The school is a private school and this is what happened.
It was my last day of clinical (and last 6 months) and I was supposed to shadow a nurse in the emergency fast track (basically a department dedicated for non emergency care). When I was put there, there were no patients around because the department just opened. So what we did was just talk and after a while she started working on her paper work. This lasted for a good 20 minutes until our first patient arrived.
Unfortunately at this point, I was very tired and I came inside with the patient. Everything was fine, I told the patient I was very tired because I stayed up the night before working on a paper and that today was my last clinical. After that was done, the nurse again started working on her paper work. Again, I just sat there for like almost 10min.
Finally she got up, ready to give a shot to the patient, and I immediately followed her but she told me to stay. After this, she came back and that was the end.
We sat for another half hour doing absolutely nothing. I even went to every patient room to look busy and went to the bathroom to clean it but still I had a great deal of free time. I sat on my chair again, and again started looking very tired. After the shift finally ended my nursing instructor came down to relieve me.
Unfortunately, the nurse told my clinical instructor what happened. My clinical instructor was furious, and a long story short she than told the dean. And then during my clinical evaluation they failed me.
I still don't understand why. I was tired, that was all. They forced the nurse to write a report about what happened, and by force I mean the dean calling that nurse several times for nearly 2 weeks until the nurse finally wrote the report.
Under why I failed it stated because of inconsistencies in performance, and paper work. However, all my paperwork was fine. I passed with everything with at least B's. The same applied to performance. I argued and argued but no avail.
Last week the V.P. of academic affairs gave me my final appeal decision which was that the nursing committee decision stands. Her final decision is "had the POTENTIAL to put patients as risk".
This doesn't make sense. If I wanted to, I could have just told the nurse I am feeling very fatigued and I need to leave. We as nursing students have every right to do that if it may endanger a patient. But obviously that was not the case because I chose to observe that day rather than having a patient assignment, as did others because it was the last day.
I am furious. I want to sue under breach of contract, (nothing states I cannot come to clinical being tired) and being arbitrary and capricious in their decision.
Any advice?
What do I need to prove to win?
Please help.
Additional details
All charges against me have been false. From paperwork to performance (have weekly clinical evaluation forms that state I was performing well. I passed all paperwork as wel.
I was in the ICU earlier that morning, without incident. Under the watch of many medical personal. No one complained.
The nurse report stated "his eyes were closing, nodding off, and jerking himself side to side to stay awake". It does not say I fell asleep. Allegations which the department said I did.
I have other nursing students who wrote for me stating that they observed others being extremely tired to clinical. And displayed similar behavior themselves. But no consequences, because obviously it was a onetime thing. (Just like my incident).
I was never warned, it was out of nowhere. Previous landmark decisions in court have stated that students are entitled to be told of their inferior performance, in order to improve. I was not told this. And again documentation states I was progressing well.
Nothing is objective. Nobody say me physically sleeping. It's one nurse assumption that I was very tired. The school is interpretating the incident as me putting a patient in danger. Impossible seeing that I had no patient assignment.
I'm sorry to hear the drastic action taken by your school. I can understand where it does reflect poorly to be so tired on yourself as well as your institution. In the past, if i ever had felt too tired or not well enough to provide care, i would notify my instructor prior to the shift or when you began to feel too tired to stay awake. I think it may have been inappropriate to tell the patient that you were tired and why...they come to the hospital for care and it is usually safe to assume they are scared or worried about themselves...we, as nurses never take the attention of the patient. And although you had no patient load, if you were present, you should be alert. I would not think that a pt could feel safe if they notice a nurse dozing off...with that said, i don't think you should have been dismissed for this one incident only. you are right in the respect that all nursing students and nurses are tired and if there is no patients in your unit, it could be easy to be bored and doze off. i think you'd have to come up with some solution or action you would take if ever you felt tired and/or bored; this way, when you re-apply or transfer, you'll have proven that it was a one time thing and you have taken the time to realize the potential dangers and how to avoid this. you might even ask for letters of reference from your instructors that can vouch for your performance. good luck!
