What exactly is expected of a student in nursing clinicals? - page 2

I just failed Peds/Ob for the second time!!! They didn't want me to graduate from the school!! Really, I was about to take my last class. I passed theory both times, the first time I wrote a... Read More

  1. by   LovebugLPN
    Quote from CRNASOMEDAY25
    The OP has been an LPN for twelve years, so I guess it doesn't really matter.
    Where does she says she has been an LPN for twelve years?
  2. by   mrm1453
    It's in the text of a previous post, accessible by clicking on her profile. I also will often attempt to garner greater context for an unusual or vague post by looking at an author's previous postings. It's a nifty feature of this site.
  3. by   Phillygryl
    DaytoNite:
    I don't know exactly how to respond to your statement that "We don't know both sides of the story" Although I agree with you precisely, and when people start to tell me a story that seems biased against them, I wonder what really happened to precipitate the situation. However, by posting this information on the site, I came in all honesty seeking the opinions of others. What good is it going to do me to misrepresent the situation. If people don't get accurate information, they cannot assess the situation accurately. It sounds like you are suggesting I have some pathological interest in comming to the board and lying about what happened. Others have not had such a negative response and person's perception is based on a number of factors, not only what they hear. Thanks anyway.
    As others stated, though, I am already a licensed LPN. I am 57 years, and I was wondering if this had any impact on the situation. I have been working as an LPN for about 12 years also, but have not had too much med surg experience. I have never been written up or reported to the State.
    Let me explain in the situation from the beginning. When I was in the first clinical peds rotation, when I was on the floor, I asked a fellow student, if you had to multiply or divide to convert pounds to ounces. Other students have come to me asking questions if they were not sure of things. Of course, I should have been more prepared for the clinical but I just wanted to be sure. Of course when I calculated the calculation for the medication, I made a mistake. In fact, the students later told me "you should have asked us before you gave the answer." How could I, I was not afforded the opportunity. Let me finish, after i asked the student how to convert lbs to kg, she went back and told the clinical instructor. Actually, this was at the beginning of the clinical rotation. We go to nursing arts lab and do math problems, etc. and I think at this point I had gone once, but I had not had a lot of time to practice the math. The teacher would always check any medications before we gave them, the order and we would look the drug up in the drug book, (because doctors make mistakes too) and make sure it was of the appropriate dosage since errors can occur anywhere along the line. She did this with everyone. I never had a client who I actually had to give medication. Just one who was a diabetic and the parents were learning to give the injections, so I observed them. (No problem). I also assisted them in learning how to do fingersticks (No problem or complaints). The teacher said it just seemed like I was not comfortable with the patients, I asked which one, she said all of them The next time the teacher asked me a question, I made sure I knew how to do the calculation correctly. My point is this, some of the other students in other pediatric rotations never gave medications at all. In my second pediatric rotation we never gave medication either, My question is to you, am I unsafe. The fact is now that I really write everything out, it doesn't sound so good on my part, I mean, I should have been sure of that calculation, but it was only one mistake.
  4. by   allthingsbright
    Quote from LovebugLPN
    Allthingsbright,
    I do not think anyone should "give up" and that is not what I was suggesting. What I was saying is if she was determined to be unsafe, and we don't know what happened the first time around, maybe she should not be taking the NCLEX PN until she is sure she can perform patient care safely. The OP also posted a thread asking about lawsuits after posting this one. It seems she is looking for everyone to blame, from both of her posts, and needs to be sure she is blaming the right person. I hope she thinks about that before she works on your family member.

    Ok--I get what you are saying! I agree. I wasn't aiming my comments at you so much as saying I think people should keep trying if they really want to be a nurse. On the other hand, there ARE people that just won't ever make it--nursing is HARD stuff. Hope I didn't offend anyone...
    Last edit by allthingsbright on Jan 27, '07
  5. by   mizzou_ivy
    [quote=Phillygryl;2037641]I just failed Peds/Ob for the second time!!! They didn't want me to graduate from the school!! Really, I was about to take my last class. I passed theory both times, the first time I wrote a letter complaining about the teacher and I think I was failed the second time in retaliation. I was put on probation and told not to fail the class again.


