Advice Needed

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I am posting to this forum to tell a looong story and would appreciate any feedback if there are ANY other nursing schools who do what happened to me. In my school there is great anxiety and tension because we have a skills performance at the end of the semester that turns the course in to a PASS/FAIL, regardless of your grades or clinical performance. The way it works is that after a lecture in lab, we are shown a skill. We then self teach and practice and we have to obtain 2 peer reviews. Next, we go to get the skill checked off by a lab instructor. Next, we have an appointment with one of the nursing instructors and they then check us off. At this point, this makes 4 check offs. We spend the next 8 or so weeks in clinical (med-surg) where we perform these skills countless times on patients. Each week we are evaluated for our clinical performance and you can receive either a U (unsatisfactory), NI (Needs Improvement) or S (Satisfactory). There is no grading scale where points are given, then added up to calculate a grade. I was checked off by both instructors, passed clinical and was carrying a B average by the last week of school.

Here is where the problem exists and I hope I don't confuse anyone. The faculty schedules a 'final' skills evaluation which is 2 hours long and the student goes in with very little knowledge of what to expect to do during the 2 hours. We have to use equipment that has been used countless times (i.e-syringes, catheters) and they are usually packaged poorly etc. making it hard to remain sterile. It starts with 'verbal report' on 3 patients (the dummies in the lab) and then you start your 'shift'. Throughout the entire 2 hours the instructor changes orders, gives verbal lab values and interrupts the student. It is nerve wracking because we get so NERVOUS because it is a PASS/FAIL. We get 2 trys and my second attempt was the week before my final. The particular instructor I had has only taught for 3 months and she put me through the ringer. She was my clinical instructor and watched me perform countless PAC Accesses and that is what she failed me for. She handed me a 2 lumen and I have never used one, or seen one!, and due to my nerves I screwed it up. And so, that's it!! I failed my entire semester ONE WEEK BEFORE THE FINAL. With a B average and after passing clinicals and doing this skill more than any other skill this semester on real people. As I said above, there is no point system. You make a mistake, you fail. When this occurs, the student is not allowed to complete final tests and I received an E on my transcript, financial aid is threatening to lower my aid and I've lost a grant I was receiving which was the only way I could afford to pay for my kids afterschool care. I now have a 2.6 GPA and I started out with a 3.97 I'm soooo devastated and it was a tough X-mas emotionally trying to stay 'happy' for 4 kids and a husband. I'm appealing but this school has been doing this for years. I hired a lawyer (LIKE I CAN AFFORD THAT!) to take me through the appeals because this school seems quite corrupt. What they expect me to do is repeat the entire semester for 1 minute of my life because the instructor gave me a piece of equipment I had never used. It will set me back another year and I was supposed to graduate in May.

Their tradition of this 'final' skills eval makes no sense to me and I was wondering if anyone out there has ever heard of such a thing. It would be appreciated because I passed these skills TWICE before (In Aug, and Sept) performed them on people and failed the week before the end of the semester. Any advice would help. Thanks.

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Specializes in Home Health Care.

No advice, but wanted to say I'm sorry to hear this. It sounds like a bad situation for you. Best of luck... If it were me, I'd go to the director of the program and or Dean and explain my side.

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Specializes in Pediatrics.

I am sorry to hear that your semester ended this way. Where I work, there are skills tests at the very end of the semester, but these are re-tests, for those wh have failed it. They need to pass it at the end, which (in our case) was the day after the final exam. If they do not pass the retest, they fail the entire class. This is the first semester for these students, they need to pass lecture, clinical and skills.

In the other place I work, the students were tested only on one skill (in their second semester). They were tested the first week (learned the skill the previous semester), retested sometime around October, and then retested (if needed again) at the end. Two of my students needed the third try, and I do not even know if they passed, because they waited to be retested until after clinicals were done. So for all I know, they could have failed the entire thing.

