Be less polite to me please! (update in #22)

[cass2591]

I'm not posting as a mod, but as a nurse. You said in your OP that "There are a few nurses who are new. They are all students." They are not nurses, meaning that they are not licensed and are still learning, considering they're students. As a few posters have said, they have instructors and/or staff nurses responsible for them, depending on how far they are in school. Leave them be, you be yourself, and trust me, they will find their way.

[TealDragon]

It appears to me that the problem is that none of the preferences you have and which have been allowed by  your doctor and the more experienced nurses has been charted so that the student nurses can read in your medical chart that you are to be called Teal, are allowed snacks, that you take your pills after the treatment and that you can dictate how often they will check on you, or something like 'check on patient every two hours instead of every half hour'.

Personally, I think it is asking too much to expect  new nurses to make allowances that are part of the stated procedure, are not in the chart and are out of their realm of authority.

I would ask for other than student nurses, if I felt as you do about it (and I do understand why you feel that way).

Unfortunately the main things I want them to make allowances for are things that will make me sick. I'm just not willing to knowingly put myself through that and subject any other patients in the room to the sights and sounds of what will happen for these student nurses. If the rules are like that, they need to change because they are to the detriment of patients. I think maybe it would be best to find out who supervises them and take it up with them because these allowances need to be made and I'm sure these students will encounter other situations like this in their careers.

Importantly, student nurses themselves are monitored, not only by the experienced nurses in their particular area, but by educators / mentors / preceptors that are more specialised educators.  Failure to abide by protocols can result in disciplinary actions at that stage of their training.

POD POD POD

You may not like how the student nurses act, but their careers may be on the line here. I would just learn to tolerate their over-helpfullness and formality, and add a note to the chart about taking the medication after treatment.

Again, there are already notes in my chart about this stuff and they are either not reading it or disregarding it, so I'm looking for an alternative way to handle the situation because dealing with the amount of stress I feel about this when I have them is not working out, and listening to them is not a feasible option as it would make me sick, and there are already notes in my chart.

[Firecat]

What about redirecting them to your chart and/or one of their supervisors? Maybe say something like, "This is something my doctor has recommended and authorized. Please refer to the notes in my chart." And then if they persist, repeat "Please refer to the notes in my chart." Lather, rinse, repeat.

[artk2002]

Tell someone in charge that if it doesn't stop, they're going to get a bad rating on their Press Ganey survey.

[AmethystAnne]

What about redirecting them to your chart and/or one of their supervisors? Maybe say something like,

"This is something my doctor has recommended and authorized. Please refer to the notes in my chart."

And then if they persist, repeat

 "Please refer to the notes in my chart."       Lather, rinse, repeat.

POD to Firecat.

You could even make up signs on poster board using those 2 phrases. Then when the student nurses check on you every 30 minutes, you hold up the appropriate sign while you're working on your laptop during your treatment.

You could also make up a sign that says "Please call me Teal! "   

Or when they insist that you take the pills before the treatment, how about a sign that says
"DO YOU WANT ME TO BARF? "

[Figgie]

I would just request no student nurses.  While I understand that they need to be trained, you are the patient and your wishes are what it is important here.  When a patient has extremely limited energy, having them be the one to educate student nurses doesn't always work very well.

I would find it exhausting to have to explain, re-explain and respond continually to student nurses.  Enough so, that it would make the treatments even more unpleasant and they seem to be unpleasant enough. 

It really isn't your responsibility to be the patient that they learn on.  You can do it if you want and on days that I have more energy, I do allow student nurses.  On the days when I don't, I request no students. 

It isn't personal.  I'm making the best possible decision for my health and well being and that is most certainly my right as the patient.

[Deetee]

I would just request no student nurses.  While I understand that they need to be trained, you are the patient and your wishes are what it is important here.  When a patient has extremely limited energy, having them be the one to educate student nurses doesn't always work very well.

I would find it exhausting to have to explain, re-explain and respond continually to student nurses.  Enough so, that it would make the treatments even more unpleasant and they seem to be unpleasant enough. 

It really isn't your responsibility to be the patient that they learn on.  You can do it if you want and on days that I have more energy, I do allow student nurses.  On the days when I don't, I request no students. 

It isn't personal.  I'm making the best possible decision for my health and well being and that is most certainly my right as the patient.

I posted earlier about ways Teal could communicate with the nurses to make her treatment more pleasant but I Aldo want to agree with this.
Teal it is up to you to decide on your treatment. If you try to communicate and it doesn't work or you just don't feel like it, you have the total right to request no students. ( you may still get new nurses of course)

[TealDragon]

In my experience, treatments like the OP is undergoing have certain protocols or policies in place. 

