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Joined Jan 14, '06. Posts: 155 (58% Liked) Likes: 385

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  • May 6

    Quote from beccalynn175
    OP here, I'm NOT the person she was referring to. The person she was referring to took "it's just a job" and turned around to the person who stated that and launched into "I hope you're never my nurse" and other things of the sort.
    My bad--I mixed things up. Both of the two of them handled themselves poorly in their exchange. I am, however, concerned about cynicism being too quick to see idealism and new grad enthusiasm as bad.

    Sorry for getting lost and messing up.

  • May 6

    Couple of ideas:

    Debrief with a nurse you respect. Ask him or her what you could (if anything) do better next time. You may find out that you actually did all you could. That might help you realize that randomly bad things happen to patients that are out of our control. Just do the best you can.

    Make a list of all the small early warning signs you caught and acted on in the last 2 weeks. Then make a list of all the kindnesses you showed, and/or how how ability to listen or provide comfort helped someone.

    Ask to talk to the chaplain before or after work, even if you are not religious. This person will listen to you, support you, and help you cope.

  • May 6

    Couple of ideas:

    Debrief with a nurse you respect. Ask him or her what you could (if anything) do better next time. You may find out that you actually did all you could. That might help you realize that randomly bad things happen to patients that are out of our control. Just do the best you can.

    Make a list of all the small early warning signs you caught and acted on in the last 2 weeks. Then make a list of all the kindnesses you showed, and/or how how ability to listen or provide comfort helped someone.

    Ask to talk to the chaplain before or after work, even if you are not religious. This person will listen to you, support you, and help you cope.

  • Dec 6 '15

    While I somewhat agree, as a faculty member, I see GPA as a stand in for a lot more than just smarts. It is a reflection of self-discipline and willingness to work hard. It is also under student control to a large extent. Some persons learn from mistakes and never make excuses for themselves. They also read their textbooks, ask questions, come to lecture and clinical prepared, stay off Facebook in class, know their priorities, and are willing to make sacrifices (like working fewer hours and not buying new clothes or going out as often). None of these things are impossible. I for one am SICK of the people who don't do these things, yet expect the same A. They say to me "but I worked so hard." My responses: the criteria for getting an A were spelled out to everyone. If you want an A the next time, what will you do differently?

  • Oct 29 '15

    This is from a document I post for my students at the start of clinical. Doing any of these things will probably result in failing clinically. Remember, we faculty have wide leeway in making a call on this. It often boils down to not letting you move on if you are unprepared, unprofessional, unsafe, unskilled, are unable to critically think, or communicate poorly with others or fail to take responsibility for your actions.

    The following infractions may result in a clinical failure:

    • Tardiness or absenteeism (See course syllabus).
    • Recurrent or flagrant dress code violations
    • Rude, disrespectful, undermining or uncivil behavior toward a patient, family member, staff member, peer, or faculty; OR repeated actions that create unnecessary conflict and turmoil for others.
    • Serious complaints from the agency nursing staff concerning the student's behavior
    • Being unprepared to provide safe patient care to patients, OR inability to answer common questions or explain the client's pathophysiology or medications, treatments, procedures and/or nursing interventions.
    • Inability to create or communicate a reasonable plan of care, or inability to through and evaluate the client outcomes
    • Serious lack of organization that leads to late treatments or medications, or that forces others to assist a student so that care can be completed on time.


    • Failure to follow up on an action after being specifically directed to do so. For example, failing to recheck I&O or vital signs or a client's response to a med after being directly told to do so by the instructor or a staff nurse.
    • Repeated failure to convey important changes in the client's status promptly to the staff nurse of the instructor.
    • Breech in confidentiality or HIPAA violations
    • Administering medication without the instructor or without having attained prior approval to administer a medication with a licensed RN
    • Misleading or misstating facts or events, or fabricating client assessment data
    • Repeated submission of late or unsatisfactory work (even if ungraded); failure to redo and resubmit written material as requested by faculty.
    • Delay in responding to or noncompliance with a faculty directive to undergo remediation to address a skill or knowledge gap.
    • Actions or inactions deemed unsafe by the faculty.This goes beyond serious medication errors; it includes actions or inaction that puts clients at risk for avoidable complications or potential harm.
    • Violations of the Code of Conduct found in the School of Nursing Student Handbook. Failure to achieve master the skills or knowledge needed to provide safe care to patients, including physical assessment skills; or failure to meet any of the other course objectives.

