kicked out of school- failed professionalism!

prmenrs, RN · Apr 15, 2006

"You might want to be quiet because you won't want to get in trouble, but if you go about it the right way, you will not. "

I might point out that this didn't exactly work out well for you. Frequently, as a student, you really need to zip it. Ask for a tip on how to handle situations from your instructor. That's what s/he is there for. For example, you could carry a small bottle of hand sanitizer and offer to share w/the nurse you're shadowing.

I also must point out that you're arguing w/us, too. LISTEN to the advice. And figure out how you're NOT going to run into the same problem again.

I do wish you well in your future endeavors, but I think the "attitude" needs to be adjusted. Especially if you want your future to be in nursing. Otherwise, you'll run into the same problems if and when you finish and get a job.

KeithEMU · Apr 15, 2006

I was just failed from a community college in Washington for questioning nurses while I was in clinicals. I was not even given the opportunity to explain what I was questioning. At the beginning of the meeting I was told I could grieve the failure, but I had already tried that at another school and I knew that the grieving process means that I was already doomed.

When you grieve, it gives you the opportunity to tell your side. HOWEVER, if you had fault you need to know it ahead of time. Even if you meant well, but know now you may have come off poorly, ADMIT to them you were wrong and tell them you need help with this, but would like them to reconcider kicking you. You'd be amazed what admitting your wrong will do. You might have to repeat some classes to make sure you had a chance to catch things you missed the first time, but they may let you back and complete.

I questioned a nurse who was hanging a bag of lipids that had Vit K in it. There was no vit K on the MAR. I was not blaming the nurse for anything. I was just trying to understand if it was ok to hang. We called the doc and he said go ahead.

A huge amount to diplomacy is how and when you say it. If you just wanted to know why it had vit K on it, it would probably been ok to ASK, but not in from of the patient, and maybe not even to the nurse, but your instructor. Instead of "is that right" it would probably be better received if you asked, after you were out of the room, "do they normally add VitK to lipids?" It's all about delivery.

The other nurse I questioned was cutting a piece of foam for a wound vac.

Let her make the mistake. It's not engeneering, and wasting a little foam will be much better then brusing her ego. She does this every day and you are the student. I can imagine many getting irritated.

I am sure if my instuctors had given me the opportunity to tell my side of the story they would have understood that I was trying to perform good nursing.

Then appeal the dicision. Just be ready to admit you didn't handle it right. Ask for help and any way they will let you go back and complete the program there. It shows amazing character for someone to admit mistakes and push through anyway.

Similar stuff happened at the other school. I went to the zoo with some disabled clients without permittion; thereby, putting the school at "risk" for a law suit. I was with the other professional staff. I was not incharge. Yet, I was written up for this.

I like being friends with people. I've done management jobs and went out for drinks and stuff with employees, but talked with my bosses first to make sure it wouldn't be a problem first. I never had a problem doing what I had to because of it, and everyone knew it.

None of my sins put patients in danger. If you can call my infractions professionalism failures at all, they are surely not worthy of failure.:angryfire

Take a good look, because if you have that attitude, your not going to be allowed back, and shouldn't IMHO. It's ok to make mistakes, but not ok to deny them.

Good luck

nursepenny · Apr 15, 2006

This may have been addressed previously. If so, I apologise. When you confornted the nurses who made these "infractions", did you do so in front of the patient?

Did the pateint who received the Lipids have a bleeding disorder? Or on Coumadin therapy? There are loads of reasons the patient could have needed the extra Vit K.

As for the dressing change, have you ever worked with a wound vac before? Have you ever changed a dressing before?

I have been a nurse for 10 years and I still learn something every day. I may question another nurse, in order to learn, but I never do so in front of others, or especially in front of patients. this is a big NO NO and tends to put others on the defensive

Just my 2 cents....

mediatix8 · Apr 15, 2006

Nurses don't have a lot of time to answer your questions and defend themselves when you make comments- neither do nursing instructors. A lot of things will be learned with time and you can't expect each question you may have to be answered immediately by the nurse or your instructor. I learned there was a time and place for my questions and most questions I tried to answer myself. In this field, it's easy to be disliked quickly. You have no idea how busy the floor nurses are- don't think of them as your personal teacher. You're an adult with graduate degrees and your style of questioning and asking questions may have helped you in your previous life as a graduate student in a classroom setting- but the nursing environment is different.

