Published Feb 23, 2018
RNintraining622
2 Posts
Hi All! :)
I am in my second semester of nursing school and was looking for some advise. This semester I am in two clincials (one med surg, and one psych). A couple of weeks ago during my med surg clinical I was assigned a pt who just had back surgery and developed delirium within the past couple of days. When I first went in to introduce myself to the pt she told me to get out and that I was incompetent because I am a student and didn't want to talk to me. I told her I would give her some space and come back later to check in with her. My hopes was that she would cool down but she was even more amped up the second time she saw me. I went a head and performed vitals feed her breakfast (she had tremors and couldn't feed herself), and gave her a bed bath. The whole time she continued to tell me that I was incompetent and that I wouldn't make it in nursing and she would make sure of it and ruin me. Needless to say she made a lot of rude remarks towards me and other nurses/staff memebers that came in through out the day. What really hit me though was her telling me that I don't have what it takes to be a nurse and that I am not a good nursing student.
I had another similar experience in my psych clincial. A pt walked up to myself and one of the other students and he told her that he could tell by looking at her that she was going to be an amazing RN. He then looked at me and said I'm not so sure about you, but then he laughed and said he was kidding but continued to compliment the other student.
I took both of those comments really to heart. I'm looking for advise to see if this has happened to anyone else and how they delt with it/didn't take it to heart.
Thank you so much!!
Triddin
380 Posts
Eh. I'd brush it off. You are really the only person who can determine how good of a nurse you'll be. You also have to remember that with delirium, people aren't in their right mind. It can make sweetest little old granny cuss like a sailor and be all sorts of insulting. You have to remember it's the delirium talking. As a student, it's easy to be insecure about your practice because you are learning a whole new skill set. Celebrate your strengths, recognize your weaknesses and work on improving them
AceOfHearts<3
916 Posts
There is a reason the patient was on a psych ward...
You will hear all sorts of awful things flung at you as a nurse and you just need to take them with a grain of salt.
I've had a patient get so worked up in delirium that all the staff were terrosits and we had planted a bomb in her room.
Neither of those patients were in any state of mind to accuarately predict what kind of nurse anybody would be.
Here.I.Stand, BSN, RN
5,047 Posts
1) She had made up her mind before she met you, and 2) you aren't alone on the receiving end of her vitriol. That says it's about her -- not you.
Going forward, if a pt expresses opposition to working with a student, approach your instructor. The pt *may* feel better after some assurance from a longtime professional... but if not, that's her right. If she refuses a student, your CI needs to find a new pt.
You don't have to accept verbal abuse, and it's ok to say "it isn't ok to speak like that." If the pt isn't truly abusive but merely irritable/salty/snarky/difficult to please/a jerk, take it as an opportunity to deal with difficult people.
blueskynurse9
20 Posts
Try to remember that whenever we are treating our patients they aren't at their best, especially if there is delirium involved; whether from illness or even medications. I remember a couple instances while training in clinical when I was verbally beaten up by my patients and it too left me feeling depleted. Over the years I have learned that unfortunately in nursing we open ourselves up to being targets for people who are either very ill and acting out, or completely out of their minds.
bugya90, ASN, BSN, LVN, RN
565 Posts
It happens. Especially to those who work with populations who are not in their right mind (dementia, psych, etc). I was called all kinds of fun things when I worked in a nursing home. I worked a lot of evenings/nights so I got to deal with the sun downers. You'll learn to just let things go and not let it get to you. As long as you are not causing harm or neglecting your patients, you're fine.
RNperdiem, RN
4,592 Posts
She probably would have said that same thing to any nursing student, not just you. Some patients just pick what they suspect is your weak spot and try to insult you there. Delirium doen't help judgement any either.
liluiass
23 Posts
Patients are people and not all of them and kind and sweet
some just refuse any student ....you either have to change their mind about you or change the patient and talk to a colleague or superior
I had patients refuse me because I looked young too young for them ...like you look 16 are you sure you're a nurse
I'd prefer that other nurse with the beard on hahaha
don't worry about them since you didn't do anything wrong and even if you made a little mistake we all do...it doesn't mean you're a bad nurse
if you see that you lack in some skills work on improving them and you will feel better about yourself..
Eris Discordia BSN, RN
277 Posts
Don't take either of those scenarios to heart. Delirium can make people nasty...it's an altered mental status after all.
As for the psych patient...take it with a very small grain of salt. I've had psych patients insult everything from my grey hair to the way I BREATHE. One day I'm "the best nurse ever!" and the next I'm Jezabel reincarnated and Satan's handmaiden. Meh.
Some normal people with no excuse are just cantankerous and don't like students of any variety...or they seem to smell fear or any lack of confidence and attack. It is what it is.
With time, it will eventually start rolling off your back.
Wuzzie
5,221 Posts
Here's how I used to deal with that. Walk into room with narcotic in hand. Patient begins hurling insults. I sweetly say "it appears you're having a difficult time at the moment. I'll come back with your pain med when it's over." Mean, nasty person will suddenly become quiet and consequently sneaky boundary has been set. Truly crazy people will keep at it and I shut off my ears and complete whatever task needs done.
Seriously though. You really need to pay no mind to what your patients with some sort of psychopathology say. It isn't personal. It's a symptom. Now your alert patients are a whole other story. I do not agree that being ill or in pain is license to mistreat those who are trying to care for you. Don't smile, don't laugh at my bad joke, no eye contact, one word answers and general grumpiness. Go right ahead but personal attacks, foul language and physical aggression will not be tolerated and I will call them on it in a heartbeat. I'm never unprofessional when I do it and I don't give them an option for another nurse (why do that to my colleagues?) but I make it very clear that I am not to be abused. it generally works and when it does they get the personal care they desire. When it doesn't they still get excellent nursing care but I will minimize my interaction with them and I do not react to their insults. They get really bored with it pretty fast and after awhile don't like the impersonal (yet still good) care. While they might not stop with me I've found they often settle down for the next shift and it gets better from then on.
Supr760
17 Posts
The patient was in psych. You are fine. This won't be your last patient to tell you that. You will see as you progress through your program, you will encounter all kinds of patients. Brush it off. Anybody with a mental health issue telling you that you are awful as a student isn't in the right state of mind. You did everthing right!
Kaisu
144 Posts
On one of my clinicals, I had a patient, an older gentleman, look at me and say "Aren't you a little old for this student nurse stuff?" LOL I laughed and said "Yep" and then proceeded to take care of him. Gotta have a thick skin in this profession.