Plan B for if you Fail/Get Kicked out of Nursing School? I may need help with this.

[Athariel]

I am curious to hear from those who have considered this or who maybe approached many options; what do my prerequisites to get into the Nursing School allow me to go for if Nursing turns out to not be for me? I have heard of Health Information Management but what other options exist, if any? I wouldn't even know how to look, to be honest. Similar questions have been asked but those were specific to Pre Nursing. While the options maybe the same, perhaps there is something that would be a good fit to segway into after getting in. Thanks in advance for responses.

Backstory/Venting (Feel Free to Skip)

I find myself having to ask this now as I am not sure I am cut out to be a nurse. I am struggling with tests, but I can study more and master those, easily. I am confident in my next exam and expect a high B if not a low A. My issues have been with Clinical work (eg the most important part of Nursing School).

I love filling out the paperwork. I love the Nursing Care plans and even aced my first Nursing Care Plan, my only issue being my rationales didn't cite page numbers, only the book sources (others in my Clinical group had trouble staying focused on one Nurse Diagnosis whereas I had no trouble with that). Sadly, paired with my knack for memorizing medical jargon well enough to sound smarter than I am, that is where my talents in Nursing tend to dry up. I approach patients with an earnest wish to help but tend to look at them as a sack of fascinating components rather than people. I felt this was justified since Maslow's Heirarchy makes it clear that Physical well being is more important than Psycho-Social well being but my instructor has made it clear that unless I manage to become more human with my patients, I won't be getting through Nursing School.

One I was asked to get a full set of Vital Signs for complained that she hadn't been comfortable with me taking her apical pulse or checking under the blanket for sores and ulcers but that she felt intimidated into letting me. This is true and I do own up to it; I had run into problems with her allowing me to take vital signs and being, generally, very difficult. I approached it in kindness, initially, but when it became clear that my grade for clinicals was going to be jeopardized when she stone walled I relied on my old bouncer/security guard mainstay (eg nothing too big, or so I though; stepping just in inch closer than is comfortable, maintaining unnerving, unbroken eye contact, speaking in a curt yet persistent way, etc - I am not proud of it, but I am a big, uncharismatic, scary guy and this has always been my means of garnering compliance from others when avoiding/quelling/convincing them wasn't an option). I feel like much of this comes down to inherent brain function and personality stuff; things you can't just study for.

I don't like how this makes me feel. I don't like that I am viewing my clinical patients as obstacles to my success rather than sick human beings that need my help, more and more. I am sticking with it but if this doesn't click and I find that I can't deal with this, I would like a Plan B to opt into instead.

[truckinusa, BSN, LPN, RN]

I have definitely had trouble with patients, but usually they let me do whatever as long as I approach things with confidence and ask permission politely.

I had a situation where a patient disagreed with her son receiving pain medication. I just told her I didn't want to let her sons pain level get out of control and the pain medicine was availabke if he needed it. The patients mom was a control freak, but I didn't let her get to me or assert my will on her or her son. I just made it her decision by reinforcing the obvious potential for out of control pain.

Best of luck to you.

[cmurra6745, ADN]

Document patient refusal after an attempt and teaching to get them to comply... If you can't get results move on don't grill them and stare at them like your going to harm them or something... They are already in an uncomfortable place they don't want to be in

[Griffin123]

If I get kicked out of nursing school? Easy. I'm moving to Mexico and majoring in English.

[Meriwhen, ASN, BSN, MSN, RN]

If you think nursing is all hugs and rainbows when dealing with patients you are wrong.

This.

Nursing--and the patients--isn't always the rosy picture depicted in nursing textbooks. It frequently takes a lot more than just a cuddly bedside manner in order to be able to do your job.

That being said...OP: I work in psych and your bouncer approach wouldn't fly here either. Perhaps in a code, but codes are exceptional circumstances and not the norm. As others have said, what you're doing can border on assault and battery.

Patients have the legal right to refuse treatment as long as they are AO3 and there is no court or emergency order dictating otherwise. This also includes patients who are there against their will. If they don't want you to take their vitals they can say No. They can say No to medications, to surgery, to anything they don't want. Even if they are sitting in death's lap and you hold the treatment that could save their life, they can refuse it. And there's little else you can do but educate them on the danger of refusing and honor their wishes.

Your initial approach--the sweet one--is good. Yes, it's frustrating as hell when your patient refuses, especially when you know they NEED this intervention. And yes, you can do a no-nonsense non-cuddly approach when you have to.

