I'm in med surg 1. I have a B average and in nursing school I'm very happy about that. However one teacher is constantly putting us down treating us and talking to us like we are stupid. She is always saying new nurses are so dumb and that she's always having to fix their mistakes. When anyone goes to her for help she tells them maybe they shouldn't be a nurse. All of that is terrible but I can handle it. I have tough skin and I beverage to be a nurse you need tough skin. What I can't handle is that she will teach us something, it would be clarified in the book and on our powerpoints given to us by the program( word for word instructions on nursing care drugs etc). But then on the exams she will ask questions and give the right answer but mark us wrong. And then won't give a rationale for why it was a different answer then the k e she taught us. For example...
A patien admitted to the ER comes in presenting left sided heart failure and 2+ pitting edema. As the nurse what should you do FIRST.
a. Assesment respiratory status
B. Take temperature
C. Take weight
D. Call the physician
Ok so left sided heart failure can lead to pulmonary edema...so does acute decompensator heart failure..actually ADHF primarily presents as pulmonary edema. So that means a lot of trouble breathing. That is what we were taught and .ales the most sense. We all put A. Assess respiratory status. That is priority. She said it would be take there weight. I said why. She said bc you just assume they are breathing. She said if they are breathing they are fine otherwise they are dead. WHAT. No i assess respiratory bc of the pulmonary edema. And yes weight is important because if they gain X amount in a certain amount of time. But seriously? As a nurse I will never ever ever just assume bc they rnt dead yet that they are breathing fine.
That is just one examplr. There are ALOT of questions like that. I need advice bc she won't listen to our rationales. She says that's the answer bc it just is. I went to the director who told me to r all to her again but that is pointless. The teacher is stubborn and obviously HATE new nurses and thinks we all are dumb and can't do anything. Where do I go from here? All the students have lost between 5-15% PER EXAM. This is a big deal when u can fail by .01% .
I always wonder if the nursing shortage isn't just about unmotivated students, lack of funding, or lack of teachers, but also about terrible teachers that can't put together valid exams that actually test our knowledge on a subject. End rant.
Justine, yes, you always assess respiratory status in HF patients, especially when they are showing signs of fluid overload. Lung sounds can signal impending respiratory failure due to pulmonary edema.
We had a patient on my unit with significant pulmonary hypertension and when he went into fluid overload, he had flash pulmonary edema. His nurse's assessment earlier in the night had diminished lung sounds, but basically clear. Later in the night, he was gasping for breath. Nurse listened and heard basically junk everywhere. Called a code, got RT and MD in the room. RT just wrote it off as anxiety. Absolutely refused to agree there was an acute cardiopulmonary issue going on. Literally, they were arguing back and forth right there in the room. Finally one of the nurses grabbed the attention of the MD, who was just caught up in the drama of the nurses and RT wondering what in the world was happening. The nurse said, "this patient is being transferred to the unit."
That's when the ICU CN showed up, and started another argument about lack of staffing for another ICU patient. It was the worst display of professionalism I have ever witnessed. Sounds like your professor would have sided with RT. Honestly, I couldn't imagine sitting there and getting a weight on that guy.
Anyway, the next time I saw that patient, he was being bagged on a stretcher, getting on an elevator to be choppered out to someplace with the ability to do open cardiothoracic procedures. That was probably 30 minutes later.
So to your professor, I counter with this - no point in getting a weight on the patient if they're drowning and you didn't bother to assess their lungs. They'll be dead anyway. And nowhere in CAB or ABC is there, "weigh the patient". Daily weights are great to assess fluid volume changes. They're important in your dialysis patients for the same reason. So yes, weight relates to "C" for circulation, but it is not an acute intervention in the scenario you gave.