    Ok first you are going to think that I am being harsh and maybe mean but hear me out, you don't have to agree.

    You say "they" didn't want you to graduate the program, right? Did you take the same test as everyone else in the group? If so did all fail or did some pass? We, as nursing students, fail tests, it happens. Either not enough preparation, not understanding the material, sometime poorly written questions, and so on and so on. But this is not a reason to complain about a teacher for lack of preparation or not understanding the material. This isn't a society anymore of teacher's teaching all the learning is placed on the students head. Whether we like it or not during nursing school you are made to jump through "STUPID" hoops but that is what is demanded. It is a short period of time to bend over backwards in order to reap the benefit in the end. Please try to think of it a different way. I know that failing is hard but things worth having don't always come easy. Get a tutor, prioritze all things in your life the best you can, quit complaining about the instructors. Put that energy into studying and remember NCLEX questions have to be studied for, that is why all the books are out there. Once you "learn" how to take an NClex test, your class tests should become easier. I have been where you are. I realized that no amount of complaining can fix the problem. You have to do that yourself. So take a DEEP breath, decide if nursing is really what you want to do, then study effectively, test often, review more, and accept a positive attitude. This will all pay off in the end when that RN is behind your name!!
  6. by   Lisa CCU RN
    Well, failing someone on the basis of you looking "uncomfortable" seems kinda stupid.

    As far as the dosage calculation goes, well you've been giving meds for 12 years and I assume you've killed no one to date, so I don't see why that matters.

    I don't know what to tell you other than to learn from your mistakes, if there were any, and try again.
  7. by   Coloradogrl
    Quote from LovebugLPN
    I hate when people suggest RN fail outs become LPNs. If this woman had difficulty taking care of a patient and her instructor felt she was unsafe, why would anyone want her to care for them as an LPN? RN students do everyone a favor and don't become an LPN if you are a scary RN student. I suggest she be a CNA where she doesn't have to make any medical decisions.
    I COMPLETLY AGREE!!!! If you cant meet standards as a student then what makes you think that someone can be a good nurse period! I also think becoming a aide where you have NO medical decisions on your shoulder's not only for your safety but for ALL OF OURS SAFETY.....ANY OF US COULD BE YOUR PATIENT!
  8. by   janis9799
    In my program you have to pass the med calc test a 100% before we can give meds and even then the instructor is with us. I am surprised that your school isn't pounding med calc into your heads so that you would know this before clinicals. Pounds to kilogram and vice versa is one of the more basic principles of med calc. This sounds pretty dangerous to me.
  9. by   KellNY
    Janis, I agree (although we needed only a 95% on the med calc test--you were allowed one half of one question to be wrong-ie you got the answer right but didn't show the work or something).

    That the OP "hasn't killed anyone to date" (as CRNASOMEDAY mentions) has nothing to do with this clinical at all. If that were the case, all med techs, LPNs, and even some CMAs would be allowed to flunk clinicals but get their ADN or BSN just on the basis that they haven't killed anyone yet.

    Yes, it sounds harsh, but there are standards that we as nurses have to uphold. And I find it a little frightening that in your second go of Peds (how many total clinicals have you taken?) you still do not know the rudimentary basics of conversions.

