Furious....abandoned by my TEACHER....

[nerdtonurse?, BSN, RN]

Okay, this is a full bore RANT.

I had a patient who was crashing. Came back from endoscopy, and this guy's temp went to 94.1, then 93.2. In for GI bleed, sepsis. I'm thinking septic shock. I go to look for my teacher to let her know (pt's primary nurse getting an order for a bear hugger), and I can't find them ANYWHERE. The floor's getting slammed with direct admits, and the charge nurse tells me to go get the bear hugger from the ED -- I tell her to make sure to tell my teacher or classmates where I've gone if she sees them. I go flying down, grab the bear hugger, come tearing back, we get the bear hugger on, pt is unresponsive and looking shocky as H***. I asked the charge if she's seen my teacher, and she says she hasn't seen anybody -- other teachers or students, asks, "Did they leave without giving us report?" I told her I don't know where they are. We're trying to get the guy to respond to us, and he's just not coming back...and not coming back...and not coming back.

Mindful that I'm NOT an LPN in this setting, I ask if I can please perform an unscheduled FSBS (since that's all I can think of that could be doing this, unless the guy's thrown another CVA or is actively dying or all of the above...). I take the FSBS -- 47! I stick my head back out of the pt's room (pt's on precautions for MRSA and shingles), and I'm trying to get someone's attention to bring D50. No students in sight, no teacher. I strip off the PPE, go in the middle of the nurse's station, and say, "My patient's blood sugar is 47, can SOMEONE please get me some D50?" The primary care nurse and charge (bless their hearts, they had 3 direct admits hit the floor at the same time, and one outbound to the heart center up 85) really rise to the occassion. I'm holding the arm for the primary care nurse so she can push the D50, (IV in a weird spot, pt is flaccid), charge is on the phone with the doc getting stat orders for blood cultures, an order for the D50 that's getting pushed, etc. Pt is gray, and that "dead guy look" is going on. In the middle of the D50 push, the vein blows.

Just as the vein blows, one of the students drops my book bag on the isolation cart in the hall, says, "there you are!" (Uh, where the H have I been for the last hour?!) I tell them the pt's temp is 93.2, FSBS is 47, and they say good bye and leave. NO TEACHER. NO HELP. The patient finally starts coming around a little, and I tell the primary nurse that if my group's left, I'm not supposed to stay on the floor. I stick my head out the door, thinking I'm going to see my teacher looking at the chart, talking with the charge -- nope, THEY ALL LEFT.

The charge nurse is furious, the primary nurse (who's an LPN) tells me I did a good job thinking about taking the FSBS. They all tell me I did a good job, and my teacher's not there to hear it. Moreover, if the patient had died, what was I supposed to do? I mean, thank GOD the guy was a DNR, and I've put more people in body bags than I want to think about, but here I'm on somebody else's playground, and honestly, if I'd had crappy nurses, they could have blown off my concerns, not let me take the FSBS, and the pt could have died. Then it would have been "oh, the student nurse never told us...." I mean, one reason we have an instructor on site is for OUR protection in such a situation. I was trying to tell her, but you can't tell someone you can't FIND.

I called my instructor when I got home, and she wasn't happy. Neither am I. I've bent over backwards to help the others, sharing my notes, my drug cards and pharmacology notes from LPN school. And what do they do when I'M the one that needs help? They book. Even if the teacher had told the other students to go, she should have stayed with me until the pt was firmly on this side of the grass.

Honestly, I'm so mad, if it wasn't this close to the end of the semester, I'd transfer to another campus to get away from these folks. We're supposed to be nurses: WE DON'T ABANDON PATIENTS, AND WE DON'T ABANDON EACH OTHER.

Unless you're the folks I go to school with.

Somebody lie to me and tell me this is going to be worth it.

[VivaLasViejas, ASN, RN]

It's going to be worth it.

And it's not a lie.:)

You caught a bad break. You got NO backup from your instructor. That was inexcusable, and I'm sure the administrator of your nursing program would appreciate some feedback on this situation. In the meantime, you did one heck of a job for this patient and are to be commended for stepping up to the plate on their behalf. If ever I were in a similar situation, I'd appreciate having a "student nurse" like you looking out for me!

Ya done good, sweetie---take comfort in that knowledge, get some good sleep tonight, and remember: "this, too, shall pass".:icon_hug:

[nerdtonurse?, BSN, RN]

Thanks!

You know, I was feeling really bad and down and "why am I putting myself thru this?" And then with Viva's kind message (thank you, thank you!), I stumbled across Susan Boyle's performance on the Brit equivalent of American Idol. She comes out, looks like the 47 year old housewife that she is, everyone's laughing at her because she's not gorgeous and she has the nerve to say she wants to be as successful as Elaine Page. Everybody in the audience is shown laughing and rolling their eyes....

Until she opened her mouth and began to sing. She sang the house down. If that woman's not being courted by broadway musicals, there's no justice in this world.

Maybe that's how I need to look at it. Folks may roll their eyes at me when I ask a question, or make smart comments about "at YOUR age..." like they did to Susan Boyle -- until she sang.

Well, you know what? With my patient today, I sang....

[Feathers]

Oh my gosh...Susan Boyle is one of my new inspirations! "I've never been given the chance" & when she got her chance she did "rock the audience", but she did it for herself... that's what I liked about her. She was Grace under fire...with an *amazing* voice!

I'm sorry that happened to you (feeling like you were abandoned), but I am happy that you were able to think on your feet & make things happen! That has to give you a boost in confidence. You can help you pt when it matters most, you didn't freeze!

