remember, you asked for feedback and my writing tends to be more blunt and to the point than most although my intent is not mean (otherwise i wouldn't bother to answer you). . .your ci was correct in her assessment of you. i am not impressed with the attitude you are showing. if you are not willing to accept your faults as a student, i would be very worried to see how you would perform as a fully licensed nurse. i am bothered that you are finding excuses not to blame yourself for the mistakes you are making. that is an essential character flaw that could get you into serious trouble down the road as a licensed nurse. the evaluation of your clinical performance is about you, not the ci. you just aren't meet the standards that are expected of the students and you are fighting it. this is going to be a big problem for you all through the program, if you even make it through the entire program. it will also prove to be problem for you with employers. you have to follow rules whether you like it or not, period, end of discussion.
you made a couple of serious errors. (1) when you found the incorrect infusion rate on the iv, you should have gone to the doctor's orders to find the correct rate and resolved the discrepancy. an iv is a medical order. you never, n-e-v-e-r, never assume anything about a medical order
. you actually used the word "assume" in your post which caught my attention right away. if the med sheet says the patient is to get 80mg of diovan and a 150mg pill is in the pyxis or med drawer, do you give the 150mg pill because that is what is there??? what kind of messed up thinking would that be? yet, that's about the same thing you did with that iv--you ignored it. that's not what i learned in nursing school
. and, i don't think it's what you learned either. the way you handled that was a big time boo-boo. if you had been a licensed nurse that would have resulted in an incident report and possible disciplinary action for not doing something about it. (2) how do you waste medication from a syringe that has an air bubble in it? how do you give an injection with an air bubble in a syringe? if i had a student that didn't know how to administer an injection with a syringe that had an air bubble in it, i wouldn't permit them to give the medication, period. this is something that should have been learned in the nursing lab at school before even giving medications to patients. to allow a student to go any farther would be unsafe nursing practice.
i can forgive the time management problem because that does come with experience. fyi, the first thing is to get doctor's orders carried out (medications and treatments), and secondly, to work within the routine of the nursing unit. it might help you to make a list of the things you have to do and list them in priority before starting your clinical shift. (http://www.ehow.com/how_3812_make-list.html
) all the time you must also be mindful of the patient's needs.
safe practice, however, is another story. you are very wrong to say that things are out of your control. i am talking about taking responsibility for your own actions. that may be your biggest problem of all. they are very much in your control. you need to be always asking yourself "why am i doing this" and "what should i be doing now". the needs of the patients always come first
. when you aren't sure of things, ask others. not everything regarding time management and critical thinking are written down in books. however, if you display attitude and indicate that you aren't reading and learning the material, no one is going to want to help you. you have to be like an inquisitive little child, but pose your questions tactfully. and, if i were you i'd bone up on medication administration and the five rights. when you find something wrong as you did with the wrong infusion rate on the iv, you don't just ignore it. you bring it to someone's attention or you start asking questions yourself to get to the bottom of the mystery. rns are problem solvers. often the buck stops with them. you've got to be thinking on your feet all the time.
when you make an error you review in your mind what you should have done to avoid the error and correct your practice so that you are less likely to make the same mistake again. this is a characteristic called analytical ability. this is how you improve; this is how we all improved. that, and actual improvement as a result of it, is what your nursing instructors (and potential bosses) are going to be looking for. if you can't demonstrate that, then you and a career in nursing will
be history. i think you know that this is probably your last chance. any further mistakes will most likely be a death blow to your career in this nursing program, so you have a lot of work to do. i was a manager. i know how this paper trail works.
quite honestly, unless you have some great epiphany and make some dramatic changes in your thinking and improvement in your performance i think your concerns for a nursing career are well-founded. you will have the same problems come up again and again over your lifetime, however, because of basic character flaws that i see in you based on what you've posted.