cnmbfa 3,856 Views
Joined Jan 14, '06.
Posts: 156 (58% Liked)
Think Maslow's hierarchy of needs. This is a breathing and circulation issue that can threaten her life, so addressing it comes ahead of all else. Give the Lasix. The rest is distraction, and the issues can be sorted out later.
As a faculty member who teaches this topic, I have found a mostly successful strategy for mastering this. We work in small groups to write a backwards case study. I give them an abnormal lab value, and have them create a story for how it developed (diuretics without eating any K+ rich foods, ran a marathon drank plain water no sodium replacement; borderline renal function using magnesium laxatives, etc) Next they describe the presenting signs/symptoms and the nursing interventions. They end by saying not just what the normal lab values will be, but the other symptoms will resolve. They know they will be handed a lab value and have to create a case on the next quiz. Works well.
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.
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.
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?
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:
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.
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.
Talk, Discuss, and Share your experience at your favorite Nursing School.
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