Clinical

[nursingstudent501235]

I need an opinion. I had my first day of clinicals today in a hospital setting. Of course nervous as I have an instructor that does not like to be asked questions, and is not willing to provide help. We were assigned a patient and had a partner. My job was to obtain vitals and complete the paperwork while the other did the assessment. I began by looking round the room and not able to find a BP cuff. I asked my instructor who was standing there observing my partner and she did not answer. I continued to look as I then took a temp. After the temp and pulse, I still did not see it. The instructor asked why I was just standing there after 6 minutes in a mean tone. I told her I could not find the cuff and she said to follow the cord from the wall. (I forgot it was on the wall and hanging on the siderail!) Duh. I then found it and took the BP. I will admit I was super nervous and not at all familiar with hospital BP cuff storage area. Later in the day the teacher also allowed the person who was to do paperwork (me) all day to get an assessment in. I failed to get everything in, by mistake! I was so preoccupied with how to enter vitals in the computer (it was assumed we would figure out where and how to enter these in) and how to find things to perfect my paperwork that I forgot to complete the assessment. Ok here I screwed up! I was also very focused on the fact I was the nurse in charge of the paperwork and it was not DONE!

The instructor asked to speak to me after class and told me I am failing and not doing well based on the days activities. I'm feeling so discouraged and find it hard to imagine how this will progress. Now I'm afraid to even be in this clinical, feeling very unsupported as a student. I'm ok with assumptions at times but I was hoping for some support and ability to ask if I'm not sure, ESPECIALLY on the first day when my nerves are in knots. I guess my lack of confidence in not knowing my way around showed today, but I felt that was kind of uncalled for from the instructor, day one observation only is not fair but this is only my opinion.

[Silverdragon102, BSN]

Moved to the General Student discussion forum

[kp2016]

You need to stop blaming your instructor. The problem wasn’t her tone or lack of supportiveness. The problem was you let your nerves get the better of you.

The instructor was correct to tell you day 1 this was not a passing performance. Take a deep breath, Shake it off and go in tomorrow ready to do your best!!! That’s how you will succeed. Best of luck!

[JKL33]

1 hour ago, kp2016 said:

The problem wasn’t her tone or lack of supportiveness. The problem was you let your nerves get the better of you.

Well...there are positive and negative routes the OP could take with this like anything else in life, but other than that...nah.

That is some BS to stand there and have a student feel utterly foolish on the very first day over the location of a damn blood pressure cuff!! That right there is someone who only feels good about themselves by knocking other people down - and if someone has to pick on a first-day student in this particular way they are just really a sad sack and need to grow up and get help for their personal problems.

So, @nursingstudent501235 how to deal with this. You have been plainly informed by this blankety-blank instructor that she is going to attack when she smells fear.

Work on this rapport immediately. You know...keep your friends close and your enemies closer. Stay in the game, be engaged. Ask her for a few tips and get her opinions on some things, make on-topic conversation. Say your thank-yous, etc. That isn't debasing yourself, it is defying her plan to make people afraid so she can attack them. ?

["nursy", RN]

I don't know if this is possible for you, but maybe be a little proactive, go back to the hospital and familiarize yourself with the environment. Maybe do it in the evening when things are a little quieter (mornings in hospitals are crazy). Familiarize yourself with where everything is (supplies, food./snacks, linens, water etc.) Practice on the computer. Maybe you'll even get lucky and find someone who can spend a few minutes with you and give you some tips. Observe someone using a glucometer (or watch a you tube video) . Also, most nurse with good time management skills use what is commonly referred to as a "brain." This is a form that a nurse customizes that outlines a daily schedule. It includes patient, diagnosis, most recent lab results, scheduled events like meds, labs, dressing changes, etc. Maybe you can do something similar, i.e. bring in a hard copy of the assessment, and make sure you cover all of the categories as you enter them into the computer. Write down all the tasks you know need to be completed by the end of the shift, and cross them out as you go. Nursing is all about time management, thinking on your feet and being proactive. I don't excuse your instructor's behavior but maybe she's doing the tough love thing to get you to step up?

[JKL33]

Quote

I don't know if this is possible for you, but maybe be a little proactive, go back to the hospital and familiarize yourself with the environment. Maybe do it in the evening when things are a little quieter (mornings in hospitals are crazy). Familiarize yourself with where everything is (supplies, food./snacks, linens, water etc.) Practice on the computer. Maybe you'll even get lucky and find someone who can spend a few minutes with you and give you some tips.

I am sure you mean well with this advice, but things have changed and this is not at all advisable. Messing with computers especially is no trifling matter, but even just wandering around here and there will raise unfriendly and unimpressed eyebrows. No student should be in a clinical area outside of supervised clinical hours.

