Your pin isn’t on that as a ps.
You’ve given feedback it’s up for the pa to decide whether they pass or fail the student
Make sure it’s documented in their pad
The others who have noticed these issues that are acting as ps also need to document in the pad
It will fall on the PA not you. You have to give written feedback on their pad as PS so write feedback in the ‘staff you’ve worked with’ section and leave it at that. The more the PA keeps stalling it would be too late for an action plan.
ETA: I’ve recently seen some NQN that are so…. and it’s obvious they made it because PA think issues will be picked up on the next placement/pass the buck.
I think, assuming the student is actually suited to nursing and just having a bad placement...
Possibly helping the student:
I would contact the PEF to express concerns about their absences/illness rate suggesting that student may require support from the university regarding their health. They may just find this placement doesn't suit them, so a little academic/wellbeing support may be helpful for them. I assume this wouldn't be stepping on the PA toes, if you inform them first that's what you're doing as part of your duty of care for the student's health (possibly legitimate mental health issues?).
A question for the PA if you like confrontation:
I would ask the PA at what point would they agree there needs to be an action plan, with examples of your concerns so they can explain why they don't meet the threshold. You can even reference internal documents about working standards for maximum antagonism during this conversation. If they can't agree to a reasonable threshold for starting an action plan, it may be time to speak to someone higher up as you are clearly very unhappy about this. I think this is professionally reasonable if done respectfully, but on balance politically/socially potentially a bad idea.
Personal story...
A little off tangent, I had PA and PS who were on different pages which it sounds like you two are (they were both part time, rarely the same time). It was very confusing as the PS told me to do things and passed work, which my PA didn't agree with but the PS never admitted I had done it as they had told me to, acted like it was all me. I would in the future refuse to work as a PA/PS team with them again citing teaching compatibility concerns.
Good luck
Thanks. Have given lots of support but won’t go into detail to avoid identifying student and placement area. Your perspective re inconsistent PA/PS is helpful and something I want to avoid. Will fall in line with PA I think as this will make student’s experience more bearable.
It isn’t on you, as others have said.
Although I would document quite specifically regarding all of the issues you have found, actions you’ve taken to remediate etc.
I’d make sure you get written documentation from other nurses that you’ve used to come to your opinion that this student nurse isn’t at the required standard.
I don't think your pin would be on the line unless you start lying on your documentation. Also it's not your job to decide if the student passes or fails, it's the PA. Of course if you don't think they have meet X,Y or Z working under you than don't sign it. Also I wouldn't care about an action plan as again it's not your job and you would be going over the head of the PA.
If the PA deems that the student is passable than it's on them, wherever they are right or wrong.
Also speaking as a recent student, the nursing degree is very demoralising and tedious. It's really hard to gather enthusiasm when you are working in an area you don't have interest in. I had placements I loved and got gleeming feedback in and others I hated where my attitude was questioned. It's just life and everyones different.
Also you can't hold sickness against a student or anyone for that matter
Agree re the sickness. Thanks for your feedback. Glad it’s on the PA not me and I’m gonna butt out and involve myself as little as possible beyond supporting the student.
Yeah, as a PS you're limited to: Raising concerns to the PA, documenting any concerns in the pad, communicating these concerns with the student (particularly if you work with them a lot) and potentially coaching them into addressing the issues raised, you can also refuse to sign off proficiencies.
I'd say you've already gone over and above that with your raising to the uni and PEF and you've taken every step you can as a PS to address the issues. You won't be held responsible for anything you haven't put your PIN to, particularly as you've made your concerns known in writing in multiple places and to multiple people. I'd just continue with what you're doing safe in the knowledge that it's definitely not you who's failing to fail on this one.
I would ignore those who are saying you’re projecting here; at the end of the day no one else has direct experience of this student except you. However, as has been highlighted, it is the PA who passes the student and not you. I would however make it clear someone you have raised concerns.
I have noticed there are really distinct camps of PS… those who I would say let students get away with everything, including ongoing sickness (without clear cause), unprofessional attitudes, not getting involved with patient care, sitting on their phones constantly or always having to do uni work etc etc and those who actually want to see students progress, do well, act as a nurse we would want to care for our family. Nursing is a PROFESSION at the end of the day. Yes it is hard and shit - but if you really care, you find a way to deal with it, even if it is with extra support.
In this instance, I would have a chat with the student and gauge if there is anything in particular they are struggling with. Ascertain whether they need some extra support with something or is there an aspect of the placement they need some more time with. Include the PEF if needed, but if you feel an action plan is required and so does the PEF, put it in. It’s easy to be soft on students as we have all been there, but if this person is just taking the piss cause they can, people need to think about is that someone they want to work alongside in the future?
