After 10 weeks, my biggest fear has come true...

[katie92]

I had a patient that went completely bonkers on me.

Now don't get me wrong - I expected this at one point, I understand that this job isn't pretty all the time, but the way I'm feeling after today's clinical is almost hard to put into words.

So obviously, I'm a first semester student and as a lot of first semester students are, my confidence levels while in the clinical setting are pretty "derp", for lack of a better word. I don't show this to the patient or my instructor, but the things going on inside my brain...

Anyways, I knew this time would come. I'd mess up and get yelled at, or I'd just do something totally wrong.. but, that's not what happened actually... I'd almost rather that had happened. I had a patient go nuts at the fact that I was a student, and nothing more. All I was going to do was maybe give him a bath, take vitals and give him his meds (Which I told him). And he completely flipped on me. And this is something I've honest to god feared the entire time, someone telling me to **** because I'm a student, and you know I'm sure it happens, but I feel so discouraged right now. I don't ever want to go to clinical again.

My confidence was already low, but now every time I walk in a patient's room I'm going to be thinking "Do they not want a student? Is this person going to yell at me because I'm a student?" This guy was so mean to me throughout the day, both my instructor and the RN apologized to me like five times each. My instructor said if I would have mentioned how bad it was earlier she would've had my patient changed, but I didn't want to seem like a cry baby or something so I didn't really go into detail on how things were. She ended up telling me to just do "the bare minimum" and "get in and out as fast as you can" and I did.

I don't know even know what I'm looking for while posting this. I just wanted to rant I suppose and see if anyone has any advice or had a similar situation.

[The_Optimist]

Not a good experience to be sure Katie92.

I'm also thinking, that this might be a case of self-fulfilling prophesy. This was your worst "nightmare" at clinical and you had been dreading it. It is also very possible that you may have put into motion, actions (non-verbal communications) that brought this behavior from the patient into play.

Rule 1: When in "enemy" territory, do not show fear, even if it is killing you inside. But remember, you got out of that situation- it did not kill you. Now you can consciously CHOOSE to not let that situation deter you from your clinical.

You can also build up your confidence by taking up "softball" patients, if your instructor would let you. Otherwise spend a few minutes each day in front of your mirror perfecting your most affable but passive face. Enjoy nursing school.Mazel Tov:)

PS: Your instructor or the nurse should have paved the way for you too.

[autumn_october]

This happened to me! It was a teaching hospital, and they were fine with student doctors, but God forbid a student nurse touch them/their mother. People do have the right to refuse students, so if they do, inform your clinical instructor so you can switch to another patient. And don't take it personally--people in hospitals are out of their element, scared, sick, and in pain. You were only trying to help, so don't sweat it.

[Stephalump]

The best thing about this situation is that this was your worst fear.

You've now faced it head-on and lived to tell the tale.

[SwansonRN]

I think of it this way, our jobs are to deal with people and there's a guarantee that we will come across patients that we don't get along with. It's bound to happen. This patient was behaving like a bit of a toddler, but don't take it personally. A very wise nursing manager once told me to "let everything roll off you like water on duck feathers". The other day I had a patient screaming and throwing things because his food was taking too long to come up from the kitchen. I dealt with the situation, he wound up apologizing, and I never let him affect my mood.

You will be very surprised how far confidence will take you with patients. Give off the vibe "I know I'm supposed to be here doing what I'm doing." It's something that has taken me a while as someone who looks very young with social anxiety to figure out how to do, but now I get a lot more respect from patients and families right off the get go.

You will be just fine! You conquered your worst fear and kept taking care of the patient when most others would have given up. You did a good job, so be proud of yourself!

[wannabecnl]

I had a patient when I was a student who told her next nurse that she didn't want me to take care of her again. No explanation, no reason, no problems or errors, just didn't like me. She did fine with my male classmate the next day but had issues with other nurses on the floor who looked like me. Hmmm...