[Tacocat, ASN, RN]

I think you need to break this down because the result is not the sum of its parts.

Unless she told you otherwise, you're being failed for not doing your patient assessment, and as a student that's considered unsafe. It may have been a practice assessment, but you're likely going to be expected to do an assessment of any patient you assume the care of and not doing it is a big deal. The BP thing rattled you and you let it get the better of you.

You need to change the way you prioritize. You were so preoccupied with the paperwork that you neglected your patient. If you have a patient assessment to do, you take care of the patient and then you can go back to your paperwork.

You were assigned a task and did not complete it. The responsibility for that is yours, not your instructor.

Regarding the paperwork, is there a way to do it more efficiently? Is it a medical history and physical assessment? Are you giving the essential information, or are you making it so detailed you're getting caught up in irrelevant facts?

[GubbyScrub]

14 hours ago, kp2016 said:

You need to stop blaming your instructor. The problem wasn’t her tone or lack of supportiveness. The problem was you let your nerves get the better of you.

I think the real problem here is that her instructor let her fail instead of pushing her to succeed. Did you skip over the part of the OP where they said it was their FIRST day in the hospital setting? I'm sure you remember your first day at clinical. If you were calm and completed all your tasks efficiently then props to you, but most people do not share that experience.

To the poster: don't let this first day syke you out! Breathe, practice, study. I'm sorry that your first day did not turn out very well, but it will get better as you orient yourself to the unit and hospital setting. Good luck to you!

[MiladyMalarkey, ASN, BSN]

Eh, the instructor, unless having a off day sounds like they may be a little off base. Your first day at hospital ever, course you'll be awkward, unsure, all thumbs, etc. Instructor perhaps could give some helpful guidance instead of psyching you out with a "youre failing" speech on first day, a "here's what you need to improve on or you could be endanger of failing" talk would've been much more productive in my opinion.

With that said, dont take that & run with it or place blame on instructor here on out. You did miss important stuff, you recognize it and will correct,, shake it off, you can improve here on out. When in doubt proactively put yourself in front of instructor & ask their thoughts on what have you. They are there to check you off so of course will not be responsive when doing that, but should be open, to you know, teaching or giving direction at other times. And if they aren't, advocate for yourself by asking them direct questions about anything you need guidance in. Good luck.

[Rionoir, ADN, RN]

On 9/5/2019 at 10:31 PM, nursingstudent501235 said:

I have an instructor that does not like to be asked questions, and is not willing to provide help.

I heard these same things about an instructor who most of us in the group agreed was the best instructor we had in any clinical.

You know what questions she probably hates: The ones you should know the answer to or have some way of finding out on your own. Same with providing help. She sounds tough for a level one instructor, but also fair and likely to make you a better nurse.

[DowntheRiver]

I'm sorry an instructor told you that you're failing after your very first clinical day ever. If your story is as stated, it really is not appropriate. As an instructor, I would have told you where you were deficient (the assessment) but made sure you understood why and where to improve in the future, and then given you another shot to work on it next clinical.

Does this person have their MSN in anything, specifically Nursing Education? I'm just curious.

That said, going forward, you will not need to let things psych you out, such as the BP cuff. Since this instructor has seemingly identified as having strict standards, that's something you'll need to reconcile with for the rest of the semester. As another poster said, it may be in your best interest to ask her questions and work on that relationship to make it better.

[NurseJamillah, MSN, NP]

My 1st semester, 1st clinical, I had a clinical instructor like this. She never answered my questions, never helped when I asked for assistance, and constantly told me that she didn't think I would make it. At times, she stood by and watched me make innocent mistakes, and then threatened to report them. She told me that, even though I "probably thought she was being tough" with me, that she was just being "honest", because she feared that if she passed me, the other instructors would "eat me alive", and blame her.

Despite the traumatic semester (and her threats to fail me), I passed. There were other students that told me that they cried every day, after clinical, although she had never actually threatened to fail them.

In the following semesters, I only had one small complaint from a clinical instructor. It was based on me coming in late, once, when I became sick on the way to work, in combination with another student lying, and telling her that I was "always late". Later in the semester, the instructor apologized to me, once she was able to verify that instance was my only "late" that semester.

My future instructors provided me with glowing recommendations, one was my professional reference at the hospital that I work at currently. I now have her students following me.

Bottom line, don't take your instructor's words personally, but understand that you are being CHALLENGED. Do whatever it is that you need to do to focus, get your **** together, and NEVER "forget" to assess a patient. Ask other students for help, nurses (if they offer). Nursing school is tough, and if you fail, there is a line of students on a waiting list, hoping to take your spot! If you want this, you have to be on your "A-game". No one else will earn it for you. You can do it!