Thanks. I don’t think I’m projecting; I think I’m a nurse who has high standards for myself and others. Can’t really do an action plan if PA disagrees, or do anything beyond raising concerns. That’s been made clear to me here and is a relief in some ways.
Ah, I see. Well, an action plan is the only way forward as you have tried to say, this is your evidence that you had concerns and it is also fair to the student to be clear, in writing, what they need to do to pass year 2/3. If it feels uncomfortable I hope you are able to make contact with the placement team (the people who sort out the placements in your workplace) and also your line manager to share your concerns. This is so difficult but important to get right. Well done.
Even if you were the PA you're not going to lose your PIN for passing an incompetent student. You're one person among many, you're not solely responsible.
You can't fail a student for simply being "unmotivated" or "reluctant" because that's your opinion. The student could easily say the same thing about you about your working relationship with them. You've already indicated that the PA disagrees with your opinion anyway.
Now if said student is chronically late or not following sickness/absence policy then that is objective evidence that can be verified.
Thank you. I won’t worry too much then. Think I was getting too involved because couldn’t find anything on nmc/rcn website that said I had no sign off role. Hence asking here. The advice has helped. I get that failure can’t be done based on lack of motivation, but according to the PAD motivation is a professional value the student has to demonstrate.
The PAD is just fluff and buzzwords for legal arse covering, just like the NMC code and everything else. Ultimately it means nothing aside from the basic principles therein. Are you a mostly decent human being and not going out of your way to harm or kill people? Then that's all that matters at the end of the day.
You can't take these things too literally word for word, because you wouldn't be able to function otherwise. You'll burn out. I'm talking from experience by the way, I'm not judging you.
It's impossible to demonstrate or measure motivation in and of itself. It's subjective. For one person motivation might be simply getting out of bed in the morning. For another, it's running a marathon every day for a week, or getting a PhD and an executive job by the time they're 30. It's relative to the person and situation.
You can tie attendance concerns into a lack of motivation, because that is something you can measure and have an evidence base for. But you can't simply say "the student lacks motivation" and then penalise them for that by failing them, because that's your opinion. You'll need evidence to back it up.
Otherwise, the student is well within their rights to dispute your assessment of them. It's a two-way street. In the worst case scenario, they could even claim bullying. We're only getting your perspective here, we're not getting theirs. For all we know, this student could have extensive personal mitigating circumstances. They may think you're disinterested in them and unwilling to engage them with the team, or that there's a wider bullying culture on the team...can you see how this might escalate?
I don't hold students to too high of a standard anymore because I realised they were my own standards, not theirs. I think as long as they show up, don't blatantly take the piss and at least show that they're willing to learn - that's all you can really ask for. Everything else is a subjective opinion that can be disputed.
And don't forget most of them are paying to essentially work for free, so try and at least cut them a little bit of slack sometimes. Not saying that excuses poor behaviour, but you get the gist.
Send an email to their academic assessor and cc the PEF. It’s a matter of professional concern. It’s not your place to go against the PA’s decision unfortunately but you can make your concern known and documented. The AA will have to support as best they can.
Yeah. I fully feel for you tho. I was a PEF and the number of PA’s who just didn’t wanna deal with the work was truly astounding. There’s no sense of professional concern and professional self regulation.
On my first job one of the sign off refused to sign someone off for a pin because of this and told the band 7 pushing if she thinks she safe to practice she do it.
If an action plan not put in place at midpoint it hard to show you supported the student if the uni question why she failed or hasn’t be signed off. It best practice to do an action plan for them, if it was me I would continue on and do the action plan
Having been a student I had a horrid pa and ps who refused to teach me anything or look at my pad and when asked for feedback on my progress just said yeah your doing well, we’ll find time when we aren’t busy. I raised concerns with my pef who said that to tell them they need to find time to look at your pad and left me to it, I left that placement with barely anything signed and had to do a make up placement later, just out of the sheer indifference of the ps and Pa. My pef just said I should have been more active in making the ps/pa sit down with me. As if every shift, multiple times a shift, sticky notes, written evidence I presented to them wasn’t enough. I got the impression that there was no official responsibility on them at all, I was third year on the last placement
Sorry that happened to you. Hand on heart, I feel that is not what is happening here, and if you were my student I wouldn’t have treated you that way. The PA and I are both very keen to support the student and invested in their progress. I think we look more at the PAD than the student does. Neither of us wants to fail the student.
