I had a very bad day in clinical (ugh)...

peaches49 · Oct 10, 2007

I'm in my med/surg rotation and I just went through an experience that has already made me think about whether or not nursing is right for me. Anyways, it all happen with my 2nd patient who wanted oral pain medication (prn) instead of using the PCA pump. I told the nurse about this and she said that we need to give her oral PRN pain meds. Well, 15 min. later, the nursing aide comes to the nurse and explains to her that the patient is frustrated, angry, and already yelling about her oral pain meds. I made the mistake of assuming that the nurse was going to get the patient's medication and it was suppose to be me that was suppose to get the patient's medication. The reason why I didn't get her pain medication in the first place is that I assume that nursing students were not allowed to give narcotics, but I found out from the instructor we can. It was my fault and I should have known better to verify with my instructor first about my dilemma with the pain medication. So far, the patient calmed down and she got her pain medication, but she didn't want me to be her student nurse. I felt so bad throughout my whole clinical day, I am beginning to question "why nursing?" Its like no matter how well I prepare for clinicals, something wrong always happens and it makes me feel so stupid. I do well in class, but clinical days are so harsh on me. This semester of nursing school is making me really think if nursing is right for me... Right now, I feel as though I do not want to go clinicals tomorrow.

Please hang in there, at my clinicals we aren't allowed to pass med's unless it's our med pass day. Otherwise the nurses do it. And I have had an instructor that has just been cruel, but hang in there you'll get and please ask questions every day, of the nurses, of your instructor and who ever you can to get info, this will really help.

I went in to this semester not knowing what was expected of me and now I know, you must act as if you are nurse even if your not licensed yet. So be specific and find out early what to do and don't give up.

smk1, LPN · Oct 10, 2007

I know you feel terrible, but it would be nothing compared to how you would feel if you had gotten the narcs and given them and the found out that was not allowed. Always continue to err on the side of caution. The only thing to do differently is to just make sure that your communication with your nurse is clear so that can reduce confusion.

rotary · Oct 10, 2007

Sorry to hear about that, but try and keep your head up. :)

In the grand scheme of things, this is quite minor. As students, we're thrown into clinical and expected to know exactly how the unit operates. We need to ask a lot of questions, but sometimes we get nervous/overwhelmed and mistakes are made. In your case, it sounds as though the instructor should have talked with you guys a little more about your scope. It was a learning experience, and you've grown from it.

Here's two incidents that might make you feel better. A friend of mine gave an IV med orally through a syringe. Another student I knew gave a suppository without unwrapping the foil.

SmashRN2 · Oct 10, 2007

Please do not feel bad about this...it will get better! Last semester was my first semester passing meds. Every week a couple more students were allowed to pass meds with the instructor. Finally, about half-way through the semester, it was my first day passing PO's.

I passed my 0900 with my teacher in a breeze. So after that, I thought I was done. 1100 rolls around, and the nurse who has my patient informs me that I have a 1000 med that I have not passed. I freak out, and I swear, to this day, she said, "don't worry about it, I'll take care of it." So I go on about my business, and here it is 1200. The nurse comes up to me again and says, "Why didn't you give that 1000 med yet? You need to find your instructor now because you've just made a med error."

MY FIRST DAY PASSING MEDS! So I cried at clinical and got all puffy-faced and blotchy; I had to fill out an incident report, and I had to live with the thought that "hey, I'm the smart student who made a med error on her first day passing meds." BUT...I did learn a valuable lesson that day. Always ask questions if you are unsure of anything that could potentially harm a patient. Even if it makes you look stupid and you feel like you are annoying your nurse, DO IT. Out of all the possible med errors you can make, I probably made the least dangerous one, but it was still scary and humiliating. But don't worry, it can happen to anyone. You're not alone!

Good luck!

SarasotaRN2b · Oct 10, 2007

My question to the OP is was the PCA pump discontinued? If her pain was that bad why couldn't she just use the pump? I'm not downgrading her pain, but unfortunately there are patients that just difficult. There will be times even when you are a nurse where you just have a personality clash with a patient. You will ask not to take that assignment again or a patient may not wish you to be their nurse...don't sweat it.

xxchafxx, I think what that nurse did was lousy. She was the one to say that she will give the med. Did you have any witnesses? Take it as a lesson. Check all meds the patient requires with the times and don't rely on others. if it is your responsiblity to pass out meds for a particular patient, make sure you pass them all out.

Kris

santhony44, MSN, RN, NP · Oct 10, 2007

Don't worry about it. The patient is doing all the students a favor by not allowing any to take care of her!

If I'm reading this right, she waited about 15 minutes for her pain med. Even if you had not been involved, there are plenty of circumstances that could have caused her to wait longer than that for her meds. If she wanted her pain meds instantly, on demand, she could have stayed with the PCA pump. The PCA pump is just sitting there, waiting for her to push the button. The nurse isn't.

ARRR10 · Oct 10, 2007

Thank you guys for the responses. The reason why she wanted the morphine pills instead of the PCA pump was due to the side effects of the PCA pump (it was making her feel very nauseated), while the morphine pills did not make her nauseated. ::sigh:: It felt kind of awkward today walking pass her room throughout clinical, her giving me that angry look whenever I passby. Anyways, today was better than yesterday and I am just going to try to pull through it.

Jamie2887 · Oct 10, 2007

Thank you guys for the responses. The reason why she wanted the morphine pills instead of the PCA pump was due to the side effects of the PCA pump (it was making her feel very nauseated), while the morphine pills did not make her nauseated. ::sigh:: It felt kind of awkward today walking pass her room throughout clinical, her giving me that angry look whenever I passby. Anyways, today was better than yesterday and I am just going to try to pull through it.

Everyday time I would have walked my the room, I would have waved and smiled cheerfully! Maybe even stuck my head in the door and asked how she was doing.

WDWpixieRN, RN · Oct 10, 2007

The good thing about a bad day at clinicals is that it passes....meaning you usually have at least one night, and hopefully at least a week, before you have to go back and face it again!! I can not tell you how many times in the last 2.5 semesters that I left a hospital thinking, "I don't ever want to come back."....but let 24 hours or a week pass and I'm ready to tough it out again. And I mean TOUGH it out....this isn't an easy course any of us has charted.

But a very wise clinical instructor pointed out to me that it's not always the mistake that's an issue; it's what we do with the lesson of that mistake -- most times you will NEVER do it again. Also, in this situation, it sounds like communication could use some improvement...alway be sure to clarify everything with your instructor or your nurse. I swear sometimes that I am going to drive an instructor batty, but if I'm not clear on something, I always ask...better to annoy them a little than pi$$ them off bigtime making an "assumption"....usually better for both of us!!