Good essay for readmission?

Episteme · Apr 23, 2014

I'm confused... You are currently a nursing student. (What semester?) and your clinical instructor has written an adverse evaluation of you. What are your grades in the classroom? What is your GPA? Have you gotten any weak clinical evaluations previously? If so, how did you respond to those?

Did this bad evaluation come out of the blue? You weren't told you were weak or doing something wrong? Did your instructor take you aside at any point and tell you how you could improve your performance?

I guess what I'm saying is that where I teach, there's no way one clinical instructor can get someone kicked out of school (unless the student was wantonly unsafe under circumstances where they put a patient at risk KNOWINGLY. I know... I've tried!)

As far as an essay to gain re-entry into school goes, you need to address the criticisms of this instructor point by point and propose how you are going to remedy each one.

kringkring5144 · Apr 23, 2014

Hello,

I am a 2nd semester student. My grades are fine in the semester. I have decent B's in two of my classes. One C in my med-surg. My GPA Is currently a 3.48(if I fail med-surg due to clinical it will be 3.1). The first half of the semester I had a different teacher who did a midterm evaluation on me. She said I was doing okay and with time my confidence should approve. She put a couple of NI(need improvement) with mostly satisfactory(which I need all for final eval)

The first day I had the new teacher I did make a good impression on her the first day since a nurse handed me a drug and left me in the room with it to give. My instructor was ****** that I did not look it up first. My mistake. Then kept prompting me about the IV bag set up.

The next week, I was going to diagnostic so I didn't have any patient care that day and only had to write a paper. She sat me down this week, asked me what my previous instructor told me and I told her she just said I need to improve my confidence. The clinical instructor followed this and said that I need to stop looking for reassurance so much since it shows Im imcompetent. I told her I was unaware of this and determined to improve in those areas. Then went on to tell me what to expect the next semester and that was it.

The next week I felt I made a better impression by getting what I needed to get done. The only comment she said to me was I did things too safe and do things that seem uneccessary (overtwisting on a cap of morphine, wearing gloves all the time even though I wont be exposed to fluid or blood--I wanted to be extra safe), also told me I need to make sure I have all the medications when I walk into the room.

The last day of clinical- I made numerous mistakes with medication.

1. I checked the patient's accucheck----it was above normal. I didn't understand the sliding scale much and told me she expected me to know this but explained the concept to me anyway.

2. There was another insulin due later that I was suppose to give during the patient's meal, but unaware since I thought everything had to go to the sliding scale(sliding scale said I didn't need a correctional dose). She explained how to look it up in the MAR since I never administered insulin before.

3. When I was taking out the medications from the cart, I was looking at what I wrote down from the MAR instead of actually looking at the MAR

4. Forgot to count the ace inhibitor taking it out-told me I wasn't thinking and made me go and count it again.

5. Mistakenly thought I should let the instructor check my insulin dose in the room instead at the nurses station. She checked it away before we went into the room.

6. Injected the insulin too slowly.

7. Said I made a med error from not remembering if I gave ferrous sulfate or not because the scanner can sometimes not pick up what I scanned.

8. Lastly, she informed that I needed to follow up on the baby aspirin that the Pyxis failed to take out.

These were numerous mistakes I made and that's why she is emailing me because she is concerned. I know what I did was potentially unsafe. The only thing I can ask her is to have another clinical day to see if I can improve but I doubt it.

You have 2 strikes to fail classes in the program and then your out of the program.

I failed one class my first semester and this might be my second one because of clinical. :/

Episteme · Apr 24, 2014

I may need a little more information. You say you're in the 2nd semester. Do you mean your second NURSING semester? Have you had a course on medication administration and/or pharmacology yet? What you appear to be experiencing doesn't track with what we do. Our students have a whole semester on med admin in the same semester where they are doing fundamentals. When they are in Fundies... students do not give any meds without the instructor present.

In our program, if a student goes to give a med and doesn't know why, what it's treating, what it's therapeutic effect is, what the side effects are... etc. etc... they fail THAT clinical day and are put on a success plan. If it happens again, then there may be more instruction, extra study... extra supervision and so on. If they fail 3 clinicals... then they fail the clinical part of the course and therefore, the course. There should be no surprises at the end of the semester.

Did you ever get a written success plan? It should spell out in very clear language what you have to do to be back on track. That way... it's not about whether you look nervous, or make extra trips to and from the room because you forgot something... it isn't about your "confidence" (vague) it's about what you do and say (specific).

If that train has not left the station... I would say get concrete expectations in writing about what exactly you need to do.

If you have to repeat the semester... go in with the determination to review with your clinical instructor each week, what the objectives for THAT clinical day are. Clarify, clarify, clarify

If you get a chance to submit an essay for readmission, I'd be real specific about the comments on your evaluations and what you intend (with their help) to do with your second chance to fix those deficiencies. No whining, no "it's not fair..." Keep it positive and determined.

kringkring5144 · Apr 24, 2014

Yes I am a second semester nursing student. The last time we had a course on medication administration was a year ago when I was in med-surg one. We have profiencies in lab that we must pass before we can do it in clinical. I passed the med admin and we just started IV stuff this semester.

There is no such thing as a success plan as my school. We go to clinical to learn and improve on skills. They expect us to know our skills and how to do them after we pass proficiency. The only problem was I had some lack of confidence and show I am unsure of things. It really depends on the instructor we have. Some teachers usually warn students that they are failing and give them what they need to improve to pass before the end of clinical rotation.

My clinical instructor told me I was showing incompetence 2 weeks before the end of clinical rotation. And it came to skills which I lacked confidence in and medication administration when it came to taking them out of the cart along with insulin. I realize that I didn't review insulin administration for almost over a year. We are not allowed to pass any meds without the instructor. Once we start our clinical rotation we are suppose to be able to know what the drug does and doing the right dosage.

I don't know if that helps at all. But yeah since I have my evaluation tomorrow...ill go in there and try to be positive as possible and show her I care. I don't know if that would miraculously work.

Episteme · Apr 24, 2014

"Confidence", "nervousness", These are vague terms. We know that there is a happy medium when it comes to anxiety... a level at which we are very focused and effective. Any lower than that... we maybe aren't so motivated. Any higher and our concentration bursts into pieces and we can't deal with the issue at hand. Every student is different in how they are going to deal with their anxiety.

If you're out... that's that for the time being. If you're still in, whether you're allowed to progress or not... insist on a written list of specific expectations. Here's an example from our school... we had a SENIOR student making boneheaded calculation mistakes. Her success plan required her to meet with an instructor twice a week outside of class and be coached. Then she had a high stakes math test she had to pass. (She did... btw.) It's kinda like using the nursing process only with pedagogy instead of illness.

The other thing you should look into is counseling. We offer students some free services in this regard. The issue you would want help with is how to deal with anxiety in stressful clinical situations. You need to review your coping skills and learn to adapt them to this new environment. Not a big deal or a life time of psychoanalysis. Just a discrete deficiency you want to improve upon. This could be something you bring up... it communicates that you are owning your problem and seeking help.

If they give you a do-over (even if its a repeat) smile, say "thanks" and develop a plan to make the next time different. If they DON'T and all is lost... (and I hesitate to mention this...) review your school's grievance policies. You may have a case in there somewhere.

Best of luck to you.

nurseprnRN, BSN, RN · Apr 24, 2014

I hope I am misunderstanding you, OP....you didn't really come here to have someone help you write your appeal letter because you have no idea why you should be granted a do-over, did you?

Because if you don't, then perhaps you aren't ready for the adult responsibility of being a nurse anyway. Think about it.