    If you had entered the wrong weight on a pt into the computers, and pharmacy calculated based on that, you could KILL a pt at worst, harm or under dose them at best. Sorry, but that is a safety issue for me-as a nurse, as a potential pt, and as a mother.
  10. by   Mags4711
    Quote from Coloradogrl
    I COMPLETLY AGREE!!!! If you cant meet standards as a student then what makes you think that someone can be a good nurse period! I also think becoming a aide where you have NO medical decisions on your shoulder's not only for your safety but for ALL OF OURS SAFETY.....ANY OF US COULD BE YOUR PATIENT!
    OMG, people!!!! Didn't you read any of her posts? She alreaady is an LPN and has been practicing for 12 years with no blemishes on her record at all. She is returning to school and I'd think if you'd look at her age, you'd realize that it is going to be a bit more of a challenge (I know it would be for me at 37!). She made a mistake with calculating the weight, true. But she isn't the one prescribing the med, and if she were to be using the hospital's references I'm sure she'd have had an online calculator that told her what the weight was. When's the last time you ever had to change lbs to kgs or vice versa by hand??? I think the OP's biggest mistake was relying on a fellow student to advise her how to calculate the weight and not going and finding some reference material on how to do it correctly. And she was unprepared for clinical, that's certainly a big no-no, but I'm sure we all were unprepared once or twice in our careers.

    Who among us has not made one mistake in our lives? I understand that this is relating to a medication, and that makes it more of a hot button. I don't know where you work, but where I work the MD writes the weight for the pharmacy. And if we input the weight, thre is a field for kilograms OR pounds/ounces, the computer does it for you and the pharmacy double checks it. After all in peds if you have a three year old who weighs 30 lbs and you incorrectly calculate that to be 63 kgs, someone somewhere is going to ask if that's correct. Same thing the other way, if the weight was listed at 13.5kgs and incorrectly calculated at 6.25 lbs I'm thinking that an alarm would go off there, too. She wasn't giving the med yet and had several checks between her and the med. I'm sure that when she looked at the dosage with the incorrectly calculated weight, a red flag would have gone off in her mind. Then she would have realized her mistake on her own. And if not, she'd have called pharmacy and they'd have straightened her out.

    I am certain that all of us double check ourselves with another nurse just about everyday on something in our care. No nurse is an island. We have to help one another out.

    I of course don't know both sides of the story, and I'm sure failing twice there is something going on, but let's not sling mud. No one here is perfect and any one of us could have gotten an nightmare instructor that enhanced our making mistakes.
    Last edit by Mags4711 on Jan 28, '07
  11. by   KellNY
    A few issues with this:

    Quote from faithmd
    She alreaady is an LPN and has been practicing for 12 years with no blemishes on her record at all.
    Again, that does not matter in this clinical at all. If anything, this makes me MORE worried.
    Quote from faithmd
    She is returning to school and I'd think if you'd look at her age, you'd realize that it is going to be a bit more of a challenge
    Again, not an issue. Student's age should not be a consideration.

    Quote from faithmd
    ... if she were to be using the hospital's references I'm sure she'd have had an online calculator that told her what the weight was. When's the last time you ever had to change lbs to kgs or vice versa by hand???
    She didn't even know HOW to convert--it has nothing to do with by hand or calculator. You should know the very basics-ie if someone is 20lbs, they are--NOT the other way around.
    Quote from faithmd
    And she was unprepared for clinical, that's certainly a big no-no, but I'm sure we all were unprepared once or twice in our careers.
    This should have been known well before she attempted her SECOND try at clinicals. She failed peds the 1st time, and really, it's her own fault for not memorizing this (here's this word again) BASIC information before mid semester hit. Leaving your stethescope at home is being unprepared. Only having a blue pen and a pencil is unprepared. Lacking basic, vital knowledge? Notsomuch.

    Quote from faithmd
    And if we input the weight, thre is a field for kilograms OR pounds/ounces, the computer does it for you and the pharmacy double checks it.
    That's wonderful for you! Where I work, we just got citrix, which does have that program. But before that, it was all punched into a calculator by the RNs.

