Bad Clinical Experience Today

[j0622]

As a nursing student going to graduate in May, I know I should not get obsessed with my bad feelings about my last day clinical rotation in the hospital. I have a bright career and future in front of me. However, I need to get it off chest.

I never expected and understand why some nurses want to see the new nurse or a student fail. I started an IV on a old lady. When I put a blood pressure cuff on her , she said “be nice”. I did not pay attention to the red flag. Then when I was trying to locate a good vein, she said “be nice” again. I was a little confused, but I still did not get the dangerous signal.

I did three IV successfully before that. Stupid confidence. Shame on me. When I started to get needle in, she started screaming, “What are you doing? It hurts.” and starts cursing like “shi*” . I got nervous. 

The vein is fragile, and she kept moving, then I blew the vein. I felt bad, and I kept apologizing. She was so mad, and turned to the nurse, “Why you do not do it?” And the cursing is really bad. The nurse said nothing to calm down the patient. She took it over and chose another hand. She showed off her skill and told me, ”See, you should choose this vein.”

I can tell from her voice she felt very proud that my failure would show how capable she is. I felt guilty, so I still stayed around to see if she needed anything. With all the confidence, she failed that vein too because the patient kept moving. She had to do on another location. She asked to get another needle very impatiently. I got it for her ... and the patient is still cursing. This time, I walked away. I could not bear those words.

About an hour later, I walked toward the nurse. She rolled her eyes on me. I do not think I deserve that, so I approached her and apologized that I did not get it. She avoided eye contact and said nothing. I asked her if the patient got her any trouble because of me. She said no. I could feel she didn’t want to talk to me, so I said thank you and left. 

I felt really bad, but I got a lesson - if you do not feel right, walk away.

When I was about to leave, another nurse asked me if I could take vital signs and start IV for her new patient. I never talked with that nurse before. She never asked me to help or so. I said OK. I was there to learn and practice. The patient was 80 years old. She has chemo therapy a year ago. She was on wheelchair with oxygen.

She had really difficult vein. They put a portal under her clavicle. With all that info, the nurse still told the patient that I was going to start an IV on her. I didn't feel right. I know my limit. This IV needed a very experienced nurse. Why would this nurse do that?

I told the nurse directly I didn’t feel comfortable to start IV. She asked another nurse to start it. The nurse ended up spending a lot of time on it. And, she was in ICU for more than 20 years.

I was glad that I dodged a bullet.

Did she do it on purpose? I don’t know. But, I had enough. I turned in my badge on the educator’s desk and left. 

[JKL33]

Everything is okay. Glad you wrote all this out and got it off your chest.

On 4/16/2021 at 6:00 PM, j0622 said:

When I put a blood pressure cuff on her , she said “be nice”. I did not pay attention to the red flag. Then when I was trying to locate a good vein, she said “be nice” again. I was a little confused, but I till did not get the dangerous signal.

On 4/16/2021 at 6:00 PM, j0622 said:

Shame on me. When I started to get needle in, she started screaming “what are you doing? It hurts.”and cursing like “shi*” . I got nervous. The vein is fragile, and she kept moving, then I blew the vein.

It's okay. I don't know if you "blew" the vein; it doesn't really matter. But understand that if people are really going to move around they can jam the needle through the vein all by themselves.

The other thing - some of this is just the way patients act when they know someone is a novice. It's kind of understandable on their part, but can just kind of be a bit of an issue until the nurse gets into a groove. In the meantime, try to focus on being kind and projecting a reasonable appearance that is reassuring to the patient as best you can.

You don't need to feel bad about being too confident or ignoring warnings. It was not wrong for you to take this opportunity to try and start an IV! After all, this was a learning experience and you won't be able to just walk away if you get mini "warnings" from patients when you're a nurse - you need to work your way through it together with them.

On 4/16/2021 at 6:00 PM, j0622 said:

I do not think I deserve that, so I approached her and apologized that I did not get it. She avoided eye contact and said nothing. I asked her if the patient got her any trouble because of me. She said no. I could feel she didn’t want to talk to me, so I said thank you and left.

Good for you for not shirking away from the situation. This nurse was not acting professionally but nevermind her. Just forget it. She has her own problems and they are not yours.

Continue to review and refine your techniques as you start working as a nurse. There's a lot more to learn but you can do it.

Good luck in your nursing career. ?

[Hannahbanana, BSN, MSN]

You had no business accessing a port (not portal) anyway as a student and the nurse probably knew that. Good thing you didn’t try.

As an aside, being 20 years in ICU Is zero guarantee of venipuncture expertise. I was nearly 24 years and couldn’t hit a vein if my life depended on it, because all my patients had central lines or arterial lines with stopcocks on ‘em, LOL. 

[rob4546, ADN, BSN, MSN]

I do not know if your preceptor did this on purpose and allow you to fail.  There are nurses like this and it baffles me.  I will tell you what I tell my students, "this person showed you the type of nurse you do not want to be, don't be like her."

Hold your head up high and graduate with confidence.  Good luck with the NCLEX!  You can do it!!

[j0622]

On 4/16/2021 at 9:28 PM, JKL33 said:

Everything is okay. Glad you wrote all this out and got it off your chest.

It's okay. I don't know if you "blew" the vein; it doesn't really matter. But understand that if people are really going to move around they can jam the needle through the vein all by themselves.

The other thing - some of this is just the way patients act when they know someone is a novice. It's kind of understandable on their part, but can just kind of be a bit of an issue until the nurse gets into a groove. In the meantime, try to focus on being kind and projecting a reasonable appearance that is reassuring to the patient as best you can.

