Am I off Base? or mentally unstable?

Nurses General Nursing

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Hello everyone,

I need your help. During a meeting with my Clinical AdvisorI was brated for a writing a paragraph in one of my reflections.

I wrote about a violent patient that I had one night that was admitted. He had to be placed in 5 point restraints and was trying to bite and spit on us.

I wrote that I preceived the expsure of salva, to be a risk to the staff and that I had asked my nursing preceptor if it was appropriate to put a OR mask on him. My preceptor said that it was not the policy and I fully accepted this. It was an aside comment to her and I made no attempt to do this.

My Adivior told me that I was completely out of place to even ask this. she state that salvia pose absolutely no risk to us and even thinking up such a thing meant that there is something fundamental wrong with my thinking and perceptions. Since i am not able to judge the risks I put the patient in danger. I told her that I did not accucually put the mask on the patient I only asked the nurse about it and as a student its my role to ask questions. I also repeated that this is my first mental health rotation.

I told her that I in fact do feel that the pt salvia posed a risk for infections like Hep B, herpes, conjuctaivsis and more. Espesically if it came in contact with my eyes or an open wound. She said that no such risk exisits and that my ability to realistically assess risk is suspect.

She then told me that under no curcumstance do we ever put anything on a pts face except a O2 mask. While this I can accept, am I not allowed to ask question as a student?

She then told me that my entire topic (violence in the workplace) was of concern to her as it is not a typical focus of a mentally stable student.

I felt like I had been hit in the stomach, all i could do was nod and hope this meeting ended asap. she says that I may fail if she doesnt feel that I can practice safely.

What I need to know was I out to lunch for (1) considering that spit exposure puts a person at risk, (2) asking a nurse the question about the OR mask, (3) choosing my topic.

or is my preception so outside the norm that I do in fact pose a threat to my patients.

thank you all.

I agree with the nurses! I don't see any problem seeking knowledge unfortunately your instructor was being ignorant. When they can't answer your question they don't know the answer. For instance when we were learning the respiratory system the whole class couldn't understand what peep pressure her response was read the chapter again. My rational thinking was this the heffa didn't know the answer so I went to work and sought out a respiratory therapist. Sometimes you have to go to alternative resources than you instructor. They are there to get a paycheck. They could care less. I say about in every rotation there is an instructor that is not on top of the game he/she thinks. Hang in there! I am not to fond of psych either just get through and learn later! :D :roll

I hafta take up for the advisor, just for the sake of it. Perhaps this advisor has experienced staff members who have trouble relating to people who are "out of the norm." What I mean is, people get used to seeing people they are familiar, and comfortable with. Then, when a human comes along we are not familiar with, our first reaction could be to restrain them. Is this right?

I am just playing devils advocate here, and offering perspective, so please don't attempt to slam me.

Consider the way the advisor may have interpreted your gut reaction? Gut reactions are interpretted differently than thought out ones, and can set the stage right away. You advisor may have smelt fear on you. Maybe they don't want your first responce to be going for a mask.

Please do not attack me for what I am saying. And if you do, more power to you. I just want to assume how the advisor could have felt :-(

Mario

When you have done your psych rotation you will find out that four point restraints are not used because "we see someone acting in a way we are not familiar with". Four point restraints are used when people are violent, threatening to kill, rape, hearing voices telling them to attack or be attacked. These are dangerous people. It is just part of their disease process. They are usually people who are severely and persistantly mentally ill. However, NONE OF THIS is the point of the original posting.

When someone is spitting as a form of intended abuse, violence, etc. GET OUT THE goggles, keep your mouth shut and read the policy and procedure manual. OH, and get an order for a CHEMICAL restraint while your putting the goggles on.

I know that the teacher's role is to be thought provoking, challenging even, but this chick was out of line to give the student a hard time. But then, often that can be the life of a student.

:rolleyes: :stone :cool: zhakrin.........no not off base at all for asking questions and thinking about yourself and safety.........