    I would add to this that a NO CALL/NO SHOW (unless you were in a serious accident) is an automatic failure.

    Nursing faculty take seriously their responsibility to protect the public from anyone who does not live up to these standards, or who lack the thinking skills, judgment, and organizational skills needed to provide safe, effective care. There are times when we recognize that a student simply is not ready to move to the next clinical, where he or she will encounter sicker, more vulnerable patients; in that case, the student may benefit from repeating a clinical, and go on to be a stronger, better nurse as a result. It is not easy to fail students clinicallly; no one I know does it lightly or looks forward to doing it. But it does happen. That said, it generally can be avoided by coming very well prepared, following the rules, being on your best behavior, communicating well, and by seeking and being open to early feedback.

  • Sep 28 '15

    Quote from nursingjudgment
    Hey everyone,
    One of the nurses who was watching told me that the mid-level felt like she could treat me like that because I appear too apologetic. But I don't know how to avoid this. I feel as though I have lost all the confidence that I had before I came off orientation, and now I am setting myself up to have people ream me even when I haven't made mistakes.
    Along with cutting way back on the apologies, maybe try this: Just say "OK." so they know you heard them. Then just don't say anything more. If they push you, say "I need a minute to take this in and think about it." Refuse to let that person get your goat. Then go back later and say "I admire you and would one day like to be as good as you. When you have time can you share with me how you would handle ______."

    I did this once with someone who was trying to grind me down--it worked like a charm, and he went out of his way to start mentoring me.Reply

  • Sep 17 '15

    Figure out how to manage your time well. Develop skills in reading and analyzing research studies, since a lot of what your learn will come from journal articles in addition to texts. If you are not already skilled at it, have a college librarian teach you how to efficiently teach the literature.

    As for clinical, be open-minded and flexible, ask questions. Treat everyone (clerks, etc.) with respect. If you do not know fetal monitoring well, buy the $50 DVD from the Wisconsin Assoc for Perinatal Care or take the AWHONN course.

  • Aug 8 '15

    Agree, it depends. I worked in one practice with enough CNMs that I did two 12-hour shifts per week in L&D, did rounds, saw ER and triage patients. In another, had two partners and we split up the month, with every third weekend on. I came in for some (not all births) even when not on if a patient who was really attached to me requested it--maybe once a month.

    I was on my own for 20 months when I started that practice, and actually found being on call 24 x 7 not too bad. Here's why: I was able to put a limit on how many patients we took in, so that I never had to do more than 10-12 births per month. I could also get a long weekend off by asking my consulting OB to cover for me. I usually did that when I had few, if any, patients due to give birth. I took vacations, and even had a choleycystectomy without any disruption to my life or the practice.

    Once we started to add CNMs, the lid was off, and we ended up doing more birth (average 16-18). It eventually became clear to me that the owners of the practice were in no hurry to hire a 4th CNM because they made a lot of $$ by keeping it to three, even if it exhausted us.

    When joining a practice, ask not just how much call, but how many births they do per month. If you have young kids, look for a practice with less call, and hope for one that does not require you to work in the clinic after being up at night.

    Yes, it's challenging, but not as bad as it sounds. And the job is VERY fulfilling and well worth it.

  • Aug 6 '15

    Figure out how to manage your time well. Develop skills in reading and analyzing research studies, since a lot of what your learn will come from journal articles in addition to texts. If you are not already skilled at it, have a college librarian teach you how to efficiently teach the literature.

    As for clinical, be open-minded and flexible, ask questions. Treat everyone (clerks, etc.) with respect. If you do not know fetal monitoring well, buy the $50 DVD from the Wisconsin Assoc for Perinatal Care or take the AWHONN course.

  • Aug 5 '15

    Quote from OCNRN63
    Do you remember that one guy not forever ago who came on here after a hospitalization asking how we are able to do our jobs with such sexual arousal being exposed to so many genitals?
    I still have nightmares about that one. I felt like telling him that our name badges are secretly outfitted with a microcamera that takes pictures of how well endowed our male patients are...or are not. The problem is, he would have likely believed me.
    Thanks for the laugh.

  • Aug 1 '15

    Go low tech. Get an alphabetized pocket sized notebook. Every evening, no matter what, go to Up-to-date and write brief notes on various conditions, beginning with the ones you encounter most often. Eventually you will have an impressive pocket brain, and the act of writing the notes will probably help you remember the information, or be able to find it quickly.

