Failed clinical because...

NurseJeanB · Mar 21, 2008

I feel bad for your friend. I am a first year nursing student and as I read posts like this I am even more careful. It may not have been your intent in posting, but by giving us new students a heads up it does help. Others might think it was so obviously wrong, but sometimes as students it isn't so obvious especially if we see someone who we are supposed to be shadowing doing it. I do see the other side as well. We never want to cause harm. I think it is a tough situation all around and like I said before I feel for your friend.

Take care,

Jean

jla623 · Mar 21, 2008

Things like that really scare me. It is definitely common sense, but I worry about the same things. What if I accidentally mess up and do something stupid because I was so nervous and wasn't thinking clearly! It's no wonder you hear so many people not being able to sleep the night before clinical. One screw up and everything you worked for is gone.

JaneyW · Mar 21, 2008

I don't know about Canada, but in the USA we are held to the standard of an RN even as a student. Students are not expected to make mistakes and learn from them, they are expected to study before being on the floor and to ask questions when they are not sure. Big lesson for students--you will see RNs do a lot of stupid things. Don't monkey see monkey do--think about what you are doing. Critical thinking takes time to acquire, but it starts as a student. Always be thinking about the patho behind what you are doing and why you are doing it. Your answer should never be because you saw someone else do it. You should know why you do what you do and if you don't know.....find out! Patients are not experiments, they are real people that can be harmed by bad judgement at any level.

Lovely_RN, MSN · Mar 21, 2008

I wonder why the RN tied the tube to the bed in the first place...can someone explain why a person would do a thing like that?

Alex_RN2b09 · Mar 21, 2008

The only conceivable reason I can think of is that it was in the way or getting tangled with other lines somehow and it was supposed to be temporary just to keep it out of the mess. Then you get everything all squared away and organized which leaves you then untying the tube and going about other tasks. Even that I still find hard to picture, mostly because the patient may move at any time. I'm not claiming to have all the facts but I have to agree with the clinical instructor's decision from the information provided.

RN BSN 2009 · Mar 21, 2008

That would constitute a failure in our program. Patient safety always comes first!

p.s. OUCH!

UM Review RN, ASN, RN · Mar 21, 2008

I understand why it is a big deal but I think that as a student mistakes/accidents are to be expected and as one makes mistakes, one learns from it. I just think being automatically failed and having to wait a year to get back into the program is quite a harsh penalty. Anyway she tied a nephrostomy tube to a bedrail because apparently she saw the RN do the same thing.

My mom used to say that if a friend of mine jumped off a bridge, would I follow? In other words, just because the student saw an RN do something wrong, does that make it OK?

NO. :nono: :down:

Your friend needs to take responsibility for what she did. It's not the RN's fault that the student tied the tube to the bed. The RN is not the student's instructor. At any rate, a savvy student would've realized that what she was doing was wrong/dangerous and would've asked the RN about it or possibly reported her.

This is why your instructor needs to be available for supervision of students.

NurseJeanB · Mar 21, 2008

I agree that the RN is not responsible, and that she isn't the instructor, but you make it sound like this girl knew that was wrong and did it just because she saw the RN do it that way. In a perfect world the clinical instructor watches over us every minute and every skill is taught before we ever hit the clinical floor. In reality, my clinical instructor had twelve of us. In one clinical I was assigned to follow and observe a med nurse. I observed the med nurse take a non scored tablet from another patient's med card and break it in half with her hands because she said the pharmacy didn't send the right prescription. Now I know that is not the way things are done because I have recently finished pharmacology. I may be wrong, but it sounds like this girl had not been taught about the care of a nephrostomy and so when she observed the RN tie it to the bedrail she did not know that it was the wrong thing to do. Some of you say it is critical thinking, but there are a lot of things that nurses do in a way that wouldn't make sense to non medical people. I don't know if I had seen a nurse, that I was told to observe by my instructor, do that whether I would have known that it was wrong. I honestly hope that I would, but I do feel bad for the OP's friend and for the injured patient as well.

TSURN2B · Mar 21, 2008

I agree she shouldn't have tied it to the bed EVER and was of very poor judgement. After that said I do believe students should be given a second chance. She may have let her nervousness take over her common sense (something that should never happen in nursing always ask if you are unsure).

I am also getting my BSN and last semester (Senior 1) there was a girl in our class whose patient had a chest tube. The very first day of theroy in this class we were shown a video on chest tubes and by the end of the movie it was very clear to us to NEVER disconnect a chest tube (duh that is what the water seal is for) Well anyways this student decided to DISCONNECT her patients chest tube to let him walk the halls. He was disconnected for 2 HOURS:eek: until our instructor did her rounds and found it disconected. The instructor quickly reconnected it and let the girl have it. Of course the doctor was called and he yelled at our instructor and it to was a big deal around the rather large hospital. I am surprised this didn't kill the patient. Anyways to make a long story short they did not kick her out of the program (she should have been because she showed no remorse for it) because after reviewing her file they couldn't find anythig else wrong that she had done. Eventually she did end up failing her final :uhoh3: .

casi, ASN, RN · Mar 21, 2008

Putting a patient in the way of physical harm doing something that I'm sure you are taught not to do isn't a simple "well I hope you learned" thing. That should be an automatic fail. I'm assuming the tube is a drainage bag? One of the things I had to get checked off for and explain during my catheterization validation is why I hung the drainage bag on the bed frame and not the railing.

suanna · Mar 21, 2008

I hate to join the chorus but part of the purpose of nursing school is to weed out those students whose judgement is so suspect that they may not be cut out for nursing. Third year and half-way through I would hope a student would know this was dangerous. It dosen't take "learning" to think through the mechanics of " what happens to this tube when the patient repositions"- it's a good judgemenet issue. I have seen nurses tie tubes to the bed rail in practice- and they were just as wrong. I hope they get out of nursing too before they kill someone as well. As for as your friend returning to the program next year, I'm all for it. There are times when the once burned are the most careful. Even the best of us can have a brain freeze once in a very great while. There are, however, consequences to a brain freeze- especially when it has had an impact on a patient outcome. Losing a year and getting a do over isn't too big a price.

justme1972 · Mar 21, 2008

I can't figure out why she would do that either...you don't tie restraints to the bedrail....nor anything else.

Unfortunately, the instructors didn't have a choice.