I know it stinks, but I'm guessing the theory is, you have had the entire semester to learn and practice the skill(s). As someone who is on 'the other side', you may hear this (in some way), that you have had plenty of time, and it is your responsibility to practice the skills on your own. I am just playing devils' advocate. As an instructor, I can't tell you how many students I see standing there after I have introduced the skill, and when it is time for them to try it, they either take a step back, or head for the door (there are many who do not too, so yes, I am generalising). And when they get to the hospital they are all thumbs, because they have not physically practiced the skill. I know this may not make you feel any better right now, but I am just preparing you for what you may hear.

And of course, I cannot comment on the double lumen catheter that you never saw. That would definitely be something that you could bring up, as you should be well informed of the things you should be tested on.

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Specializes in Urgent Care.

I am so sorry.

We have somewhat the same situation. However, we had one student do her head to toe assessment 4 times and was then checked off. She did not fail for it, but had to do it over and over until the instructors felt comfortable with her performance- then passed her. Considering you had done well in clinicals and everything else, it is really unfortunate they couldn't work with you on it.

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Specializes in MICU/SICU.

That stinks, completely. I would go to the Board of Regents supervising educational institutions in your state (along with your lawyer), and contact the NLN and/or the CC....(sorry, I forgot the other certification body!)...ANYWAY, the certification-granting organizations that granted your school i'ts right to graduate nurses. I can't believe what's happened to you. NO, my school isn't that insane. Keep us posted.

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I think you misunderstood part of the story. I passed the skill twice already, and was signed off by 2 different RN's. I then went to clinical where I performed the skill numerous times, each time receiving an S. I was never given any remediation to go to the lab and practice more or informed that there was a problem with the skill. Then they do not evaluate one or two skills during the 2 hour fiasco. It is 2 hours of 'pretend' where you have to act like you are in the hospital, pulling a shift and cannot make a single mistake. They shoot out telephone orders from the pretend 'MD', change the patients conditions and throw skills at you and constant interuptions. I think it would make a good learning tool, but should not pass or fail a student who has already passed the skill twice . And it is not a grading scale where points are calculated to formulate a grade. It is a subjective call. As such, my positive performance reviews and my grade, in other words, all my hard work came to an E on my transcript. I get no credit for the lecture or clinical portion of the semester.

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I am working on letters to the financial aid agencies and will take this to the top of the Board which oversees colleges here in this state if I have to . Thanks for your advice. Do you think the NLN would do anything because I have considered a letter to them of this unfair practice.

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Specializes in Ortho, Neuro, Detox, Tele.

Well, every school does it differently. I'm sure you don't want to mention which one, but what city/state is it in? Every state may have a different policy on schools. Certainly the board under your nurse practice act may be an option for you to complain to.

Myself, at our CC, we are shown/taught a skill in class. We then must go to the lab and sign up to get it signed off with an instructor...at xxxx available times. We were at a disadvantage being the R class and being 1st semester, we often got screwed over in terms of when demo times were available. You could NEVER perform a skill in clinical that you hadn't gotten signed off for in the lab. We also have skill cards that have about 70-80 skills we must be signed off for by instructor during each semester, and around say 11-20 are covered in each semester.

Sorry that this has happened to you, but is this a private/public university/cc? sometimes the policy is explained, this is what you are held to, and it sucks, but be resigned to the fact that you may NOT have any recourse. Hope things work out for you.

