Sloppy clinical instructor?

  1. I had one clinical day (my first clinical day) with an instructor that just started working at my college recently and I just can't stop thinking about an incident that occurred with her. I'm in my first semester.

    In the incident she didn't obtain clear consent from a patient when she asked if we could watch a catheter insertion. The patient was elderly, but she was very forceful about us watching and he seemed very uncomfortable, attempting to cover up and never said "yes they can". She just rushed in, got too excited and forgot their was a human being? I'm not sure.

    When we were walking to the elevator, one of my classmates mentioned to her how uncomfortable he looked and she actually said "well I asked and he didn't say no. He didn't say yes either, but he didn't say no when he could have". But honestly I don't feel she gave him much of a choice to say no.

    Her response made me cringe. The whole incident just makes me feel not so great. She used a lot of phrases like "this is how nursing is", and "this is the real world" when referring to other sloppy incidents.

    I don't know any nurses, besides other professors/classmates and I feel I can't go to them. This is my first and only clinical day so far and all I'm thinking is maybe I just don't understand nursing.

    And then I'm cringing inside that she gets to be the influence on students, because realistically some students will follow that example.

    I'm just not sure what to do. I don't want to create drama, I'm worried that as a student I either won't be believed or told I don't understand nursing? And maybe I don't?
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  2. 18 Comments

  3. by   Castiela
    It's not best practice but I personally wouldn't bring it up, but rather file it away for how you don't want to act or behave when you're practicing on your own.
  4. by   midwifemae
    Quote from Castiela
    It's not best practice but I personally wouldn't bring it up, but rather file it away for how you don't want to act or behave when you're practicing on your own.
    I agree. There will be good and bad clinical instructors throughout the program and you just have to roll with it. In this case, I would just keep an eye on these sorts of things. If she continues to glaze over consent with patients, then I would say something to my instructor. Consent is a HUGE part of nursing, as you seem to clearly understand. In my clinical experiences, I have always made sure that I received consent from the patient and even family members for my being present for a procedure or performing the procedure. Hope this helps and hopefully this was an off day for her.
  5. by   caliotter3
    A clinical instructor did the same thing with me and a patient who clearly stated they no longer wanted the encounter. I wondered what would have happened to me had the patient filed a formal complaint. I was certain the instructor was well-versed in how to avoid accountability for herself.
  6. by   Mavrick
    At some, if not most, University/teaching hospitals the patients give consent to being observed for educational purposes when they sign consent for admission to the hospital. However, if the patient is clearly uncomfortable, a better educational experience is obtained by students NOT being present for the procedure.

    You will see things that are not best practice even in nursing school. An unfortunate reality. If it persists and interferes with your education, you can mention it in a post clinical evaluation.

    Good on you for noting that patients do have rights.
  7. by   Wuzzie
    Quote from Potatoskins
    In the incident she didn't obtain clear consent from a patient when she asked if we could watch a catheter insertion.
    "WE"? As in more than one? You have got to be kidding me?! Catheterizations are not some side show. They're extremely personal. No wonder he was uncomfortable. One student sure but I wouldn't want my private bits put on display for the peanut gallery.
  8. by   Apple-Core
    Quote from Castiela
    It's not best practice but I personally wouldn't bring it up, but rather file it away for how you don't want to act or behave when you're practicing on your own.
    This.

    And in future, if you are super uncomfortable, you can always step out of the room.

    Good for you for recognizing the human in the patient, and that they have rights to dignity and privacy,
  9. by   37changes
    Quote from Wuzzie
    "WE"? As in more than one? You have got to be kidding me?! Catheterizations are not some side show. They're extremely personal. No wonder he was uncomfortable. One student sure but I wouldn't want my private bits put on display for the peanut gallery.
    Every single one of the TEN of us were told to file in to an elderly man's room to witness a straight cath recently. Add to that two nurses, a CNA, and our clinical instructor = 14 people in one half of a nursing home room, watching. This went on for awhile, too, as they were having problems actually reaching his bladder. They tried multiple different kinds of catheters. And we were all there watching the entire time.
  10. by   ThatChickOmi
    Quote from 37changes
    Every single one of the TEN of us were told to file in to an elderly man's room to witness a straight cath recently. Add to that two nurses, a CNA, and our clinical instructor = 14 people in one half of a nursing home room, watching. This went on for awhile, too, as they were having problems actually reaching his bladder. They tried multiple different kinds of catheters. And we were all there watching the entire time.

    Just reading that makes me super uncomfortable. It's uncomfortable enough as it is having the healthcare staff member even touching you and they're the only one in there. I'd have been livid and told everyone to get the hell out.
  11. by   Potatoskins
    Quote from Wuzzie
    "WE"? As in more than one? You have got to be kidding me?! Catheterizations are not some side show. They're extremely personal. No wonder he was uncomfortable. One student sure but I wouldn't want my private bits put on display for the peanut gallery.
    Yes, there was three student's watching and one performing the insertion. We had not even learned proper catheterization technique (we learned it the next day). She was standing over a student instructing him on sterile technique and insertion and the patient looked terrified. Because she had to explain so much and coach him and even mentioned in front of the patient that we had not learned it yet.

    The whole incident just made me feel ill inside
  12. by   Potatoskins
    Quote from Castiela
    It's not best practice but I personally wouldn't bring it up, but rather file it away for how you don't want to act or behave when you're practicing on your own.
    I think you're probably right, there's not much use mentioning it unless it becomes some pattern. Hopefully she was having an off day and I know I won't be treating patients like this in the future.
  13. by   anewsns
    that instructor should be teaching you the textbook things to do, you can not be a good nurse without knowing correct fundamentals. She also should have had more consideration for the patient , I agree. And that part is NOT how it is. Good example of how not to be.
  14. by   pixierose
    As nurses, we should be promoting and protecting the dignity of our patients. Urinary catheterization can indeed be a personal and uncomfortable experience. And so can other intrusive nursing procedures, even ones we don't necessarily deem so. I always ask my patients ahead of time if a student can even chat with them (in a psych setting). No means no, yes means yes; there are no "maybes." It is up to us to obtain the informed consent of our patients -- especially so in a geriatric population, but any population really.

    You are in a difficult position as you are a student. Hopefully she was having that "off" day. However, of it does become a pattern, it needs to be addressed.

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