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Kooky Korky 18,026 Views

Joined Feb 12, '10. Posts: 2,958 (52% Liked) Likes: 3,943

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  • Mar 21

    You all as a unit need to have a committed front of zero tolerance with these people. Raise hell with your managers until something is done.

  • Mar 20

    Go to various states' BON sites and check their categories. You probably will get an answer more quickly. Not every one in every state will know the answer to the question, and I hazard a guess that most of us are informed only about the status of our individual licenses.

  • Mar 19

    I always request a chaperone when genitals are involved. Not that I don't trust people. I just don't trust people. My first two years of practice were behind bars. I trust no one these days.

  • Mar 19

    When you write this state "bed alarm found in the off position". Don't conjecture as to who turned it off or how. Simply state the fact.

  • Mar 18

    Thank you. I think my new grad nerves are starting to come through. I appreciate your responses a lot; it's definitely calmed me down a bit.

  • Mar 18

    Exactly. This is a big, fat non-issue. You don't care for family as an employee and that's it. No biggie.

  • Mar 18

    Mountains out of molehills annieb. Nobody there cares that your grandma was a patient nor do they care if she becomes one again (and by caring I mean it isn't an issue). This happens all the time. There is nothing to disclose. If she gets admitted again let your charge nurse know so she isn't assigned to you and carry on. They are not going to fire you for this but you must let your family know that if it occurs you are not available to them while you are on duty. That's where things can get sticky.

  • Mar 18

    Quote from Wuzzie
    Dwelly, no need to defend yourself.
    That is correct. It was apparent to most of us, from your first post, that you had put all you had into Alice and she was not up to it. I can't believe all the people who have come on here to make excuses for Alice ("...maybe she didn't feel comfortable..." ?!) or to flat out try to pick a fight with you, like Alice's poor attitude is your fault.

    What more does Alice have to do to prove herself unfit for nursing? Put a pillow over someone's head? I'm blown away by the ones who've swooped in on Alice's behalf. Do they tolerate coworkers like Alice? Or maybe they are coworkers like Alice.

  • Mar 18

    Quote from DWelly14
    For all of you suggesting she wasn't interested in L&D, you are incorrect. She chose L&D and wanted to be hired on our floor after this rotation.
    I am a new grad CNM and am finishing my time as a bedside L&D RN, she is not being asked to do anything advanced or beyond the basics. Mostly vitals, head to toe assessments, electronic fetal monitoring, IV starts, foleys, and repositioning as well as some patient eduction and medication education with my direct supervision. She has observed all of this for the first half of her clinical with some guided participation and voiced confidence in each portion before she was asked to do it independently. I am always in the room with her for her to ask questions. For an IV, she gets one poke. If she doesn't get it I take over, same rules I use with all my students.
    I have been in communication with her faculty about my concerns and we did have a meeting in which Alice tried to blame me for not making her feel welcome and for "pushing her too hard." Her faculty member literally told her that what I was asking of her was the basics and that she could have been asked to do more.
    Alice was told last night that she failed her practicuum and would have to repeat it with another preceptor and in another area. I have never seen such a tantrum thrown by an adult before. I know for sure now that all my suspicions were true about Alice. She skated by in group clinical as never drawing attention to herself. I pity her future patients and hope no one I love ever comes into her care if she ever becomes a full fledged RN. At least I know that I did not take part in passing her along.
    I want to offer you sympathy for being put through this. What a horrible situation for that miserable individual to suck you into. Thank you for doing your job even when it is hard. She needed to fail. She deserved to fail. I am glad she failed.

  • Mar 18

    Dwelly, no need to defend yourself.

  • Mar 18

    -OP, given that Alice was likely your 3rd or 4th preceptee, I and a few other saw immediately to question your communication skills and leadership abilities. I'll elaborate as I go.

    Not sure why you immediately question my leadership skills but ok ...

    -Good observation and efforts on your part.

    The point was that in the first half of her rotation I was right there with her holding her hand and watching her. Alice is by no means ignorant or incapable, in fact, she is quite capable. She has a bad attitude and is lazy. That's the issue I tried to get at later ....

    -Communication/Leadership: Wk1 thru Wk 6 she was "improving"--what is less than "lazy"? Moving on...on day 1 solo, did you re-iterate the expectations of her? See next comment.

    Alice started out with the stereotypical student big eyed terror look when you hit the floor for the first time without your nursing school buddies. The first time we walked into a patient room she could barely speak let alone do an assessment or anything else. So I taught her to deal with that. And I taught her the work flow on my unit, how to do an admit, how to prioritize, how to do a targeted assessment, how to interpret a fetal monitoring strip, how to place the fetal monitors, how to start and IV. So by midterm, she had calmed down, she could talk to the patients. She was still nervous and had a bit of an attitude but I thought it was still nerves. That's the improvements I saw. Every single shift when we were walking from the locker room where we met to the nursing station where we received our assignment we reviewed what the expectations for the shift were. Was it an observation day? Was she to be primary with me as a resource? At no time should she have had any question in her mind what her role was in relation to me.

