Content That mercurysmom Likes

Content That mercurysmom Likes

mercurysmom 4,564 Views

Joined Jul 25, '11. Posts: 150 (70% Liked) Likes: 479

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  • 1:16 am

    I did my clinicals over 20 years ago. Our clinical instructor was In Charge of us, and was present on the floor/s to supervise us during our clinical experience. We were taught to interact with the nurses only when really necessary; i.e. to report a significant change in patient condition or to communicate necessary patient information. It was understood that we were expected to be extremely courteous and respectful in our behavior towards all of the staff.

    We provided total care for patients from the second week of class, so there was no opportunity to "sit down during clinicals", and I can only imagine what would have happened to a student if they had been found "sitting down." We would go to the hospitals the day before to research our patients, prepare laborious care plans and well researched medication sheets, review any procedures that we were likely to perform, and arrive early at the facility with not a hair out of place ready to begin patient care at exactly the time we were scheduled to be on the floor. We had no doubts about the nursing school's expectations of our conduct while we were at the facility.

    Why has the role of the clinical instructor devolved to the nursing staff being expected to provide students' clinical experience? I have asked this question more than once on this forum, and I had hoped that a Nurse Educator would share their insights, but so far no-one has answered my question.

  • 1:15 am

    Quote from Jensmom7
    I was a student nurse 40 years ago. Frankly, the floor nurses didn't get upset with us for one simple reason; we stayed the Hell out of their way and didn't expect them to teach us the things that were our Clinical Instructor's responsibility.

    We would have been in a world of trouble if we had shown up without having fully researched the patient's chart the evening before, written drug cards for every single med they were taking (the main side effects always seemed to be "nausea, vomiting, constipation, diarrhea and death"), done a complete care plan (some were at least 10 pages long, oy!) and/or talked to the floor nurses with less than respect (still thinking of the "How about a REAL report?" student. No. Just no).

    This subject comes up every few months. Seems like students just aren't instructed on how they should act, and that the floor nurses aren't ancillary school staff.
    Today's students are supposed to be so Internet-savvy. It amazes me that this topic has to come up so often . . . That means those Internet-savvy students aren't looking up previous threads. Which makes me wonder if they're actually asking the question to LEARN, or whether they're actually just here to complain about nurses.

    I went to school about the same time you did, and had similar experiences. One thing I will say about my nursing education -- those instructors made damnsure we knew how to behave on the floor, and we knew that if we didn't behave as instructed, we'd be sent home and our grade would reflect it.

  • 1:15 am

    I was a student nurse 40 years ago. Frankly, the floor nurses didn't get upset with us for one simple reason; we stayed the Hell out of their way and didn't expect them to teach us the things that were our Clinical Instructor's responsibility.

    We would have been in a world of trouble if we had shown up without having fully researched the patient's chart the evening before, written drug cards for every single med they were taking (the main side effects always seemed to be "nausea, vomiting, constipation, diarrhea and death"), done a complete care plan (some were at least 10 pages long, oy!) and/or talked to the floor nurses with less than respect (still thinking of the "How about a REAL report?" student. No. Just no).

    This subject comes up every few months. Seems like students just aren't instructed on how they should act, and that the floor nurses aren't ancillary school staff.

  • 1:14 am

    Quote from nutella
    Not to open up another topic - but when nursing education was based in hospital schools ("diploma" programs) the nursing students were more "integrated" and more part of the hospital. With the academic model, students are not perceived as "part of the team" and there does not seem to be a collective responsibility for students as students pay to get educated - thus nursing school is responsible.
    Having said that, I still think that we need to treat students kindly and make sure they feel welcome. It is the right thing to do. Students come eager to learn (in most cases), they are not aware of the realities of nursing and how little time nurses really have.
    I attended a hospital-based diploma school. All the hospital physicians and staff were pleasant and supportive of us (it was like we were the hospital's "children" ), but, at the same time, our clinical instruction and supervision was provided by our clinical instructors, and the staff were never expected to take time to teach us or take any kind of responsibility for us in clinical. They were well aware that they weren't allowed to supervise us doing any kind of invasive procedure -- if we were supposed to be supervised/observed, that had to be our CI. From my experiences as a student and, more recently, as a clinical instructor, I think that kind of approach makes it a lot easier for the staff nurses to be pleasant and positive about having students around.

