Crossed the line... or expected behavior?

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Specializes in Med/Surg, Clinic, and Mental Health.

As an LPN to RN transition student, I had a patient who had to have a thoracentesis done in Radiology. During the procedure, I was placed in the supportive position for the patient and made sure her shoulders were in the proper position. As the procedure was taking place, I began to inform the patient of what was happening and what to expect (pin stick, etc.) HOWEVER... the radiologist later complained that I "talked the whole time." Um... nobody was providing inforormation to the patient and I felt it was my role to be the patient advocate and give her information about what was taking place to her during this invasice procedure.

Can someone PLEASE tell me if I acted inappropriately?

Specializes in Nursing Professional Development.

I think it depends on "how" you did it. If the physician actually performing the procedure felt you were "taking over" the communication with the patient, I can see where he/she may have felt you were inappropriate.

On the other hand, if you were repeatedly giving ample opportunity for the physician to talk to the patient without interrupting you ... and you were talking quietly into the patient's ear ... then it may have been totally appropriate.

I can pictue it either way, depending on the specific details as to "how" you did it.

Specializes in Med/Surg, Clinic, and Mental Health.

I was face-to-face with her. He began the procedure without any type of communication with the pt. After it appeared he was not going to tell her what he was doing, I thought it was then MY role to provide that ongoing information and support.

Specializes in Med/Surg, Clinic, and Mental Health.

It appears that it's a matter of perspective. Unfortunately, my clinical instructor perceived it as being "disrespectful" and this has cause a major issue with my continuing on in my current program.

Personally when I am with a room with a practitioner and patient I tend to follow the practitioner's lead and allow them to perform how they feel most comfortable.

If the practitioner wants quiet then I stay quiet, some practitioners like a lot of noise and music when performing, some want silence. Personally when I am performing a procedure I like silence and limit my distractions.

Specializes in Med/Surg, Clinic, and Mental Health.

Unfortunately, I am not familiar with the physician. I was in a clinical setting and didn't know his preferences. It never showed on his face that he was disrupted and he never gave me a cue to be quiet.

Unfortunately, I am not familiar with the physician. I was in a clinical setting and didn't know his preferences. It never showed on his face that he was disrupted and he never gave me a cue to be quiet.

Him not saying anything WAS the cue to be quiet. Would have been embarrassing for everyone if he had to tell you to shut your trap lol.

Think about if one of your CNAs started to describe a dressing change you were performing or describe a foley change to a patient. How annoying would that be?

Specializes in Med/Surg, Clinic, and Mental Health.

Well, so much for being a patient advocate and providing instruction and emotional support for my patients. I'm so discouraged and my spirit is definitely broken. I guess I should've let my patient be left totally unaware that an 8 inch long needle was getting ready to be inserted into her pleural space.

cant really answer if you crossed the line..it depends on several things..more importantly at this point are you getting kicked out the program because of it?

Well, so much for being a patient advocate and providing instruction and emotional support for my patients. I'm so discouraged and my spirit is definitely broken. I guess I should've let my patient be left totally unaware that an 8 inch long needle was getting ready to be inserted into her pleural space.

I understand your frustration and please do not allow this event to discourage you. You seem very genuine and gung-ho. There is a time and place for everything, don't be a bull in a china shop. Allow the practitioner to describe their procedure but definitely provide the support.

Being a nurse you have a different perspective on procedures. Most people do not want to know an 8 inch needles is about to be plunged into their back.

I am imagining, "Ok, now he is pulling out an 8 inch needle that looks similar to a knitting needle. He is going to plunge that into your back and scewer you like a roasted pig, don't worry though he is only going to puncture your lungs with it. Wait, wait, he is going to stab you...right about...NOW!"

Cheer up, take it as a life lesson, you're human and you make mistakes. You were not totally wrong but just take a step back and allow the "Gods" to do as they wish. Remember you are a student yet, you're standing on shaky ground.

You are assuming that the patient wanted to know everything that was happening. You can certainly be supportive and follow the lead of the one performing the procedure. Can you imagine the concentration it takes to perform a thoracentesis? Part of the critical thinking required of a nurse includes seeing things from the perspective of others before acting. Please do not let this break your spirit, don't even take it personally. Take it for what it is, a learning experience Grasshopper. Be a little more open minded to those around you, you are part of a team now. :loveya:

Specializes in Emergency Dept. Trauma. Pediatrics.
Well, so much for being a patient advocate and providing instruction and emotional support for my patients. I'm so discouraged and my spirit is definitely broken. I guess I should've let my patient be left totally unaware that an 8 inch long needle was getting ready to be inserted into her pleural space.

I don't really know if you were out of line or not because I wasn't there to see how the whole thing went down. But speaking to this part, I am assuming the procedure was explained to the patient prior and she signed a consent. I as a student was in on one of these before and the Dr was for the most part quiet and concentrating, the nurse would say a few supportive things like "take a deep breath" or "it's almost done." and I assisted with the collection. But prior the patient had to sign a consent after it was thoroughly.

Speaking for myself, when I am going through something painful, like an epidural. I like it quiet, I like a heads up right when the needle is about to go in so I am not taken by surprise, but I am a breather for pain and I need to be able to focus and breath and I can't do that when someone is talking.

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