Failing a student in clinical - page 2

by Berkshire1995 | 10,643 Views | 36 Comments

I had a student in the last stretch of clinical before he goes into a preceptored clinical. In the preceptored clinical, they are basically on their own and can ask questions to the preceptor. Graduation is in June. This student... Read More


  1. 10
    Quote from berkshire1995
    i had a student in the last stretch of clinical before he goes into a preceptored clinical. in the preceptored clinical, they are basically on their own and can ask questions to the preceptor. graduation is in june. this student read an order for insulin wrong and drew up 6 times the ordered dose. the student commented that it seemed like a bit much. i was watching and asked the student to read the order again. he continued to say the wrong dose. i told him he could have killed this patient. the student commented that he is "there to learn, that's why i pay tuition." at this stage of clinical, i find this to be unacceptable and dangerous. i could not pass this student. he had been warned for weeks that he needed to improve. he received weekly written evaluations and we discussed ways to improve. he is now contesting this and feels that i was not fair. your thoughts?
    everyone makes mistakes, but the attitude is dangerous. he deserved to fail!
    psu_213, wooh, SHGR, and 7 others like this.
  2. 1
    Was the MD's order hand-written and illegible? Even so, a student nurse should know what the patient's blood sugar is, and should know if the dosage is a safe range or not, unless it was lantus or some other type that doesn't peak. I am sometimes shocked at how much insulin some patients require.
    Vespertinas likes this.
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    Here goes the old crabby LPN. I was taught in nursing school all about insulin, and was tested on it many times. I can't believe a student nurse almost ready to graduate could be so careless about a medication, especially insulin. That BSN student needed the heavehoe too. What was she being taught in school to make her have that attitude? It makes me wonder about some of the students coming up. Sometimes when I read threads on AN's, I just shake my head and click to another thread, because I can't believe the questions they ask. What is going on in some of these programs? I just don't get it!:icon_roll
  4. 3
    Quote from ruby vee
    everyone makes mistakes, but the attitude is dangerous. he deserved to fail!

    i agree, anyone can have a bad day, and make a mistake. but the sense of entitlement was what struck me. a nursing license can be as dangerous as a loaded gun. any medication given should be treated as if it can kill. i work in icu and i see nurses who have been practicing for 30 years ask someone to check their insulin doses. i had one of my fellow nurses show me a syringe the other day and say "i'm giving 6 units of r". i looked at the syringe, but just before i turned my head back to my charting, out of the corner of my eye, i noticed the big n on the vial. it would have been so simple to miss that. we can't be perfect, but we have to try to be.

    i was an older nursing student, and i felt sometimes that the instructors were too easy on the students about following the rules. if they can't follow a simple rule like no cell phones in class, no big, skin tearing engagement rings at clinicals, and save the hot pink "juicy" across your back side for saturday night instead of under your white scrubs, then do you really think that person is going to check the 7 rights before giving meds? i say that if they fail to do what is required in clinicals, then they fail. simple as that. pay or no pay. they are not paying for a nursing license, they are paying for the education. if they fail to learn, then so be it. harsh? maybe, but we are in a harsh profession. the md's are not going to coddle them at 3:00am, and the families are not going to coddle them when they feel their loved ones are not getting enough attention. clinicals and precepting is the time they are pedaling with training wheels on, not laying back and being pushed along the path.
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    As a student myself, I would be afraid of the caliber of nurses coming out of that school had he not been failed. I understand a mistake, we all make them, but he brushed it aside as if it were something that he shouldn't be bothered with. That is SCARY! He could've killed that patient and he thinks it is ok because "he pays tuition" OMG! Stick to your guns, you did the right thing and the public applauds you for it!
  6. 2
    Quote from Berkshire1995
    I had a student in the last stretch of clinical before he goes into a preceptored clinical. In the preceptored clinical, they are basically on their own and can ask questions to the preceptor. Graduation is in June. This student read an order for insulin wrong and drew up 6 times the ordered dose. The student commented that it seemed like a bit much. I was watching and asked the student to read the order again. He continued to say the wrong dose. I told him he could have killed this patient. The student commented that he is "there to learn, that's why I pay tuition." At this stage of clinical, I find this to be unacceptable and dangerous. I could not pass this student. He had been warned for weeks that he needed to improve. He received weekly written evaluations and we discussed ways to improve. He is now contesting this and feels that I was not fair. Your thoughts?
    contesting it on what grounds. You did the right thing. The guy was there to learn but also to follow orders. If he wants to be a fool, there is no law against ignorance. Make sure that you keep any record of the incident and you will be fine and he will be out or repeating Nursing school.
    aileenve and JustBeachyNurse like this.
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    Moderator's friendly reminder: Please keep to the topic at hand and avoid personal attacks. Debate the issues, but do not attack another poster. Please also avoid off topic posts which will only derail this thread. All such posts have been and will be removed from the thread. Thank you and carry on.
    JBudd, pecanpies, nursel56, and 1 other like this.
  8. 0
    It is all about the atitiude! This student should have been grateful that he was stopped before giving the incorrect dose.

    I feel you were correct!
  9. 2
    Quote from ruby vee
    everyone makes mistakes, but the attitude is dangerous. he deserved to fail!
    i agree with this. he sounds like he doesn't care/doesn't comprehend the gravity of the situation.

    i had taken a couple semesters off after my freshman year because i wasn't sure if nursing was for me. when i went back, on my first clinical i made a mistake (not a serious one, but still.) i went to my instructor, practically in tears, thinking i was going to get the boot. my instructor was from the old-time nursing program, very grandmotherly. she put her arm around me and said not to worry, everyone makes a mistake at some point.

    the difference between my experience and your student's is he seems reckless and arrogant. had i made that kind of mistake, it would have shaken me to the core. i think he needs to be dismissed. he's a menace.
    CrufflerJJ and JustBeachyNurse like this.
  10. 0
    As Clinical Faculty it is our job to ethically keep patients safe. In doing so, students must learn the importance of safe medication calculation and safe medication administration. Insulin being a high risk medication and known for medication errors it was vital that you fail this student until he matures and understands the importance of "doing no harm" to patients. Our job as nurses is to keep all patients safe. Safety is key in the nursing profession.


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