  • Jun 24

    Quote from mercurysmom
    As a Mom who had to make decisions surrounding end-of-life care for a toddler with a progressive neuromuscular disease (Leigh's), I truly wish that my child had been able to indicate something, anything, regarding her perception of QOL. Unfortunately, she experienced a rapid cognitive decline just after her second birthday. (Prior to that, she was close to age-appropriate cognitively but had always been non-verbal and blind.)

    We enrolled her in a palliative care program, decided not to initiate invasive ventilation even though she was a candidate, and planned that her only admissions would be for "mechanical issues," such as replacing Broviacs or adjusting her VNS. We hoped to care for her at home in her final days, with support from pedi pall/hospice, depending on whether we were continuing TPN at the time. (She had been on TPN for nearly her entire life, after developing GP and CIPO, rendering her G and J tubes useless except for drainage/decompression.)

    Unfortunately, nothing went according to plan. She had her Broviac replaced because it had split. The trauma of the surgery started a full cascade of complications, from DIC to ARDS to ARF. We were unable to evaluate brain function while she was on a HFOV, and she couldn't even tolerate BID suctioning with pre-oxygenation and the quickest bagger/suctioner in the PICU. She

    When the PICU staff recommended ECMO, I knew that there was no way I could put her through that. We invited family and friends to come and say goodbye, and she was in my arms as we withdrew support. The only "positive" that came out of her demise at the hospital was that the pathologists were able to obtain lots of samples of muscles and organs for research purposes. One of her "unknown pathogenic mtDNA defects has been confirmed as a marker for maternally inherited myopathy with chronic respiratory failure.

    IMO, End of Life plans are in the same category as Labor and Delivery plans:nice idea, but don't think it's the way everything is going to happen.

    In addition, I agree with whichone'spink's post: palliative care can significantly prolong life simply by removing the child from the risk of iatrogenic infections and the stress of a hospital stay. (This is coming from a Hospice Flunkie who is alive and well, working and playing, earning my M.Ed, growing old with my Hubby and watching my two other kids grow up, several years after my "expiration date." [emoji41])
    I'm so sorry for your loss. I can't imagine going through something like that. Thank you for sharing your story.

  • Jun 24

    As long as this doesn't lead to policy making I don't have a problem with anything the parents are doing.

    I wish most sick kids, or any kids for that matter, had parents like that.

    And I envy their belief in heaven. I would certainly feign a belief in heaven for my young child.

    And while I don't believe a child that young can make an informed decision re future events, I don't see anything wrong with talking to her about it and then making the best decision for her as it comes.

    Maybe it will help ease some fears when the time comes, how are we to know anyway?

  • Jun 24

    Funny. Since Julianna has stopped going to the hospital, it's been 1 year since she got an infection. Sometimes palliative care adds a little more time to someone's life because they're not putting themselves or loved ones through the rigors of a hospital stay.

  • Jun 21

    Quote from Emergent
    Yeah, let's ban the nearest and dearest from their loved one's side because they annoy us. We'd all appreciate that when those we care for are ill.

    Just saying, if I was getting in my loved one's nurse's face and asking for coffee while that nurse was trying to hang critical drips on my loved one, and trying to interrupt her and getting upset when she wouldn't stop what she was doing to get my coffee right then, I'd really hope someone would kick me out or at least put me in my place.

    Sometimes the visitors are more than just annoying.