But there's a line between no-nonsense and intimidation, i.e., your bouncer. You can't cross that line. I can (and often have to!) be firm and strictly business with my patients, but I will never force something on them either directly or through intimidating them into accepting. And I never lie to my patients either to try to get them through deceit.

Put yourself on the other side of the bedrail: if YOU were the patient, would you want these traits in your nurse? Would you want to feel bullied, intimidated, coerced, lied to, just so your nurse can check off the boxes on her list and move on? And your nurse need not be a 6'3" hulking guy to do all of this. The scariest nurse I know is only 5'2" and female.

The fact is that your patients are people with rights that they are free to exercise. They're a lot more than sacks of fascinating components. If that's how you view them, then perhaps research or surgery or something in post-mortem care would be appealing to you.

I think that once you understand and accept these concepts, you'll start to improve in your interactions with patients.

Best of luck whatever you decide.

[Yuppers21]

While your pre-reqs may not transfer over to anothe degree perfectly, I'm sure a decent portion of them will. In the grand scheme of things, why would you let another year or two of pre reqs keep you from a career that will take up many hours in your lifetime? In nursing, many specialties put in you in direct contact with patients. I disagree with the previous poster who stated that being a NP or physician may be a better fit for you. These practitioners still interact with patients on a daily basis and are be faced with situations were intimidation can be used to coerce the patient into doing something they dont want to do.

Nursing research and informatics may be an option, but dont just pick those because they get you away from the bedside. You will regret it if it turns out you dont like those specialties either.

[swansonplace]

Hey. The first semester is tough. Learning how to communicate effectively with patients is your first step. I believe there is a basic intro communication class that helps people speak better with patients.

Also, our school has a free career tests to help individuals choose careers based on their whole view life goals. This may be an option for you also. It lists areas that you may consider. There may be free career tests online too, but the schools have advisors that help to direct you and interpret what the career options mean.

[Athariel]

Esme: It isn't that I dislike the patients at all; it is quite the opposite. Part of why my stress causing me to see it as me versus them is so alarming is for that reason. The woman I was dealing with was having crazy high heart rate and had become septic due to an abscess that had broken into her blood stream, evidently, and messed her blood and insides up something fierce. Much of the nurse staff was busy and I wanted to help with her, in particular, since she was such a mess, but I just don't know how to inspire confidence in others. I am much better at inspiring fear, like a father to a kid more than a mother. Part of her issue was refusing medications she needed too; she was just generally very fearful and difficult, which upset me because she could have died, rights or none, from refusing stuff. When the nursing instructor began to bust my chops about not havign done much of the vitals and med check by the time the other students had, I snapped and simply became intent on getting them. Eventually, one of the charismatic nurses came in and helped teach her while I helped the CNA on the floor adjust patients for the rest of the day. Hence why I began thinking this job might not be for me.

brian_j: I do try to make conversation but smiling has always been an issue with me. I always feel like I can't quite access both my thinking and my people skills at the same time. I do inform patients of what I am going to do but carry it out more like a robot than a person because it all has so much riding on it and needs to be done right. I can appreciate that approach though and do somewhat envy people who know how to smile and be personable.

kaydensmom01: That is why I don't want to give up on it. I will see how far I get with my countenance. It may just magically click or something like I read it happening with some others.

Dranger: I do intend to stick to it. I just wasn't really aware of what the career entailed before joining up. I figured you followed orders from doctors and things would be clear cut - not so much having to anticipate problems before they happen and so on.

minnibrown/Caribbean_Character: I agree, it is clearly abnormal. I would like to change it but this tends to be how I react in high stress situations (eg I become aggressive). I am trying to curb it but don't get me wrong in thinking I am angry at the patient. In truth, I am angry at the school for turning my grade into a crap shoot (I got an Unsatisfactory for getting Vitals and when I brought it up, the teacher basically said "Learn to inspire trust in strangers, fast, or expect to fail this course"). Hence the thread asking for Plan B's, just in case this is a permanent problem.

nrobinson: I have never been much of a people person. I thought I was but clinicals and class have showed me that I have relied on my size and intimidating demeanor to get what I want from others without realizing it. While I do care about others, maybe pursuing a less people oriented part of medicine might be a good idea. I will look into it.

truckinusa/Merriwhen: That is part of what I dislike; I don't like the idea of someone being in pain because they are too foolish/misguided/strong headed to accept medication for it. I also don't like that a patient refusing a medication they need to combat their illness isn't considered "threat to self" but if a patient says he is going to the roof to jump off it is suddenly is okay to deny them their right to choose. Whether jumping off the roof or refusing medication to treat sepsis, it is suicide either way. I don't understand that rationale and never will, I think.

