Supervising nursing students and new staff: ask, show, watch, tell
How a practical nurse supervises a nursing student or new staff member in four steps, and why the client's care stays with the nurse.
- Workload never makes a learner ready.
- The client's safety comes before any learning goal.
- The student answers for her actions. You answer for what you let her do.
To supervise a nursing student or a new staff member, use four steps: ask what they have done and may do, show the skill once, watch from the bedside, and tell them how it went. The client's care stays with you the whole time. This guide follows one student through one dressing change.
“Let the student do it on her own”: why the answer is no
It is a busy Wednesday. Your practical nursing student is on her second placement. She has changed a dressing only in the lab. Her school allows it with a nurse supervising.
A colleague says, “We're slammed. Let the student do that dressing on her own, she's done it in the lab.” But workload never makes a learner ready, and the client's care stays with you.
Four steps: ask, show, watch, tell
| Step | What you do |
|---|---|
| 1. Ask | What has she done, and what may she do here? Ask the client if a student may take part. |
| 2. Show | Do one dressing change yourself, and say why at each step. |
| 3. Watch | She does the next one. You stay at the bedside the whole time. |
| 4. Tell | Afterwards, in private: ask her first, say what went well and one thing to change, and tell her instructor. |
Step in at once
The client agrees, and the student starts the dressing change. Then her glove touches the bed rail. Step in at once: “Stop for a moment. That glove is no longer sterile. Let's change it.”
The client's safety comes before any learning goal.
Give feedback, soon and in private
Afterwards, in private, ask her first how it went. Then say what went well: “You changed your glove calmly.” And say one thing to change: “Next time, tell the client what you'll do before you take off the old dressing.” Then tell her instructor how it went.
Your student says, “Thank you. Can I do the next one with you there?”
Who answers for what
- Your student answers for her own actions, to her school.
- You answer for what you let her do, and for how closely you watched.
The same care applies to a new staff member. Do not assume that a person is competent. Read who to assign a task to.
What a student may do differs between schools, provinces and employers. Follow the school's rules and your agency's policy.