    Random warning ahead: I don't know about you guys, but my workplace is always comparing healthcare efficiency and airline efficiency, feels like. One thing that strikes me is that on a plane, everyone has to behave. In a hospital, nobody has to behave, and visitors are allowed to interfere with critical activities being performed by hospital staff in the name of the almighty satisfaction score. If someone tried to screw with the pilot on a plane, you can bet an air marshal would have that person on the ground in cuffs in a hot minute. I'm a little tired of the airline comparisons when we can't treat our disruptive visitors like disruptive airline passengers are treated.

  • Jun 21

    I work in a prison hospital, visiting hours are never

  • Jun 21

    This is probably not popular opinion, but I do agree with OP and Neural to a degree. I think health care moving towards the customer service model has hurt us in ways we can only begin to imagine. Speaking from my own experiences only, I think the general public view nurses like wait staff. The public knows all about patient satisfaction surveys and that translates to "we can get whatever we want from this place because they need our good score." Family is often in the way of providing personal care, and I too have encountered many rude family members that don't care at all about being in my way. Don't get me wrong - I don't mind family members that are respectful of my job and duties. But family members sending me on drink runs (for them, not the patient), fighting with me over policies like how many people can be in the delivery room, opening the door and coming in whenever they please even though very personal patient care is still happening, or crowding the patient's bed to where I have to constantly excuse myself to do a simple check on mom and baby is really quite ridiculous. I equate it to this. ...say you were a lawyer. If I went in your office and literally threw everything on your desk into the floor and played loud music when you were trying to talk on the phone...that's what it feels like to me. It makes everything I have to get done that much harder. I get upset with ignorance. For instance...when the patient and her room full of visitors are told that the baby needs to stay on the warmer after his bath to warm up so he doesnt get cold stressed/hypoglycemic and then I come back 5 min later and find baby in someone's arms half swaddled.....I've had enough. It's just a total "eff you" and lack of respect for how things need to be done. And yes, this is after they are educated on why we are doing things the way we are doing them. I'd never go to the mechanic and throw his tools around or get in his way while he is trying to fix my car. Would you? Don't get me wrong, I think visitors and families can do awesome things to promote healing, it's not all about the medicine....I really do like to be hollistic. But I'm just tired of the "we know this hospital has to make us all happy and so we are doing whatever we want because we can" attitude. Ok, done ranting :-)

  • Jun 20

    Quote from Crystalroselynn
    Okay at to make things clear I accidentally didn't hit the 'quote' button when replying. This was who that 'it's my Instagram I can do what I want' was for. This post came off rude so that was my reply. I know there are consequences to what I post. I'm not stupid I know what's on the internet is there forever. I was kind of talking about the deletion of accounts as I posted immature stuff when I was younger. I've had my account ta since I was 16. We all make mistakes and now I'm trying to fix what I've done. Sorry if I sounded like a brat to everyone.
    Deleting the accounts might be a good idea. Start fresh with the adult you. I doubt that nursing schools and potential employers are going to go all hacker trying to find stuff floating around from when you were a carefree kid.

    I think deleting old accounts and starting new ones (so those will be the first thing someone finds) is the best solution, since the internet tends to bring the searcher to the newest information. Good luck to you.

    I feel lucky to have been young and dumb in the years prior to social media.

  • Jun 16

    OP, are you questioning the nurse in front of the patient? If so, expect a trip to the woodshed.

    And as for that s3, what is clinically significant about that finding?

  • Jun 16

    Quote from psu_213
    The student replies to me "well, how about a real report."


    Wow. WOW. When I was in school, I had to go to the unit the night before and research my patient and was expected to know all about them, including their scheduled meds, by the time I arrived bright and early 1 hour before shift change. The *only* exception to this was L&D.

    Interesting. Things sure have changed.

  • Jun 16
  • Jun 16

    First of all I suggest you do a search of this site. This question has been asked many times before and there are some particularly good threads with very comprehensive answers to you question. Secondly, I suggest you re-read your post and find the extremely inflammatory and rude sentence that is going to get you burned to a crisp when more people respond. Or get your flame-proof undies on because it's going to get real for you very fast.


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