You don't need to feel bad about being too confident or ignoring warnings. It was not wrong for you to take this opportunity to try and start an IV! After all, this was a learning experience and you won't be able to just walk away if you get mini "warnings" from patients when you're a nurse - you need to work your way through it together with them.

Good for you for not shirking away from the situation. This nurse was not acting professionally but nevermind her. Just forget it. She has her own problems and they are not yours.

Continue to review and refine your techniques as you start working as a nurse. There's a lot more to learn but you can do it.

Good luck in your nursing career. ?

 

Thanks for your kind word. I was just so confused at that time. I did not know how to respond to that situation. Most nurses they are respectful. They are nice to me. At least, they made eye contact and talk to me. Some of them taught me patiently. I am always grateful.  But this one is too much. I just pray that I will never meet a person like her. 

[j0622]

On 4/17/2021 at 11:52 AM, Hannahbanana said:

You had no business accessing a port (not portal) anyway as a student and the nurse probably knew that. Good thing you didn’t try.

As an aside, being 20 years in ICU Is zero guarantee of venipuncture expertise. I was nearly 24 years and couldn’t hit a vein if my life depended on it, because all my patients had central lines or arterial lines with stopcocks on ‘em, LOL. 

Yes. I am very glad that I told that nurse I was not comfortable to do this. She mumbled or complained like I was not even trying to take a look. I ignored her. I know I made a right decision. 

[j0622]

20 hours ago, rob4546 said:

I do not know if your preceptor did this on purpose and allow you to fail.  There are nurses like this and it baffles me.  I will tell you what I tell my students, "this person showed you the type of nurse you do not want to be, don't be like her."

Hold your head up high and graduate with confidence.  Good luck with the NCLEX!  You can do it!!

Thanks for your encouragements. I was so confused when I was in that unit. I helped around non-stop. Cleaning the room, setting the stretcher and doing errands. I do not understand why some nurses just treated me in a mean way. I mean, most of nurses I met are good and respectful. But finally, I understand that it is not my problem. Some nurses feel so good when they see new nurses or student fail or struggle. I did not know why, but it is true based on my experience. I did not know it before, but I will be cautious to stay away form them. I will never be like them. 

[JKL33]

58 minutes ago, j0622 said:

At least, they made eye contact and talk to me. Some of them taught me patiently. I am always grateful.  But this one is too much. I just pray that I will never meet a person like her. 

Oh, you will. You WILL.

Nurses are just people, not angels or extra-special beings. Don't put them on such a pedestal as if they can't be expected to have the same types of  problems easily found in the rest of the population. That is a mistake.

Begin right now to learn how to not take others' problems personally as if they are your problem.

When you meet someone who has a problem that temporarily affects you, recognize it as such, remain professional until the situation is concluded and then move on.

We end up being part of our own problem if we allow others' problems to take up too much space in our heads.

[Hannahbanana, BSN, MSN]

Mild assertiveness is a contradiction in terms. When confronted with an expectation to do something you are not allowed to do, you must say so clearly. "I'm not comfortable c that" doesn't tell the nurse that you're not allowed to touch a port.

Likewise, even after you graduate and go to work, when confronted c something you've never done or seen (as you inevitably will, perhaps for years and years), "I'm not comfortable with that" says nothing about why, leaving the other person to wonder why you're being such a butthead-- lazy? not a team player? scared? poor orientation? rather be on break? Who knows?

Say what has to be said. "I've never done that before. Can you walk me through it?" "I've never seen one of those before. Can I watch you do it?"

[NICU Guy, BSN, RN]

On 4/17/2021 at 12:52 PM, Hannahbanana said:

You had no business accessing a port (not portal) anyway as a student and the nurse probably knew that. Good thing you didn’t try.

He didn't say that he was asked to access the port. He was asked to insert a peripheral IV.

On 4/16/2021 at 6:00 PM, j0622 said:

With all those info, the nurse was still comfortable to tell the patient that I was going to start an IV on her.

 

[Hannahbanana, BSN, MSN]

9 hours ago, NICU Guy said:

On 4/17/2021 at 12:52 PM, Hannahbanana said:

You had no business accessing a port (not portal) anyway as a student and the nurse probably knew that. Good thing you didn’t try.

He didn't say that he was asked to access the port. He was asked to insert a peripheral IV.

 Not initially clear on original reading, but I take your point. The existence of the port should have clued the nurse that a peripheral line was not a great option. Perhaps she missed that part, LOL. Plenty of blame to go around here. I stand by my statement that a student shouldn’t be asked to access a port, and I think we can all agree c that.  Moving on. 

[TriciaJ, RN]

What really stands out for me, OP, is your tendency to personalize everyone else's behaviour.  You seem to worry about other people's motives like "wanting me to fail" or "showing off her skill".

What really happened is you had a crotchety patient who was a hard stick.  The nurse had trouble too, and the patient gave both of you a difficult time.  Maybe the nurse did behave unprofessionally toward you; that does make it unpleasant for you but she has no power over any aspect of your life.

It's great that during your rotation you went out of your way to be helpful.  Unfortunately, being a good person is no guarantee that others will treat you well; it only increases the likelihood that most of them will.

The bright career and future you have ahead of you will be a lot brighter when you can emotionally separate yourself from the people around you.  You WILL have a lot of unpleasant patients, snarky coworkers and unsupportive managers.  Try to be as pleasant to everyone as you can muster under the circumstances.  Sometimes the most stellar people will have a bad day and behave badly toward you.  Maintain your compassion and professionalism simply because you are compassionate and professional.  Not because of other peoples' motives or behaviour.

  Think about what you can learn from your crappy day that will serve you in the future.  The best to you.