i hope that is not part of your argument and you are just venting. the reality is student nurses fall under a similar practice as registered nurses; we cannot come to work impaired. being "too tired" to remain alert is considered impaired in most states.
the excuse for being too tired was made for having a patient assignment. i made it clear i was felt too tired to have a patient assignment. thus i was told to observe and watch that day along with several other students who felt the same way. thus, i was not impaired but rather took the safest route possible. it was the last day of clinical and everyone was more worn out and i didn't feel comfortable having a patient that day. but that is not an excuse to miss clinical. i assumed "tell the instructor how you feel, and she will determine whether to stay or not". she said "just shadow and observe" which i did. but when there was nothing to observe or watch i looked very tired. it's completely logical and makes sense.
yes, but that is in direct contrast to this incident, which one can argue means that your performance is inconsistent overall.
actually that logic is incorrect. it is more appropriate to state that several seeks of passing marks without incident show my consistency. a outlier does not reflect a person's entire scope of performance but rather should be looked as an "isolated incident".
this does not matter. the incident still occurred despite your earlier performance. this is similar to a nurse making a med error on one patient in the pm but passed the other meds with success in the am and defending his/her self by noting that fact.
. i made this remark to rebuke any idea of me coming to clinical "impaired". i want to prove that i was perfectly capable of being in icu, and obviously capable of being in a non-emergency fast track system.
it looks like the nurse was specific in his/her description of your behaviors. understand that if he/she said you fell asleep, then the statement would have assumed too much. stating that he/she observed you in this way gives a clear idea to the school of the behaviors that were seen, which is what they will probably use to counter any suit.
actually if she stated "he was asleep, and i had to wake him up" that would have been fine. so was "he was sleeping". but it is direct observation and would have been much better (according to several attorneys). the fact remains, is that it states i was jerking myself side to side to stay awake. key word: stay awake. i was not asleep. accusations in which state i fell asleep are wrong. that is what i would like to make clear. if i was asleep, how was i able to immediately follow the nurse the moment she got up and went to the patients room?
fyi, that was not a good thing to do. if you want people to write on your behalf, they need to focus on what they observed about you or the incident. i am not a lawyer but i would not be surprised if their statements would be considered hearsay and be of no use to you...
i wrote this because, i want people to understand that i was not the only student who came to clinicals tired. i wanted to explain that people came just as tired as me, but said it was a one time incident. things like this happen to students, we are trying to learn after all and we make mistakes.
um... that is what they did otherwise you would not have this information. in fact, this may be a case where your performance, which put someone in danger gives them the right to make the decision that results in your dismissal from the program. this information may be found in your nursing student handbook... it is in mine (not spelled out in normal people speak... it is in vague legal speak).
as you can see it is not impossible to interpret your behaviors as dangerous. however, if you want to fight then do so. my advice is similar to the other... i think you are wasting your time if you wish to re-apply.
i have read this board for three years now. i have seen students dismissed for the craziest of things that were interpreted in such a way that their actions (or lack there of) may have caused patient harm or had potential to do so. i have yet to see one student who fought a long hard fight post being a nurse today. on the other hand, students that were dismissed and acknowledged errors (even as minor as providing comfort to a patient and family before the irate assigned nurse had done so) have posted that he/she are nurse today.
they did not give me any recommendations to improve during my midterm evaluation. only "work on tardies" which was immediately fixed, and documentation to support the claim. in addition, the whole concept of putting a danger is rather subjective. if anything, i would like to know, how exactly could i have put this specific patient in danger? now if you are stating what the school states claiming" if you were a nurse" but i am not one. i am a student, who is learning. making mistakes and then learning not to do it again. what are we showing here, that this incident proves without doubt that my performance demands failure? there is doubt in this accusation, and as nurses we are told never to go with doubts or assumptions. i just don't understand. i want to move on, but i can't. i owe 20,000 dollars. all because of an assumption, which states i "probably put a patient" in danger because i "probably fell asleep". my last appeal failed. i no choice but to seek legal action. =(
basid, I was once fired because it was thought that I "might" be unsafe. Absolutely no basis for that, no evidence, but it is what it is.
