Currently failing clinical... feel aweful

[Sadblobnurse]

My CI gave me a compentency form showing me I did not meet a few criteria for passing clinicals. I only have one clinical left to really PASS it. I'm so scared, I feel like my future is on the line, and I feel like it's already over. My issue is that I don't critically think, which we have discussed.she wants me to bring a bulletin sheet and check off things I need to do to have a focused assessment as I'm doing the assessment of my pt . I'm worried I will freeze like a deer in headlights. ...and fail. She says she notices I tend to get flustered and that I see things as black and white, for example a PT didn't want their temp taken so I misinterepted that as "refusal of vital signs" and...didn't take the rest. I think she is a great professor. I score 90s on my theory tests an I feel like I'm just shooting myself in the foot. I feel like a moron and went home and cried so much...ugh

[AliNajaCat]

If you don't have an ongoing relationship with this instructor you're wasting a great resource. Make an appt to meet c her before your next clinical. Tell her exactly what you just said. If you were just skating by on tests, i'd be giving you different advice, but she knows you're doing well and wants you to pull it all together. She wants to help you do that. She has told you a good hint to help you pass your next check-off, so do what she says-- bring a check-off list of things you know you have to do, prepare them, and do them.

[Buyer beware, BSN]

This professor sounds like Attila the Hun.

If the patient didn't want her temp taken, what? The patient should then pick and choose like a Chinese restaurant: one from colume A, you can take my pulse but not my blood pressure and so on.

You get a patient like this and as the student she knows who you are and that you have no leverage with her to get the crone to do what you want her to do: which is simply let you take her vital signs so your professor doesn't make a big deal out of the natural irrational tendency of old people to control you and what ever is left in their lives they still have power over.

So tell "the professor" if she wants to fight with this lady have at it. She's wrong about this. It's assault to touch her and battery to suggest you're going to touch her against her will. I've seen the accusation made.

As for you, just chart: REFUSED VITALS like a normal nurse would and later go back and beg the patient to let you take her temp; especially if king kong is going to fail you over such a trivial matter and conflate the situation into accusing you of not having critical thinking skills.

Look if a patient says "bug off" take them on their word and LEAVE THEM BE!!!

How's that for critical thinking skills?

[pmabraham, BSN, RN]

I re-read the opening post several times, and don't see where you are coming from Buyer Beware. At our clinicals, it is our instructor who picks what nurse(s) we work with and what patients will be our patients. And we are to treat our patients with respect. The patient referred to in the opening post didn't want the temp taken, so one does move on to other parts of the assessment; one does not write refuse vitals and give up... And to respond to a professor as you would have responded... sad state.

Now, to Sadblobnurse, don't give up. A good professor will push you, and the professor is correct in terms of wanting future nurses to learn how to use critical thinking, and proper nursing judgement. While I'm not sure what you describe as being "black and white," I take it as jumping to conclusions. I.e. the patient refused having the temperature taken, then assume the patient doesn't want any other vitals taken.

Now, in terms of doing better next time... practice skills as you are able outside of clinical. Get a family member or friend to role play with you as you go through a full head to toe assessment.

What I found helpful at clinicals, as well, is that I start off meeting my patient by having a conversation with them to get to know them better... what brought them to the hospital/facility, when did they get admitted, etc... not only does that act like an ice breaker and help me remain calm, it also starts off the orientation portion of the head-to-toe assessment.

Don't give up; conquer the dream.

[AliNajaCat]

True that. If you enter a room, say, "Hi, my name is Studentnurse and I'm going to take your temperature," and pop that thing in one end or the other right off, that sorta kills the whole develop-a-therapeutic-relationship thing in an instant. Chat a bit first, ask about what brought them in for this admission, what does your physician tell you? and the like. THEN say, "I need to take your vital signs, OK? I'll go get the BP cuff and be right back."