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Discussion

Am I wrong?

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

Featured Replies

  • Author

thank all of you SO much. I really needed some advise from experienced nurses- and other students too- thank you

I really felt I had not done anything wrong and actually was kind of shoked to get a lecture on being too chatty when it boiled down to questions that only pertained to meds. I understand the need to complete the task effeciently, but I just thought that what I did actually was good- not bad, adressing pt concerns.

School blows.

:chuckle Hang in there. lol

Ditto the above responses. Everyone has bad days; the trick to both nursing school and nursing is to have those pat responses that are nonconfrontational.

You also asked about how to deal with patients who talk talk talk during procedures. If I'm starting an IV on a hard stick, I will smile and say "I want to put all my concentration into this right now, but I'll be glad to answer your question in a moment." I would rather have a nurse do that for me than be a Chatty Cathy and miss a vein. I think just being upfront with patients - that way they know you are a nice person and will talk to them, but also that your first concern is them and their treatment/safety.

Good luck!

  • Experts

Personally, I always listen to the patients concerns and address them prior to doing any med administration. .

I think this 3rd approach is the best one. You should have paused in your attempt to hang the med and talked with the patient first ... resolved the med issues ... then returned to the phyisical task.

In essence, I think that both you and your instructor were partly right and partly wrong. Your instructor was right that you should not be working on a phyisical task that was new to you with your focus on answering the patient's questions and double-checking the med. You are too much of a beginner to do both at the same time. However, you were right that you should address the patient's questions and double-check the med prior to giving it. The BEST solution would have been to answer the patient's questions and double-check the med and then perform the unfamiliar phyisical tasks involved with hanging it.

This situation would make a good test question.

llg

I'm a new RN, about six months out of school. Sometimes when a patient is talking to me while I'm doing something that I need to concentrate on, I will politely tell them, hold on one second and I'll explain that. Sometimes if I do quit what I'm doing in the middle, I get sidetracked and forget, like accidently set the pump wrong. They understand, and it's for their safety.

You were right. It's not always going to be like that. You just have to put up with stuff like that while you are in school. When your on your own, you'll do things your own way, and it sound like your way is the right way. Every single thing you do is for the patient. Not for you, the facility, the doctor, the instructor, the family, or the insurance company. You chose this path to help the helpless. You knew what to do and you did it. I not only would have done the same thing, but I may even completely stop what I'm doing, put the stuff down, and sat down with the patient and talked even more about it. What the med is called, what she's getting it for, how often she gets it, and whatever she wants to know. Trust me, it may take 5 minutes from your busy schedule of a million things to do, but you may be the only one to take the time to do that. I can't even tell you how many times I've been trying to give someone their meds and they ask questions like, "didn't I already have this today?" or "Then what was the pink one for that the other nurse gave me?" And for some patients I will even write down a list of their meds, the times, and what their for; that way it will be handy for the next time they ask me, and they feel somewhat involved in their own care. Keep up the good work and don't let sour pusses get you down. You knew in your heart you were doing the right thing, so chin up.:kiss

The bottom line is this- WE are here for the Patients. Period.

Your instructor was obviously trying to have you concentrate on med admin. Vitally important. However, this is OVER-RIDDEN by the fact the the Patient ALWAYS comes first!!!

You could have compromised- Stopped what you were doing to allay her fears/concerns and spend 5 minutes just talking with her. Then, completed the IV setup.

Keep up the good work!!!

  • Author

thanks! You guys are the best!

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