really annoying day in clinical

pca_85 · Jun 6, 2010

I find your empathy refreshing, honestly, I hope I never become one of those jaded nurses as well. What can be done? You can go above your instructors head and complain (not smart), call the hospital anonymously(their lawyers will care), or do nothing...............please don't do option c.................option a may have the instructor bullseye you for the rest of your program................if I were you, I'd just do something anonymously. Oh, and once you get your license, tell your instructor that people may be hooked on drugs, but she made a poor judgement call in what she said and she may say it in front of the wrong person one day. Sigh.........can you tell clinicals are bugging me too? Hang in there................

Isitpossible, LPN, LVN · Jun 6, 2010

thanks pca..i dont want to get on anyones radar...really nsg school is welllllll..... u know! we often discuss clinical experience in the classroom setting, so i will mention it...but more along the lines of "hey, if a patient with COPD has a pulse of so and so, and exhibiting these signs, what would YOU do? just so i will know should I ever see that situation again!

its one thing for the other nurses to have a certain attitude, but i really felt my clinical instructor should support and demonstrate what the theory classes are trying to instill...she missed the boat...

AOx1 · Jun 7, 2010

The problem is your instructor and the nurses on the floor. I am a nursing instructor. I can, and often do, learn plenty from my students. Anyone can give you valuable information, from the housekeeper to the CNO. I have seen this happen too often.

I had a student report a change in condition to the primary nurse; the nurse paid no attention. The student was afraid and came to get me; I went with her to assess myself and the patient was in apparent distress and rapid response was called in that case too. Too bad the nurse didn't listen earlier!

You were appropriate. You noted a change in patient condition, notified the primary nurse, and were ignored. The difference between theory and practice can be great: for example, when securing an IV, I don't give a flip if my students secure it using a chevron, a strip of tape, etc. So long as the entry site is not contaminated and I can view it. Some will argue that their means of securement is vastly superior, but really it is preference. You will see things that matter and things that don't.

In this case, unfortunately, you saw people using poor practices and a lack of proper and timely assessment. Use it for what you can, as a learning experience that you personally will at least consider all information to be valid unless proven otherwise. Good for you!

HouTx, BSN, MSN, EdD · Jun 7, 2010

Isitpossible,

Your post has restored my faith in New grads - even though you aren't quite there yet. Your logic and reasoning in this situation were faultless. You are well on your way to becoming an expert nurse. You already have the critical thinking thing down pat. Your instructor ? -- hmm -- it's just a good thing she is not actually trying to care for any patients.

FYI, people in pain should not be considered 'addicted' even if they are physically dependent upon very high levels of pain meds. The distinction is based on the underlying need that is driving this process... it's not to get high, it's to ease pain.

You go Baby Nurse!!!

CAL05699 · Jun 7, 2010

That is really sad that your instructor had that attitude. I understand the problems of talking about your instructor with someone else at the school and the possibile repercussions, however, if there is someone at the school that you can trust to talk to, I would do so.

Isitpossible, LPN, LVN · Jun 8, 2010

thank you for your kind words...it really means alot! to the experienced nurses, please tell me what you would have done given those same set of circumstance...

as post conference, she really minimized and downplayed the whole thing, and basically told us students, that were so new and dont know much, we dont see the whole picture......but I heard that doctor talking to someone on the phone about that patient and he definitly was not pleased..(by this time patient was gone)...

AOx1 · Jun 8, 2010

As a nursing student it is true that you may not see the full clinical picture, but this is NOT a reason to discount what you did see, which is a significant change in patient condition. Again, any source of info may be valid and should be treated as such until ruled out.

I once had a situation in which a patient was fine. I had just assessed her an hour ago, she was eating, laughing, talking, vitals and all assessments normal. An hour later a housekeeper ran out and yelled "something's wrong!" And when I checked the patient, she was showing s/s of a stroke. She successfully received lifesaving meds quickly and survived due to the quick report of the housekeeper. What if I had ignored that and said "oh, it's not like that housekeeper is a nurse."

Yes, nurses have training and advanced assessment skills, but that doesn't mean others don't have common sense. I've seen the input of family members disregarded lightly, only to have it turn out to be correct when they say "something is wrong..."

Often, as a student nurse, you have the privilege of spending more time with each patient and can pick up on subtle changes quickly. You did exactly what you should have. I would be very wary of that instructor and that primary nurse. Not only did they fail to act, but they are now covering their error.

As an experienced nurse, the correct thing to do would have been to carefully and fully assess the patient, ask someone to call rapid response if such a team exists and call the doctor, and STAY with the patient, ready to support the ABCs. Statistics show that the majority of people who code show signs in the 8 hrs prior to arrest. This was the case here.

Most importantly, you advocated for the patient. I would rather be laughed at for a false alarm than do nothing like the primary nurse and your instructor did.

CrazierThanYou · Jun 9, 2010

I have seen this kind of behavior often while working as a CNA and in clinicals. I remember a man in the nursing home who was obviously in some kind of distress. When I reported his condition to the nurse, her response was "Don't pay any attention. He's a no code". I was stunned. So, a no code means ignore the patient regardless??

Another time, more recently, some other students and I were just coming in to clinical and noticed a woman in bed, literally gasping for air. We went into her room and observed her gasping, her skin was deathly pale, and she was covered in sweat. When we reported it, we were told that was normal for her. It may have been, I don't know, but I think more attention should have been paid.

Where I work now (an ALF), we have a resident who is very little trouble. He's very sweet and pleasant. Occasionally, he will complain of being SOB, dizzy, unsteady on his feet, or "staggery". But, whenever I report these observations to our administrator, her response, every time, is "He just wants attention". Every time.