Failed Capstone clincial....

sophia_29k · Mar 17, 2019

15 hours ago, FolksBtrippin said:

My school require us to have our preceptor grade us weekly. In my signed logs, I have all 3 or 4's on scale of 4. In my last log of Capstone, I got 2's on everything. I hve all these logs saved to my computer and phone.

2. I understand that even though it was just an OTC, it could have been fatal if it was another medication or if the patient had a reaction to it. The principle behind it was not obeying the 5 rights of admin. I felt bad afterwards because something so simple could have been prevented. Before That moment, my nurse told me " Go give patient 29 his meds". I literally gave him his meds which was an OTC congestion.

As a student nurse, I was just following what my preceptor told me to do. Ideally, I understand a real nurse shouldn't do what I did (ex. a doctor ordering a bad medication, the nurse should question the doctor). But as a student, I was just doing what my superior told me....that is just what I'm coming from, I hope you guys understand.

Another reason for suspicion ( I'm going to keep to myself in the appeal) is both my parents have experience with legal issues in the healthcare field. They told me she is just trying to cover her behind by painting me as an incompetent student who disobeyed her just incase that medication error comes back to haunt her. In my "Final Report" to my clinical faculty, my preceptor wrote that I told her after she confronted me " Student responded that "Patient is just a hospice patient" ". This is a blatant lie on my integrity. I was 50% sure about submitting an appeal, but after reading this, I am submitting it first thing tomorrow morning. I've spent hours reading this case and the appeals process in my school's website since we got off school earlier this week. Hopefully things come out good and the truth comes to light. Thank you to everyone on this thread for the advice and constructive criticism.

0.9%NormalSarah, BSN, RN · Mar 17, 2019

16 minutes ago, xarelto2 said:
Another reason for suspicion ( I'm going to keep to myself in the appeal) is both my parents have experience with legal issues in the healthcare field. They told me she is just trying to cover her behind by painting me as an incompetent student who disobeyed her just incase that medication error comes back to haunt her. In my "Final Report" to my clinical faculty, my preceptor wrote that I told her after she confronted me " Student responded that "Patient is just a hospice patient" ". This is a blatant lie on my integrity. I was 50% sure about submitting an appeal, but after reading this, I am submitting it first thing tomorrow morning. I've spent hours reading this case and the appeals process in my school's website since we got off school earlier this week. Hopefully things come out good and the truth comes to light. Thank you to everyone on this thread for the advice and constructive criticism.

Wow, if the preceptor told a blatant lie about you in that way, I would definitely include that in the appeal. No matter your mistake, lies about your performance or making up things you said is something that should be brought to the school’s attention as that preceptor clearly has no integrity.

FolksBtrippin, BSN, RN · Mar 18, 2019

12 hours ago, xarelto2 said:

You seem set on what you're going to do. But I do think you are going about this the wrong way.

You need to have a conversation with your clinical instructor about why she thinks you are unprepared. Your clinical instructor makes the decision on whether you pass or fail, not your preceptor. Your 1s 2s 3s and 4s are not grades.

You will get nowhere assuming your preceptor is lying. You need to always assume there was a miscommunication. Have a conversation to clarify. This isn't just about you passing clinical, it's also about being ready to practice as a nurse.

You are not ready for an appeal. Those conversations need to happen first.

I have seen students win appeals; but only when they were humble, show that they have learned from their mistakes, and do not blame or attack.

With respect, your parents are not helping you here. This is definitely not about a nurse covering her ***.

**CommunityRNBSN, BSN, RN** · Mar 18, 2019

42 minutes ago, FolksBtrippin said:
With respect, your parents are not helping you here. This is definitely not about a nurse covering her ***.

I agree with this 100%. Your parents are in parent mode— so they are entirely on your side ready to cheer you on. They are not being objective. So be thankful for their support but do NOT take them at their word about the nurse “covering” herself. That doesn’t sound at all like what is happening in reality.