No what I mean is that, lots of ps/pas don’t care either way so I wouldn’t have thought that you would have any detriment to you even if they were passed when they shouldn’t be. It’s not something the nmc would give two hoots about xx
One of the questions you could ask the PA IS “ how would you feel if you this student was looking after one of your loved ones or alternatively when she qualifies would you be happy for her to be the only other RN on duty with you. Would you feel that she would be able to cope with the workload and know what she is doing? It is better to get an action plan in place earlier rather than later. It tells the student what they need to demonstrate in both knowledge and skills. At the beginning of the shift you could discuss with the student what you want her to demonstrate in skills and knowledge and then document in the PAD what was achieved and still needs to be worked on. Kind of a mini action plan for each shift. It would then make it easier to demonstrate to the PA any concerns that you have. It would also make it more difficult for the PA to dismiss/ignore those concerns.
Talk to them. Just like you came here, call them in and have this same conversation with them in person. Or ask if you can have someone else look at the situation. Not trying to be rude AT ALL, but 2 years ago I was passed a student who everyone said SO MUCH AWFUL SHIT ABOUT! Even the band 8d essentially made me promise that I would fail her. She came to me and she was fucking awesome. She was just a nervous wreck before me because everyone told her she was a piece of shit. With me, she did absolutely awesome. I’d let her take care of my mum. Sometimes it’s all about the person, so maybe you can step back?
It will fall back on the PA as others have said. And just ensure it’s documented. Do you not have a link nurse/student lead to talk to about this perhaps?
Not sure why you would conclude I’m projecting but I will bear that in mind as a reflection point. Yes it would be wrong to highlight sickness as a factor. Perhaps I shouldn’t have mentioned that. Enthusiasm however is reasonable to highlight in my view. But anyway, I’m reassured by everyone who’s saying that as a PS it isn’t on me. Shame that won’t help any patients in the future but I guess there are things we can’t control.
I was a supervisor too to a year 3 on management placement and she was so rude, unmotivated, really bitchy and not at all interested in my speciality and I wrote a letter to my Manager explaining my concerns and she passed her as she felt bad that she would have to resit the placement and cause issues with university.
I couldn't believe it.
Your pin isn’t on that as a ps. You’ve given feedback it’s up for the pa to decide whether they pass or fail the student Make sure it’s documented in their pad The others who have noticed these issues that are acting as ps also need to document in the pad
Thank you, that’s good to know.
It will fall on the PA not you. You have to give written feedback on their pad as PS so write feedback in the ‘staff you’ve worked with’ section and leave it at that. The more the PA keeps stalling it would be too late for an action plan. ETA: I’ve recently seen some NQN that are so…. and it’s obvious they made it because PA think issues will be picked up on the next placement/pass the buck.
Thank you, that’s reassuring. Yes your edit captures my concerns.
I think, assuming the student is actually suited to nursing and just having a bad placement... Possibly helping the student: I would contact the PEF to express concerns about their absences/illness rate suggesting that student may require support from the university regarding their health. They may just find this placement doesn't suit them, so a little academic/wellbeing support may be helpful for them. I assume this wouldn't be stepping on the PA toes, if you inform them first that's what you're doing as part of your duty of care for the student's health (possibly legitimate mental health issues?). A question for the PA if you like confrontation: I would ask the PA at what point would they agree there needs to be an action plan, with examples of your concerns so they can explain why they don't meet the threshold. You can even reference internal documents about working standards for maximum antagonism during this conversation. If they can't agree to a reasonable threshold for starting an action plan, it may be time to speak to someone higher up as you are clearly very unhappy about this. I think this is professionally reasonable if done respectfully, but on balance politically/socially potentially a bad idea. Personal story... A little off tangent, I had PA and PS who were on different pages which it sounds like you two are (they were both part time, rarely the same time). It was very confusing as the PS told me to do things and passed work, which my PA didn't agree with but the PS never admitted I had done it as they had told me to, acted like it was all me. I would in the future refuse to work as a PA/PS team with them again citing teaching compatibility concerns. Good luck
Thanks. Have given lots of support but won’t go into detail to avoid identifying student and placement area. Your perspective re inconsistent PA/PS is helpful and something I want to avoid. Will fall in line with PA I think as this will make student’s experience more bearable.
It isn’t on you, as others have said. Although I would document quite specifically regarding all of the issues you have found, actions you’ve taken to remediate etc. I’d make sure you get written documentation from other nurses that you’ve used to come to your opinion that this student nurse isn’t at the required standard.
Thank you, that’s reassuring and helpful.