Also, I agree with the self-fulfilling prophecy theory above. If you go into the patients' rooms worrying that they won't trust you, you will not seem credible to them (no reflection on your ability, but patient perception IS their reality), and they will not trust you! Even after 6 months on the job, a wise colleague pointed out that I was still acting apologetic for being new, and that made me look less trustworthy to the patient. Not that you should ever have actual false confidence or think/claim you know more than you do (which is dangerous), but there's nothing wrong with a little "fake it till you make it"! Most patients want to trust us, but they are very vulnerable. If you can make them more comfortable by walking in with a confident smile, as if you are exactly where you should be (which you are!), that is worth a lot to them.

[Dranger]

Not judging your personal style......however.....I am sure that baiting a patient and communicating with them on their level is NOT the best advice to give anyone...especially a student.

I have been a nurse for 35 years....all critical care and emergency department. I have dealt with every walk of life, level or intoxication, mental illness, and personality. I became a nurse at 18 (child prodigy) .....I have had my fair share of dumb blonde, get me the real nurse, you are too young, "head nurse", dirty knee jokes and racial slurs...to last a lifetime.

Never, and I mean NEVER, regardless of the socioeconomic or health status/problem, have EVER I baited a patient by inferring I would with hold their treatment/meds in order to gain cooperation or to control their behavior.

OP....welcome to nursing...((HUGS)). You will be working with the general public, sigh, and meet all kinds of, shall i say, personalities and preferences. Step away, don't take it personal, and realize you will NEVER make all the people happy all of the time, you can't fix stupid, and some people are just jerks...defecation occurs....((HUGS))

I am not advising the OP to act like me but if you were there you probably would have laughed at how I said and delivered it. It wasn't confrontational or coercing at all. I know what and what not to say in a clinical at atmosphere without being too brash.

Perhaps because I am a human being and I expect to be treated like one. In NO other profession that I have witnessed do employees get treated like a nurse does. Where else can you you be spit on, hit or berated without any defense and rarely anything come from it? Cop? Yeah right. Flight attendant? Air marshals. Retail? Security guards. Under the guise of sickness or medical problems everything seems to be fair game.

I never was going to her hold her meds that's not my job to decide but I don't see how reminding her that even as a lowly student I am still acting as her nurse for the day which includes giving her coveted pain meds, conducting assessments etc. Seriously, I am doing theses things without pay and while I am doing the best I can can I get flak every step of the way. Yeah screw that. It is not OK for an employee to go to work and wonder if they will be yelled at or demeaned in some way day in and day out and just because it is the saintly profession of nursing where everyone trusts us and we have no faults doesn't make it any better or acceptable. We are providing a service, a service called care and with that service we still have rights that the patients should not abuse no matter if we are a nurse with 35 years experience or a student.

[Susie2310]

When I was a student we went to the hospital the evening before clinical to get our assignments and to research patient information related to the care we would be giving. We also introduced ourselves to our assigned patients and explained we were students in the nursing program at xyz college, and would be helping to take care of them the next day. We were told by our clinical instructor that if a patient told us they didn't wish to receive care from a student, that we were to politely say "thank you" and we would not provide care to that patient. It was understood that we would obviously inform our instructor if this situation arose. Our instructor told us that there may be many reasons for the patient's refusal of a student, and gave the example of a patient saying "I'm too sick to have a student."

If the patient told you they didn't want a student or indicated by their words and behavior that they were uncomfortable with this arrangement, I believe you should have brought this to the attention of your instructor as soon as possible. A competent patient does have the right to refuse care from anyone for any reason.

Along with nurse156, it appears to me too that you were put in the position of caring for a patient who was apparently refusing care from you, and that there was a system failure.

[microkate]

Awww, I'm sorry that happened to you. The one that drives me nuts is when I hear other nurses who won't allow students to take care of them! Had it happen to a classmate of mine. When I had my first baby I was in a teaching hospital and I had med students, residents, and nursing students all over the place. I even let a student nurse anesthetist place my epidural. It was a little nerve-wracking, but she did a fabulous job.

[Ladyt03]

Number One: as a nurse you need to build your confidence. Lack of confidence can make you mess up easily. You're already a nurse. Better to be brave and fail than to be afraid and fail.

I am a nursing student. I work at a hospital. I have worked as a clerk at my job where I had every day direct contact with the patients. This opened my eyes to alot of things. There I learnt that no matter how nice and kind you are to people, when someone is generally ANGRY, some of them do not accept sincerity and lash out at you for absolutely no reason. Some people are angry for all kinds of reasons. With patients, majority of the time its cause of hormones and terminal illnesses.