If I am ever in a situation like yours I pray that I'll be able to react the way you did..."real world" experience. Well done!

[BBFRN, BSN, PhD]

Well done, nerdtonurse. Could it be that your instructor wasn't made aware of the situation? Did you go to endo with the patient, and maybe she assumed you were still down there?

It may be a good idea to get your instructor's cell phone #, so you can call her in situations such as this.

It is all worth it, and you're almost done.

[ImMrBill3, RN]

Wow, sorry to hear you went through that. I am glad it worked out OK for the pt. My experience has been much better. All of our instructors have the same "yellow phones" as the nursing staff. If there is any need we can call them or the primary nurse whose number is on a dry erase board in each pt's room.

Realize you did a great job in a critical situation not just working on the pt but applying critical thinking. This is why you will make a great nurse.

[mama_d, BSN, RN]

Your instructor was just flat out wrong. Not only did she abandon you, she abandoned the rest of the students by not taking advantage of a great teaching opportunity. And thank goodness someone who knew what they were doing were in the spot you were in. I don't know how far along you are in your clinicals, but I know that we've had plenty of RN students in their last semester at our facility who would have been totally clueless.

I have a fear of going back to nursing school and doing clinicals, especially since the school I'll probably end up at doesn't have the brightest or most up-to-date clinical instructors (clinicals are done at my facility). I know myself well enough to know that I won't be able to hide entirely the "I've been doing floor nursing for over a decade while you've been a clinical instructor, lemme do stuff my way b/c it works!" attitude. And honestly, I think I'll be bored out of my mind on clinicals...I'm used to dealing with heavy teams of 5-6 acutely ill patients on my own, I can't imagine what it will be like to only have two or three patients to deal with all day long!

Hopefully my witty personality, superior intelligence, and outstanding good looks will help me through any rough spots

[BabyLady, BSN, RN]

Here is the thing...in nursing schools we hear from the instructors about all of these "expectations" that they have.

Well, here is a newsflash: STUDENTS HAVE EXPECTATIONS TOO!

I cannot tell you how many times I have went to clinical, only to see my clinical instructor disappear to chat with a friend in another part of the hospital we aren't even working in, or sitting at the nurses station, hanging out in the lab (behind closed doors...where we have no idea of where she is)...I could go on and on.

You have every right to be ticked...you did a WONDERFUL job about not saying, "Well, my group left, here you go!" and peeled off your gloves, grabbed your bookbag and waltzed out the door.

If that situation had taken a turn for the worst...that instructor could have been looking for a new job.

There are times when the instructor is WRONG...and this sure as H is one of them.

[morte, LPN, LVN]

Thanks!

You know, I was feeling really bad and down and "why am I putting myself thru this?" And then with Viva's kind message (thank you, thank you!), I stumbled across Susan Boyle's performance on the Brit equivalent of American Idol. She comes out, looks like the 47 year old housewife that she is, everyone's laughing at her because she's not gorgeous and she has the nerve to say she wants to be as successful as Elaine Page. Everybody in the audience is shown laughing and rolling their eyes....

Until she opened her mouth and began to sing. She sang the house down. If that woman's not being courted by broadway musicals, there's no justice in this world.

Maybe that's how I need to look at it. Folks may roll their eyes at me when I ask a question, or make smart comments about "at YOUR age..." like they did to Susan Boyle -- until she sang.

Well, you know what? With my patient today, I sang....

please, take this thought, and hold it close, not only in work, but in life in general, NEVER let it go.....

[FireStarterRN, BSN, RN]

You did a great job and had a good learning experience. Good call on getting a blood sugar!

It sounds like your instructor is out of touch with the real world of nursing, but thinks the clinical experience is, rather, a neat and orderly classroom. Maybe she's been away from the bedside too long, I saw that while in school with some of my instructors.

[nerdtonurse?, BSN, RN]

Did she know what was going on? I kept looking for her (and so did the charge nurse). What made me so mad was she stuck her head in the door (when they were dropping off my bag) and she KNEW the pt was crashing, and she sailed out the door. I thought to myself, she's one of those who if her pt coded 15 minutes before the end of shift, she'd sit in the nurse's station and chart....

Lack of hospital experience? No, she's only out of school 3 years and works at the facility we're doing clinicals at. She works peds, I work in an tele/ICU stepdown, and half the time, they're called out because they have no Peds pt. Hour for hour, we've probably got about the same amount of on the floor clinical experience.....

I get to go back and do another clinical with her tomorrow. Boy, am I looking forward to this....NOT. I swear, if she was the instructor for next semester, I'd change to a different program to save the license I already have.

[Mandylpn]

Did she know what was going on? I kept looking for her (and so did the charge nurse). What made me so mad was she stuck her head in the door (when they were dropping off my bag) and she KNEW the pt was crashing, and she sailed out the door. I thought to myself, she's one of those who if her pt coded 15 minutes before the end of shift, she'd sit in the nurse's station and chart....

Lack of hospital experience? No, she's only out of school 3 years and works at the facility we're doing clinicals at. She works peds, I work in an tele/ICU stepdown, and half the time, they're called out because they have no Peds pt. Hour for hour, we've probably got about the same amount of on the floor clinical experience.....

I get to go back and do another clinical with her tomorrow. Boy, am I looking forward to this....NOT. I swear, if she was the instructor for next semester, I'd change to a different program to save the license I already have.

:uhoh3:Lucky you! If had the same instructors next semester I would not be going back AT ALL. We are not getting much direction either. Let me guess, you are 3rd semester? Thank God only three more weeks left. Did you talk to your director about this incident?