How to best handle this situation with my instructor?

[snowlion_m]

Hello everyone,

So I have encountered a situation where there was probably a misunderstanding between me and my instructor at the clinical today. Two days into the clinical, my instructor assigned everyone’s duty each day. Some were assigned med pass, some were assigned to look after two patient, I was assigned to one patient today.

One hour drive to the clinical site at 5 a.m gave me a brain fart during the first hour into the clinical.

1) My instructor wanted us to wait outside of an assigned room while waiting for the nurse to arrive. Apparently, I didn’t hear that part so I followed my nurse to each patient’s room instead of waiting outside the room of my patient.

2) After my mind started to clear a little bit, I wanted to assess my patient so I rushed into his room while he was seating on the bedside commode… My instructor did try to stop me but I honestly just focusing on my patient so I didn’t hear her, again.

3) During downtime, I asked my nurse if she needs help with anything. She said she’d love me to help her with medication because she was falling behind. So I asked my instructor if I can pass med so she can supervise me. She said she had many people to look after so she’d be too busy to let me pass meds - since I was not on the schedule for med pass. My understanding of the schedule was - it’s mandatory to pass med if you are on med pass day, if not then it’s optional - so I’d ask for permission first. I didn’t know that means “ absolutely not ”. Anyways, it wasn’t like she was busy - she was chatting with another instructor who’s in charge of another cohort on a different floor for 30 minutes straight. I meant you get paid to teach us, not to chat.

Anyways, at the end of the clinical, we had a conference. She addressed the above issues to everyone and avoid looking at me. I knew she was talking about me. She also said she’d write comments on the clinical feedback and all we need to reply was to admit the mistake we made, nothing else needed. It seems like she is not interested in an explanation. I possibly gave her the impression of being standoffish and not following the instruction. But honestly…I just didn’t know. For my clinical feedback, she wrote, " Did ok communication with staff but need to let the nurse know before giving the med & follow instructions given". Well, my nurse knew I was giving meds and there's no miscommunication between me and the nurse so IDK why you said that.

I felt like I came off a little clumsy and missed the window to explain my brain fart mistakes. But should I explain myself a little on a weekly journal that I am about to turn in? For clinical feedback, I plan on just admit my mistakes as she asked me to. I’d like to know your guys' opinion on how to best handle this situation. Much appreciated.

[JKL33]

Stop talking about "brain farts" and stop blaming things on them.

17 hours ago, snowlion_m said:

3) During downtime, I asked my nurse if she needs help with anything. She said she’d love me to help her with medication because she was falling behind. So I asked my instructor if I can pass med so she can supervise me. She said she had many people to look after so she’d be too busy to let me pass meds - since I was not on the schedule for med pass. My understanding of the schedule was - it’s mandatory to pass med if you are on med pass day, if not then it’s optional - so I’d ask for permission first. I didn’t know that means “ absolutely not ”. Anyways, it wasn’t like she was busy - she was chatting with another instructor who’s in charge of another cohort on a different floor for 30 minutes straight. I meant you get paid to teach us, not to chat.

I would've filed formal discipline against you for blatantly ignoring my instructions in favor of your own reasoning, which you used even though your whole post is about your brain farts and the things you have misunderstood or "not heard" so far in clinical.

Lets get a few things straight:

You do not "help" a licensed nurse pass meds because she is getting behind.

You do not pass meds if your instructor clearly tells you that she doesn't have time to supervise you. You knew you were not on the schedule to pass meds that day, and you also knew that you needed your instructor's supervision to do so. You knew that you needed to ask permission. You received all the answers you needed and you did exactly what you wanted to do anyway. If I were instructing your group I would refuse to instruct you further and insist that you be out of my group. That's the same with any orientee/preceptee I ever work with. If they will not follow my instructions I will not have them for a student or orientee. Period.

17 hours ago, snowlion_m said:

Anyways, it wasn’t like she was busy - she was chatting with another instructor who’s in charge of another cohort on a different floor for 30 minutes straight. I meant you get paid to teach us, not to chat.

IF (and I mean one huge ginormous "if") you have something to be disgruntled about with regard to this, then you handle it properly in the manner that a hopeful professional would. You do not go around and do what you want as a nursing student based on your own rationales.

I know I am being very blunt, but your time in school will be exceedingly short if you keep this up. You are very lucky you aren't done and out already based on your medication stunt.

[snowlion_m]

20 minutes ago, JKL33 said:

Stop talking about "brain farts" and stop blaming things on them.

I would've filed formal discipline against you for blatantly ignoring my instructions in favor of your own reasoning, which you used even though your whole post is about your brain farts and the things you have misunderstood or "not heard" so far in clinical.

Lets get a few things straight:

You do not "help" a licensed nurse pass meds because she is getting behind.

