Friend kicked out/quit the program

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I am an ADN student due to graduate this summer. There was a girl in my class (we'll call her Liz) who was always friendly to me. Over the past 2 years we always joked, sat together at lunch, did a presentation together, and went out to eat once, but aside from that we never really hung out outside of class. I'd say she is in my gorup of 7 or 8 close select friends.

At our clinical site the instructor is the only one with pyxis acess so she pulls our meds for us puts them in individual bags per patient with the pyxis recipt in the bag. We then get those meds together along with any meds not in the pyxis like insulin, stuff in the fridge ect. We are then supposed to go over the meds with the instructor before giving the meds to the patient. But it is important to know that this was our second day with this instructor and at this site. Our last site was LTC and we pulled the meds out of the med carts and gave them ourselves without checking with the instructor. :uhoh3:

So Myself and the other leaders were in the breakroom discussing tele strips when Liz comes in. She asked the instructor a question and the instructor answered her and asked if her meds were ready to be checked. Liz: I gave the med. Instructor: Liz! you know you're not supposed to give meds without checking them with me first. Liz: I'm sorry Instructor: What did you give? Liz: blah blah blah Digoxin Instructor: What was the apical pulse rate? Liz: Well the nurse said you can't hear one of the heart sounds and to multiply by two, so it was 88. Instructor: no, how many beats did you hear?

Liz: 44. :eek: At this point the instructor gets up and takes liz out of the room. The instructor called the director, Liz was sent home for the day.

The next day at class was a theory day and I didn't ask her about it before class. Before break the instructor announced that the director wanted to speak with her. After break she wasn't there, about 15 minutes into class she came in, got her stuff, and slammed her door on the way out. I haven't seen her since. I don't know if she quit, got kicked out or what.

I want to call her, but I don't know what to say. Should I ask what happened? Should I just tell her I'm here if she needs a friend? should I let her call me, or what? It has been over a week since this happened though, I don't think she's gonna call me. Also another question I have is have anyone out there who's ever heard of such a thing. To me it seems strange that a nurse would tell someone that and not show them what they mean, and I've never heard of anything like that. But on the other hand I know the nurse must have told her something?!? but what? Sorry this is so long..... any thoughts???

Don't get involved. First of all, anything that was said to this student was done in private, as it should have been, and that is why you don't know the whole story. If "Liz" wanted to share what was said to her, that was her choice. Obviously, she didn't want you to know what the people in charge of the program had to say to her. Secondly, you said that aside from sitting together at lunch, going out to eat once, and doing a presentation together one time you guys never hung out outside of class. "Liz" obviously wants to keep it that way. She's also angry right now and you could probably rightfully imagine that she could be too embarrassed to talked about what happened. Knowing how management works I would also add that it's possible that she was told not to discuss anything about her situation with the other students.

I know it is only human nature to want to know what happened. My best guess is that her biggest sin was not following instructions. However, there is probably much more that you, I and anyone else will ever know about because "Liz" and the people running your nursing department chose to keep confidential--as they should.

Lesson to you, and a really hard one to follow: No matter how hard you want to know what has gone on with someone with regard to their employment or, as in this case, matriculation stasis, you just have to keep your nose out of it and anything you might know about it you need to keep your trap shut about it. Your nursing department leaders handled this very, very professionally and I am proud of them! Some might have broken down and given in to the desire to gossip about this and share what went on behind the closed doors with the student. For the future, just remember that whenever you take aside any subordinate who you have supervisory authority over, any conversation between the two of you is confidential and no one else's business. If the subordinate chooses to break the confidence and tell all their cronies, so be it. But it can't be you or you lose any respect and authority you have as a leader.

ummm...... Perhaps you took me the wrong way. I have absolutely no intrest in the "gossipy" details of this story. I never went to an instructor or anyone else in the program dying to know the details. The only reason I went into such detail here was because I wanted to know if anyone had ever heard of doubling a heartrate for whatever reason (can't hear s2 ect.). I have absolutely no intrest in what was said to her by the instructors or the directors. I only want to know if she needs a friend. As far as the friend issue there is no way in the world that you can tell me that Liz "obviously wants to keep it that way". It's not like she isn't returning my calls or something. There have been numerous times I have wanted to call people but didn't for this reason or that. Not to be disrespectful or anything like that but you just go on and on about how I should keep my nose out of it ect. but I really don't care what happened as far as school goes. I just wanted to get some good advice on how to approach her correctly so she doesn't think I am pumping her for info. (which I am not). I honestly care for her and could see myself continuing a friendship with her. I was thinking she might have wanted to call me but was wondering what to say, just like me.