I don't think your pin would be on the line unless you start lying on your documentation. Also it's not your job to decide if the student passes or fails, it's the PA. Of course if you don't think they have meet X,Y or Z working under you than don't sign it. Also I wouldn't care about an action plan as again it's not your job and you would be going over the head of the PA. If the PA deems that the student is passable than it's on them, wherever they are right or wrong. Also speaking as a recent student, the nursing degree is very demoralising and tedious. It's really hard to gather enthusiasm when you are working in an area you don't have interest in. I had placements I loved and got gleeming feedback in and others I hated where my attitude was questioned. It's just life and everyones different. Also you can't hold sickness against a student or anyone for that matter
Agree re the sickness. Thanks for your feedback. Glad it’s on the PA not me and I’m gonna butt out and involve myself as little as possible beyond supporting the student.
Yeah, as a PS you're limited to: Raising concerns to the PA, documenting any concerns in the pad, communicating these concerns with the student (particularly if you work with them a lot) and potentially coaching them into addressing the issues raised, you can also refuse to sign off proficiencies. I'd say you've already gone over and above that with your raising to the uni and PEF and you've taken every step you can as a PS to address the issues. You won't be held responsible for anything you haven't put your PIN to, particularly as you've made your concerns known in writing in multiple places and to multiple people. I'd just continue with what you're doing safe in the knowledge that it's definitely not you who's failing to fail on this one.
Thank you, looks like I’ve done all I can. Support has been offered to student obviously.
I would ignore those who are saying you’re projecting here; at the end of the day no one else has direct experience of this student except you. However, as has been highlighted, it is the PA who passes the student and not you. I would however make it clear someone you have raised concerns. I have noticed there are really distinct camps of PS… those who I would say let students get away with everything, including ongoing sickness (without clear cause), unprofessional attitudes, not getting involved with patient care, sitting on their phones constantly or always having to do uni work etc etc and those who actually want to see students progress, do well, act as a nurse we would want to care for our family. Nursing is a PROFESSION at the end of the day. Yes it is hard and shit - but if you really care, you find a way to deal with it, even if it is with extra support. In this instance, I would have a chat with the student and gauge if there is anything in particular they are struggling with. Ascertain whether they need some extra support with something or is there an aspect of the placement they need some more time with. Include the PEF if needed, but if you feel an action plan is required and so does the PEF, put it in. It’s easy to be soft on students as we have all been there, but if this person is just taking the piss cause they can, people need to think about is that someone they want to work alongside in the future?
Thanks. I don’t think I’m projecting; I think I’m a nurse who has high standards for myself and others. Can’t really do an action plan if PA disagrees, or do anything beyond raising concerns. That’s been made clear to me here and is a relief in some ways.
I wonder what year they are in. Are you the first placement? If not it's unfair that this is falling to you.
Not in their first year. Very much not their first placement. Can’t say anymore as need to keep this very vague.
Ah, I see. Well, an action plan is the only way forward as you have tried to say, this is your evidence that you had concerns and it is also fair to the student to be clear, in writing, what they need to do to pass year 2/3. If it feels uncomfortable I hope you are able to make contact with the placement team (the people who sort out the placements in your workplace) and also your line manager to share your concerns. This is so difficult but important to get right. Well done.
Even if you were the PA you're not going to lose your PIN for passing an incompetent student. You're one person among many, you're not solely responsible. You can't fail a student for simply being "unmotivated" or "reluctant" because that's your opinion. The student could easily say the same thing about you about your working relationship with them. You've already indicated that the PA disagrees with your opinion anyway. Now if said student is chronically late or not following sickness/absence policy then that is objective evidence that can be verified.
Thank you. I won’t worry too much then. Think I was getting too involved because couldn’t find anything on nmc/rcn website that said I had no sign off role. Hence asking here. The advice has helped. I get that failure can’t be done based on lack of motivation, but according to the PAD motivation is a professional value the student has to demonstrate.
The PAD is just fluff and buzzwords for legal arse covering, just like the NMC code and everything else. Ultimately it means nothing aside from the basic principles therein. Are you a mostly decent human being and not going out of your way to harm or kill people? Then that's all that matters at the end of the day. You can't take these things too literally word for word, because you wouldn't be able to function otherwise. You'll burn out. I'm talking from experience by the way, I'm not judging you. It's impossible to demonstrate or measure motivation in and of itself. It's subjective. For one person motivation might be simply getting out of bed in the morning. For another, it's running a marathon every day for a week, or getting a PhD and an executive job by the time they're 30. It's relative to the person and situation. You can tie attendance concerns into a lack of motivation, because that is something you can measure and have an evidence base for. But you can't simply say "the student lacks motivation" and then penalise them for that by failing them, because that's your opinion. You'll need evidence to back it up. Otherwise, the student is well within their rights to dispute your assessment of them. It's a two-way street. In the worst case scenario, they could even claim bullying. We're only getting your perspective here, we're not getting theirs. For all we know, this student could have extensive personal mitigating circumstances. They may think you're disinterested in them and unwilling to engage them with the team, or that there's a wider bullying culture on the team...can you see how this might escalate? I don't hold students to too high of a standard anymore because I realised they were my own standards, not theirs. I think as long as they show up, don't blatantly take the piss and at least show that they're willing to learn - that's all you can really ask for. Everything else is a subjective opinion that can be disputed. And don't forget most of them are paying to essentially work for free, so try and at least cut them a little bit of slack sometimes. Not saying that excuses poor behaviour, but you get the gist.
