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As an LPN to RN transition student, I had a patient who had to have a thoracentesis done in Radiology. During the procedure, I was placed in the supportive position for the patient and made sure her shoulders were in the proper position. As the procedure was taking place, I began to inform the patient of what was happening and what to expect (pin stick, etc.) HOWEVER... the radiologist later complained that I "talked the whole time." Um... nobody was providing inforormation to the patient and I felt it was my role to be the patient advocate and give her information about what was taking place to her during this invasice procedure.
Can someone PLEASE tell me if I acted inappropriately?
As long as you were just providing the pt with reasurance and NURSING education then you were not crossing the line. Remember the Doc should have explained all the details to the pt prior to the procedure. As far as for the pt she/he should be the one to decide if they want to be talked to during the procedure.
as other people have already commented, none of us were there.but I think it is reasonable to expect the radiologist to SAY something if they found your talking the patient through the procedure to be disruptive. How are you supposed to know someone's preferences if they don't tell you? Are we supposed to be mind readers? Not only that, but I think it was disrespectful of the radiologist to not say anything to you about your technique, and then complain to your clinical instructor afterwards. It's not like the radiologist asked for you to support quietly, and then you refused. In my eyes, merely talking the pt. through the procedure is nothing to be criticized for.
some posters are saying, "I would/wouldn't have liked to listen to a running commentary.." but who cares? This isn't about them right now. They're not the patient. What we're concerned about is whether or not the PATIENT was comfortable with the commentary. and we don't know that.
I think it's ridiculous the school is trying to call you out on being disrespectful.
The radiologist is an adult. They should know how to be able to speak up civilly about their preferences. Talking about team work, how about open communication between colleagues?
The radiologist might have felt it was inappropriate to "Scold" the student in front of the patient, might also felt it wasn't their place to say something to the student since it was a nursing student and they weren't the instructor or a nurse. I would imagine if the radiologist said something to the tune of the student being quiet in front of the patient, that too would have been an uncomfortable and embarrassing situation. Yes it is the patient that is the concern, I think by some of us adding we would or wouldn't have wanted to listen to the commentary is just to clarify not everyone wants a play by play. I have been a patient many times and had a huge needle stuck in me for a procedure. It was just adding another perspective to the story given. None of us were there to know what really happen.
Man, you guys need to go back to nursing school and take nursing 101 again. Pt. advocacy is the first thing they teach you. I think maybe you need to have an 8" needle coming at you with a couple of zombie's doing the procedure and see if your anxiety hits the roof. It's the nurses role to keep the pt. informed of all procedures and explain as it's taking place-What you you think they're paying you for?!!!!!! It's your PATIENT!!!!!!!!!! This joker radiologist is just doing a procedure and it's just another procedure on his list. Now, if an MD wants to be quiet, that's another thing. I usually explain things before they happen and then keep quiet when the actual insertion is taking place. Otherwise, screw what the MD is complaining about-Most are just a bunch of 3 yr. old whiners anyway:yawn:. Also, your instructor isn't much of an instructor for not backing you up and you can quote me on that one-Been there and done that and there's a nice shiny app. at Burger King waiting on them!!!!!
Sorry, but your immaturity and lack of knowledge is showing. Radiologists are physicians and not all physicians are MD. Maybe you need to continue to learn. I would not let you near me or any of mine with your attitude, lack of knowledge, and disrespect of what others may know and you don't.
You appear to have been insensitive to the situation. When you're a student, you don't want to be the "dominant force" in the room. It was an environment where you don't really know what's going on, and you're better off listening much more than you talk.
Is it possible that this is not the only time you've been obtuse in this way, that that is why the nursing school has an issue with you?
I think your heart is in the right place. And sometimes you do everything "right" and still catch flak. But I get the feeling you charged in where it wasn't appropriate, and that maybe you do that often, just out of passion to do good things.
Sorry, but your immaturity and lack of knowledge is showing. Radiologists are physicians and not all physicians are MD. Maybe you need to continue to learn. I would not let you near me or any of mine with your attitude, lack of knowledge, and disrespect of what others may know and you don't.
