catlover314 3,562 Views
Joined Jan 16, '04.
Posts: 137 (20% Liked)
Wow that's kinda harsh punishment. I've told a pt that I'm giving pain medicine when in fact I was just pushing 5cc of NS. But that was because the MD didn't want to order iv pain medicine. It was a last resort and miraculously that solved her problem lol.
I don't see anyone here posting from the instructor perspective. I have been a student, too, and remember it vividly, good instructors and not so good ones (my psych instructor had a breakdown halfway through the semester and had to leave... oy). And I have also been a staff nurse, a manager, and an instructor, which students have not. No matter what you think you know about the performance issues of other students, all you know is what the student tells you, loudly and aggrievedly.
Your student friend is not likely to tell you that the reason she was put on probation by the department, not just by me alone, due to poor clinical performance was because her care plans were late, incredibly poor, completely illegible, and/or missing the required elements of assessment and planning.
Or that her "med cards" had nothing more than the name of the drug on it, and she wasn't able to tell me why her patient was getting any of them, and couldn't figure out the dose.
Or that because she was an LPN and knew how to make an occupied bed with both eyes closed, she thought that meant she knew everything there was to patient care.
Or that, having being incompetent in all these IN ONE WEEK, after missing one or two of them in the previous three weeks, she was put on an improvement plan and committed to making up the missing work, knowing her meds, and knowing her patient's diagnosis next week....and did none of it. Showed up at clinical without having done any of it at all.
So yes, when you walked past me at the med cart with her and heard me tell her that it was inexcusable that she had not done what she had agreed to do, in writing, in front of me and the program coordinator, then you might not really know what was going on and think I was a terrible person. But when you heard her tell it later, I was the world's biggest soandso because I got mad at her just because she didn't know one medication. And I was mean to her because my best friend was the coordinator (um, not so much), or because we were of different ethnic groups (oh, puhleeze). And the program was prejudiced against her because she came from (some other region of the country). Or some other BS.
Just sayin'. Sometimes they really are terrible students and they really do deserve to get put on probation and they really do flunk out.
Would you want us to do otherwise? Is your mother in that bed? Believe me, no matter what it looks like to you or what anecdotal things you hear, people do not go into teaching nursing (which pays a lot less than being a working nurse on a floor) to make life miserable for students. We do it because we care deeply about our profession and want to see how many, if any, of our students will have that spark and catch our passion for it.
We are also evaluated by our managers, and if we have a larger than average number of failing students we have to account for that. Yes, we discuss students among ourselves, just as you discuss instructors. We work hard to read and critique care plans, journals, papers; we take continuing ed ourselves to help us be better teachers. As I said, we've been students, we know how it is. It's probably not reasonable for you to think about what it's like to be instructors and deal with the groups we see. But it wouldn't hurt to think, just for a moment, that you don't really know much about what you're talking about so cavalierly.
Nursing school is not always fair. And, in my honest opinion, the most unfair aspect of the nursing school experience is the clinical practicum portion, also known as clinical rotations. Here is why.
The grades that students earn in the classroom-based theoretical nursing courses are, in most cases, usually objective. Even though the professor who teaches the advanced medical/surgical nursing course might hold personal grudges against a couple of students, the multiple choice exams and quizzes help to even the playing field by giving all pupils a fair chance to demonstrate their knowledge base.
A few exceptions exist, such as the occasional poorly written test question, and the subjectively-graded essay or paper. However, students who are personally disliked by their classroom professor, classmates who are outspoken or opinionated, and those who have been labeled as difficult trouble makers by certain faculty members can still pass (and even do well) in the theory portion of their nursing courses through strong performance on objectively graded tests if they study, use all the resources at their disposal, and fully comprehend the material.
On the other hand, the grades students receive in the clinical practicum portion of their nursing school educations are purely subjective and based almost solely on the opinion of the clinical instructor. This is certainly not a problem if the clinical instructor is fair, balanced, rational, has realistic expectations of pupils, and capable of modulating his or her emotions while evaluating students performance. It also helps greatly if the clinical instructor possesses a true fondness for transmitting nuggets of knowledge and wisdom to the next generation of nurses.
Lets return to the subjective evaluation of the clinical portion of nursing education. This is not problematic if the instructor is fair and impartial. However, the end result could be a disaster if an outspoken or mouthy student is being taught by a clinical instructor who has old-fashioned values and expects students to obey, conform, comply, respect authority, and avoid painting her in an unfavorable brush in front of others. No matter how intelligent or skilled the student might be, he will almost certainly fail clinical practicum if he rubs his instructor the wrong way.
Many clinical instructors currently work in inpatient settings such as hospitals where they practice procedural skills regularly; teaching students is a second job for these instructors. However, other clinical instructors exist in academia who have not regularly performed patient care in many years. You may notice some of these instructors performing skills in an outdated manner, or quite possibly, they might do something incorrectly.
The outspoken student who announces in front of other students and nurses in the clinical setting that Mrs. Smith gave a bolus tube feeding while the patient was laying flat in bed will become a target, even if he is right and the instructor was wrong. This is the same instructor who will be checking students off on skills. This is the same instructor who evaluates students performance and determines who passes or fails the clinical practicum.
If the instructor is the old-fashioned type who does not like it when students correct her in public, do you think shes going to penalize the mouthy student? If she disapproves of students who question authority, do you think she might give the student who openly questions her a hard time? Keep in mind that if she refuses to check you off on a skill, it is her word against yours. If she insists you failed your most recent clinical rotation due to substandard performance, be cognizant that the director of the nursing program might side with her.