As an example, back when I was a student nurse (around when the dinosaurs roamed) blood transfusions required full observations every 10 minutes for the whole duration, plus a certain time period afterwards.  Student nurses were taught these protocols, and were expected to follow them to the letter.  They were also expected to treat their patients in a certain manner, such as how they're addressed.  Medication charts were another very black and white area - medications to be administered prior to x event were administered then, not after. 

Importantly, student nurses themselves are monitored, not only by the experienced nurses in their particular area, but by educators / mentors / preceptors that are more specialised educators.  Failure to abide by protocols can result in disciplinary actions at that stage of their training.

More experienced nurses know, particularly after working in a specialised area long enough, when variations can and should be substituted.  It should be documented in the patient's record when these substitutions are permitted, particularly if recommended by the treating physician.  They also have had time to develop a 'bedside manner' that puts patients at ease, rather than on edge, and the experience to judge how much informality a patient prefers.  In the case of experienced patients, these nurses understand that the patients understand the treatment, and can, to a point, trust you to self-monitor, so that you will alert them to problems rather than have them hovering around watching.

OP, as suggested, you can probably request that no students be allocated to your care.  Alternatively, having an experienced patient can be a valuable learning experience for a student nurse.  Do you feel comfortable enough to talk to them about your treatment?  How it affects you?  About anything not related to your treatment?  Sometimes all it takes is a little chat with a patient for a student to start to relax a bit, to see you less as 'patient' and more as 'person'.  Once that barrier is crossed, it may be easier for the student to relax the formality somewhat.

Of course, if you don't feel comfortable with that, you're not obliged to.

Somehow I missed this before, oops! I actually wouldn't mind this with one, maybe two, of the three. One is a guy that is a little bit better at listening overall, and he has read my chart, but still calls and asks for permission to break the rules every time. The other two are girls and one of them, I think our personalities just don't mesh well and I'd probably prefer to not have her as a nurse even if she were not a student. The other one seems to have days where she is better at listening and days where she doesn't listen at all. I've tried to chat with them all a little bit because I tend to be a friendly person, and when someone is asking you detailed questions about your bowel movements, well, you may as well just be outgoing and try to just cheerful your way through the awkwardness. They seem like they're afraid to talk to me though, which I'm not sure if that's shyness or sticking to some rule. If not being allowed to make conversation with your patients is a rule, that seems quite sad to me. I would think actually interacting with patients is an important part of learning, but it just seems so weird that they are all so stiff and shy in such similar ways. I guess anything is possible though.

I think I'll try not to be so frustrated and give them all another chance and see if I can talk to them (after making sure with a nurse-in-charge that the notes in my chart are clear and easy to find and that the students are informed that they are important and should be followed) and even if they can't stop following the rules, maybe there's some sort of compromise, like quietly sticking their head in the door and I can give a thumbs up or something if all is well. If after a couple of tries, it's still not working out, I'll go ahead and request no student nurses. The hospital sends me monthly satisfaction surveys, so I'll also be sure to mention these issues. Maybe someone in charge will realize that policies sometimes sound better on paper than in practice and consider making some changes.

[Julian]

Hi Teal

It does sound like you've tried, and it could well be different personality types that are causing some issue.

Re the 'afraid to talk to you'.  Nurses learn to deal with a lot of difficult things during their training, and it can take some time before students feel comfortable dealing with patients going through life altering treatments.  I remember the first time I nursed someone who knew he was in hospital to die - it was very confronting and upsetting for me, but as a budding professional, I had to put on a good face and deal with it. 

It could well be that these students are still in that 'learning' phase where they're trying to stay emotionally detached for their own mental wellbeing.  It can be a difficult task to maintain empathy* without it developing into sympathy, particularly when treating patients with long term health problems.  It can be harder for some people than others, too.

There may be rules about addressing a patient, but I've never heard of a rule where students shouldn't talk to patients, that would be a definite negative in any training program I would think!

Teal, I think you're taking the right approach.  You certainly have the right to request specifics such as no students, or even particular students.  I hope it all works out for you!

*By empathy, I mean the ability to understand what a patient is undergoing, and sympathy as feeling what the patient is undergoing.  Sympathy, while admirable in most other circumstances, can be detrimental to both the carer and the patient.  From my experience it is impossible not to get deeply affected by some patients, but I learned how to keep a professional demeanour, even if I was crying on the inside or in the tea room.   

[bopper]

You could also tell them that you know they are supposed to come every 30 minutes to check your IV and they are welcome to do that, but you are going to be dozing/reading/watching a video so they don't have to ask you if you need something, you will ask them if you do.

