Gladys* was a senior nursing student, in her fourth semester (out of five) in the rough and tough ADN program. She was very insecure and it showed in her demeanor. She had self-esteem issues and sometimes came across as “goofy.” She was middle-aged and morbidly obese, with an awkward air, and was clumsy. She had a loud, booming voice with a thick country accent and her speech was littered with poor grammar. Her grades were mediocre and she just managed to “squeak by” with a low C each semester.
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Some of the other instructors did not like Gladys. They did not feel she would make a good-quality nurse and they wanted to weed her out of the program.
The opportunity came for one of the instructors during a clinical with Gladys on a specialty unit. The instructor wrote up Gladys for behaving "unprofessionally" and for having difficulty with a lab draw procedure. The more this instructor "rode" Gladys, the more her insecurity grew and the worse her performance became in clinical, a vicious cycle. This instructor meticulously documented each of Gladys' clinical shortcomings. By the time Gladys came to me (during the second half of the semester), she was failing clinical.
Now it was my turn with Gladys. It would be up to me to make the judgment call as to whether Gladys passed or failed clinical that semester. If she failed clinical, she would be out of the program, with the possibility of re-entering one year later. I did not feel comfortable being placed in this position. Gladys would need to perform superlatively during my six-week rotation in order to overcome all the "black marks" from the previous six weeks and to earn enough points to pass.
The first clinical day during the second half of the rotation, Gladys had a "deer in the headlight" look. She seemed terrified and was almost shaking. To alleviate her anxiety, I quietly took her aside and gently spoke to her. I told her, "You're in my clinical now. I am not Mrs. ___. I make up my own mind about students and am not swayed by prior negative reports. You need to put the bad experiences of the past six weeks out of your mind and start anew today." With that soothing overture, she seemed to immediately calm down. I then gently probed, "What can I do to help you succeed?"
The transformation in Gladys from that point on was amazing. She went from being a nervous wreck to a much more confident and competent student. I allowed her space, but kept a watchful eye on her from a nonthreatening distance. I complimented her on positives. I sought her input about her preferences concerning patient assignments and procedures she would like to perform. She came to clinical prepared and her performance on the unit truly was superlative. In fact, patients and staff alike remarked about Gladys' high quality care. She received many compliments on the floor.
Gladys passed the semester and six months later, graduated from the program. After that, I lost track of Gladys.
Fast track six years later. My husband and I are eating lunch in a restaurant in a neighboring town. I suddenly hear a familiar booming voice from the past, calling out my name. It is Gladys! She relates to me about her satisfying career as a corrections nurse. She also appears much slimmer. She states she has lost over 60 pounds since her recent gastric bypass surgery. She seems very happy with her life.
This goes to show, that as nursing instructors, sometimes students can surprise us. Gladys, contrary to all the negative expectations, went on to become a successful nurse working in corrections, which is a very challenging practice area. Gladys is now a contributing and functioning member of society. We have to be careful not to judge from the outward appearance, but to allow the true human potential to shine through.