0.9%NormalSarah, BSN, RN · Mar 18, 2019

3 hours ago, 0.9%NormalSarah said:
Wow, if the preceptor told a blatant lie about you in that way, I would definitely include that in the appeal. No matter your mistake, lies about your performance or making up things you said is something that should be brought to the school’s attention as that preceptor clearly has no integrity.

I’m sorry, I think I’ll correct my above statement. After reading what Folks and Community said above, I think I would take their advice as it’s probably not super likely that your preceptor is doing anything underhanded. Like they both said, you’re going to have to find out what actually happened and how your clinical instructor sees it before you can make a strong appeal case. I wanted to side with you on that lie thing because it hit a nerve and I really feel for you if that’s the case. But it is prudent to maintain a more positive attitude toward the preceptor even if you believe she did that. I apologize for jumping to that conclusion.

Kallie3006, ADN · Mar 18, 2019

Is it common practice to allow SN access to the pixis and not have to have the RN preceptor access the pixis?

When doing anything with any patient, I believe firmly in informing the patient and family, if present, whatever I am doing or preparing to do. This is on patients that are A&Ox4, x1, sedated, in a coma, palliative/hospice, or taking their last breath. You never know what they are able to hear, understand, retain etc. Just a thought.

I would also think about future practice, being a student or professional, and do not do anything without an order or verifying the order, even if the preceptor is telling you to do it. Ask to see the order, use the MAR and go through your patient's medication administration rights, every patient, every time.

I would also be careful on how you are relating your version of events, this is a public forum and could easily be found and read by someone at your school, someone who could be on your appeal committee and puts 2 and 2 together, just another thought.

Trauma Columnist · Mar 18, 2019

STAFF NOTE - multiple posts have been edited so as to increase privacy. Thanks for your understanding.

aprilmoss · Mar 18, 2019

I had a hell of a time doing venipunctures at first. I'd have hated to fail the clinical because of that. My instructor had me do some interesting practice sticks before I went back on real patients again and it helped a lot.

A good instructor can get a willing student through a lot.

TriciaJ, RN · Mar 19, 2019

On 3/17/2019 at 3:10 PM, xarelto2 said:
As a student nurse, I was just following what my preceptor told me to do. Ideally, I understand a real nurse shouldn't do what I did (ex. a doctor ordering a bad medication, the nurse should question the doctor). But as a student, I was just doing what my superior told me....that is just what I'm coming from, I hope you guys understand.

This defense is not going to help you. The whole point of a capstone clinical is to demonstrate readiness to assume a professional role. Saying "...as a student I was just doing what my superior told me..." shows that you are not yet ready to assume professional responsibility for your actions. If the appeals committee hears you say this, they will conclude that you are not ready to move out of a student role.

adreamdeferred, MSN, RN, APRN, NP · Mar 20, 2019

On 3/17/2019 at 10:48 AM, ShadowNurse said:
I agree with the above posters and that it is very odd to suddenly grade you poorly at the end of your capstone. At the very least, it's worth examining by the review board. Good luck.

I too agree. In my grad program we were required to take an exit exam to prep for boards, one at the start of the course and one at the end. We did not get our results back from the first test until a week before the course was done and I did not do well and it was worth a large portion of my grade which meant one week before completing my program after three years I would be failing my first course. I had all A's and 1 B up until that point. I couldn't breathe. By morning, an email had been sent out saying the exams were going to be pass/fail and our grades would be adjusted accordingly. I believe what happened was she was going to have to fail a majority of the class due to not passing a mock exam that people usually take prep courses for. Moral of the story is, you have to give people ample time to correct their mistakes. We were not given time to review where we were weak and adequately prepare for the retake at the end. Had she done her job and returned the first exams in a timely fashion there would be no recourse. You should appeal because no one should be blindsided. Even if it is not in your favor don't hang your head. I know quite a few excellent nurses who had setbacks in school and did not get to finish with the class. A year seems like a lifetime in terms of school but when you are operating in the "real world" it is like the blink of an eye. Best of luck.