Now, all that aside, this is a professional message board where grammar and spelling do matter. As anonymous as this place is, I guarantee you have future instructors, coworkers and bosses here. If any of them do happen to realize your identity, the way you represent yourself publicly amongst other colleagues matters. You may not see that now, but when you have that nursing license in your hands, the license you spent years and thousands of dollars for, it would be a huge shame to have something like your command of the written word damage your credibility and ability to get hired and stay hired. I know you may think it's crazy now, but people do take it that seriously. Represent yourself well - better than textspeak and many misspelled words.
I do hope you take the exam questions that you disagree with above your professor's head, if you don't receive a good answer from her.
I think this is also why it is better if test questions come from approved test banks. The questions are typically in an NCLEX format, and they tend to be "proven" questions. There may be more than one answer that is correct but you need to choose which is *most* correct.
This is an example of some instructors having difficulty writing good test questions.
Here is my advice, get over it and move on. I had an instructor who was difficult. Guess what? We had to deal with it. As long as I passed the tests, I went forward, no matter what the rationale for her answers were and believe me, I can top yours. Nothing good ever comes from going up against an instructor. Let me tell you, I had absolutely nothing to do with the people that tried to bring her down last semester, but guess what, my name got drug into it. Now, I am not a liked person because another student decided she didn't want to go down so drag me into it. I was upset and insulted. Now, I don't even speak to a classmate. I sit by myself in the back and talk to no one.
Now these particular students are pissed about another issue, with another instructor. I overheard it in the student lounge the other day. I'm hoping this instructor can see I am not apart of anything this semester. The last thing I want, is my career to be over before I even have the chance to get is started.
It's not a big deal. Get through the semester is my advice to you. Also, you should not use text speak here. Be an adult and type the words. You getting mad about that is doing you no favors here. Look at the big picture. That is what nursing is all about.
ixchel
4,547 Posts
Justine, yes, you always assess respiratory status in HF patients, especially when they are showing signs of fluid overload. Lung sounds can signal impending respiratory failure due to pulmonary edema.
We had a patient on my unit with significant pulmonary hypertension and when he went into fluid overload, he had flash pulmonary edema. His nurse's assessment earlier in the night had diminished lung sounds, but basically clear. Later in the night, he was gasping for breath. Nurse listened and heard basically junk everywhere. Called a code, got RT and MD in the room. RT just wrote it off as anxiety. Absolutely refused to agree there was an acute cardiopulmonary issue going on. Literally, they were arguing back and forth right there in the room. Finally one of the nurses grabbed the attention of the MD, who was just caught up in the drama of the nurses and RT wondering what in the world was happening. The nurse said, "this patient is being transferred to the unit."
That's when the ICU CN showed up, and started another argument about lack of staffing for another ICU patient. It was the worst display of professionalism I have ever witnessed. Sounds like your professor would have sided with RT. Honestly, I couldn't imagine sitting there and getting a weight on that guy.
Anyway, the next time I saw that patient, he was being bagged on a stretcher, getting on an elevator to be choppered out to someplace with the ability to do open cardiothoracic procedures. That was probably 30 minutes later.
So to your professor, I counter with this - no point in getting a weight on the patient if they're drowning and you didn't bother to assess their lungs. They'll be dead anyway. And nowhere in CAB or ABC is there, "weigh the patient". Daily weights are great to assess fluid volume changes. They're important in your dialysis patients for the same reason. So yes, weight relates to "C" for circulation, but it is not an acute intervention in the scenario you gave.
Now, all that aside, this is a professional message board where grammar and spelling do matter. As anonymous as this place is, I guarantee you have future instructors, coworkers and bosses here. If any of them do happen to realize your identity, the way you represent yourself publicly amongst other colleagues matters. You may not see that now, but when you have that nursing license in your hands, the license you spent years and thousands of dollars for, it would be a huge shame to have something like your command of the written word damage your credibility and ability to get hired and stay hired. I know you may think it's crazy now, but people do take it that seriously. Represent yourself well - better than textspeak and many misspelled words.
I do hope you take the exam questions that you disagree with above your professor's head, if you don't receive a good answer from her.