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We are checked off twice before our clinicals and that is the worst part about this. A student should never perform a skill on a patient unless they are competent, which I was twice before. Another of the problems is that you are sooooo nervous and it is two hours of 'pretend'. One student failed because she didn't go to the 'nurse's station' to check an EKG strip. We all wondered afterward where the 'pretend' nurses station is in the 'pretend' hospital. On the other hand, another student passed eventhough she didn't check the PT/PTT before giving a heparin drip!!! So, it is very subjective and the instructors can overlook things if they so choose. I never felt like there was a conflict between this instructor and myself but she is brand new and I think she was trying to show the next class coming up that she is tough. She refers to herself as Professor Vicious and she doesn't even have a Master's yet! I thought you had to have at least a Master's to teach. Not at this school. If they made this a portion of the end grade I could understand two hours in "Pretend World" but it shouldn't fail someone who has already passed their skills check off. It is really hard to pretend and being that we are still students we should not be expected to be perfect under such enormous pressure. Oh, and they do this EVERY semester so any skill from each semester can come up all the way down to an enema or suppository which I have never done in the real world yet. So, lets say you haven't inserted a cath since first semester and have been so busy practicing the new skills of the present semester and you do ANYTHING wrong, you fail. Eventhough we are not exposed on a regular basis to each skill. I know of no other school that does this in the state and I wanted to post this and see how it is in other states. I will PM you and tell you where I am.

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Wow, this is really difficult thing for you I'm sure. Did they not tell you before the 2 hour thing as to what to review and expect? And how can they fail you if you haven't been taught about a double lumen before? AND why do they want to put this pressure and stress on you folks the week before final exams? I would be highly upset as well. Did anyone else fail for the double lumen thing too, or any other reason?

I could never understand why they want to make skill testing as stressful as possible. For example, I would always practice with and instructor before the actual skill test and get it right without their help, yet they wouldn't just check me off then and there, they wanted us to wait until our actual appt. time. I think they want to see if we can perform these skills under stress or something. Sigh...I'm sorry you're going through this. I wish I had some advice for you.

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We've had some pretty tough instructors for skill tests but, this does sound a little overboard to me.

Question: do you have documentation of the skill you were failed for and, also, passing the same skill on real patients? We always had copies of our skills check offs and final skill evaluation tests so hopefully you have these? Because, that would seem to me to be your strongest case.

However, if you don't have the documentation ... I would try to get it from the school before hiring a lawyer and/or putting them on notice that you intend to fight this (if it's not too late). They may be less inclined to give it to you if they feel it's an adversarial situation.

If there's no way you can document this then, pursuing the case will be much more difficult because it then comes down to she said ... she said.

But if you can document it and have that documentation in hand then, I'd go ahead and fight it. Afterall ... what have you got to lose? It's not like they're going to cut you any breaks as it is.

:typing

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All that was given to us was things like 1)Patient #1- Abdominal Pain.....and then I was given like 3 meds he might receive and,for example, one I looked up is ONLY given if there are heart arrythmias!! (By the way, I never gave it so I wasted my time looking it up the night before) So, it could be anything: pancreatitis, gallbladder etc,etc. And then the worst part was I looked up the meds and gave almost NONE of the meds because I got telephone orders for new meds as the "patient's' condition had changed....or I got to the "MAR" and there were other meds I had not been able to prepare for. It was crazy and I can't believe this school does this fiasco. Yes, another girl in my semester failed because she didn't check a BP after giving a heart medication......Please keep in mind that she was being constantly interrupted and it is just a frenzied 2 hours and we are students. This semester we had a girl who was BACK IN repeating the entire semester because she failed for the fact that when she was starting an IV on the fake arm (and by the end of the semester the rubber skins are ruined and it is not like a real vein) and her glove stuck to the tape and they failed her. She, as well, had good grades, had passed the IV check off the PREVIOUS SEMESTER a full six months prior, she had passed clinicals and they made her repeat. The worst part is it is wasting all that loan and grant money that the TAXPAYER pays for!!!! They get us to the very end and then we get no money back and have to pay for the whole thing all over to get the E off our transcript for one mistake and for skills we have checked off countless times during checkoffs and the hospital clinicals. If we are so inadequate a week before final why are we touching patients? I'm being facicious(sp?) here. We were checked off....so why are they playing this game????? I feel so depressed. They took all my hard work away, my GPA is gone....I have bills piling up and 4 kids looking at me to improve our livelihood.

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