JMP-----yes, nursing school is a different animal.....either here or there............but lighten up.............

mario-----yes, could see that side of it......teaching is an awesome responsibility(and yes, all......can agree that some(not all instructors ???behind the times))

hey all great replies and support for zhakrin.........

now just a few more thoughts..........

know I don't walk around with my eye goggles in pocket.......

psych..........hate it??????no way..............we all have psych and a psyche...............

now to the question at hand.....

couldn't have said it better myself........mattc......so I won''t.....

amy-----------love your sense of humor and life perspective........

from one that has had (way too many) body fluids spashed in face, os, eyes, etc........you know that paper cut you got yesterday.................

use the best PPP(personal protective equipment) and if in question.....flush flush flush and ...................

keep on nursing and smilin'...................

micro:stone :stone :stone

life is far too serious to take so seriously!!!!!!!!

Sad to say, we nurses have a reputation of eating our young. And I see it more with nursing instructors....and they are the ones who should be supportive.

Sounds as if this instructor has issues of her own that need to be dealt with...and not at your expense!

Take heart....the rotation can't last forever (though it may seem like it). And don't let this stop you from asking questions! There are many of us out there (the majority, I think) who welcome questions and the opportunity to pass along knowledge.

Originally posted by hoolahan

Fergus, relax, you are in no way mentally unstable for your line of thinking. Your instructor is nuts.

.

I hope I;m not mentally unstable, seeing as it was Zharkrin who posted;). I am not a student anymore (thankGOD!) and haven't been in psych since then (I have been in OB for almost 5 years, and never plan on leaving):)

Hugs to you, Zhakrin, I'm sorry you had this experience but we can all remember a power-tripping nursing instructor I'd bet!!

The point about this being an American board with American responses is thought provoking.....you gotta follow policy and current practice in your area. Injury to nurses in psych is a hot button here due to recent deaths of nurses and 'patient rights' overpowering our right to a safe environment....

Your questions and concerns should not have been attacked.

I would swallow hard, and try to get along with this 'instructor' (if anything, silently learn from her poor example) but if she tries to harm your future in this school....well, best ask the Canadian nurses in your area as I would hate to give you the wrong advice...different areas of the US do things differently as well.

Good luck and keep asking questions ...carefully...LOL!! ;)

Specializes in Community Health Nurse.

If your Instructor refuses to do something about the patient spitting on everyone, then you do something to protect yourself as a person who does not deserve to be spit on. Wear protective gear! There is nothing illegal or out of line for you doing this.

Be thankful for having to deal with that particular Instructor's personality in your psych rotation for that particular personality will often crop up again in some of the health care professionals you will have to work alongside of, be in charge of, or have in charge of you during your nursing career.

Nursing is 90% psych, and 10% "other"...IMHO as a nurse. Once you can handle coping assertively with personalities like you encounter with that particular Instructor, you're on the way to becoming the best damn nurse you could possibly be!

Speaking from experience...been there/done that! ;)

Specializes in Home Health.

I'm sorry fergus, had another brain toot! Please accept my apologies :kiss

Of course you are right, I meant to say Zhakrin, sorry to you both. :kiss

Hey...

While we are all so understanding on this issue, how would you feel about the use of duct tape and plastic bags?

OK OK .... just kidding... I agree with this group... Protect yourself, but do your best to protect the dignity of the pt. So many times they have no clue what they are doing...

George

You were absolutely right to ask a question...you're a student, that's what you're SUPPOSED to do. Your preceptor didn't seem to think you were out of line for asking...so I don't know why your instructor has such a problem with it.

Workplace Violence as a topic is EXTREMELY relevant to nursing today. I did a paper on it myself, and I consider myself to be mentally stable! (most of the time) ;)

If your instructor tries to fail you over this, you need to go to the dean of the nursing school, or whoever the instructors' boss is.

Good luck. You did the right thing!

mario...you want a mask?

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