Failed clinical because...

[Rebel_Kitty]

My very good friend got pulled out of clinical yesterday and now has to wait a year to get back into the program (we're third year doing the BSN) because she tied a nephrostomy tube to the bed railing and when she put down the bedrailing, she forgot she tied it there in the first place; well it popped out of the patient. It was a big deal in our ward with everyone including patient care coordinator, family, rn, drs yelling at the instructor and student...It was a very ugly scene...

Do you guys agree with the fail she got? We are nursing students and we are there to learn are we not? I believe this is her first incident report.

[greygooseuria]

In my CNA clinicals, I saw a nephrostomy and never in a HUNDRED YEARS would I have tied it to a bed rail. Would you do that with a foley? NO!

I wouldn't have let her come back in the program at all. Total disregard for patient safety. Even people not becoming nurses should know that.

[LesMonsterRN, ADN, RN]

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.

This wasn't a "dropping a pill on the floor" mistake, this was a "putting the resident in jeopardy" mistake. My vote would be for immediate expulsion from the program with no chance of return if her judgment is that poor. And just because the RN did the same thing does not mean it was the right thing to do. As nurses we should be able to think for ourselves and our patients.

[DebanamRN, MSN, RN]

This wasn't a "dropping a pill on the floor" mistake, this was a "putting the resident in jeopardy" mistake. My vote would be for immediate expulsion from the program with no chance of return if her judgment is that poor. And just because the RN did the same thing does not mean it was the right thing to do. As nurses we should be able to think for ourselves and our patients.

I agree. If the RN jumped of the roof, would she? She may not have seen what she thought she saw. Also, you have to use your own judgement. I've seen RNs/LPNs in clinicals and in the real world do stuff that makes me cringe, but I sure wouldn't do it myself. I am responsible for the care I give to my patients. The state sure wouldn't accept "I saw another nurse do it" as an excuse if you harmed a patient. Bye-bye license. Hello 7-11.

[rgroyer1RNBSN, BSN, RN]

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.

Uh, I doubt theres any patho. behind tying a nephro. tube to a bed rail, sorry but I would have failed her to, it makes absolutely no sense why anyone in there right mind would tie a nephro tube to the rail.Ouchhhh!!!!

[onyx77]

In the school I attended if a pt is harmed because of an action or lack of action by a student, the student is immediately kicked out of the program!

I don't understand how anyone (student, nurse, or laymen)would even think that it was okay to tie something attached to a pt to the bedrail.

Plain lack of common sense and REALLY scarey!!!

[trepinCT]

Our instructors are constantly telling us that just because we see a nurse doing something doesn't make it right for us to do! Saying that we saw someone else do it is a poor excuse and should be kicked out just based on that statement..is this someone who will never question a med order? Or a DR order she doesn't feel is safe just because he said so?? She should be lucky she is even being considered for readmission next year. It is reasonable for these patients and their families to expect that the student has worked hard and EARNED her place at the patients bedside..for a 3rd year student to do this is shameful..even a non medical person can see this is not safe..think of it from the other perspective..what if this was YOUR family member? She put that patient at risk for injury, permanent damage, infection and the ordeal of having it reinserted..As for nurses doing things the "real world way"..I work for a facility that hold their nurse to the highest of standards..when you expect it, you get it..I have never seen a nurse ever cut a corner that would jeopardize a patients safety..Student nurse, veteran nurse..either way a GOOD nurse would not compromise safety for the sake of..well, I am not sure why she did this..???

[SANERN10]

I understand that this seems like common sense but I know at some of my clinicals with some of the "different" instructors I had, I felt my common sense was not there at 50% of the time I did not trust some of the instructors nor the staff. so without knowing the whole story I do not believe we can pass judgement. She probably was told to do that by someone on staff (CNA,LPN, RN). As a brand new student I felt like a robot and felt if I questioned anything I would have had my butt rode throught those long 6 weeks. Tell your friend I am sorry for her and now she knows.

[Apollorn]

I just can't believe the student didn't have any remorse.

[dcampbell]

wow.

we learned the urgency of pt safety, our first month in school...

and, in our very first clinical, we were emphatically taught why never to secure anything on the bed rails.

your classmate being a 3rd yr student, makes it even more incredulous.

similarly, i find it a bit unsettling that you find her failing, harsh and unwarranted.

what aren't you understanding?

and again....wow.

leslie

I think the OP thinks the punishment was harsh because her friend was doing what she says she saw the RN do and should not have gotten into trouble even though the patient suffered horribly. In my opinion I don't believe the story about the RN tying the tube to the siderails, I think the student "thinks" she saw the RN tie the tube to the rails--it probably was a call bell. The student, not being familiar with every tube, just repeated what she "thought" she saw the RN do.

Just wondering, what is a RN's liability if a student nurse does something awful?

[Alternator81]

All I can say is that I heard of students failing (or worse) for much more minor things. That is a STUPID mistake-- it almost doesn't make any sense. But, you never know what was going on in her head. I would like to believe that other factors, that we don't know about, led to her doing this. Never the less, it clearly is not follow the standard of care.

The instructor has no choice but to fail the student. But I think that I am more forgiving than others. I really believe in second chance, even at completing nursing school after failing. But, I also understand that she should be considered unsafe-- I wouldn't want her to be assigned alone to care for my loved one. It just really unfortunate.

[NeoNurseTX, RN]

I've never seen a nephrostomy tube in my life.. but I know better than to tie ANYTHING to the bedrail. Wow....what in the world was she thinking?

Yeah, the fail was definitely appropriate IMHO and she might want to look into careers where she's can't harm people....

[ReinventingMyselfAgain, MSN, RN]

I didn't read all the replies before this one, so excuse me if I am reiterating what may have been said already. SOmething like this is a denagerous mistake. This is not a 'I don't know what type of antihypertensive this is" type of mistake. This isn't even a 'I gave 50 mg instead of 100 mg (and now I can go in and give the rest)'. This is a mistake that put the patient at great risk and (I am assuming) sent this patient back to the OR or special procedures.

As far as the 'aren't we here to learn' theory: sure you are. But so is a 3rd grader who just can't do the work. What does the third grade teacher do with this student: she fails the kid, and they need to repeat third grade. Not all mistakes are forgivable. And in the final semester? no way. What would have happened if this were 4 months from now and she was working. On orientation, she very well may have been let go for soemthing like this.

I know it stinks for your friend. She made a big boo boo.