As for if it was me, I can't imagine a time I would turn down medical advice so I don't understand a mentality of someone like that (and that maybe part of my problem). To me it is like someone who refuses to drink water when dying of thirst or something.

cmurra: I do always document, at least. That is one thing I have been good at.

Yuppers1: I have seen a few of the informatics type things that seem interesting to me. Where I can help people, make a living at it, and cut the weakest component out of the picture (eg my personality) when it comes to giving that aid. Working from the shadows has always been my style anyways, since way back in grade school. Perhaps I just haven't been playing to my strengths.

swanson: I will check on that. I remember taking it and getting something silly like artist or author. Something that doesn't really have much in the way of job security or the like. Still, that was years back so maybe I have changed and should retry it. I will give it a shot.

[Meriwhen, ASN, BSN, MSN, RN]

truckinusa/Merriwhen: That is part of what I dislike; I don't like the idea of someone being in pain because they are too foolish/misguided/strong headed to accept medication for it. I also don't like that a patient refusing a medication they need to combat their illness isn't considered "threat to self" but if a patient says he is going to the roof to jump off it is suddenly is okay to deny them their right to choose. Whether jumping off the roof or refusing medication to treat sepsis, it is suicide either way. I don't understand that rationale and never will, I think.

As for if it was me, I can't imagine a time I would turn down medical advice so I don't understand a mentality of someone like that (and that maybe part of my problem). To me it is like someone who refuses to drink water when dying of thirst or something.

I know, what constitutes a patient being a danger to themselves is very grey: for example, we can pull that suicidal patient off of the roof and slap a 5150 hold on them, but if the alcoholic patient states they are planning to resume drinking after discharge even though their liver is on its last lobe, we still discharge them.

We may not like it, but we HAVE to accept it. Autonomy is one of the patient's rights as well as one of the tenets that guide our care. It trumps everything else.

I don't like it anymore than you do. I deal with refusals constantly. But as long as the patient has the legal right to choose, I have to swallow those feelings and honor that choice even if I know it'll be detrimental. It doesn't mean I won't try like hell to educate them to decide otherwise, but at the end of the day, if they still refuse something no matter what you've tried, all you can do is document it, accept that they made that choice of their own free will, try again tomorrow, and don't let the feelings get to you.

[swansonplace]

It's important when considering careers that ones values are kept in the equation: Job security, work environment, lifestyle, etc. Some career analysis does take this info consideration.

There are also free career tests based on personality online.

You may be pleasantly surprised that nursing does fit, but it's an important life decision, and it's good to find something that fits into your whole lifestyle.

Communication skills can be improved; or as you are doing, making adjustments so your career and current communication skills match.

[grad2012RN]

To the OP, you'll have to fake a chipper attitude, do a little bit of acting. During my nursing school clinicals, I worked with 2 male nurses who were Gordon Ramsay outside of the patient's room. F-bombs all day long and even "talked back" to the MDs. Then, when they entered the patient's room they were Rachel Ray (oops, maybe I should say, Emeril Lagasse). Grinning from ear to ear, laughing with the patient as they conducted a particular intervention. Then, they would return to the nurse's station and cuss about the patient and whomever else.

However, both of theses male nurses repeatedly received high patient satisfaction scores. Also, at a unit meeting, I saw one of them get recognition for having the highest pt. satisfaction scores for that month. I too, have to change my demeanor when with my patients,...... and I'm never asked for back rubs, LOL. They are like putty in you hands when you give them warmth!

From, your previous post, I see that you learned not to push any intervention on a client. So, continue to learn and grow as you go along. Best wishes to you in whatever you decide!

[ThePrincessBride, MSN, RN, NP]

Sounds like you would be a good candidate for med school. Ever thought about being a surgeon? Their patients are usually knocked out most of the time and their interaction with patients is minimal.

Or have you looked into OR nursing? It seems as though it would be a good fit for you.

[priorities2]

Really? They would dock your grade if a patient refused to be treated by a student nurse? Did you actually ask your clinical instructor to ensure that this is the case?

Your grade should not be affected by one patient's refusal for treatment by an SN. Your clinical instructor could/should have been willing to find you another patient to try again, or to come with you to make the patient more comfortable. Strong-handing should not be necessary (in addition to what other responders have said: it should not be tolerated either).

Sometimes you have to learn how to act. I think all student nurses or new CNAs or people new to inpatient health care have to learn how to act in one way or another (tolerating gross smells, acting not tired when you really are, etc). It sounds like you are just starting out and if you don't make a practice out of strong-handing I think you will be okay.