Your situation stinks, but it is over. You can want to make a legal case out of this but you don't have one. If you find an attorney to take it I will be shocked.
I do wish you luck. But I think you will end up in another nursing school and paying another student loan.
Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.
Next time if that happends, try following PCTs or CNAs so you can help them, ask your nurse if there is anything you can do, ask her questions, ask for assistance with what you dont know!
*pamper* her by saying tht you think she is a great nurse.. make her feel happy
AND FOR GOODNESS SAKES, you should have a 6 hour EXTREME energy bottle on your pocket!
I find it interesting that nobody has addressed this yet (unless I missed it) so i'm going to.
As a nursing student, you are expected to act like a nurse, and be professional, even though you are learning.
You stated that you "told the patient you were tired". No offense, but if anyone taking care of me EVER told me they were tired, I'd refuse their care. Perhaps the patient said something to the nurse, as I would have. In fact, if my patient told me the student assigned to me told them how tired they were, you bet I'd let the instructor know.
By telling the patient you were tired, you set yourself up. You did have the potential to put patients at risk, and you have admitted it.
If you felt that you were that unsafe to function, you should have gone home, or not even come in that day. What would have happened if you were the nurse? Would you have told your manager you are too tired to function, so you wont be taking patients? That wouldnt fly..
As for a lawsuit, SueSquatch is right - no one would take it. The school did what they felt was best, and you learned a lesson, acknowledge the lesson and move on. You now have the choice to repeat the semester, or change schools.
I agree with you that one, isolated incident of being tired does not warrant your dismissal. Perhaps the way you behaved subsequently is what prompted your dismissal--but not having been there I really can't say.
What *appears* to have been the precipitating factor was telling the patient that you were tired, which was very unprofessional and probably made the patient feel like you were a risk to him/her. The patient probably mentioned something which is why the nurse told you to stay behind when you asked to go with her--suggesting the patient was probably upset and did not want to see you again. Then the nurse likely had to report the patient's complaint and then comment on your behavior throughout the rest of the day to which you were dozing off (which you were if you were having to jerk yourself back awake).
Even after all of this, if you had just admitted you had made a mistake instead of trying to justify your actions over and over--as you have done on this board (so I can only assume you did the same with the higher-ups)--you may have gotten somewhere and been allowed to stay in the program.
I would plan on applying to different places and start over. Or better yet, you argue well---do you have an undergraduate degree? If so, take the LSAT and apply to law school would be my recommendation. I used to be pre-law and your post has "attorney" written in between the lines!!!
Hey buddy, I dont want to knock you when youre already down but its more or less like "HELP! I dismissed myself from nursing school!"
This is our job, we are held to a standard of care
I really dont see an excuse for nodding off during clinicals. There are so many things you could do to fill your time, restocking something ..making the beds, assisting the nurse with her paper work..something!
On a given day I wake up at 0530 for clinicals to get there an hour early (breakfast at the site is cheap and yummy) then get home around 4 ..only to go to my night job at 7, so I can get home 0730 the next day.
I have yet to nod off anywhere (luckily for me I work friday, saturday, and sundays) ..Its extreme, but if my job prevented me from succeeding in NS or placed a patient in danger I wouldve said check please ..this is much more important.
Im sure you learned a wonderful lesson from this, its not a conspiracy against you. One day you'll make a wonderful, energetic nurse...Im sure.
You told your preceptor you were too tired to take pts, so you would just observe--on your last day of clinicals? Talk about phoning it in. I would have failed you, too. As well as any classmates who tried to pull that crap.
I am sorry that you are having to deal with this. I had a bad experience with my first attempt at a nursing school, and I wouldn't advise pressing the issue because if you want to repeat this semester, the faculty/ dean will find a way to deny your re-admittance. It's not right, but people in a position of power can do that, so you must tread lightly. Just pray about it, you'll get through this.
You've somehow managed to make his falling asleep the fault of his school. That's an amazing skill you've developed.
Thanks for the responses people! I'm getting a really good picture of the situation and how the school is thinking as well. But just one more thing...
