I posted previously that I had been placed on a clinical action plan on April 17th with only 3 clincial days left in the semester and today I was told that I still wasn't functioning on the level of a second semester student and I wouldn't be moving forward in program.
Yesterday, my guest CI rated my performance as "fair" but not satisfactory and said that I was unorganized and reprimanded me for not being able to start an IVPB on my own. I told the guest CI that I hadn't done one on my own before and she actually grabbed my skills checklist and searched to see whether or not I'd been checked on it (I had done one with another CI) then she said, "You've done this once with my CI and you gave me the impression that you had never done one. I would've thought you hadn't done it at all." I told her that I hadn't done one alone and that I was sorry if she got the wrong impression, so I guess she thought I wa a liar. I got my patient assignment and told myself that I would do everything right today but everything went downhill quickly.
This morning when I got in, I checked my pts info and listened to report. I looked up my pts meds and she was receiving Humulin 70/30 @ 0730. I did an Accuchek. I talked to my CI about the pt's insulin order, sliding scale insulin, the pts BS level and I was told that we wouldn't be giving sliding scale insulin because of her results, so I thought I was prepared. I gathered up all my meds and we were standing outside of the pt's room when my CI says, "You're forgetting something. Something the pt asked me about early this morning when I went in." I said, "Okay, let me think this through." I couldn't think of anything and the pt hadn't talked to me about anything when I'd gone in so, I clicked through the MAR and looked at everything, so I'm standing there looking confused because I thought I had gotten all of the meds. I finally said, "I don't know what I forgot." Then my CI says, "You forgot the pt's insulin." I said, "I thought we aren't giving the insulin." My CI says, "We aren't giving the regular insulin, we are giving the combo insulin. I explained to her that I had gotten confused because I had asked her about the insulin earlier and I had the vial in my hand and had put it back because I thought we weren't giving it. My CI goes on to say, "You should know the difference between the pts sliding scale orders and her insulin order and if I wouldn't have been standing here, you wouldn't have given the insulin and that is unsafe." So that was strike one.
Strike two, was when I was trying to set up a new IVPB. I had went over the steps at least 50 times in my mind and I just knew I was ready. Well, when we got in the pt's room and I started going through the process, I had to change the line so I unhooked the old one and got ready to spike the new one and my instructor says, "You're forgetting something and you're going to lose all of that medicine." So, I'm standing there holding the bag and the line and running through my steps and then I figure dout that I hadn't clamped down the roller. So I clamped the roller shut and primed the tubing and hung the IVPB and stood for a couple of secs to watch the drip start. My CI says, "Is it dripping?" It wasn't dripping, so I opened the roller clamp. It still wasn't dripping. I'd opened the roller clamp for the primary set instead of the secondary set. So I realized the mistake and opened the roller clamp for the secondary but it was too late because I'd already messed up the procedure. My CI said, "Did you not do this yesterday, you should know how to do this by now."
Anyway, I don't want to go into all the excruiating details but I guess it all boils down to some stupid mistakes that have cost me this semester. I'm very sad about it but I am trying to be strong. I have to meet with her before class tommorrow and she's already told me her evaluation. She says because of the insulin I am unsafe and I don't know what I should know and maybe I should rethink my career because while I am a caring person, I'm not on the level of a second semester student.
At this point, I'm depressed and I don't know what to do. I want to reapply for the next sememster and restart all over but I don't know if I will be allowed to since I didn't pass clincials. I'm just really sad. I've worked so hard and spent so much money and I am really disappointed with myself.
