I'm a nursing student and this is second time I've pricked a patient for glucose monitoring. I did everything right I thought, alcohol wipe, pricked the side of the finger, and the patient complained in front of my preceptor that that was the most painful prick he had. He said in general the pricks here are painful and leave marks- the needle is longer at the hospital. The one time I felt I did everything perfectly is the one time I get yelled at and so now I feel unconfident. Did I push the needle in too hard? Is there such a thing as pushing too hard? I wanted to make sure to get the blood. That' the only thing I can think of....
In some ways while my internship is making me more confident in other ways it's making me less confident. I just feel like I'm a slow learner, like I need to do things 3-4 times before it imprints in my brain and even then I'm slow for some things, like filling up a syringe from a vial. Did anyone else feel this way?
Also, this is a stupid question, but whenever peal the backing of a medication, it doesn't peal fully so I have to push it out and twice now it popped out and once it fell on the floor. So I go really slow just to make sure it stays in the med cup. What am i doing wrong??? Grr, nursing makes me feel dumb
I give credit for Pricking the side of the finger( there are no/less nerves there) . Maybe the patient was reAlly in pain but I don't like it when instructors yell for stupid things. Out of all people,instructors should understand that you are a student and you are in a learning process. Don't stress, don't let little things ruin your day.
If you were using a sheathed lancet, then it only goes in so deep. There isn't a way to make it go in further unless you have an adjustable depth lancet. That might have just been a sensitive finger that was pricked a lot the past couple of days, or maybe the patient was just having a bad day.
As far as the medications go- you are so not alone there. I sometimes call the packages "nurse-proof"! Some packages open by peeling the paper. Others you need to pop the pill through the back. Remember that it takes a lot more time to go get a new pill than it does to open them slowly. If I have a package I am having a hard time with, I usually grab a pair of gloves and wear them to open the package. Then I can hold the package a little firmer and not have to worry about touching the pill with my fingers.
"In some ways while my internship is making me more confident in other ways it's making me less confident. I just feel like I'm a slow learner, like I need to do things 3-4 times before it imprints in my brain and even then I'm slow for some things, like filling up a syringe from a vial. Did anyone else feel this way?"
(raises hand) Yes. I'm about 9 months into working a surgical floor, and it seems like it took a long time before anything "came naturally". I did great in nursing school, but the hands on stuff seemed to come slowly for me. I dunno, maybe it's just that everyone around me was so seasoned and smooth! :) Even now, I will panic a bit inside if I have to do something that I haven't done for a few weeks. I guess the best advice I could give you is to not berate yourself over what is truly just a natural learning process. Everybody learns at a different pace. The important thing is to learn to do it the *safe* way... the clunkiness of it all will go away with time. So no worries.
Like almost everyone else have said you are not alone in this. I am fairly new nurse and I remember how embarrasing it was so spend almost 5 minutes to try to pop a pill out of the package only for it to fly across the room and land in the floor. It is OK, it gets better, you will do this every single day of your nursing life plus you will not have the eyes of your instructor watching over your shoulder.
As far as the incident with the lancet just let every patient know you are sorry whenever some type of discomfort has been caused but remember sometimes you can't help it. What is uncomfortable will be uncomfortable regardless of how much we try to make our best. Good luck and welcome to nursing. Enjoy nursing school, it is a great phase of your life and in no time you will realize it is over.
.....and the Oscar goes to. My God I know it might sting or hurt a bit but this patient made it seen like you were butchering him. I will just let it go or if you see the patient again, "What did I do wrong?, so next time this won't happen again. You need to learn right. Some of these patients too sensitive.
Try doing it on yourself a few times before you criticize others for being too sensitive. And remember that different people have different pain tolerance/threshholds.
Assuming you did everything correctly, this sounds like somebody was just being dramatic. This is likely the kind of person who always finds something to nit pick about. Take it with a grain of salt.
As for the pill packaging, I still drop the darned things on the floor and I've passed hundreds, no thousands, of pills!!! It doesn't embarrass me anymore, but it does irritate me because I have to find it, pick it up, dispose of it appropriately, and go get a new one. This is stuff I just don't have time for.
