Failing clinical

allnurses Guide · Mar 22, 2012

Have you spoken with your clinical instructor?

What has she/he told you about what you need to work on?

Concentrate on those things and be positive.

The only thing you can do is to make sure you know your stuff and understand it...

And show some confidence (which may require you to hone your acting skills).

I'm sure you're not "stupid" and I can't possibly know about your competence or suitability for nursing, but I can tell you this:

If you really want this, you will fight very hard for it and do what you need to do to pass.

I have been amazed at what I have been able to do when I see the threat of all my hard work going down the drain!

Good luck and don't give up :)

Sean-S · Mar 22, 2012

Hi, I think you are not the only one who has the feeling, but most people who feel this way got proved they are good nurses.

I don't know which areas you need to further improve. According to your description, I think it is very possible that you were stuck on the answers. I am a 3rd semester nursing student. For example, last wk I went to clinic and I found there were 2 diseases I never heard before (Right coronary artery dissection & Mitochondrial cytopathy). When my clinical instructor asked me I admitted that I didn't know. And when I got home, I didn't even find the 2 conditions from my textbook of pathology.

As a nursing student, it does make sense you don't know many things. That is why you are a student. And even after you graduate, there are so many things you are still confused. One of my friend who is in 4th semester told me that the charge nurse in her unit even doesn't understand what insulin 30/70 is used for and what the action of the drug is.

I don't know you at all but I am sure you are not stupid. Just keep in mind whatever you do must have a rationale. And follow nursing process. I believe you will be great in the future.

Don't give up!!! ^^

patty554 · Mar 22, 2012

Don't give up! I am feeling very disappointed in myself too! I have the opposite problem I am passing clinical but bombing in lecture! I do great on elolve and great on ATI test. When it comes to the exams I don't do well! I keep telling myself if I have to repeat then I will have a better foundation for med/surg II. I know how you feel. I am sick of studying and being shot down when I take an exam! :banghead:

ctran · Mar 24, 2012

Thanks to everybody that replied. You don't know how much it means to me to have people being so supportive. I never had doubt myself so much as I did in nursing school. Each day I come back from clinical replaying the scenes over and over again trying to think what I could have done or how I could have done better. Sometimes I couldn't sleep at night trying to come up with scenarios so that I could prepare myself when she asks me questions again. I got so stressed out that I got sick and is still fighting the illness. But to get such support from you guys makes me feel so much better. Thanks you very much. Some of you were wondering how I am failing clinical.. my eval from the teacher stated that I am too black and white and cannot think in the gray area. I have two weeks before my next eval and I must get at least all two's or otherwise I fail. I already prepare myself for the inevitable. The hardest part was telling my family that I may not pass my second semester because they put so much hope in me. I feel like I fail not only myself but my entire family.

patty554 · Mar 25, 2012

I was unsure of myself this semester, totally different from last, I went to one of the other instructors that tutors me she gave me a GREAT suggestion to help stay organized and how not to forget anything! I take index cards I put on the colored one the information that never changes, example needle gauge sizes, soloutions(isotonic etc) I have one card specifically for bath supplies, one card with what to to if patient is on TPN, tube feeding etc, I have white cards with questions to ask the patient, one for assesment etc, I put meds that specific patient is on, I write questions I have on one and ask the instructor, I sometimes will go into the bathroom and stand there just to think something out before I do it step by step, sometimes I will tell my partner to just stop for a min so I can think about something, it helps, I find taking my time and thinking it through helps me, I think about meds the night before, I had a pt who has G tube straight drain, so when we give her meds we have to clamp off for half hr, I write that on my sheet the night before so I don't forget! Try it and see how it works for you, the worst case is that you don't like it :lol2:

Phoenixbyrd · Mar 25, 2012

Do you mind sharing a sample question - and a sample answer that might illustrate the "black and white" thinking that you mention? Maybe others will give you the feedback you need to perhaps "widen" your thought processes.

