'm trying REALLY HARD to help). And I had this wide-eyed soon-to-be-RN who is so new to the field in the room with me.

The pressure! I didn't feel pressure to perform, but handling extremely difficult patients while trying to turn it in to a positive learning experience for her almost made my head crack. I've felt a need to be upbeat and optimistic at all times.

That didn't work. So here's what I finally did. I'm not sure whether it was "right" or not, but we both regrouped and finished the shift on a better trajectory, so maybe it was. I just called a time out, had a colleague watch our section, and gave us both a breather.

We took our toys and went home for 5 minutes, I guess. I leveled with my student. I told her I was really upset and hurt by the situation, that I was trying not to take it personally, but that for some reason it was truly bothering me. I didn't want her to pick up on it and think I was angry with her. I asked her if she had any ideas for what I could have done differently in the situation, so we talked about strategies and such. And then we went back into the buzz saw. I told her I was sorry things were so stressful but that sometimes this is just now nursing is.

I don't know whether that's good or not. My idea was to model appropriate coping techniques for her (admit when something is wrong, leave the floor to chill out and process, ask for feedback, leave it behind and get back to work) rather than just sit there with steam coming out my ears for the rest of the shift. But maybe I should have just removed her from the situation from the beginning when I saw it was going to get really, really ugly.

She said she wanted reality, and putting it all out there so we could talk about it together did seem to take everything down a few notches.

How real should a Capstone experience be? Because my student is getting the nitty gritty. She still seems to be liking it. It's tricky, isn't it, having student nurses. It's not your job to make them into good nurses all by yourself, but yet you have a huge responsibility!