Am I wrong?

[moongirl]

My CI was all over my case and I dont feel I did anything worng and sure would like some opinions.

I went in to pts room to hang a IV abx with instructor. The pt was elderly, a bit confused and I told her I was going to hang her Levaquin. She said" Didn't I already have that today" I was just coming on shift, so I referred to the MAr, and said no, that was your Vancomycin." she says "Oh" so I go to setting up the pump with a bit of cueing cuz this is only like the 3rd time I have used this type of pump- different from other hospital I was previoulsy at- and while I am doing it, the pt asks, "well what was that little pill I had this morning", and I glance down again at the MAR- still priming, spiking etc, explain the med. WHen I am all done I leave the room and get lashed by the instructor telling me that I should have told her to wait and ask her questions when I am done setting things up and that " I converse alot when I should be concentrating" OHHHHKAAAY. if a pt is questioning you what your are sticking in their vein do you politely tell them to shut up and keep doing what YOU want to get done or do you answer them so that they feel better about WHAT you are doing? I dont think I was wrong.. was I??

She has made me feel terrible about myself. It wasnt like I was asking the pt what she watched on TV last night, or if her son came in to visit, or that I was making idle chit chat, I was responding to her questions...

sometimes I feel like I cant win.

I dont know whether to stand up for myself or bawl:o

[LadyT618, MSN, APRN, NP]

I think you did the right thing in answering your patient's questions about her meds. And like you said, it's not like you were just chit chatting about nothing. Keep your head up.

[nurse4theplanet, RN]

I do not agree with your instructor.

Sometimes med errors can be discovered by the patient inquiring about what they are getting and questioning the nurse/student. I feel that you acted appropriately. I would have done the same.

Perhaps your instructor was hurried, or felt that you could have performed better if you had been concentrating only on your actions, or maybe he/she felt like you should have clarified such topics before you began hanging the IV...don't know.

Best thing to do...discuss it with the instructor.

Next time, go into pt's room and tell them you are about to give them whatever medicine, allowing them to ask their questions. Then retrieve instructor, and perhaps prime IV before entering the room...that way once you are in the room you just have to announce what med you are about to hang and fool with the pump.

[ms_orion]

Maybe the instructor could have helped out. You do what you need to do and she could be observing you while discussing things with the pt. Anyway, i think YOU were right

[Pompom]

Sounds like your instructor is nit picking. If your major infraction is educating your patient about the medications she received then you should recieve a gold star!

[TazziRN, RN]

You were right. What if she had already gotten the levaquin and you didn't stop to check? Don't ever brush the pt off when they question what you're about to do, always stop and explain or check...otherwise you a) may be guilty of assault if the pt doesn't agree with what you're about to do and you do it anyway and b) you risk a med error.

[carolCCRN]

Nursing school for me seems like such a long time ago. I learned to "stay under the radar" and say "Yes, Ma'am" alot because right or wrong, instructors wield a lot of power (and some of them really like it). You know you were right to address your pt's concerns immediately, and you should continue to do so. It keeps you and the pt safe.

Now, you may want to practice a little phrase I've used often- "I hadn't considered that." It buys you a little time after the unexpected slam to catch you breath. I never saw a student win an argument with an instructor, so look at this as an opportunity to learn not to take it personally. Most of the time when someone lashes out like that, it's about them, anyway.

[RGN1]

I agree with the above posts, after the "I hadn't considered that" phrase (indeed a good one) you can then go on to say "would you explain how you would have done it so that I can do better next time?" Then watch them squirm as they realise that perhaps you did the best you could & actually it wasn't so bad afterall!!

I think you did just fine!! As the others have said you can so often prevent a med error from just such a conversation.

[ms_orion]

Tazzi - your post says it all. NEVER brush off the pt. Exactly right! What if she had already recieved the Levaquin.....

[lovinghands]

I think your instructor wanted you to concentrate on your task at hand = much easier said than done. There are times that I need to ask a patient to give me a moment when performing a task but when it comes to meds, I will stop and listen. Once the med is given, it's given and there is no turning back. Best wishes to you in your nursing career

[Tweety, BSN, RN]

You stand up for yourself. You might go to the instructor and clarify "I'm a bit confused, a patient asks me a question during a procedure, how should I respond. Evidentally answering the question is incorrect."

I've had a couple of "near misses" when patients have said "didn't I get that already...........".

Unfortunately nursing school can be like a game, you're not the coach and you have to play by their rules.

[weirdRN, RN]

While in nursing school, listen to your instructors and do as they tell you to. When you get into nursing on your own you will have to relie on your own judgement to do the right thing.

Personally, I always listen to the patients concerns and address them prior to doing any med administration. Yesterday, I had a resident who asked me if she had already taken her meds when I was giving them for the first time that day. That she was confused led me to believe that she may have an infection going on, a UA confirmed it.

Learn all you can while in school, they teach a lot of good and valuable things.