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.
You got some pretty blunt feedback from londonflo which of course isn't pleasant to hear. Then you responded with anger and defensiveness. I really don't think londonflo is trying to slam you as a person or a student. Just giving you another perspective that you can choose to make use of.
Physical skills (like IV inserts) are important. But a huge unseen (and often unaddressed) part of nursing is providing the emotional support. It's not something you can cross off a skills checklist because it's not something any of us ever get done learning.
I don't think londonflo is second-guessing how you were with that patient. I think she is giving you something to think about for the next one. When you approach the next patient for an IV stick or anything else, always be thinking "What kind of day is this person having? How are they going to experience what I'm about to do?" Just bearing those thoughts in mind will have an unconscious effect on what you project and the patient will usually pick up on that empathy.
Here's one concrete suggestion: when someone is having a terrible hospital experience and you feel helpless to change it, ask them "Is there anything I can do right this minute to make your day a little less crummy?" You'll get some surprising (and often helpful) answers.
Learning to be a nurse is where it stops being about you. A bit of a hurdle for all of us.
Yes, I did become some defensive at first, but what she said is also right with a second thoughts. I believe things will get better in the future. After all, nursing is a relationship, not an individual.
Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.
For my money, nursing is doing things for a patient until s/he can do them for her/himself. (Extra points if you recognize the origin of that definition). It’s a service profession. That doesn’t mean you’re an inferior, like a maid in Downton Abbey, but it does require an interesting mix of self-awareness, self-confidence, and humility. Knee-jerk reactions of aggrievedness serve nothing and bespeak an immature appreciation of your *potential* for doing good.
It’s a lot to take in and develop, so don’t beat yourself up (or your classmates) for not being remotely there yet. It’ll come.
Do they still teach nsg theory? Any on a baccalaureate level?
I am sure they do but why would you ask that? I cannot say nursing theory ever benefited me much in real life. Perhaps self-care theory. Learning about theories is interesting though. The body of nursing knowledge continues to grow and nursing theories are part of that. But when you are in the trenches pushing IV morphine to a patient moaning in pain or trying to find a vein theories do not help much. You need critical thinking skills in nursing more than theory. Even in my home health days writing complex care plans before they had pre-printed packaged ones I never once thought to myself- What would Betty Neuman do? But there will always be the need to understand the big picture of what nursing as a profession is all about so theories still have their place in learning.
You're right - I was a bit off-tracked, but I'm going to blame PP Hannahbanana's preceding post. Her first sentence was referencing Virginia Henderson's nsg theory (I humbly think so?). Am I right re VH?
For the record, I too think that for the most part, nsg theory in school was just an academic exercise.
Thank you so much for sharing this!! I just finished my last NP clinical for acute care NP. My first three were absolutely fantastic with great preceptors and evaluations. My final one was with a couple PA's in ER who chewed me up and spit me out ?. It's just nice to know I'm not the only one.
Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.
On 5/1/2021 at 9:34 PM, amoLucia said:
You're right - I was a bit off-tracked, but I'm going to blame PP Hannahbanana's preceding post. Her first sentence was referencing Virginia Henderson's nsg theory (I humbly think so?). Am I right re VH?
For the record, I too think that for the most part, nsg theory in school was just an academic exercise.
? It’s Orem, but good on ya for recognizing there’s a theoretical structure for nursing care that has always resonated c me. Nurses assess what things patients are unable to do for themselves, do them, and facilitate their learning how to care for themselves after they don’t need us anymore. That’s how I look at it. There are other ways of looking at it, but that works for me.
The point of learning about the different ways to think about nursing is just that — to think about the different ways you can look at nursing practice. Which one or two resonate c you can determine how you live your professional life beyond whatever task- and bureaucracy-focused structure you are in.
So yes, an academic exercise, but not “just” an academic exercise. All learning is academic, right? Consider that at some point nursing students need to learn more about our profession than tasks and bureaucracy.
Lots of water under the bridge since I had to study nsg theories in early '80s. Hard time remembering. Nsg theories were more isoteric to me than Nanda nsg care plans!
Altho I do truly espouse Becker's Health Belief Model Theory for nursing and life in general. But I get headaches thinking Martha Rogers (?) from NYU. I met her at a Sigma conference - she was a brilliant thinker.
j0622
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Yes, I did become some defensive at first, but what she said is also right with a second thoughts. I believe things will get better in the future. After all, nursing is a relationship, not an individual.