Respect works both ways-If these physicians(I'll get that right just for you) want respect, they need to earn it. The mature thing would have been for the "physician" to politely tell the student during the procedure that he/she would prefer to have it quiet during the workings of the procedure(He could have done this in a nice manner w/o placing the student in the spotlight). Instead, he wanted to act like a 3 yr. old and go tattle to the instructor over something simple. I used to know a physician who always had incident reports in his pocket just so he could whip one out when he caught a nurse doing something wrong. Gosh, I wonder what this is doing for our profession? As far as you, you're not doing anything for the profession of nursing advocating these physicians and their manner and when you have 10 pts. instead of 4(Because you helped run off another student), maybe you can think about that. Nurses like you are the reason the profession isn't respected and is still stuck in the Stone Age !!!!:yeah:
It would have been more unprofessional of the radiologist to call her out in front of a patient. Discord between staff IN FRONT OF a patient is majorly frowned upon. He knew they were a student, so he decided to inform the instructor of it to let them deal with the issue - it honestly would not have been appropriate for him to discipline the student. So, I would hardly call it tatteling, so much as providing feedback to the appropriate channels.
Is this an offense that should land the student in hot water? Not at all. More of the issue may lie in how the instructor chose to act upon the situation - take it as a learning experience in how to better tailor education/support/whatever during a procedure, instead of the student getting in that much trouble.
Tracey - I'm not sure what happened as a result of all this but the fact that this is so major to your instructor that your place in the program is being jeapordized - that is absurd. I know that now you've probably invested so much time in this one you won't want to switch, but for them to not realize you had the best interests of your patient in mind and maybe not allowed the radiologist his preferred ambience it is nothing to consider a failing offense. I'll just say that if you want to finish you may have to tread very lightly around these people even if you are justifiably angry and upset. I know it isn't right or fair but it is reality and remember to keep the big picture in mind when faced with crapola like that. Your instructor sounds exactly like those woosie nurse managers you meet on the job that will sell the nurse down the river at the first peep of a doctor or an irate family member. Hope it all works out - your instinct is right - dealing with fussy people takes time to learn.
. . . .I think you are a prime example of what new nurses of today and nurses of the future should be. These nurses now are old school, washed up, still scared of the doctor type nurses that would have kept quiet and let the patient experience pain before being informed of it.
No we tell them "this is going to hurt" after they start screaming in agony. FYI-if the patient is in pain they already know it's going to hurt, hence no need to inform them.
. . . As far as you, you're not doing anything for the profession of nursing advocating these physicians and their manner and when you have 10 pts. instead of 4(Because you helped run off another student), maybe you can think about that. Nurses like you are the reason the profession isn't respected and is still stuck in the Stone Age !!!!:yeah:
These must be examples of that nurses eat their young thing I keep hearing about. Oh wait. :uhoh21:
The radiologist might have felt it was inappropriate to "Scold" the student in front of the patient, might also felt it wasn't their place to say something to the student since it was a nursing student and they weren't the instructor or a nurse. I would imagine if the radiologist said something to the tune of the student being quiet in front of the patient, that too would have been an uncomfortable and embarrassing situation. Yes it is the patient that is the concern, I think by some of us adding we would or wouldn't have wanted to listen to the commentary is just to clarify not everyone wants a play by play. I have been a patient many times and had a huge needle stuck in me for a procedure. It was just adding another perspective to the story given. None of us were there to know what really happen.
Why does the action of the radiologist speaking up to the SN have to be termed as "scolding" or "discipline"? How come not just... speaking up? It's not hard to say, "Excuse me, but I like to work in silence," or "Excuse me, I like to work in a quieter environment." How would you expect the radiologist to have spoken up to an RN who was doing the same thing?
re: people voicing their own preferences to running commentary, sure, it's fine, your opinions are valid, but what value does it add to this discussion? Right now this thread is not about whether or not one personally likes to hear play by plays. And as you've said, this preference could go EITHER WAY. It's as if the issue was about a patient who is uncomfortable about being called "sweetie" and OP is asking, "Am I in the wrong?" and commentors say, "I don't like to be called sweetie either" or "I love being called sweetie." Since this issue is about the patient's preferences, any other person's preferences is irrelevant.