Your confidence is supposed to be in the toilet. You're a student. I remember being in a constant state of feeling like a deer in the headlights throughout nursing school.
Try doing it on yourself a few times before you criticize others for being too sensitive. And remember that different people have different pain tolerance/threshholds.
This is true. There are both psychological and physiological factors involved in pain perception, and this varies from individual to individual.
However, I think in this case, it's likely that the fact that it was a nursing student doing the fingerstick influenced this person's perception of pain, and that the student did everything right.
I remember when I was a student, one of my assigned patients' PIV was accidentally pulled out. I applied pressure with a gauze pad to the site, dressed the site appropriately when the bleeding stopped, and cleaned up the blood. The next thing I know, I'm being told that the patient didn't want a student nurse. Even though I had absolutely nothing to do with his PIV getting dislodged, and I handled everything correctly, he made the association between the incident and a student nurse. He connected those dots in his mind, so that Student Nurse=Blood on the Sheets.
I think it's quite possible that the patient in this thread had a similar emotional reaction.
I agree, some patients just hate the thought of a student taking care of them but for whatever reason they don't say so in the beginning.
I am an Excelsior grad. I had been a LPN with 19 years of experience the day I was at the clinical testing portion of the program. I had this 40 something year old male patient 2 days post op. The instructor presented me as a nursing student and the patient of course had no idea I had 19 years experience. I simply took his radial pulse and as soon as I was done he complained to the instructor that I had pushed to hard on his wrist and now he had a massive headache. Thankfully the instructor also thought the guy was full of it and didn't hold it against me.
When I was a nursing student, I was doing clinicals in a local hospital and I had 3 patients to do FBSB's on. The first two were males with thick skin that I had to really try hard to prick. The last was an elderly lady with delicate feminine fingers. Right as I stuck her, I realized I used a bit more force than necessary. She graciously waited until I was finished before stating in her southern belle drawl... "Deah, that was just fine, but next time you might want to just prick it a little - you don't need to get a runnin' start and jab it like a spear!" What a trooper!
As a diabetic I will add that there are areas more sensitive then others. You can always ask the patient to do it and then you finish the task.
I am "pre-diabetic" and test my blood glucose 2 or 3 times per day. This is the exact same thing I was going to say. Why not ask the patient if he/she has a preference? And if the patient is capable of sticking himself, why not let him do it? I know where my "good" and "bad" spots are. I also have a regular rotation of sites so that I don't stick too often in the same place.
I'd be offended by any nurse who made such decisions on his/her own without asking for my input -- unless I was incapacitated, of course. It doesn't sound as if the OP's patient was incapacitated.
And as for the person who said to always use the deepest setting, that's just cruel. I always use the most shallow setting and have no trouble getting sufficient blood on myself. The deeper settings hurt much more -- and should not be used unless it it necessary. Finget tips can be quite sensitive and it is cruel to hurt people unnecessarily.
And BTW: my index fingers are VERY sensitive and I rarely use them at all.
I am a diabetic and I have tested my blood sugar at work. The lancets we use at work are FAR FAR more painful than the ones I use at home. At home, I barely feel it, and the ones at work have been known to leave me with a numb, swelled up fingertip for several days. This cannot be attributed to practicioner error because it is always the same person doing the poking and receiving the poking - me.
I work with several type one diabetics, and they say the lancets our hospital has good deeper and hurt more than the lancets they use at home.
I *always* offer diabetics the opportunity to poke themselves. They know how and where they like to obtain their blood. Most just want me to do it, but often the younger ones (40 and younger) seem to prefer to do it themselves.
If someone complains about the pain, I tell them a couple of things. *Yes, it hurts, I'm sorry, I hate to get a fingerstick, too. *Would you like to do it yourself? Sometimes that makes it not quite as painful. *Would you like to use your own lancets?
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healthstar, BSN, RN
1 Article; 944 Posts
I give credit for Pricking the side of the finger( there are no/less nerves there) . Maybe the patient was reAlly in pain but I don't like it when instructors yell for stupid things. Out of all people,instructors should understand that you are a student and you are in a learning process. Don't stress, don't let little things ruin your day.