[happygrrl]

As a 3 month old RN, I can understand your aggravation, but let me see if I can explain this from the student nurse' perspective.

OMMV, but at my college, we.were.told.to.follow.specific.patient.protocol. These were set by the college/facility, and were completely non-negotible. Completely. Failure to follow them could you dismissed from the program. They weren't kidding. They applied to any level student at any clinical facility. Period. Alll of our clinical classes were limited to 10 students and on RN instructor. Unlike other school, we didn't go the night before and be assigned our patient. We got them the morning we got to the hospital, and no one, including the intructor, was intimately familiar with the patient. Or the staff. So, we would meet, get our assignments, read the chart (as much as we could), and off we go for the day.

One of the things we were taught was to call the patient by Title. Lastname. Even if we were told by the patient to call them by their first name. I had to explain several times that due to my program requirements, I had to call them Mr. Doe, and that I wasn't trying to be deliberately rude by ignoring their requests. (Honestly, you could be expelled from the program for this; not that it was life or death, obviously, but it had to do with following orders---kinda like making a bed in the Army. Make sense?) We were also told that ***we*** needed to follow all facility protocol, even if the staff wasn't. So, just becasue the staff RN didn't check on the patient every hour, we needed to. No, wait---we had to. For example, if
I hung blood, I had to stay in the patient's room for 15 minutes to monitor for any reactions. No exceptions, no excuses.

Now that I'm experienced (haha!), I do have the freedom to call you Mary, if that's what you perfer. I can just stick my head in the room and take a peek to see if you're OK. If the dr has odered your meds to be given XXX, then yep, that's what you're gonna get. But not as a student nurse. We could not.

My heart felt suggestion from a not-to-long-ago- student nurse; request that they aren't assigned to you. I think it would make your treatment better for you, and quite frankly, it would probably take some stress off of them. (We had to answer to our intructors for any infractions, and I'd hate to see them get in trouble only because they were following non-negotible orders and protecting their student position. Students were kicked out for seemingly inane actions--none that endangered the patients lives, but yet they failed to follow protocol. Again, kinda like the Army. )

[Sharnita]

That is exactly what I expected.  I think it would be kinder to ask not to have a student then to put them between a rock and a hard place.

[cicero]

Unfortunately the main things I want them to make allowances for are things that will make me sick. I'm just not willing to knowingly put myself through that and subject any other patients in the room to the sights and sounds of what will happen for these student nurses. If the rules are like that, they need to change because they are to the detriment of patients. I think maybe it would be best to find out who supervises them and take it up with them because these allowances need to be made and I'm sure these students will encounter other situations like this in their careers.

I think that for the things that will cause you harm or discomfort - you speak up and speak out loudly. speak to supervisors if you need to. that's what i learned to do when i was diagnosed with cancer many years ago - eg., had an intern try to take blood, my hand turned black and blue, and it didn't get done properly. i told him to stop. he said "but we need to take your blood". i said as firmly and nicely as i could "then get someone who knows how to do it". now, i understand that interns and students need to practice, and i understand that (in my case) choosing a university hospital had its pros and cons (this being a con) but i didn't care -this was *my* arm.

On the things like calling you Mrs. Smith instead of teal - i would let it go at this stage.

[allgone]

I just want to point out that if you complain about the student nurses for following floor protocol and mention that the veteran nurses are not following the same policies, you may get the veteran nurses in trouble.  I'm a nurse and on my floor, the nurses got in trouble after a patient complained about the student nurses checking on him every hour.  Our manager decided that if he was only complaining about the student nurses, it meant the we (the floor nurses) were not doing our jobs and not doing our hourly rounds.  We were marked off on our evaluations and we all got less points, which resulted in much smaller raises.  Just something to think about.

I think if you have talked directly to the student nurses and there is no change, you should request no student nurses. 

[snowdragon]

Honestly, it is not the OP's responsibility to conform to the student nurses protocols - it's her responsibility to follow the protocols that her Dr has set up and approved for her. I believe that Nurse take their orders for patient care from the Dr's, even if they are experienced.
 If these student nurses can't be bothered/allowed to  even follow the dr's orders  - it would be the last time they treated me.  My comfort during a serious procedure is paramount - not their  careers...that's not the patient's job to worry about.  And honestly I would not be too happy with being addressed in a manner which I did not want to be addressed.
  If they have to be in the room, I don't have to be chatty with them, I don't have to do with them at all and I would go on with reading or crafting or sleeping - if they continued to talk or ask questions after I told them to be quite - again I would be requesting they never return. If it reflects badly on them - it should.
  The nurses evaluations student or not are not the patient's issues to worry about. and it's wrong to lay that on the shoulder's of another person.