I'm a bit confused as to how this all played out.
Your instructor considered you behavior to be disrespectful? Wow.
Were you speaking THAT loudly and that much? *laugh*
I mean, my God.
On a serious note, if you didn't transport the pt to radiology then they likely were already briefed.
But...it doesn't help to kind of talk them through it. Was your pt looking to you with confusion?
I wouldn't wait until the exam BEGAN to discuss exam expectations, though. You know? Do you think that may be where you erred?
Anyway, Radiology runs shop like a d*mn assembly line. During most rad exams(I've participated in), unless it's to get them into position or calm them down, we don't spend a lot of time yacking.
*laugh*
That can be really distracting to a rad doc. Hell any doc. If you must talk (incessantly) to the pt, do so quietly.
I don't have issue with you doing what you did...but maybe it was the WAY you went about it?
Overall, it's about getting a feel for the way that they do things. Learn how and when to follow the lead...and how and when to take the reigns.
With some docs, I'm more of an assistant. I just hand them things and comfort the pt.
With others, I perform the bulk of the work. The doc just goes in for 5 minutes, to do work that I legally cannnot do. They give a quick yay/nay to the nodding pt. They conclude with, '...and if you have any further questions, be sure to get in contact with primary care physician.' They look at me, "Uh, Steph -- you got it?"
I say, "I'm on it."
They say, "Alright, let's get to going. We're burning daylight, here!"
...slaps me on the back and disappear out the door like a fart in the wind! (While I ensure that the pt completely understands what has just transpired, provide instructions, assist and perform any other legwork required.)
*laugh*
Uh...I think it's okay to 'correct' an individual during an exam.
It doesn't have to be scolding. There's a right and wrong way to do everything. Usually, when mistakes were made, the rad docs would speak to us after we've dismissed the pt and gone to the 'Doc Cave' to look at the study. They were never nasty about it. One of our docs did it in such a way that it felt like 'coaching'.
It didn't dawn on you that you actually screwed up - until half-way through the conversation.
..and I'd like to mention that it has nothing to do with you being a student nurse. I truly don't understand why some nurses have such a complex about the nurse/doc thing. You made a boo-boo. You were corrected. It happens. You're still learning. Don't take it to heart.
You weren't 'of' the dept...so, he probably just voiced concerns to your dept head/instructor or whatever.
When we (as xray students) shot an inferior study or were too slow in our work or what have you - we'd get the 'stink eye' and hear about it from our instructor the next day(or THAT day, if the screwup was bad enough).
Now - if we're talking OR? Oh, yeah - you're getting 'chewed out'!
Right in the OR room.
The pts under. They can't hear a thing.*laugh*
Perfect timing for a full-on conniption fit!
OR docs are crazy...
biwa
13 Posts
as other people have already commented, none of us were there.
but I think it is reasonable to expect the radiologist to SAY something if they found your talking the patient through the procedure to be disruptive. How are you supposed to know someone's preferences if they don't tell you? Are we supposed to be mind readers? Not only that, but I think it was disrespectful of the radiologist to not say anything to you about your technique, and then complain to your clinical instructor afterwards. It's not like the radiologist asked for you to support quietly, and then you refused. In my eyes, merely talking the pt. through the procedure is nothing to be criticized for.
some posters are saying, "I would/wouldn't have liked to listen to a running commentary.." but who cares? This isn't about them right now. They're not the patient. What we're concerned about is whether or not the PATIENT was comfortable with the commentary. and we don't know that.
I think it's ridiculous the school is trying to call you out on being disrespectful.
The radiologist is an adult. They should know how to be able to speak up civilly about their preferences. Talking about team work, how about open communication between colleagues?