Dilemma in clinical? - page 4

The preceptor came up to me today and told me that a nurse complained about me. What happened was a confused patient wanted to go to the washroom, I said ok I'll take you but she requested that the... Read More

  1. Visit  barnstormin' profile page
    1
    Dealing with difficult patients successfully takes experience and is a learned skill. I don't know the age of the OP, but I would think it's fairly hard for a younger student to be able to stand their ground with a difficult pt than an older student who has had more life experience in dealing with difficult people. I wouldn't worry about it too much, I feel the primary could have given you some better guidance on how to handle the pt and sent you back in to try again. We are in school to learn, unfortunately quite a few nurses find us a bother, take it in stride and try to get as much out your experiences with RN's who care enough to teach.
    loriangel14 likes this.
  2. Visit  Jolie profile page
    2
    I agree with the previous poster, but would like to encourage all here to look at the primary nurse's actions from a different pespective:

    She saw a weakness, probably due to lack of experience, in the actions of the student. She did not address that directly to the student, for reasons that we are not aware of. Maybe she was too annoyed by the student to speak constructively with her. Maybe she had a number of other pressing patient issues to deal with and didn't have the time. She did bring the issue up to the instructor, whose job it is to teach the student.

    I love having students and enjoy teaching, actually far more than I enjoy most patient care situations. I am the rarity among staff nurses. Most have students assigned to work under them regardless of their training, interest or desire to participate in the education process. I don't think it is fair to bash the staff nurse for not taking a significant amount of time to work thru the issue with the student when she likely had a full load of patients and had no say in precepting a student (or multiple students.)

    The staff nurse gave the student the guidance needed in the moment, as she should have. The responsibility for teaching the student how to handle a similar situation in the future properly lies with the clinical instructor, where it was placed by the staff nurse.

    I don't see the gripe.
    RN/Mom and wooh like this.
  3. Visit  mursetudent25 profile page
    0
    Quote from dudette10
    OP, what you did wasn't a big deal. Just a few things:

    1) You said nothing in your posts about the depth of knowledge you have on the patient's personality and behaviors. Possibly the patient had a habit of demanding things, and the nurse was implementing a legitimate nursing intervention called "limit setting." That said, I wouldn't judge her too quickly on what she said to the patient.

    2) The nurse ran to mommy, and that is one of my biggest pet peeves in this profession. Because what you did wasn't a big deal in the great scheme of things, it could have been an opportunity to talk to YOU a little bit about limit setting with patients, if that's indeed what she did. Instead of a teaching opportunity (which takes all of a couple of minutes), it turned into a "complaint." That's ********. And before anyone tries to tell me, "It takes tiiiiiiiime to teach students," I have to point out that there was probably more time spent venting to the preceptor about the student. Time that could have been used in a much more constructive fashion.

    3) What is missing from your replies, though, is your preceptor's reaction when she spoke with you about the nurse's complaint. I'm curious to know how that conversation went.
    The instructor suggested that I maybe tried to 'dump' the patient onto the nurse and did that to not have to take her to the washroom, she then asked me if this is an issue of me not wanting to 'do this'..This is actually what got me a bit worried. I told her that I told the patient that I could take her multiple times, that it's not a problem and that the patient requested the nurse so I got her since I don't want to tell the patient that they cant have a choice of who's caring for them (consent issue). She told me I could have controlled the situation better and asked what I would do if I was a nurse, I told her that the other nurse wouldn't be there then and it wouldn't be a problem...Anyway, I'm still pretty annoyed with the nurse and that the instructor went straight to thinking that I may have tried to pass off the patient as soon as possible to do less work. I guess I need to be more careful now.
  4. Visit  loriangel14 profile page
    0
    But the patients don't have a choice of who cares for them.If they have a nurse they like one day and the next day that nurse has a different assignment the patient can't demand the assignment be changed.You have to set limits when it comes to patient demands.If it was an issue such as a female not wanting a male employee to toilet them,that's fine.But if it's just because they like someone better then you have to draw the line.
  5. Visit  ivikatasha profile page
    0
    Quote from loriangel14
    But the patients don't have a choice of who cares for them.If they have a nurse they like one day and the next day that nurse has a different assignment the patient can't demand the assignment be changed.You have to set limits when it comes to patient demands.If it was an issue such as a female not wanting a male employee to toilet them,that's fine.But if it's just because they like someone better then you have to draw the line.
    They do when it comes to student nurses.
  6. Visit  GrnTea profile page
    0
    i keep coming back to the fact that in the original post, the patient wanted pain medication and a bathroom trip. perhaps this patient thought that if she asked the nurse (as opposed to the student) she could get that too. op: was that really not such an issue, and did you also tell the nurse the patient wants her pain med, or just a bathroom trip?

    otherwise, great ideas for better communication/limit-setting.
  7. Visit  MN-Nurse profile page
    1
    Quote from mursetudent25
    The nurse then told the preceptor that i shoulkd have taken control and not called her.
    If any student working under me decides to "take control" when my patient is asking for a nurse and/or medication (if the situation has not previously been addressed), they - and their instructor - are going to get reamed.
    melmarie23 likes this.
  8. Visit  mindlor profile page
    0
    Quote from MN-Nurse
    If any student working under me decides to "take control" when my patient is asking for a nurse and/or medication (if the situation has not previously been addressed), they - and their instructor - are going to get reamed.
    Get reamed? Is that not a little severe? Why not just a calm discussion regarding your preferences?
  9. Visit  mindlor profile page
    0
    Quote from grntea
    i keep coming back to the fact that in the original post, the patient wanted pain medication and a bathroom trip. perhaps this patient thought that if she asked the nurse (as opposed to the student) she could get that too. op: was that really not such an issue, and did you also tell the nurse the patient wants her pain med, or just a bathroom trip?

    otherwise, great ideas for better communication/limit-setting.
    not to split hairs but i dont think the type of meds were ever mentioned......not that it matters.....i could be wrong......as i often am
  10. Visit  mindlor profile page
    0
    Bottom line is that we now live in a world where medicare reimbursement back to the hospitals is going to partially determined by patient surveys. Patients have a lot more power than they did in the past. This is not going to change, it is only gong to be amplified. We had all best get used to it.....
  11. Visit  mursetudent25 profile page
    0
    Quote from grntea
    i keep coming back to the fact that in the original post, the patient wanted pain medication and a bathroom trip. perhaps this patient thought that if she asked the nurse (as opposed to the student) she could get that too. op: was that really not such an issue, and did you also tell the nurse the patient wants her pain med, or just a bathroom trip?

    otherwise, great ideas for better communication/limit-setting.
    the patient just wanted the nurse to give her her meds and take her to the washroom..i'm not sure if she just wanted that nurse in general (and not me)/just confused but i just told the rn shes assigned to that she's asking for her and wants her to take her to the washroom and get medication..


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