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Specializes in Pediatrics.
Is it just me, or is anyone else not getting what was meant by the ''missed beats'' comment?

Can someone explain?

I had just this experience in clinical the other day. A classmate came up and asked me to listen to her patient's AP, because it seemed slow and she was passing meds that day and one was Digoxin. I said I'm no pro, but sure. I listened over one minute and heard 44 slow, muffled beats-very weird sounding. Now, I knew nothing about this patient at all, just listening. I confirmed my classmate's count, but the RN came in and listened and said 88, that because of CHF and a multiplicity of sounds (not just s1 and s2), each muffled half a beat we thought we heard was actually a full beat. How to check this with common sense? Both radial pulses were 84. BUT STILL, we of course let the RN pass that med, not us, b/c we did not hear it. BTW, "Liz" is passing meds without the instructor? Aren't you not supposed to do that 'til you are licensed?

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Specializes in med/surg, telemetry, IV therapy, mgmt.
I want to call her, but I don't know what to say. Should I ask what happened? Should I just tell her I'm here if she needs a friend? should I let her call me, or what? It has been over a week since this happened though, I don't think she's gonna call me. Also another question I have is have anyone out there who's ever heard of such a thing. To me it seems strange that a nurse would tell someone that and not show them what they mean, and I've never heard of anything like that. But on the other hand I know the nurse must have told her something?!? but what? Sorry this is so long..... any thoughts???

I wanted to know if anyone had ever heard of doubling a heartrate for whatever reason (can't hear s2 ect.).

That's not what I read in your first post at all! You wanted to know if anyone had ever heard of such a thing. What thing? I thought you were talking about being tossed out of the nursing program. I have a lot of experience in management and I recognized immediately the problem your friend got into. The business about the pulse was only the incident leading up to a much bigger problem to my way of thinking.

I just wanted to get some good advice on how to approach her correctly so she doesn't think I am pumping her for info. (which I am not). I honestly care for her and could see myself continuing a friendship with her. I was thinking she might have wanted to call me but was wondering what to say, just like me.

I'm going to repeat my advice. Don't get involved. The girl doesn't want to or isn't ready talk or she would have made contact with you already. There is no way to approach her correctly. Just leave the poor thing alone in her misery. She has a lot to contemplate right now.

Here is the drug information from the PDR on Digoxin

http://www.drugs.com/pdr/digoxin.html#G05

Yes, I've heard of people who take an apical pulse for 15 seconds and multiply it times 4 and people who take it for 30 seconds and multiply it times 2. They're sloppy practitioners who think they are saving time by cutting corners. A full minute count is much more accurate, particularly if the heartbeat is irregular.

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Specializes in Geriatrics, Cardiac, ICU.

Personally, if I were kicked out of the nursing program, I'd be too embarrassed to call and talk to anyone.

Maybe that's the case here and "LIZ" would appreciate someone calling her.

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Specializes in Utilization Management.
Is it just me, or is anyone else not getting what was meant by the ''missed beats'' comment?

Can someone explain?

I would imagine that the nurse was referring to the erratic pulse of Atrial fibrillation, which is sometimes referred to as "skipped" beats.

It could've meant a number of things--first that the rate was not correct if taken by Dinamap, or that the heart rate was difficult to hear, or that it was going too fast to count accurately.

In any case, the student (and possibly the nurse) did or did not do something correctly, and the student is now out.

Just remember---Dig is one that you don't want to give for an apical pulse of less than 60 beats a minute, and you have to listen for the full minute because it's typically a medication given to people who have irregular heart rates.

