Putting this out there to see if anyone has had some experience or have known an RN student similar to myself. I’d appreciate any impressions you have about the scenario I describe below. Be brutal if you have to … I’m making a major decision and would like to hear good thoughts and brutal alike. Thanks for taking to do so.
The Good
I am in the top 5% of my class when it comes to exam grades and writing assignments. I am comfortable with medication administration and have developed a routine that ensures safety and am prepared (via med cards) to observe for any adverse or side effects (not that I believe I'm not immune to making a mistake but just that I am hyper-vigilant when it comes to med administration). If med administration is late, it’s usually because the instructor is with classmates or the primary care RN is not available to supervise my administration. After my 3rd experience, I am comfortable and sterile hanging IVs and IVPBs. I’m thorough and gentle (if somewhat slow) with wound care.
I do very well conceiving care plans after reviewing a patient's med-surg chart before performing, I am still developing in that respect but my instructors have told me preparation needs only be adjusted a little.
The Bad
The problem arises when I actually have to execute the plan of care. On the floor I get muddled and anxious and my common sense takes a 7 hour lunch break, I get tongue tied and so forth. Here are some examples:
- I am the student nurse who once in the room, forget one or other aspect of the grand plan and end up missing opportunities to teach because I'm busy catching up.
- If I can't take at least 10M to do my head to toe assessment, I will end up missing 2 or 3 aspects of my head to toe exam and disturb my patient again. (Note: I'm super vigilant about ABCs).
- I am the student who is too timid to ask visitors to leave the room in order to do assessments or care.
- If my 18H postpartum patient (whose slept a grand total of 2H after delivering) says she does not want to move so I can do a second of the shift check of her fundus/episiotomy because she doesn't want to disturb the baby in her bed (and declines that I move baby to bassinet), I say "okay" and end up getting sent back by instructor to complete it further annoying this sleep deprived (r/t infant care) woman.
- I don't normally do this in normal life but on the floor I am dropping things left and right and end up needing extra time to swipe them down with industrial strength wipes if possible.
- Bed baths are super slow because I will only gently lift each limb and softly/thoroughly wash. Then I see proficient clinical assistance come in and do everything so smoothly (I have had no other patient care experience other than LPN and RN clinicals).
- My clinical experience write ups are okay. On paper I can describe the patient’s condition and appropriate interventions. My low marks are mostly because I didn't carry the interventions out and because I missed subtle clues and did not adjust my care plan to accommodate.
- I was half an hour late to administer eye drops because when my instructor asked me about the steps - I forgot that I had to hold the inner canthus to let soln keep in the eye. Note: The last time I had given an eye medication was 9 months prior but still my fault because I should have reviewed administration instructions.
My med-surg instructor is fair but verbal and doubts my safety. So after 3 med-surge rotations this semester I have decided that I’m gonna take her’s and another instructor’s advice to find LPN work in a skilled nursing facility (cool because I have a passion for geriatric clients) and reapply next year.
It still sucks sour lemons that it’s either drop with a W or risk a clinical fail (which means an F grade despite a very high B average in all else). But I have read on these boards some great stories of how other students restarted and everything finally clicked so I cling to that hope.
Anyway, what are you impressions based on this lil tale? Again, anything and anyway you say it will be appreciated. At this point I really need perspective if I am to plan my next steps. And I appreciate your time.
