I am in my second semester of an associates nursing program. My grades in lecture/class are ok, but I'm generally good in clinical. This semester we had new (to us) lecture AND clinical instructors and everything became much more accelerated very quickly. We had class the same days and clinical the same day with the same instructor every week first semester. This semester, we started clinical the first week and the expectations on everything including paperwork were way different. The first clinical day, I was marked late though I wasn't and there was no arguing it because I tried. I couldn't get one of the doors open even with the code to put my belongings in but I had been on the floor already and had to ask a classmate for the code again in case I had it wrong. I didn't, and was able to get it once I turned the knob the right way first. The instructor said that I should have already known the code...but I had. Then, same day, I didn't have one of my clinical papers and told her that I hadn't been able to get it since I had a major problem with my computer and couldn't access it, but was working on it. That day, I got 2 unsats.
fast forward a few weeks, I was scheduled in the OR rotation for the first time. Before the surgery, I walked in on staff speaking in a derogatory manner regarding students. I hate when this happens, but normally my instructor has been around. I get really anxious at this point already. I had been anxious already about the O.R. I feared this is where I would get queasy. My instructor wasn't on site. I did get nervous and a little woozy and while the staff was talking to each other, some of the conversation not entirely professional and didn't expect to be addressed and I was in a corner of the large OR room, I attempted to refocus and was praying a little as I did NOT want to pass out or anything, when I realized they were speaking to me. I said oh, I'm sorry, I didn't realize you were talking to me. I did tell one of the nurses closest to me that I had been praying a little because I had never been in the OR at all and didn't want to get sick or pass out. Later, the surgeon kept asking me to touch the part of the organ that was removed and was insistent. Again, I felt woozy and again, closed my eyes momentarily when (I thought) no one was looking because I did NOT want to handle this organ and I didn't even know if I was allowed to, I didn't know if it was going to pathology, etc. I pulled it back together and went over to the container where this was located and did poke at it a little, but was mostly uncomfortable.
I followed my patient to PACU, then to the floor like we were supposed to and came back down to the O.R. Again hearing staff badmouth students/school. Was sent back to PACU and helped them with a patient, getting a patient to the floor etc. Then my day was over.
Two days later I was called into the office and wasn't told by another clinical instructor that they had received an email from the O.R. Director that I was reported to have been "nodding off" or "sleeping" on a couple of instances. I explained that I had become a little woozy and did close my eyes on two occasions, BRIEFLY to recenter so I didn't pass out during surgery, that I was across the room, not near the patient or the staff working on this patient, etc, that I wasn't st all sleepy on this morning and was actually excited and a little nervous. i received a clinical unsastisfactory for safety and was told that we were told what to do if we didn't feel well (report it to our clinical instructor????) and that it was my 3rd clinical unsat and that it was a clinical failure.
I am in disbelief and I feel terrible. Maybe I did it all wrong, but I feel like such a loser and what they wrote makes it sound like I was under the influence or something. I get an F in the class which may not even allow me to return when they said I can which is next spring, putting me out a lot of $ in tuition and putting me back an entire year. What do I do now?
I could be wrong, but from reading your post, it appears as though you don't think the reasons you got unsats were a big deal.
During clinicals, your instructor is not only looking at your ability to complete skills. That's not all that nurses do. They are looking at your ability to communicate (OR situation), your ability to get to work on time and be prepared (not showing up early and not being able to get into the break room), and your ability to think critically (doing nothing when you realized you couldn't access your patient's chart, instead of thinking about ways to resolve the situation).
All of of those things are as important in nursing as clinical skills. That's why you got the unsats. In order to be successful, you need to understand these things and accept how you failed at them, so you can come back in the next semester being able to hit all the competencies.
...At least then there's an explanation even if their assumption about what is going on is inaccurate.
I don't blame anyone but myself. I do think that the surgeon was a bit of a jerk insisting over and over that I handle and touch the organ just for the experience when it's clear I was trying to learn not to be woozy from the sight of surgery for the very first time ever. We hadn't even covered this material, so I didn't know what to expect.
You state that you don't blame anyone but yourself, and in the very next sentence, you blame the surgeon for insisting that you touch a surgical specimen and for not knowing that you were woozy, even though you had not informed anyone that you felt ill, and you tried to conceal your queasiness.
Please take responsibility for your actions, mistakes, misjudgments, etc., or you can expect next semester to follow a similar path.
I have no intention of making excuses, good or bad, right or wrong this is what happened. The first clinical day, they are things I could have helped, but I don't believe the third unsat was entirely fair considering they took only the word of others, particularly those in an environment that clearly wasn't student-friendly to begin with. When they called me in to ask me about the clinical day, they had already made up their minds about the unsat, so nothing I said mattered, and I don't feel like that was appropriate. I can't change it, do anything about it. They said I could redo the semester "if I still qualify" and the F might make that impossible.