I know of a patient whose student gave her the med with a HR in the 40s and the patient wound up in the CCU. Could've been a real disaster for the patient, but it was caught by the nurse in time for the antidote Digibind to be given. Still, the patient had to be very closely monitored, and it changed the length of her stay and possibly impinged on her recovery time.

So it was a VERY serious error.

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That's not what I read in your first post at all! You wanted to know if anyone had ever heard of such a thing. What thing? I thought you were talking about being tossed out of the nursing program.

You obviously misunderstood me. When I said I wondered if anyone ever heard of such a thing I meant doubling a heartbeat not getting kicked out of a program for this paticular mistake.

I'm going to repeat my advice. Don't get involved. The girl doesn't want to or isn't ready talk or she would have made contact with you already. There is no way to approach her correctly. Just leave the poor thing alone in her misery. She has a lot to contemplate right now.
I appriciate the advice. Others on here obviously think differently. I am thinking you must be a male........ no offense

Yes, I've heard of people who take an apical pulse for 15 seconds and multiply it times 4 and people who take it for 30 seconds and multiply it times 2. They're sloppy practitioners who think they are saving time by cutting corners. A full minute count is much more accurate, particularly if the heartbeat is irregular.

You are misunderstanding me here also....... She took the apical pulse for a full minute, but the nurse said she needed to double her count due to unheard heart sounds.

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I had just this experience in clinical the other day. A classmate came up and asked me to listen to her patient's AP, because it seemed slow and she was passing meds that day and one was Digoxin. I said I'm no pro, but sure. I listened over one minute and heard 44 slow, muffled beats-very weird sounding. Now, I knew nothing about this patient at all, just listening. I confirmed my classmate's count, but the RN came in and listened and said 88, that because of CHF and a multiplicity of sounds (not just s1 and s2), each muffled half a beat we thought we heard was actually a full beat. How to check this with common sense? Both radial pulses were 84. BUT STILL, we of course let the RN pass that med, not us, b/c we did not hear it. BTW, "Liz" is passing meds without the instructor? Aren't you not supposed to do that 'til you are licensed?

Thank you so much for your reply! This is exactly what I am talking about. I knew someone out there had been experienced the same thing. As far as liz passing meds alone, she was supposed to have gone over the meds with the instructor first, but the first part of this semester in LTC we were allowed to pass meds on our own without checking with the instructor. Thanks again!!!

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Specializes in Emergency Dept, M/S.

I think she probably could use a friend now. What about emailing her, then she can contact you when she feels up to it, and doesn't feel obligated to talk right now if doesn't want to? I know I've emailed people under similar circumstances in the past, or even snailed a note, just to let them know I'm thinking of them, and the door is always open to talk if they need a shoulder.

BTW, I've not heard of the doubling of the AP. I would think, if you can't hear it, it's not there, and I certainly don't want to "guess" at what's there if I can't hear it. I always check the AP for a full minute. Things may change once I get into the "real" world of nursing, but for now, I try to do it all by the book.

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Specializes in Telemetry & Obs.
You obviously misunderstood me. When I said I wondered if anyone ever heard of such a thing I meant doubling a heartbeat not getting kicked out of a program for this paticular mistake.

I appriciate the advice. Others on here obviously think differently. I am thinking you must be a male........ no offense

You are misunderstanding me here also....... She took the apical pulse for a full minute, but the nurse said she needed to double her count due to unheard heart sounds.

spookygirl, Daytonite is a must respected valuable poster here. She's always ready with study aids and helpful links. You might do well to listen to what she has to say :p

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I think spooky is entitled to express her opinions and correct mistakes regardless of how 'important' a responder may be. furthermore, I do not believe that she should have any less opportunity to share her opinion.

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Specializes in Telemetry & Obs.
I think spooky is entitled to express her opinions and correct mistakes regardless of how 'important' a responder may be. furthermore, I do not believe that she should have any less opportunity to share her opinion.

Where did I say different??

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Specializes in Labor and Delivery.

Back to the subject...........spooky, have you heard anything from her?

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