    Skip electronic versions--make your own.

    Every night in bed, reread some critical content from school. Hopefully, you now realize that NP school gave you the bare essentials you need to practice, and that there is far more that you need to learn, fast. Go to Medscape and subscribe to get emails on your specialty areas or any areas you are week on. My other favorites that I skim through are Health Day and Consult 360. There is no reason not to be able to keep up, and often its easier than you might think. Ask your colleagues if they have any favorite sites.

    Don't be hard on yourself, but don't EVER make excuses for yourself, and work diligently to master the learning curve. The mark of an excellent practitioner is that they always wonder what it is that they don't know that they don't know! That drives them to continually learn, even years after graduation, so that they can stay on top of their field.

  • Jul 30 '15

    While I somewhat agree, as a faculty member, I see GPA as a stand in for a lot more than just smarts. It is a reflection of self-discipline and willingness to work hard. It is also under student control to a large extent. Some persons learn from mistakes and never make excuses for themselves. They also read their textbooks, ask questions, come to lecture and clinical prepared, stay off Facebook in class, know their priorities, and are willing to make sacrifices (like working fewer hours and not buying new clothes or going out as often). None of these things are impossible. I for one am SICK of the people who don't do these things, yet expect the same A. They say to me "but I worked so hard." My responses: the criteria for getting an A were spelled out to everyone. If you want an A the next time, what will you do differently?

  • Jul 27 '15

    Don't quit. You will always wonder about what might have been if you do.

    Be sure to meet with the faculty and ask them what you should do differently to pass. Do not be defensive, do not make excuses, listen and then do whatever they say. Schedule a meeting with this person for every two weeks, so you don't fall behind. Ask if there is a tutor.

    Think about how you learn best. For example, if you are visual, look on You Tube, where there are dozens of pharm videos ranging from simple to high level. Become a time management expert. Use every spare moment to study pharm. For example, write key points on index cards immediately after lecture. Carry them with you and review them when in line at the bank, etc. Or go over the Power Points out loud while taping your voice, then listen to them while driving to school.

    I worked full-time and went to school full time with kids in first and third grade (would not do it again--it was too hard on my kids). I used to go to bed with then at 8:30, then got up at 4AM to study on the day of tests. Hard, but possible.

    Ask your family to agree to do laundry for you and clean your house in place of Christmas and birthday gifts.

    Calculate out for your husband how much money you will make over 40 years as an RN (It will come out to about $2 million bucks) and talk about what that would mean for your lives. Then ask him to make a list of tangible things he will do to help you have time to study and to get there.

    This is doable, but the more organized you are and the more help you line up, the better.

  • Jul 27 '15

    When I was in undergrad, I HATED them because others used it to get a free ride off my good work. I had much better experiences in grad school probably because everyone there was a serious student, contributed ideas, and did their share--so there is hope.

    Fast forward to now--I am the faculty, and for a variety of reasons, sometimes need to put people in groups. I know full well that the problem of freeloaders still exists, along with the type A control freaks. I have an idea I may try out this fall: I plan to ask who hates group projects and why and then put them all in the same group!

    My thoughts are that this would mean that I could create a group with no freeloaders, or one made up entirely of persons who like to get things done early (or made up of procrastinators). That way, the good students will not feel put upon, and the free loaders might not be able to get by on other's work.

    Do you think this might work?

  • Jul 27 '15

    Quote from pmabraham
    Since almost all nursing programs require you to have mastered and remember your prerequisites (nursing is not like other degrees where you take a course and can forget it), looking for the fastest, easiest can lead you down the path of failure when your RN instructor expects you to remember what you learned in microbiology, sociology, etc. at the mastery level (i.e. no faking it or partial answers).
    This is 100% correct. You may not want to hear this, but here goes: There is no easy, fast, simple way to gain the knowledge you need to be a nurse. Nursing requires a high level of knowledge and skill, and a lot of hard work and dedication. If that doesn't appeal to you, go into something less critical.

    Think of it this way: Would you want your child to be cared for by nurse with a superficial level of knowledge of A&P? And don't you WANT to have a high level of knowledge? If so, then why are you looking for "the easiest and shortest program"?

    And have you considered these two things: If the program is easy, might that handicap you when you get to NCLEX? And, local hospitals DO know and take into consideration the reputation of various schools when they hire nurses. Same is true for any reputable grad school. Don't you want to graduate from a well-respected program?


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