I've always been curious as to the frequent use of this statement by students. As a student, how would you know what is appropriate action from the credentialed instructor who, by the way, holds the license you're trying to acquire? What would have been appropriate or acceptable to you, the student?
As for the "jerk" of a surgeon, he was probably trying to alleviate some of your anxiety. Not all surgeons feel the need to walk on water. This same display was done by a surgeon towards me during my clinical rotation in 1985. When he offered me the cyst that he'd just removed, I took it from his hands and headed directly towards the garbage pail with it until a couple of OR nurses caught up with me and stopped me. Hey, I was gonna throw the thing in the trash...he didn't want it and I didn't need it:sneaky:. (What can I say? I was a dumb nursing student once:blink:...not to imply that you're dumb).
No one wants to be disciplined...none of us. And until we are called onto the carpet for inadequacies, we tend to pass by the mirror without so much as a glance. As inappropriate as you feel these "unsats" are, I'm willing to bet that it will be a long time before you make those same three mistakes again.
Now this time thing. I am a stickler for being on time, not because I was disciplined, but because I learned my lesson a long time ago. I ran late once, and since my colleagues knew that I was coming, none of my duties were done for me; and I had what was left over after everybody had picked over the assignment. When I arrived, I was so far behind in medications, charting, and had to deal with such selfish patients and family members who didn't care that I'd just arrived; they wanted things done yesterday. My entire routine was screwed up for hours to come. Toss in the fact that my new admit rode up on the elevator with me, and I had the shift from hell!
I would say to not take these things personally. But you should because the lessons learned here should make you a better student and someday, an efficient nurse. Time management, accountability, and powers of observation (eyes and ears wide open ) are among the biggies in the nursing world.
As an older student in a nursing program, you know that they are watching you a bit closer than the younger ones. The professors know that you have a background and that they do not have to work on being a professional with you at this point. I was in your shoes as a second career person and older student, so I knew that I had to put in 110% to make sure that I was holding myself to the standard that the professors were holding me to. That meant, arrive to clinical sites an hour to a half hour early to make sure I was able to get in. Saving all papers multiple times in multiple ways so that I never turned in anything late.
The OR situation, you were there to observe. Who cares what they were talking about before hand? Like PP said, people who have worked together are more comfortable speaking their minds to each other. You stated that you were standing in the corner with your eyes close, they might not have even noticed you at this point, so their chatter was just that, chatter among coworkers. I agree with others that even though you were uncomfortable, you are responsible for your learning. Even though your instructor was not there, you needed to speak up for yourself and the safety of the room.
I feel bad that this happened to you however, I also feel that the unstats were things you had control over. Good luck going forward.
As a fellow student and a person whose anxiety gets the best of her and I could easily have this day, I have no room to judge you. I have fainted in the OR but I was far from the pt and luckily one of the nurse's caught me. Mine was nerves and just standing for too long, mostly. I apologized and they laughed because it wasn't the first time it happened. I got cookies and some orange juice. I was lucky that the staff were a lot more accepting to nursing students.
I'm guessing you are in RN program? The stakes are probably a lot higher because I'm in a LPN program and we start with 100 percent and then antidotes we get warning, 2 points deducted then if we make the same mistake, 5 points deducted. You had a bad day and it resulted into a worse day but I'm sure you learn from your mistakes. So either wait year, look for other school options, maybe consider a LPN program and see if it has a fast track to an RN program....in our state you can become LPN in 18 months then work a year then be able to get your RN in about year or two.
You were woozy? And you're in nursing school? I would have jumped at the chance to handle the organs. We never even had an OR rotation.
I sure hope, IF you get to continue school, that you don't come face to face with a case of Fournier's gangrene! Jeeze.
ALSO- ALWAYS, ALWAYS, ALWAYS be early.
Plenty of people are woozy around blood and guts when they start in health care. That's totally normal, and says nothing about someone's ability to be a nurse.
OP, I feel for you. I agree with the previous posters- you have to arrive early enough to give yourself wiggle room for things like the code issue you mentioned. And computer issues are NOT an excuse for being unprepared for clinical. Again, it's all about planning ahead. And absolutely, if I was in the OR with a student who kept appearing to doze off, or seemed uninterested in participating, I would give that feedback to her clinical instructor. If you were feeling lightheaded, you should have notified someone immediately. There's no shame in getting woozy in the OR, but it becomes a safety issue if you try to tough it out in silence.
I think the surgeon was trying to be nice. Most of the time, nursing students are left in the corner to fend for themselves, craning to get a partial view of the surgical field. Did you tell the surgeon that you are new to this and trying to keep it together? You can't expect him to psychically know you are feeling woozy.
) are among the biggies in the nursing world.
gM_2010, MSN, PhD, RN, NP
48 Posts
It seems like all 3 "unsatisfactories" were avoidable for the following reasons"
1. Plan to have enough time to access key areas and make sure your codes work
2. Make sure you have a functioning computer and get your assignments done on time
3. Tell someone ASAP (particularly your faculty) if you aren't feeling well and excuse yourself from the patient care setting