    -On day 1 solo, you lose nothing by re-running through the process for her, as in, first lets do H2T assessment, then we start IVs, etc. especially when she voices her poor IV skills to you in front of the patient (imagine her embarrassment, that's why she said this 'Alice tried to blame me for not making her feel welcome and for "pushing her too hard."')

    This was not her first day solo. We don't always start IVs, sometimes they come from triage with them already in place, sometimes we come in to a patient who has been admitted by another nurse, it was one example I was using of her refusing to take advantage of a learning opportunity. On her rubric it clearly states that if the opportunity is available to practice skills such as IVs, did the student take advantage of it? At that specific point she had maybe 6 shifts left and she had yet to independently start an IV. I wanted to see if she would even try, as I didn't know I felt another chance would even happen. I'm sorry I wasn't clear enough for you. Perhaps you're right that my communication on an online chat board wasn't clear enough.

    “Fast forward to when the patient is complete. Alice is nowhere to be found. I'm in pushing with her and the charge nurse has to find her.”

    -At this point, you were rightly frustrated, but how is it that she left the room without you knowing? That's a major disrespect which likely stems from lack of communication and leadership abilities...on your part. (Please refer to my first comment above).

    We don't stay in the room with the patient, we watch tones from the desk at times. She had many opportunities to wander away, as admit to pushing specifically for this patient and for many patients is often hours apart. And my first priority is my patient. Even my students that have functioned well left the room to run and grabbed needed supplies and didn't feel the need to inform me every time.

    “I've confronted her on it and she always makes excuses, and I've now emailed her faculty.”

    -You confronted her multiple times? Did you once sit down with her to discuss she might be on track of failing this portion of her program? She makes excuses because throughout this 7-week relationship, she simply doesn't respect you (it takes two to tango).

    YES!!!!!!! It didn't always start with confrontation. We had many discussions which eventually led to confrontations,if I was going to detail the entire interaction from start to finish no one was going to read it. It would have been too long. I was hitting the highlights.

    “...she only has 3-4 shifts left with me and I'm getting really frustrated with her...of the behavior I've observed. I feel like she's skated by through her whole program somehow and now she's finally having to actually do it and she can't.”

    -Those who lack good communication skills do experience more stress in life in general. Your resentment of her ("she's skated") likely manifested in your speech and body language => instant or further disrespect of you.

    TL;DR: OP, you had "easy" first 2 or 3 preceptees, now you got a "harder" preceptee and d/t your lack of experience you did not know how to interact with her, ultimately leading to neither respecting either.

    I'm boarding in MS, going to ER training soon, so I'm big with communication skills and leadership abilities.

    No matter how you define leadership, the main focus of a leader is to get the most out of his/her people. And the first step is to get to know your people

    so I'm curious, would you work with her? Based on everything I've seen from Alice, she's going to continue to do this until someone makes her stop or she's made to leave the field of nursing. I for one would not feel comfortable being her coworker because I'd feel responsible for her patients and mine because I'd wonder if she was paying attention to them or even on the floor. The words "patient abandonment" ran through my head a lot with her because literally if I was not directly supervising even the most basic task (read taking a temperature) she was gone. Even if I have the worst communication and leadership skills on the face of the planet, you cannot place 100% of the failure at my feet and I still can't see how you think you can deduced all these terrible shortcomings of mine from my post.

  • Mar 18

    When I was explaining to a patient that smoking cigarettes while you're pregnant could contribute to a low birth weight the patient asked if I meant low birth weight for her or the baby. It was hard to keep a straight face.

  • Mar 18

    Quote from RNNPICU
    Is there a way you could walk over to the Dr with whom she is conversing and say Dr.... I am sorry to interrupt your conversation, I have some clinical questions regarding pt.... and then say I also need to borrow <><> I need her to help me with pt... who needs their blood sugar drawn, or what ever the task is.
    I like this strategy!

  • Mar 18

    Is there a way you could walk over to the Dr with whom she is conversing and say Dr.... I am sorry to interrupt your conversation, I have some clinical questions regarding pt.... and then say I also need to borrow <><> I need her to help me with pt... who needs their blood sugar drawn, or what ever the task is.

  • Mar 18

    I agree with those who have suggested to write up and go up the chain of command. When you write her up, leave out the bit about throwing herself at doctors. Be really short and to the point. A list is fine. 1. I asked her to do X. 2. She told me she did X. 3. I checked, and X was not done. 4. I asked why X was not done, she did not answer my question and walked away. Learn to take out the extraneous information, and you have a better chance of really being heard. Better to hand in 10 half page write ups then three 4 page write ups.