Failing a student in clinical - page 3

by Berkshire1995 | 10,644 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. 2
    Met with a face that went white and an "OMG!! Thank you...I can't believe I did that!" might have met with a totally different outcome. This was not something you did to him. He did it to himself.
    FORTHELOVEOF!!!! and Vespertinas like this.
  2. 1
    Quote from Dixielee
    The student defiantly told me that SHE was in a BSN program and she would never have to do "aide's work" and she would find an "aide" to do it.
    My instructor, who I believe has retired now, made it clear that this attitude would get us booted out of the program, no buts about it.

    It's a good rule.
    Dixielee likes this.
  3. 0
    I had limited experience in giving medication during nursing school so when I became a licensed RN, that was really the first time I started giving medication and I was very, very paranoid about making a mistake.

    New nurses, as you know, sometimes don't know what a large dose "looks" like. In other words, because of inexperience, they don't know that visually, it's a larger amount than normally given.

    However, for me, the key difference is that he obviously did not carefully calculate and double check the dose before he drew it up...I am assuming that your school requires students to take a med-math test before they are allowed to administer. If he doesn't take the time to calculate it or tries to 'do it in his head' in clinical, he will absolutely do it in practice....THAT is what makes him dangerous.

    Not only that, he didn't even seem to care about the error nor care to check his work when he was clearly instructed to do so.

    I would be mortified if I had made an error like that in clinicals.

    I am all for changes, but I would have failed him too...mostly for his attitude and not performing due diligence.
  4. 0
    I am in an ADN program and I am flabbergasted at the OP and the comments. This would not fly in my program at all!
    Last edit by VickyRN on Apr 15, '12 : Reason: offensive comment removed
  5. 3
    Quote from reagansm
    I am in an ADN program and I am flabbergasted at the OP and the comments. This would not fly in my program at all!
    Not all BSNs are like this person. I think it all depends on the person, their maturity, and the values of their program. I have worked in healthcare before my bachelor's and my school and professors are very clear that we are in no way better.

    I deliver meal trays at the hospital. A student from a local college (not BSN) approaches me with a dirty tray in her had, literally drops it into the med prep station counter in front of me, and says "Get rid of this." And walks away. If that had been me, my professor would have skinned me alive.

    Anyway, this person the OP is talking about obviously has a bad attitude and would be dangerous in a practice setting regardless of their level of education.
    Last edit by VickyRN on Apr 15, '12 : Reason: quoting offensive comment which was removed to avoid ADN versus BSN derail of thread
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    It seems to me the school has a simple decision. Either they condone that student's performance or they don't. I suspect as long as you are not willing to change your objective description of the problem, the school will not want to accept the liability of passing that student.
  7. 1
    Owned up to the mistake and recognized the danger in it = maybe pass

    His attitude and the way he presented to you = automatic fail

    We all made mistakes in clinical and in school but its how you deal with it that sets you apart from this kid and nurses that make it through and are good.
    jelly221,RN likes this.
  8. 1
    The student had been warned for weeks that he needed to improve. He drew up 6x the ordered dose and read the order incorrectly a second time. He seems to feel paying tuition takes precedence over being appropriate. He would have been more on his own in the near future....

    Let me be devil's advocate, and all these thoughts and the questions are rhetorical...

    Did he argue over giving or not giving the insulin or did he accept that he was wrong? I think his response could have been a bit of an attitude that some have that isn't intentionally saying he's without fault, but more of a, "wow, I'm here to learn and now I have." I wasn't there, so I can't judge completely. Was he voicing entitlement or a different way of accepting the situation?

    The fact that he would be going into a less-observed clinical next bothers me, though, since if he didn't ask someone to verify insulin dosage, he very well could kill a patient. I'm not sure I'd fail him, but I'd be watching him like a hawk and his autonomy would be tiny until he would show me he had earned it. I don't know how your school is set up to monitor the preceptored students though, and maybe watching like a hawk isn't possible?

    Insulin doesn't require another person to verify the dosage where you take your students? The verification is there so such errors don't get injected. If that policy isn't in place, it should be! Was he ignoring it? Did he come to you for verification?

    Would you fire a coworker who responded as he did (if you could fire) or would you work to make sure the coworker knew what was correct, so it didn't progress to injection, and so the coworker would be more careful the next time?

    Other than this incident how has he improved or stayed the same, or gotten worse? How does any improvement stack up against the non-improvement and glaring errors?
    Last edit by Whispera on Apr 15, '12
    VickyRN likes this.
  9. 0
    Sounds like he needs an attitude adjustment. I think you did the right thing in failing him, when he said " it seemed like a BIT much" was a red flag that he wasnt going to ask about if the dose was wrong or not, plus he continued to repeat the wrong dose? I would have rewritten the order on another piece of scrap paper and ask him to read it again.....maybe he was seeing something else on the original? I know I came across some horrific handwriting in my days.......on ALL levels of healthcare, from social workers to doctors!!!!! WAS HE going to question the order? Did he FEEL something in his gut that the dose was drawn up incorrectly or written wrong or anything or did he just assume? He definitely sounds like a major accident waiting to happen and when you said to him "you couldve killed a patient" He comes back with" I am here to learn and I pay tuition? So...to him killing a patient is a part of the learning process!!!!!!!! NOPE, take your stethoscope and go home.!!!
  10. 0
    Quote from azhiker96
    It seems to me the school has a simple decision. Either they condone that student's performance or they don't. I suspect as long as you are not willing to change your objective description of the problem, the school will not want to accept the liability of passing that student.
    Do you want the responsibly of passing that student and maybe with his next injection of insulin kill someone and give lip to anyone that points out his mistake. it's not black or white, it's shads of gray. Perhaps if he was more caring he might still be in school. But he wasn't. We could go on and on with the 'What if's"


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