You do not pass meds if your instructor clearly tells you that she doesn't have time to supervise you. You knew you were not on the schedule to pass meds that day, and you also knew that you needed your instructor's supervision to do so. You knew that you needed to ask permission. You received all the answers you needed and you did exactly what you wanted to do anyway. If I were instructing your group I would refuse to instruct you further and insist that you be out of my group. That's the same with any orientee/preceptee I ever work with. If they will not follow my instructions I will not have them for a student or orientee. Period.

IF (and I mean one huge ginormous "if") you have something to be disgruntled about with regard to this, then you handle it properly in the manner that a hopeful professional would. You do not go around and do what you want as a nursing student based on your own rationales.

I know I am being very blunt, but your time in school will be exceedingly short if you keep this up. You are very lucky you aren't done and out already based on your medication stunt.

First of all, I need to clarify that I did NOT end up giving med on that day because I didn’t get the permission. So I did not violate anything. Your whole response was based on an assumption of me DID give the med.

[Cowboyardee]

You probably came off as standoffish and confused about the directions because you were standoffish and confused about the directions. On the upside, it doesn't really sound like your instructor came down particularly hard on you.

My advice:

1) Be less standoff-ish. If you instructor spends some time talking with other clinicians or instructors rather than passing meds with you on a day you're not scheduled to pass meds, don't begrudge her. She knows what she's paid to do much better than you do. It's likely enough that your attitude shows through. Do your best to adjust it.

2) Apologize sincerely for any confusion, and ask sincerely if there's anything you can do to perform better. A brain fart is just a mistake, like any other mistake. Do what you need to do not to make mistakes. Go to sleep earlier, drink more or less coffee, ask for advice. Brain farts happen to everyone, but that doesn't excuse them.

3) If you're still confused about your duties and responsibilities, ask away.

[snowlion_m]

1 hour ago, Cowboyardee said:

You probably came off as standoffish and confused about the directions because you were standoffish and confused about the directions. On the upside, it doesn't really sound like your instructor came down particularly hard on you.

My advice:

1) Be less standoff-ish. If you instructor spends some time talking with other clinicians or instructors rather than passing meds with you on a day you're not scheduled to pass meds, don't begrudge her. She knows what she's paid to do much better than you do. It's likely enough that your attitude shows through. Do your best to adjust it.

2) Apologize sincerely for any confusion, and ask sincerely if there's anything you can do to perform better. A brain fart is just a mistake, like any other mistake. Do what you need to do not to make mistakes. Go to sleep earlier, drink more or less coffee, ask for advice. Brain farts happen to everyone, but that doesn't excuse them.

3) If you're still confused about your duties and responsibilities, ask away.

1

I was not standoffish but definitely confused. I asked her if I could pass med because my classmates who had other instructors told me their instructors would let them pass med as much as they can. I possibly gave an unpleasant vibe after she denied my request because I felt like she could have put in more effort into our learning cohort instead of chatting with other people. In my opinion, there was no harm in asking if I wanted to do more within the student nurse protocol, so I don't know why she wrote: " I need to follow instruction." I was told if I have questions, ask. That's what I did -especially I did follow instruction by not giving med.

I just felt like I missed the opportunity to explain myself.

[RNNPICU, BSN, RN]

2 minutes ago, snowlion_m said:

. In my opinion, there was no harm in asking if I wanted to do more within the student nurse protocol, so I don't know why she wrote: " I need to follow instruction." I was told if I have questions, ask. That's what I did -especially I did follow instruction by no giving med.

Apparently, I didn’t hear that part so I followed my nurse to each patient’s room instead of waiting outside the room of my patient.

2) After my mind started to clear a little bit, I wanted to assess my patient so I rushed into his room while he was seating on the bedside commode… My instructor did try to stop me but I honestly just focusing on my patient so I didn’t hear her, again.

The two areas above are what indicated you need to follow instruction.

It sounds like you were not focused today. You are a student. You are there to learn, you are not a helper, you are a learner. Stop, listen to your instructor. It sounds like you were focused on your needs, not your patients. Unless a patient is in need of CPR or other emergent interventions, you do not need to rush into the troom to do an assessment as a student. Don't try and do more than what you are assigned, it comes accross as unfocused and not able to follow instructions

[JKL33]

2 hours ago, snowlion_m said:

First of all, I need to clarify that I did NOT end up giving med on that day because I didn’t get the permission. So I did not violate anything. Your whole response was based on an assumption of me DID give the med.

19 hours ago, snowlion_m said:

I possibly gave her the impression of being standoffish and not following the instruction. But honestly…I just didn’t know.

19 hours ago, snowlion_m said:

For my clinical feedback, she wrote, " Did ok communication with staff but need to let the nurse know before giving the med & follow instructions given".

