Appropriate Action?

  1. I am Nursing student with just over a semester until graduation, and I want your opinion on a situation that happened in clinicals.

    A first-year student was discharging a patient who happened to be a gun shot wound victim. While he was removing the patient's IV, he was overheard telling the patient to "stop acting like a baby" when the patient complained of pain. He then told the patient that "if he was a big enough man to take a bullet, then he should be able to handle a little tape being pulled off his skin."

    In the discharge papers the student prepared for the patient, he wrote down that perhaps in the future, the patient should avoid his current friend set, and stay outta trouble to avoid being shot at again.

    This student knew nothing of the circumstances of the shooting; just offered his "helpful" advice.

    The patient was, of course, outraged and reported the student to the unit manager. The clinical instructor who is a MSN, NP, was livid. She failed him on the spot and he has been expelled from the nursing program.

    Although I thoroughly agree that his actions were wrong, I am wondering if the actions taken by the school were appropriate or not. Whaddya think?
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  2. 43 Comments

  3. by   P_RN
    I'd have to have a lot more information before venturing an opinion. Were you the student? Who heard the dialog?

    Without knowing more I wouldn't even try to answer this.
  4. by   Simba&NalasMom
    Wow. Shocking behavior, but I've heard about such behavior in people who have actually BECOME nurses; in fact, I got a complaint from a resident about a weekend charge nurse who told her she was too whiny and was looking forward to her discharge so she wouldn't have to listen to her whining anymore. Unfortunately, the resident could not remember the nurse's name but described her to a T. I reported the complaint to my staff dev. coordinator but I'm not longer at that job so don't know the outcome.

    As far as the student behavior goes, my intuition tells me that if he behaved like that during a clinical, the staff and other students probably noticed negative things about his behavior/personality during class and labs. If his attitude was noticed before he got to clinicals, I wonder if steps were taken to deal with it before he was placed into a care position.

    Just curious: did you know this guy personally, and if so, did you notice anything about his attitude during school hours?

    I think that technically the school was completely appropriate; his behavior was completely inexcusable. I'm also sure that your student handbook outlines specifically what happens to students who treat their patients that badly. Not only did he cause another human being to feel awful, he cast the school in a bad light, which is a cardinal sin as far as school personnel are concerned. Having said that, if the school noticed the attitude beforehand and did not take steps to deal with that, then the program needs work as well. Tough call to say the least, but I'm inclined to back the school in this case, based on what you have posted.
  5. by   live4today
    I agree with Simba.
  6. by   mdmetz
    No, I was not the student. He was a 1st year student. The person who overheard the conversation was a student from my group. One of our clinical assignments is to oversee a small group (4) of 1st year students as if we were a charge nurse. We then interact with their clinical instructor, who oversees everything. This all came to light when the patient complained to the unit manager.
  7. by   mdmetz
    Simba,
    No, I didn't know him personally. And you're right, I would've hoped that such behaviors could have been caught prior to actual patient care.
    And thanks for the feedback, I really appreciate it.
  8. by   Luv2BAnurse
    That was inappropriate behavior and documentation. I just wonder, however, if that student nurse knew that patient....outside of the hospital setting.
  9. by   nurse4theplanet
    I agree with P_RN...not enough info to give an appropriate response to your question.

    I would hope that there was more to the story than just what was divulged in your post, because, although inappropriate, it seems more like grounds for education/counselling rather than dismissal.

    If the student was dismissed purely for this incidence alone, I think that is a little harsh. Sometimes one thinks that they are being helpful and it was probably an honest attempt to help the pt in that students eyes...like i said...education was needed.

    Also, this is third party information. Sometimes what a person says can be taken out of context completely. I have been known to joke around with my pts and if I typed some of the things I said verbatim then they would seem a little odd. But if the pt complained, then obviously he didn't perceive it as funny. Lots more to this story I am afraid....
  10. by   SFCardiacRN
    Immediate expulsion tells me this was not a first incident. I'll side with the clinical instructor's judgement over this person's ability to become a nurse.
  11. by   Daytonite
    No one is ever just terminated from a nursing program like that without some kind of meeting and discussion being held by the people in charge. The school has total say in who stays and who goes. There most likely were other problems you students are not aware of. You'll never know as it is confidential information.
  12. by   babynurselsa
    IF and I repeat IF this situation occured as you posted, yep appropriate action was taken. Especially if they had written proof of these actions. If you had done those things as an employee the same actions would have occured.
  13. by   VeryPlainJane
    I agree with the actions of the school. This patient was a victim of a crime! The nursing student totally disregarded the emotional trauma that the victim may be suffering from, and open the hosp. and school up to litigation.
  14. by   nurse4theplanet
    Quote from VeryPlainJane
    I agree with the actions of the school. This patient was a victim of a crime! The nursing student totally disregarded the emotional trauma that the victim may be suffering from, and open the hosp. and school up to litigation.
    I wouldn't call passing on unwanted advice and judgement a crime. Inappropriate yes! Grounds for diciplinary action, yes! But let's keep in mind, this is a student...a first year student at that. I really think there is more to the story here. This student probably has a history of odd behavoir and maybe even unsafe behavoir.

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