This patient you had really acted ignorant but, try to understand it from his end and dont take it too personal. he might have been one of those who's naturally angry cause of a terminal illness. He might be one of those who lost trust in his care cause you were associated with the name STUDENT.....meaning, he may have felt like a lab rat. I am sure there are people in this forum or you, might have felt that you would prefer an experienced person take care of you than a student. you may have more trust in the experienced individual. it seems a bit ignorant but its understandable. also remember that different people handle things differently. i tell you, DO NOT use that to discourage you because, take it from me, THERES MORE TO COME. everytime you're faced with an incident like this, just smile and in your head say its not personal. keep telling yourself its not personal. continue to be kind and pass on the patient to someone else. AGAIN, DO NOT BE DISCOURAGED. IT COMES WITH THE TERRITORY. BUT STILL BE YOU. STILL BE THE CARING NURSE YOURE SUPPOSED TO BE.

[kmlpennington]

I hate sounding like a mean person myself, BUT you're going to be presented with this A LOT as a nurse. And if this makes you think about quitting then what are you going to do when patients are threatening you and looking at your name badge so they can research where you live and etc.? You have to brush it off because you're not going to be able to concentrate on anything!!

Don't let it get to you its just a patient. There will always be grouchy individuals and you can't let it get in the way of your mindset.

[Meriwhen, ASN, BSN, MSN, RN]

Some patients do not like having student nurses for whatever reason. Maybe they're very nervous about their condition, maybe they had a bad experience with a student in the past, maybe they don't have the patience to deal with a student and a hovering instructor, maybe their mind is elsewhere and they don't want to be pestered roo much, or maybe for absolutely no good reason whatsoever.

Regardless of the reason--or lack thereof--it's their right to request that they don't have a student nurse.

All you can do is notify your clinical instructor and move on. Don't let it get to you. If this one incident makes you you want to quit nursing school, you may want to rethink your career choice--once you are calmer--because it won't be the last time you're "fired" by a patient, I promise you. It's going to happen when you're a nurse as well. You just can't take it personally.

Flipping out on you is unacceptable, however. Again, tell your CI and let him/her handle it, and don't let it get to you.

[Esme12, ASN, BSN, RN]

I am not advising the OP to act like me but if you were there you probably would have laughed at how I said and delivered it. It wasn't confrontational or coercing at all. I know what and what not to say in a clinical at atmosphere without being too brash.

Perhaps because I am a human being and I expect to be treated like one. In NO other profession that I have witnessed do employees get treated like a nurse does. Where else can you you be spit on, hit or berated without any defense and rarely anything come from it? Cop? Yeah right. Flight attendant? Air marshals. Retail? Security guards. Under the guise of sickness or medical problems everything seems to be fair game.

I never was going to her hold her meds that's not my job to decide but I don't see how reminding her that even as a lowly student I am still acting as her nurse for the day which includes giving her coveted pain meds, conducting assessments etc. Seriously, I am doing theses things without pay and while I am doing the best I can can I get flak every step of the way. Yeah screw that. It is not OK for an employee to go to work and wonder if they will be yelled at or demeaned in some way day in and day out and just because it is the saintly profession of nursing where everyone trusts us and we have no faults doesn't make it any better or acceptable. We are providing a service, a service called care and with that service we still have rights that the patients should not abuse no matter if we are a nurse with 35 years experience or a student.

I get what you are saying I really do....however....you were lucky that patient didn't flip out on you.

I never condone abuse from the patients.....but it is a reality. There are way to handle it and way to ignore it. I have been firm with patients and informed them that their language will not be tolerated and they can shout just as loud in jail

As nurses we are obligated to treat patients...unlike any other profession.....even when they are not behaving appropriately...unlike any other industry...we can't turn them away for being a jerk. while I will tell a patient that I do not response to "Hey B word" I don't imply that their treatment will be any different because they are...how shall I say...less than polite.

I work in the rough and tumble world of the ED and I have worked in some rough areas...I can be as tough as nails. I just don't equate the care they receive with behaving.

I just don't.