At wit's end

CBlover, BSN, RN · Sep 24, 2015

Ok...you were dismissed from school for failing to identify a patient (who was a student in a simulation?) and for not taking vital signs correctly? Do you mind elaborating a little more? And is this in the US? From your post it seems English may not be your first language. Perhaps there were some difficulties in school due to this or?

Insearchof · Sep 24, 2015

I really don't know what else to tell you, I was dismissed for exactly what I stated above. Failing to identify patient and not taking Vital signs accurately.

**NICU Guy, BSN, RN** · Sep 24, 2015

There is more to this story than what you are telling us. What else in previous labs/sims/clinicals were you making mistakes doing or not doing? Sim labs are a time to make mistakes without injuring or killing a real patient. I can't imagine a school dismissing a student for incorrect vitals and not identifying a patient in sim lab.

Insearchof · Sep 24, 2015

You are exactly right; labs/sims/clinicals should be the only place that you make mistakes in. However, it happen to me, I forgot to identify the patient before giving an injection on two occasions and inaccurately taking vital signs during two Sims labs. Let's just put it like this I made some mistake during the clinical labs and therefore I have been dismissed due to safety issues is what I was told. Believe it or not

NurseGirl525, ASN, RN · Sep 25, 2015

Are you a first semester student? Is this a for profit commercial school? That is the only place I could see this happening. Unless, you attempted the check off too many times and failed the check off therefore failing the lab, therefore failing a class. Some places do dismiss you for failing a class. I know we got three attempts at each check off. If you failed all three, you failed the course. By failing, that meant missing more than two critical indicators on each check off. Identifying a patient is a critical indicator. But, you are only dismissed from the program if you fail two classes.

They cannot send you out to the clinical setting if you are not safe. Failing to identify the patient during passing meds is a big no-no. They also need to ensure you can take vital signs as the nurses and CNAs at your facility will be relying on you and your vital signs. If you mess up on someone who is say in a hypertensive crisis, that person could die. So you do have to be safe.

We had open lab where we could go in and practice each thing before a check off. Like I said, we got three chances. I do know of people who failed the lab course after failing all of their designated check off skill attempts. We were given tons of time to practice so we would not screw up that day. Did you try and meet with your instructor after at least your first failed attempt? Were you understanding why you were failing? I see you failed several times for the same thing not identifying a patient. You still have to verify patient name and date of birth every, single time. It does not matter if you know they are your patient and who they are. You have to verify each time. It's done in the hospital also. I know it seems silly, but it's for patient safety.

If you were in clinical and you did not identify your patient before med pass because you say you knew who they were and the state joint commission was in there, that clinical site would be in big trouble. They would be disciplined and your school would lose that site. Clinical sites are hard to come by. Yes, lab is the place to make your mistakes. But you were making a big one repeatedly. Therefore, you are not safe.

Insearchof · Sep 25, 2015

This is what was stated to me due to the fact I fail to identify the patient on 3 occasion, and inaccurate BP. Any suggest as were to go from here, I know what I am doing wrong, its just I forget along with nervousness during lab. I really don't know why I made the same mistake on three occasion. What should I do to help correct this error. :barf02:

mrsboots87 · Sep 25, 2015

Your original story implies you didn't identify your patient once. Then another post states it was twice. Now your last port states it was 3 separate occasions. You are unsafe and I would have dismissed you as well. That may sound harsh but nurses kill people everyday with medication for errors just like this. It's incredibly important. If you think it's nerve racking in sum lab and forget, I can imagine it being worse in clinical. I was more nervous during my first couple med passes in clinical then I have ever been in sim lab. Knowing what you did wrong should have kept you from repeating this mistake 2 times ago.

Most this point I don't know if you would be able to get into another program since you were dismissed from this one for unsafe clinical practice. Your best bet may be to appeal the dismissal decision and see if you can get readmitted for next semester. Since every time you tell the story it gets worse, I can only imagine that you were not at the same level, clinically, as the other students in your cohort and were behind. Take some time to dust yourself off and deal with your nervous instability, then try to get back in and do better next time.

Insearchof · Sep 25, 2015

I do not need you to tell me what was done wrong I am fully aware that I made a huge error during labs. My story does not get worse with new incidents this is the issue that I stated in the original post. How can you insinuate were I was or was not with fellow classmate, FYI some were at the same level as myself, it's just they were pass due to staff showing partiality and this occurs; day in and day out as well my friend. I stated as well that I knew who my patient was and this is a fact as well.

You stated that Nurses kill people every day with medication errors just like this. If error should occur and they will, I believe it should happen in a safe environment would you not agree. Besides, it irritate me when other nursing students insinuate they never made or make mistake during clinical or labs this is not a fact, I've seen it too many times.

cracklingkraken, ASN, RN · Sep 25, 2015

I think it's rather the repetition of your mistakes that the PP was addressing. You mistook VS and forgot to identify the pt on more than one occasion. Was this during check-offs? If it was for check-offs, then the dismissal was completely justifiable. I don't know what to tell you about favoritism shown towards other classmates. Admittedly, it can happen, but it is not something that occurs solely in nursing.

elkpark · Sep 25, 2015

I do not need you to tell me what was done wrong I am fully aware that I made a huge error during labs. My story does not get worse with new incidents this is the issue that I stated in the original post. How can you insinuate were I was or was not with fellow classmate, FYI some were at the same level as myself, it's just they were pass due to staff showing partiality and this occurs; day in and day out as well my friend. I stated as well that I knew who my patient was and this is a fact as well.
You stated that Nurses kill people every day with medication errors just like this. If error should occur and they will, I believe it should happen in a safe environment would you not agree. Besides, it irritate me when other nursing students insinuate they never made or make mistake during clinical or labs this is not a fact, I've seen it too many times.

I believe that the concern is that, as you've stated, you've repeated the same mistake multiple times without correcting your practice. Also, it doesn't really matter that you stated you "knew" who your client was -- lots of errors, some of them v. dangerous, occur in healthcare settings because people are sure they "know" who the client is and skip the required verification. That's precisely why procedures like checking multiple verifiers and scanning bar codes were developed -- because people were confident they "knew" they had the right person, but they were wrong.

Yes, the lab/sim environment is a "safe" one in the sense that you're practicing and not really treating live clients, but that doesn't mean it's okay to make repeated errors and omit required safety procedures. And how is it that you're so sure this is about favoritism towards your classmates? Did they make the same errors you did, the same number of times, and not also get dismissed? Or are you looking for some other explanation for your dismissal besides your own failings (which is human nature -- but you're not going to "get it" and be able to make improvements until you take responsibility for your own performance).

I hope you'll be able to learn from this and have an opportunity to continue your education. Best wishes!

Mavrick, BSN, RN · Sep 25, 2015

Your dismissal paperwork may have mentioned only these two very specific incidents but the real problem is what they represent.

You can not or will not follow instructions, leading to unsafe clinical practice. Your instructors can not knowingly pass an unsafe student.

You make repeated mistakes despite having been instructed how to do a procedure properly.

You are defensive, will not take responsibility for yourself and attempt to blame others for your errors.

Unless you demonstrate you are capable of learning from this, you may very well not succeed in any nursing school.