Ive revealed the nastier side of the politics that permeate clinical rotations in nursing school. My advice is to pick your battles wisely and tread very carefully. Think before you speak, especially when addressing instructors who make grading decisions that impact your future. The grades you receive in clinical practicum are purely subjective, so do not end up on a faculty members bad side due to your strong personality and outspokenness. Be aware that no matter how bright you are, the evaluation of one dishonest clinical instructor who dislikes you can set your career back.
Learn to walk the political tightrope. After all, what you know is often as important as who you know in this day and age. Keep that bulls eye off your back.
It isn't about what's professional or moral. If they've treated you like crap, then you owe them nothing.
It's not about what you owe them. It's about what you owe yourself. It's not in your self interest to be jobless with a great big hole on your resume.
We are a 60 bed 5 pod unit. We have 4 huge freezers with bins that store milk. Each pod has a dorm fridge that stores milk for the patients in that room. Labeled bins are also used in these mini-fridges. All are monitored for temp and adjusted accordingly.
I'm not sure of the brand we use, but we have a large freezer and fridge in a separate room on the unit, the "Nutrition Room", to store every infant's milk. We have a tech in that room who is responsible for mixing fortifications, making 24 hr worth of feeds, and then distributing them near the infant's room on the unit. (We are a 66 bed unit, although our census is usually 30s-40s). Then, we have 3 different fridges in the unit that hold each section's milk. There are plastic bins labeled with the last name of each baby. I love having your own little fridge in your section so you wouldn't have to travel a ways to get milk.
We are a smll unit, less than 50 beds, with 3 rooms. We have one large freezer for all the breast milk, (like a refrigerator, but it's just a freezer). East patient has their own bin and it's stored according to pumped date. Two rooms have a mini fridge. It works for us. No idea about the brands though
Some states may require you to go to a "lab grade" refrigerator and freezer. Our small (10 bed) unit had to do this. These have a graphic recorder which provided a weekly chart of temps. @ the very least, you should be checking the temps of both appliances Qshift and keep a log of the temperatures.
Lab grade units are $$$$, but the quality control is built in--all we had to do was change the graph every week and keep them on file. And call maintanence when the "I'm not cold enough" alarm went off.
We used plastic bins to "organize" the milk; for larger quantities of milk, the "patient belonging bags" work well.
hmm we have two HUGE (floor to ceiling) freezers. Organized alphabetically, each kid has a page in the log book and we write down when we add or take out bottles and how much is left in the freezer. Each kiddo then has their own mini-refrigerator in the room. 52 beds.
The cardiac ICU also has a large freezer but not as big as the NICU's, it's poorly organized with people just throwing bags of bottles in no particular order :-( Then there is one small-ish fridge. 26 beds and not all of them are neonates but still, it could be more organized.
I think the nicu was great for breastmilk storage. The cicu could do better
Plain old kitchen refrigerator, two doors (top freezer, bottom fridge).
Conflict resolution is tricky. No one ever seems to be happy. There are a few things missing from the other postings:
First......violations of HIPPA are a federal offense and need to be taken seriously.
Second......Many times, managers hands are tied. Employees are covered by human resource policies. Perhaps you should consult your HR department
Third......let's face it...........ill feelings spread like wild fire. One person starts, and others join in. It goes viral.
Fourth.....you don't know for sure if your manager has addressed this employee on the issues you post. She cannot discuss personnel records with you nor should she.
I could go on and on.........
It does seem like you work in a toxic envioronment and maybe its time for a change
It's called OBSESSING, and every addict and alcoholic is guilty of it.
We get something on our mind and it takes away 95% of our thoughts and energy away from enjoying life on life's terms.
God, Grant me the Serenity to accept the things I cannot change, the Courage to change the things I can, and the Wisdom to know the difference.
I'm with Cheryl. You are in very EARLY recovery. 7 months is not far out but the early period is the worst because you're still short on coping skills and long on shame, guilt, anxiety, depression, etc.
You've heard the advice often given to widows? Don't make major life or financial decisions during the first year - you're still not over your grief enough to be rational re: your self interests. I can guarantee that the Commissioner of Nursing does not have a vendetta of hate against you. I highly doubt that this person even knows your name. The Board is not there to pave the road with rose petals - their first consideration is public safety and they don't really give a hoot about your feelings. However, the people who have designated themselves to help you through the process are totally empathetic to the rigors of recovery - they've seen it 100's of times; nurses who come in depressed and crying, unable to make a living, worrying about what their colleagues think of them, etc. The reward is seeing them a year later - able to smile and feeling grateful to have a sane life. YOU are responsible for your future happiness; the Board is NOT. Now I know that you're not spending 8 or 10 hours a day wrangling with the Board; if you think about it, very little time is devoted to going to urine screens, meetings, etc. There's plenty of time think negative thoughts about yourself and others. The large majority of nurses manage to get a job again while they are still being monitored. It may be helpful to you at this point if you just stop thinking so much (and doing more). Just let life happen - most of what happens is totally out of your control anyway. Electronic hug to you.
We draw our own labs, line, venous or heelstick. We also have a Gem for blood gases. Some of our staff do art sticks if need be.
I don't let the lab near my babies. They might be perfectly competent, but I'm territorial!
The only thing we've had to redraw lately has been platelets which were clumping. (come to find out we had a bad batch of tubes). Put in enough incident reports and Mahogany Row starts to pay attention.
I have used the iStat quite a bit and always enjoyed that you need such a small amount of blood. Often we would correlate the lytes on the iStat with a lab specimen the first time and then just use the iStat after that. Currently we don't have any thing like that in our unit and could really use it for gas draws which are sent to lab with prayers that they don't clot.
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