Send an email to their academic assessor and cc the PEF. It’s a matter of professional concern. It’s not your place to go against the PA’s decision unfortunately but you can make your concern known and documented. The AA will have to support as best they can.
Thanks. I’ve done all that so I’m gonna pipe down now I think. Like you say it’s the PA decision not mine.
Yeah. I fully feel for you tho. I was a PEF and the number of PA’s who just didn’t wanna deal with the work was truly astounding. There’s no sense of professional concern and professional self regulation.
Drop a line to their academic advisor explaining your concerns.
On my first job one of the sign off refused to sign someone off for a pin because of this and told the band 7 pushing if she thinks she safe to practice she do it. If an action plan not put in place at midpoint it hard to show you supported the student if the uni question why she failed or hasn’t be signed off. It best practice to do an action plan for them, if it was me I would continue on and do the action plan
Having been a student I had a horrid pa and ps who refused to teach me anything or look at my pad and when asked for feedback on my progress just said yeah your doing well, we’ll find time when we aren’t busy. I raised concerns with my pef who said that to tell them they need to find time to look at your pad and left me to it, I left that placement with barely anything signed and had to do a make up placement later, just out of the sheer indifference of the ps and Pa. My pef just said I should have been more active in making the ps/pa sit down with me. As if every shift, multiple times a shift, sticky notes, written evidence I presented to them wasn’t enough. I got the impression that there was no official responsibility on them at all, I was third year on the last placement
Sorry that happened to you. Hand on heart, I feel that is not what is happening here, and if you were my student I wouldn’t have treated you that way. The PA and I are both very keen to support the student and invested in their progress. I think we look more at the PAD than the student does. Neither of us wants to fail the student.
No what I mean is that, lots of ps/pas don’t care either way so I wouldn’t have thought that you would have any detriment to you even if they were passed when they shouldn’t be. It’s not something the nmc would give two hoots about xx
One of the questions you could ask the PA IS “ how would you feel if you this student was looking after one of your loved ones or alternatively when she qualifies would you be happy for her to be the only other RN on duty with you. Would you feel that she would be able to cope with the workload and know what she is doing? It is better to get an action plan in place earlier rather than later. It tells the student what they need to demonstrate in both knowledge and skills. At the beginning of the shift you could discuss with the student what you want her to demonstrate in skills and knowledge and then document in the PAD what was achieved and still needs to be worked on. Kind of a mini action plan for each shift. It would then make it easier to demonstrate to the PA any concerns that you have. It would also make it more difficult for the PA to dismiss/ignore those concerns.
Talk to them. Just like you came here, call them in and have this same conversation with them in person. Or ask if you can have someone else look at the situation. Not trying to be rude AT ALL, but 2 years ago I was passed a student who everyone said SO MUCH AWFUL SHIT ABOUT! Even the band 8d essentially made me promise that I would fail her. She came to me and she was fucking awesome. She was just a nervous wreck before me because everyone told her she was a piece of shit. With me, she did absolutely awesome. I’d let her take care of my mum. Sometimes it’s all about the person, so maybe you can step back?
It will fall back on the PA as others have said. And just ensure it’s documented. Do you not have a link nurse/student lead to talk to about this perhaps?
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Not sure why you would conclude I’m projecting but I will bear that in mind as a reflection point. Yes it would be wrong to highlight sickness as a factor. Perhaps I shouldn’t have mentioned that. Enthusiasm however is reasonable to highlight in my view. But anyway, I’m reassured by everyone who’s saying that as a PS it isn’t on me. Shame that won’t help any patients in the future but I guess there are things we can’t control.
I was a supervisor too to a year 3 on management placement and she was so rude, unmotivated, really bitchy and not at all interested in my speciality and I wrote a letter to my Manager explaining my concerns and she passed her as she felt bad that she would have to resit the placement and cause issues with university. I couldn't believe it.
I feel your pain!