OK so what I'm getting from everyone is that i made a great error in telling the patient I was tired. I should have not done that because as a patient, she probably got worried (most patients would), and told the nurse how she felt. However, I forgot to mention that when I told the patient I was tired, I specifically told her I was not taking care of her. We even laughed about it, after stating that. She knew I was just there to observe. So she did not say anything to the nurse because I was there the entire time in conversation with her, talking about nursing school and finals and such. Nothing was said that would make the nurse feel uncomfortable following me to see the patient again but the nurse just felt like doing it b/c she "thought" I was too tired.
Another point of contention is the area of me putting a patient in danger. Again can someone on this board answer how exactly, (as an observer) could have harmed this SPECIFIC patient in this SPECIFIC incident. I keep hearing, that you could have harmed the patient if I was nurse, but thats also assuming I was a nurse in a hospital, and assuming I took a morning position and assuming I came to work extremely tired with nothing to do. There seems to be a great deal of assumptions and hypotheticals at work here. Lets concentrate on the specific incident and on that specific patient.
Let assume I came late after lunch, the teacher can than fail me because she states "you could have had a patient waiting for your services and you put that patient in danger" and I fail. I say logic, reasoning and objectivity should be placed on my dismissal. Remember, I can't go back. And going to another nursing school is going to take significant time and money.
Lastly, let me make this clear...
I DID NOT FALL ASLEEP. If I did, why would I be arguing? Because I did not. The nurse herself herself didn't claim I fell asleep. You can assume I did, but at the same time, I can argue I didn't. No one saw me physically sleeping, and I followed her immediately when she got up. That alone states I wasn't asleep.
By the way...my clinical instructor asked who wanted to take patient assignments. I said no, on the basis that I could learn more as an observer that day. In addition to feeling fatigued, I felt that I could take the observer position as a better learning experience. I could have easily taken a patient assignment but felt that an observer assignment would benefit me better. There is nothing wrong with that, nor does it say anything about it in the syllabus or student handbook (I looked) coming clinical tired is not recommended. On the last day everyone was tired, and we all verbally expressed that. But no one was barely able to walk or talk or comprehend directions (same goes for me) but put us in a room with nothing to do or watch, you would naturally be able to see fatigue. Again I see nothing wrong with this, as long as you can take care of your patient.
thanks to everyone again for their input. I do appreciate this.
OK...let me start and say I am tired...so I might have missed somethings. :)
A preceptor IMHO should eumulate what is expected. They should be direct but kind. They should have an open way of communicating. If I have someone who is tired, I normally say, Dude...get yourself some coffee and take 5 minutes outside and get some fresh air, do some jumping jacks or something. Why? Because we all have been there... dead tired and over worked. The preceptor is the mentor, not the instructor. If the preceptor wasn't getting anywhere with someone, then they should report it.
I agree with other posters...if you are more on the sidelines, then ask the preceptor if you could help out the aides to stay busy.
Either way I don't think you will win your point. The decision has been made. It sucks. I wish you the best
In my program's rules it did say that being excessively fatigued or suffering from sleep deprivation while in clinical is reason for dismissal. You're sure there's nothing in your program's rules about this?
~island girl~
14 Posts
I'm sorry to hear the drastic action taken by your school. I can understand where it does reflect poorly to be so tired on yourself as well as your institution. In the past, if i ever had felt too tired or not well enough to provide care, i would notify my instructor prior to the shift or when you began to feel too tired to stay awake. I think it may have been inappropriate to tell the patient that you were tired and why...they come to the hospital for care and it is usually safe to assume they are scared or worried about themselves...we, as nurses never take the attention of the patient. And although you had no patient load, if you were present, you should be alert. I would not think that a pt could feel safe if they notice a nurse dozing off...with that said, i don't think you should have been dismissed for this one incident only. you are right in the respect that all nursing students and nurses are tired and if there is no patients in your unit, it could be easy to be bored and doze off. i think you'd have to come up with some solution or action you would take if ever you felt tired and/or bored; this way, when you re-apply or transfer, you'll have proven that it was a one time thing and you have taken the time to realize the potential dangers and how to avoid this. you might even ask for letters of reference from your instructors that can vouch for your performance. good luck!