Am I off Base? or mentally unstable? - page 3

Hello everyone, I need your help. During a meeting with my Clinical AdvisorI was brated for a writing a paragraph in one of my reflections. I wrote about a violent patient that I had one... Read More

  1. by   live4today
    This is one of those situations that could have been an excellent and appropriate time to utilize the "Reflective Practice" or "Praxis" method, wouldn't you all agree? That Instructor lost out on a valuable lesson that she could have assisted the student (Zhakrin) in learning by having him rethink the process of that particular situation with the "spitting patient".
  2. by   rn2binmay
    perhaps your clinical advisor is unstable
  3. by   fiestynurse
    Spit does not transmit AIDs, if that's what you are worried about. However, being spit on is gross! I would have done something to protect myself. Your questions and thoughts on this were not out of line at all.

    Here is some interesting legal stuff on cops being spit on:
    http://www.thebody.com/lambda/saliva.html
  4. by   JMP
    Fiesty

    Thank you for your post-you are so right to point out that AIDS is not transmitted via saliva. I went to a conference about a year ago regarding issues like this and you have reminded me how difficult it is to acquire AIDS from pt. So much depends on the viral load- how much blood was in the needle ( if it is a needle stick injury).
    Hep B is quite another story. It is extremely strong and dangerous the enviroment. If my memory from the conference serves me right I remember that even blood that is old and dried on to a surface is capable of delivering Hep B is someone touches the spot with an open wound. Scary.

    True too that being spit on is gross. I guess these days UNIVERSAL precautions are the ABSOLUTE best tool we have. I know in the ICU when I suction, gloves, goggles are the lastest fashion statements.
  5. by   grouchy
    JMP- I heard the same thing about dried blood and Hepatitis in an inservice. Hep is VERY transmissable, unlike HIV. If my memory serves me correctly, I believe saliva can transmit Hep B and C if it comes into contact with your mucous membranes, eyes, or broken skin. Also, psych pts are often high-risk for hepatitis.
  6. by   pebbles
    I dunno, this is going to sound bad - but -
    I don't care what is transmitted by what fluids - I do not want to come into contact with bodily fluids if I can help it. Period. I have put a mask on a patient - in a step-down unit where I was whirling from patient to patient and the gown/gloves/mask thing would have been so inappropriate as to be laughable. To what extent are nurses expected to put themselves at risk for any pathogen - doesn't have to be aids, could be tetanus or there are lots of bugs in saliva - in order to protect pt's rights? Is putting a mask on someone really *that* horrible? I'd consider that a *very* mild restraint, worth the protection to staff.

    *

    I also think that any instructor who does not discuss this issue further with the student is an incompetent instructor - wouldn't be the first time, I am sure. The point of being a student is to learn and gain insight. Even if what you had suggested was totally awful, if you had been given the opportunity to see why it was bad and learn from it, the experience would have made you a better nurse. But to be slapped away from your line of thought like a child is wrong. YOu can't be a really good nurse until you can critically think your way through these types of issues, and *that* is what the instructor is supposed to focus on teaching. Not the situational specifics of right and wrong, but the *whys* and deeper rationale.

    Zhakrin, don't lose heart. Sometimes there is no "right" answer, and not all teachers will be golden, but it is worth it in the end to succeed in this profession.
  7. by   fergus51
    I think it's interesting that if a person spits on a police officer it is considered assault, but if they spit on a nurse it's just part of the job...
  8. by   kaycee
    It should never be wrong in any situation for a student to ask an instructor a question. My question to your instructor is, Why the hell are you a teacher if you don't like questions?
    You were not off base or mentally unstable, but IMO your instructor is. Keep asking those questions and you'll be a better nurse then she will ever be!!!!
  9. by   MHN
    Zharkin ,don't stop asking questions its one of the best ways to learn .Like some of the others have said the instructor needs help.as for your interest in violence in the work place its an interesting an admiral topic .Look up The Broset Violence checklist on the net google is a good search engine or the international forensic nurses web site .MHN
  10. by   CindyCCRN
    ...It's quite obvious why your clinical instructor chose Psyche - she obviously is unhealthy, has a very abusive personality, and lacks healthy judgement and normal boundaries. You were right in all your assessments, thought processes, and to express concern for your own health and safety. This type of thing is tolerated far too frequently in nursing. Law enforcement would never tolerate such behavior or threat, nor would most physicians or administrators... and according to OSHA and JCAHO Standards, facilities MUST protect their employees from ALL potential dangers and health risks...
    Your instructor attempted to justify her role and position-of-power by belittling your opinion, devaluing your rights, and attacking your stability. Personally, I strongly feel that this instructor does not belong in the role of a nurse-educator - or even in the profession... she needs to be in therapy...
    These unacceptable and unsupported "silent-teachings" and sick attempts to control and victimize nurses is a main reason why so many nurses eventually leave the profession...
  11. by   shyviolet78
    Originally posted by Zhakrin

    She then told me that under no curcumstance do we ever put anything on a pts face except a O2 mask.
    Well, I'm just a student myself, but I believe we do put a regular mask on a patient with TB, and also when doing certain sterile procedures. So, she was wrong about that! I don't think your question was out of line at all. It is better to ask questions and be informed than to make decisions based on assumptions. If you knew everything there is to know, you wouldn't have to go to school, right !
    Last edit by shyviolet78 on Mar 19, '02
  12. by   micro
    just because you are a student.........does not mean that you are ignorant, lack opinions, or have insight.............
    just because you are an instructor.......does not mean that you are all powerful and in control.......
    you job is too teach, guide, instruct.......and help shape new nurses......not get into power trips or shoot down their questions........
  13. by   live4today
    Amen, Micro! Well said!

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