ctran · Mar 25, 2012

Oh, gosh where should I start? When we passed out meds, we need to know the info regarding the med which I was well prepared for. My patient had cipro and I felt good because I got all my info ready for her but when my professor asked me why is my patient getting cipro? Why not levaquin? My patient had hepatic encephalopathy and liver cirrhosis. One of the side effect of levaquin is hepatic encephalopathy. Needless to say, I had no clue why until she explained to me. Another time, she asked all of us and although vitamin B12 was so important for this patient. I thought the patient needed nutrition because patient is at risk for malnourishment (he has cancer), but the answer is because patient was anemic and B12 helps with hgb. another question with the same patient. Why is he getting protonix? I couldn't think of the answer. He did not have gerd so why? Well she explained that because patient is undergoing chemotherapy and side effect of chemo is n/v and it is used for prophylaxis in such case. Only one out of the whole group thought of chemo. So that was the reason why I was too black and white.

nurseprnRN, BSN, RN · Mar 25, 2012

those are examples of the level of thought you will have to put into your preparation for patient care. understanding how the diagnosis, the labs, the medications, and the side effects of treatment will be critical for any professional nurse.

your instructor has given you some good, factual feedback. she says you need to put the big picture all together better, or at least make progress at doing that, in the next two weeks.

spend extra time with her. show her you are working on it-- show her where you get your information and how you think about putting it together. do not hide from her, and do not give up.

nursing school is hard-- did you expect otherwise?-- because it involves a higher level of thinking than many other courses of study. there is so much to understand and put together because nursing has responsibilities beyond just implementing the medical plan of care. that's why you are in nursing school. she is there to help you, so let her help you.

Pachinko · Mar 25, 2012

Based on your responses in this thread, I'm still not sure of why you are failing, and I'm not sure that you do, either. You are not being criticized for having the wrong answers; you are being criticized for being "too black and white." To be frank, that is poor feedback to receive from an instructor (meaning that she's not being clear with her feedback). It's a metaphor and is pretty meaningless without more explanation. Either your instructor is not providing you with effective feedback, or you are not hearing the feedback correctly.

I'm a clinical instructor, and when I think of my own student being "too black and white," I tend to think of those who jump to conclusions and give pat answers without thinking through those answers. For instance, with your antibiotic question, it's the difference between immediately answering with, "I don't know," or "The infection?" instead of saying, "I'm not positive but...antibiotics can be changed based on culture results showing that the microorganisms are sensitive to some antibiotics and not others. And because medications are broken down by the liver and the kidneys, a patient who has impairment in one of those organs may require special medications. Am I on the right track?" I can only speak for myself as an instructor, but I would be satisfied with that answer; it shows me that your critical thinking is strong, and you know how to speculate meaningfully about clinical scenarios. The ability to think critically is as important, if not more important, than memorizing facts, because if you can think critically, you'll know how to find the facts and use them in the right way.

But all of that is speculation because I don't know what's going on in your instructor's head, and either do you, which is the real problem. In any event, before you end up failing your clinical, I would put great priority on working with your clinical instructor to clarify how you are not meeting expectations and come up with CONCRETE, measurable criteria for evaluating your progress (or lack thereof). This is a minimum expectation for instructors. If you are not clear on how you need to improve and your instructor isn't able to articulate it, you should take it to the professor and have him or her mediate, or go beyond that if necessary.

ctran · Mar 26, 2012

Exactly as you describe it, I really said I did not know. It is the critical thinking skills that I lacked. My instructor is awesome and she nailed it with my eval. I can only say I failed myself. She is trying to work with me so I still have hope.

Katie71275 · Mar 27, 2012

I don't see how you could be failing from those types of things. Nursing is different, the thought process is different than anything you have ever seen and it can take a minute to get to that process! I've been in clinical where similar things happened with the meds...and guess what? i didn't forget it! I made note to remember that..but our instructors would never fail us on something like that. They are here to make sure we learn.