    Quote from faithmd
    I'm sure that when she looked at the dosage with the incorrectly calculated weight, a red flag would have gone off in her mind. Then she would have realized the mistake on her own.
    Are you sure? Sure enough to bet someone's life on it? Because I'm not, and I don't think her instructor was either. It's not like she was training to be a produce manager and a slip up would have resulted in way too many apples being ordered. As you know, a med error can KILL or seriously harm a pt. You can't assume that pharmacy or anyone else will catch it.

    Quote from faithmd
    ... but let's not sling mud. No one here is perfect and any one of us could have gotten an nightmare instructor that enhanced our making mistakes.
    No one is slinging mud, that's a bit much. And no one here is claiming to have never made mistakes. Some of us are being honest and real (and also pt advocated-one of the main principals of nursing, wouldn't you agree?). And I really don't see anywhere--even with the one-sided story--that her instructor was a nightmare. She doesn't mention anyone else in the class having these issues....
  12. by   Mags4711
    KellNY, you say that her being an LPN without an issue makes you more concerned? For me it just sends up a flag (along with her age, that you say shouldn't be a consideration) that the OP may have needed more help in her clinical. Certainly if that was the case, she should have recognized that and sought out help, but we don't know about that for sure. She's (by her report) been a successful LPN for a number of years and while not everyone is cut out to be a RN, there is also the possibility that her clinical instructor (the same one both times) either didn't like her, or didn't like or didn't have the patience for older students. There is the possibility that she was just scary, too. But if that were the case, I would hope that a clinical instructor wouldn't let someone go through the clinicals *twice* without extensive documentation to that effect.

    To quote you: "She didn't even know HOW to convert"
    You're right, she DIDN'T but that was one time in her first clinical try and she corrected that, isn't that what clinicals are for, to learn?
    OP:
    "Of course, I should have been more prepared for the clinical but I just wanted to be sure. Of course when I calculated the calculation for the medication, I made a mistake...Actually, this was at the beginning of the clinical rotation...The next time the teacher asked me a question, I made sure I knew how to do the calculation correctly."

    The OP did not fail her second clinical because of a med problem, she failed it based on a careplan, and by her telling the story, one that she was NOT given the chance (as the other stdents were) to have proofread and to correct:
    "The clinical instructor has the final word though and even though at about midterm she told me that I had started out a little shaky, but had improved she said she would pass me if I handed in a "perfect" careplan. I just looked at her, of course I would try, but what exactly is "perfect". Why was I being held to this standard when other students were given back a care plan to make corrections if necessary. I was very upset. I went to register for the final class because I knew I had passed the final. I was told I had received an "F" I couldn't believe it."


    KellNY:
    "No one is slinging mud, that's a bit much..."

    Perhaps "slinging mud" was the incorrect term to use, but if I were the OP, I'd think based on the following post, someone was slinging something at me (and they somehow missed in her original post where she said she is already a nurse):
    "Quote:
    Originally Posted by LovebugLPN
    I hate when people suggest RN fail outs become LPNs. If this woman had difficulty taking care of a patient and her instructor felt she was unsafe, why would anyone want her to care for them as an LPN? RN students do everyone a favor and don't become an LPN if you are a scary RN student. I suggest she be a CNA where she doesn't have to make any medical decisions.
    Coloradogrl:
    I COMPLETLY AGREE!!!! If you cant meet standards as a student then what makes you think that someone can be a good nurse period! I also think becoming a aide where you have NO medical decisions on your shoulder's not only for your safety but for ALL OF OURS SAFETY.....ANY OF US COULD BE YOUR PATIENT!"

    Again, folks are concentrating on her med error, made at the beginning of her first clinical and according to her story, that was not why she was failed the second time. She took that earlier mistake and said she learned from it. If she didn't, and meds were an issue in her second clinical, then why didn't the nursing instructor have documentation of her issues and cite examples of errors the OP made to present to the review board?

    If her story is 100% true, I'd call it a nightmare.
  13. by   Mags4711
    Heck, if it's 75% true, I'd say it's close to a nightmare, too.

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