Bad clinical day

[dragonhawk]

We started term 2 recently and began clinicals at the new site, everything in term one went well so I wasn't expecting things to take a downturn, especially on the first day. It did, I feel like an absolute failure. Our clinical group changed, and I was sent off to do treatments with two girls who are best friends in real life. I was getting vibes that I was a third wheel so I volunteered to go around and do half the workload on my own. Now, I did end up partnering with another girl who was experienced, and had years working in the healthcare field prior to nursing school. I am new so everything I'm doing is usually for the first time with a real, live patient. Basically I did a fingerstick, didn't get the reading, the patient got upset and started yelling at us, I had to do it again, moved onto another patient and didn't get a good stick on her.

Next, the facilities BP cuff malfunctioned, so I used my own. Later on the first two girls I started out with come to me, asking me for the cuff, I handed them the one in my pocket...

Fast forward to later on, the teacher has me stay after class to tell me she's concerned about my performance. That I used a broken blood pressure cuff and messed up the finger stick reading. I wanted to fall in a hole. I realized other students thought I used a broken cuff, and went and told the teacher, as well as filled her in on my finger stick experience. Now the instructor feels I need to be partnered up...So now I need a babysitter.

I just needed to vent that. I know I need to do better. It just really really feels crumby to be taken so far down on the totem pole so quickly, especially since I do enjoy nursing and I want to do well at it. I know now that I could do a finger stick no problem, I just needed that learning experience, but it's like since I didn't get the technique just right, right away I'm a total idiot, and that's what's frustrating.

[KrCmommy522, BSN, RN]

Ouch! I'm so sorry for your experience!! First of all, you said you already did clinicals? Had you never done a fingerstick before? At the school I went to, each time we started at a clinical site, when we went there for orientation they made us go through the process of doing a glucose fingerstick on each other to practice and then we had to sign the paper saying we did it, and then we got a number that we had to input before doing a fingerstick so the results would be linked to us in the computer. I found it really annoying that they made us do it every single time before a new clinical, but it helped get us really good at it!! Did you explain to your instructor that you had your own BP cuff and that's what you had used, but when the other students came in asking for one you just happened to hand them the one in your pocket which was broken? Either way, being partnered up isn't a bad thing. It will give you some one-on-one learning experience that the other students aren't getting. You can choose to look at it as having a babysitter and failing, or choose to look at it as an extra opportunity to learn! I know it stinks and you feel like everything went wrong. But just breathe and look for the good in it!

[ItsThatJenGirl, CNA]

Getting yelled at can really ruin a perfectly good day, can't it?

I'm so sorry you had a rough start. Hopefully it's all downhill from here on out!

[neuron]

Always be careful around these clinical instructors. Even though you are a student, they will expect you to do things as if you were a nurse for 20 years. Backstabbing. Be very careful.

[AnLe, ASN, RN]

Being partnered with other students who are more familiar with them and not you can be really difficult. I joined a clinical group who had already done labs together and were already well acquainted before I joined. (Their last names were from A-C while I was the only L.)

Explaining to the instructor that you did not use a malfunctioned BP cuff and accidently gave it to them should clear it up. Finger sticks are hard to do on thin individuals and those with poor circulation. In my nursing school, we weren't able to perform finger sticks, so I don't have that extra experience. Talking to instructor about how you plan to improve should help.

[neogirl]

I don't see why the instructor is evaluating you on heresay.

[Hygiene Queen]

I realized other students thought I used a broken cuff, and went and told the teacher, as well as filled her in on my finger stick experience.

Ah. Seems like there's always a student or two who think "telling on" another student makes them look smart. If they were really smart, they'd realize that things aren't always what they seem, sometimes things don't go as smoothly as they should and that (unless it is something profoundly dangerous) they need to be a tad more gracious to other students' difficulties because they will make mistakes or have trouble with things themselves.

What a bunch of baloney and I'm sorry that happened to you.

[Ddestiny, BSN, RN]

Sorry you had a rough day. Some people that aren't feeling well like to seize an opportunity to feel some control when they see students or someone that's unsure of themselves. You'll find that yelling in healthcare often doesn't have any reflection on what you've done, it's just a stressful time for people. With experience you'll get better with deescalating situations as you noticed the tension rising. Sometimes just coming in with an air of confidence is all it takes to stop it before it starts, but it's still bound to happen. It makes you appreciate the patients that are grateful, that request your advice, etc.

As far as blood sugar sticks go.... I've been doing them for 8 years or so as a CNA and then a nurse, and I still occasionally have to repeat one -- usually for an inadequate sample. Either the patient has poor circulation or has calloused fingers from long-term and frequent sticks. It's not the end of the world, I just apologize and do what needs to be done. I also found that having a fan blowing on the patient definitely contributed to me having to repeat the stick so now I mentally note if there's a fan blowing and will turn it off for the finger stick.

As far as the BP cuff thing goes....sounds like there are some interesting dynamics here, either with the instructor, some members of your cohort, or both. Either way, don't allow yourself to get flustered. Be confident, even if you have to fake it. That's not to say that you don't ask questions if you're not sure of something, but look up information instead when at all able and once you know you need to do a task, commit to it and don't let on if you're nervous. If there are some other hands-on tasks you're nervous about, watch YouTube videos on them until you can recite what you need to do.

Ultimately I think these kinds of tasks are important, but I also think students tend to fixate upon them disproportionately. It's much easier and faster to teach how to insert a foley than it is to explain the pathophysiology behind common renal issues, the meanings and reference ranges of labworks, the 50+ most common medications administered along with their side effects, reasons to hold, side effect panel, etc.

Best wishes.