19 hours ago, snowlion_m said:

Well, my nurse knew I was giving meds and there's no miscommunication between me and the nurse

Yes, I did indeed think you gave the med.

[Cowboyardee]

4 minutes ago, snowlion_m said:

I was not standoffish but definitely confused. I asked her if I could pass med because my classmates who had other instructors told me their instructors would let them pass med as much as they can. I possibly gave an unpleasant vibe after she denied my request because I felt like she could have put in more effort into our learning cohort instead of chatting with other people. In my opinion, there was no harm in asking if I wanted to do more within the student nurse protocol, so I don't know why she wrote: " I need to follow instruction." I was told if I have questions, ask. That's what I did -especially I did follow instruction by not giving med.

I just felt like I missed the opportunity to explain myself.

I suspect that explaining yourself without reconsidering your attitudes, assumptions, and response to the day could potentially do more harm than good. If you genuinely believe that your instructor shouldn't have been talking to a colleague or that any mistakes you made should have been overlooked as brain farts, then those assumptions are likely to leak through in your explanation, and probably won't help you out.

Re-examine your expectations of your instructor and yourself, or else just let it go and get through clinicals, doing what you need to do to pass whether or not you agree with your instructor's style.

You're a grown up who can decide for yourself - you can ignore my advice if you like. But it's honest and well-meant.

[snowlion_m]

14 minutes ago, JKL33 said:

Yes, I did indeed think you gave the med.

Yeah, I had to ask my nurse’s permission first - so she knew I was giving med to her patient IF my instructor would be present; then I asked my instructor to supervise me after nurse’s acknowledgment. Instructor did not grant permission so med pass did not continue. Let me know if you need further clarification.

[snowlion_m]

28 minutes ago, RNNPICU said:

The two areas above are what indicated you need to follow instruction.

It sounds like you were not focused today. You are a student. You are there to learn, you are not a helper, you are a learner. Stop, listen to your instructor. It sounds like you were focused on your needs, not your patients. Unless a patient is in need of CPR or other emergent interventions, you do not need to rush into the troom to do an assessment as a student. Don't try and do more than what you are assigned, it comes accross as unfocused and not able to follow instructions

Yes indeed I was not focused in the first hour because I didn’t take my ADD med on that day. I had to force myself to focus.

[snowlion_m]

49 minutes ago, Cowboyardee said:

I suspect that explaining yourself without reconsidering your attitudes, assumptions, and response to the day could potentially do more harm than good. If you genuinely believe that your instructor shouldn't have been talking to a colleague or that any mistakes you made should have been overlooked as brain farts, then those assumptions are likely to leak through in your explanation, and probably won't help you out.

Re-examine your expectations of your instructor and yourself, or else just let it go and get through clinicals, doing what you need to do to pass whether or not you agree with your instructor's style.

You're a grown up who can decide for yourself - you can ignore my advice if you like. But it's honest and well-meant.

Agreed. I am in a tricky situation so I am asking for advice. I am still upset about how she handled this matter and her ways of dealing with our cohorts. But the last thing I want is to make a enemy with my instructor. If there isn’t a smart way to improve the situation, I will just let it go and act accordingly with her from now on.

[thoughtful21, BSN, RN]

The expectations in clinical can be confusing. Each instructor can have different expectations, as you mentioned. In addition, the schedules and requirements are rigorous. Anxiety and pressure can often cause students to "rush into things" and not think/listen well.

I wouldn't worry about your instructor taking a little time to stand and talk. I don't know if she's a good instructor or not...I don't know her. But sometimes instructors need to compare notes and support one another. And chatting with the other nurses in the facility builds up goodwill between the school and the facility, helps the instructor learn their expectations, and uncovers new opportunities for students like yourself to get in on a cool procedure or learn something new.

I recommend that you start earlier, or prepare the night before, to make sure that you arrive to clinical on time and ready to go. Starting the day off on the wrong foot seems like it was part of your problem. Pack a breakfast to eat it in the car, pack all your clinical supplies the night before, and take your prescribed medications. That's part of being a safe nurse.

I understand how hard it can be with the lack of sleep and many other responsibilities to juggle! But blaming in on "brain farts" and making excuses is not the right solution.

It seems like the instructor handled it pretty well. She addressed the issues to the entire group without singling you out. (I'm sure the other members of the group have things to improve on as well.) And then she only asks that you admit your mistakes on the clinical feedback tool. It doesn't even sound like she's terribly upset with you. You might be thinking about it much more than she is.

I think you have some ideas of what you can work on to improve. Start prepared, listen well, and follow instruction. If you didn't give a med without permission, then overall you didn't do anything too terrible. Don't take this to heart too much! Admit your mistakes, make a plan to improve on the things you can, and go to the next clinical and be the best you can be!