In the line of fire! 2nd semester, what do I do? - page 2

Hello, Im in second semester of LVN school. I have been in the line of fire since day one, and now threatened with contract, everything the teacher can throw at me she has. Most of it is things I... Read More

  1. by   peaches49
    Quote from daytonite
    well, now that i've had my morning shower and have had some time to think about this a little bit i have a few things to say.
    1. you are supposed to know as much as there is to know about your patient. as a student, you have the luxury of being able to make a thorough investigation of one patient's medical record. so, i stand with your instructor on this. you should have known this information. (http://allnurses.com/forums/2228927-post5.html)
    2. if you didn't know that information, didn't have time to review that information or you didn't know that you were supposed to be reviewing each of your patient's medical records then you should say to your instructor, "oh, i didn't know that was part of what i was supposed to be doing. i won't make that mistake again." and then don't. or, "i didn't get time to review the chart yet." make it a point to get into the medical record of every one of your subsequent patients asap to review the previously written doctor's orders, progress notes, lab and x-ray results and nurses notes. this is part of the nursing process, step #1, assessment. you can't write a thorough care plan without doing this anyway.
    3. much of what you will learn in clinicals is done as on-the-job kind of stuff. you have to be prepared to own up to shortcomings, not be defensive or make excuses for them. i have a feeling that it is your reactions to your mistakes that has your instructor's panties in a twist and not the mistakes you are making.
    4. you said, "i dont feel we are told or taught what we need to know." nor will you if you ever become a licensed nurse. you have to be proactive and ask, and ask in a tactful way. i was in a nursing program where we had no formal lectures. we were given objectives, a list of resources, and told to find the information on our own! it was a shock to all of us at first. this was done to help us learn how to find out what we needed to know on our own. after you graduate you still won't know every thing and there will be no instructors around to help you out. then, what are you going to do? this was done to help us learn how to find the information when we were on our own. if we were stuck all we had to do was go to an instructor or a nurse in our clinical site and say, "i've looked here, here, and here and i still can't find the answer. is there somewhere else i should be looking?" they would never, however, tell us the answer directly. it's the "teach a person to fish and they can feed themselves for a lifetime" principle. this is what every student should ultimately learn from their school experience--not necessarily all the facts of the subject they are studying. learn to find where the facts are; learning the facts follows. this is what you should be striving to develop as well. it will make you a better nurse in the long run and you will learn far more than if the information is spoon fed to you.
    5. i stress again that you should approach this instructor in a very open way and ask what you could be doing to improve your performance. and then listen to what she has to say and not argue back.
    6. when i am interviewing people for jobs i am asking questions to determine their attitude, initiative, capacity to learn and ability to adapt under stress. i want someone who sees flowers growing out of mud, who takes the bull by the horns when no one else is stepping forward to do it, isn't afraid to admit there is something they don't know and then pursue learning about it and helping others to learn it too. i have no use for people who stand and complain about the situation they are in and do nothing to help themselves or others out. these are not problem solvers or leaders or the qualities of a professional licensed nurse. when they run across their first patient crisis they fall apart and fail not because they don't know what to do but because they can't deal with their own insecurities and ask for the help they need.
    thanks so much for info and instruction, i will take it to heart and use it to learn by.
    as far as contract-- i dont know what that means either except i've heard it may mean signing something and if i don't meet exxpectations then i can be kicked out this semester.
    but i really am not sure, i've not been told about that process either.
    thanks again for all your help
  2. by   BelLPN
    You say you are an older student and that you are/have been employed, so I'm sure you have some knowledge of the way the world works, i.e. if you don't know what a "contract" is, ask, or look in your student handbook. In nursing school, as in nursing, it is best not to guess or assume, instead, to be successful you must take responsibilty for finding out answers for yourself.

    Regarding how you were supposed to know about your patient getting Haldol, you need to read the chart, MAR, etc. once you are a nurse, so they are trying to teach you these skills of self-motivation, thinking ahead, etc. Again, it all comes back to the fact that as a nurse you are responsible; you cannot pass the buck or expect to be handed a neat package of all the information you need.

    Finally, regarding the clinical facility, if your instructor told you to chart on the "rand" card, then you do it. No need to check with the charge nurse. If the charge nurse had approached you about it, then it would be appropriate to clarify with your instructor immediately, but certainly not in a way that is critical of the charge nurse. Even if a facility and the employees there are the worst in the world, it is in no way your concern, except to take note of how you will not practice that way. There is plenty of oversight in healthcare facilities; students do not take on this role. Students must ignore a lot and focus on the goal, unless, as a previous poster stated, it is a situation in which you are a mandated reporter (if you don't know what this means, you need to find out).

    Best of luck to you
  3. by   peaches49
    Quote from BelLPN
    You say you are an older student and that you are/have been employed, so I'm sure you have some knowledge of the way the world works, i.e. if you don't know what a "contract" is, ask, or look in your student handbook. In nursing school, as in nursing, it is best not to guess or assume, instead, to be successful you must take responsibilty for finding out answers for yourself.

    Regarding how you were supposed to know about your patient getting Haldol, you need to read the chart, MAR, etc. once you are a nurse, so they are trying to teach you these skills of self-motivation, thinking ahead, etc. Again, it all comes back to the fact that as a nurse you are responsible; you cannot pass the buck or expect to be handed a neat package of all the information you need.

    Finally, regarding the clinical facility, if your instructor told you to chart on the "rand" card, then you do it. No need to check with the charge nurse. If the charge nurse had approached you about it, then it would be appropriate to clarify with your instructor immediately, but certainly not in a way that is critical of the charge nurse. Even if a facility and the employees there are the worst in the world, it is in no way your concern, except to take note of how you will not practice that way. There is plenty of oversight in healthcare facilities; students do not take on this role. Students must ignore a lot and focus on the goal, unless, as a previous poster stated, it is a situation in which you are a mandated reporter (if you don't know what this means, you need to find out).

    Best of luck to you
    As far as the haldol was concerned I learned of it in nursing report, but I didn't know the dr was coming in that day or that I needed to know the amount to tell him.
    As far as nursing protocol, I have been in 2nd semester for 3 weeks now, I 'm figuring out that we must find anwers for ourselves. I am not a nurse yet and dont know all the answers, im just learning.
    As far as mandated reporter, we are all one. I've been a CNA for 7 years and know all about reporting and such.
    As far as nursing skills Im a learning and a newbie at that.
    As far as minor mistakes I've made they are just that----minor compared to what I've seen as far as neglect from all the nurses on this floor I'm working, if state came in, they would be shut down for sure.
    But I am learning that to make it in nursing school I must keep my mouth shut. Hows that for a mandatory reporter???

    thanks so much for the input. I really appreciate it.
  4. by   Jules A
    Quote from peaches49
    But I am learning that to make it in nursing school I must keep my mouth shut. Hows that for a mandatory reporter???
    This made me smile because it is the best plan I could come up with: learning to keep my big mouth shut which was easier said than done, lol. Just suck it up and move forward. I have a feeling that you will be just fine.
  5. by   peaches49
    Quote from Jules A
    This made me smile because it is the best plan I could come up with: learning to keep my big mouth shut which was easier said than done, lol. Just suck it up and move forward. I have a feeling that you will be just fine.

    Sorry I was getting a little perturbed here. I will move forward each week and progress to better nursing skills, and try to keep my mouth shut when I have to.
    Thanks so much for all the encouragement. Good luck everyone.

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