CseMgr1, ASN, RN · Apr 15, 2006

I also saw nurses (and doctors) do a lot of things I didn't necessarily agree with while I was a student. One incident which I will never forget was witnessing an intern trying to insert a foley catheter into an elderly woman's

bladder. He dropped it into feces-soiled linen, then picked it up and put it in as if nothing had happened. Although I was horrified, I knew better

than to say anything, fearing that I would get kicked out of school....

wooh, BSN, RN · Apr 15, 2006

... But when things are wrong because staff aren't held to a higher standard and supervisor's don't want to take steps to increase low standards, these are the things that are unnacceptable. Hospice patient's with pressure ulcers not being turned every 2 hours because "they aren't going to be here much longer" is not an excuse. It's an excuse to be fired.... So do I think these things need to be reported, yes, habitual things that are from laziness, not busyness. Do I care if someone who has been allowed to slack is called on it, absolutely not, they need to get it together. I'm not talking about the staff members picking up their slack.

At some point you may learn (you know, after you get some the experience that is apparently unneccessary in your eyes) that there comes a point where turning a pt can be more cruel than helpful. If they do truly have a short time left with us, and they aren't soiled, I've often just gently repositioned the arms, maybe the legs, sometimes even just left them alone. Pressure ulcers aren't going to kill them, they're already dying. It's all about comfort. And if ignoring nursing school edicts makes a sying person more comfortable, that's what I'm going to do. And if a facility ever wants to use it as "an excuse to be fired" then I'd rather look for a job than cause needless cruelty to a dying person. It's about advocating for your patients, not blindly following a "q2 turning" plan. That's the kind of thing you learn with experience. Your other examples, wasn't there to know the whole story. But this one example alone shows to me that you don't always know best. And you might be wise to shut up and learn instead of spouting, "but in nursing school..."

lna2rn · Apr 15, 2006

I am at the end of my first year as a student. I have seen things done by nurses I did not agree with but I would never discuss it with the nurses directly. What if they were correct and I didn't know. I always ASKED my instructor "Is that the correct and most efficient and safe way of doing.....?" If it was not, my instructor would handle it, but 90% of the time the nurses were right. There is a huge gray area that we students have not ventured into yet. Always keep this in mind. Oh BTW, remember if you have a great clinical experience thank the nurses for teaching you the correct way of doing things.....and if you have a bad clinical experience thank your nurse for the learning experience and get them a gift. They must be stressed out and now you know how NOT to act!

LilPeanut, MSN, RN, NP · Apr 15, 2006

As nursing students, we always go to our instructor first with any issues, because our instructor is in a much better position to judge whether the nurse's actions were appropriate and if something needs to be addressed, the instructor will be the one best able to handle it.

Now, the hand washing thing, I might say something about (but try to keep it lighthearted) because on my clinical unit right now, rota is becoming an epidemic and is likely being passed by the staff.

Sometimes you WANT to do something, but you just can't. I had a pt. that was developmentally delayed and no one knew why she was delayed. She had come in for a ruptured appy and no one had really done much past that. She had a post-op abscess, so she's been in the hospital longer. I talked to my instructor about what's going on with her, about what could/should be done for her, and the bottom line is that it has to come from the nurse who has her as a pt.

As a student, I didn't just march up to the nurse and ask her about why wasn't she advocating for her pt. and doing a b and c, I just asked if she knew more about the pt's history and during the conversation asked about services or consults that could be done. She made it clear the surgeons only cared about her appy, and the rest wasn't her problem (she wasn't an incredibly warm nurse either). I had to accept that, smile and nod my head and take it that she was not going to help her and so this child would continue to not receive care she needed. My hands are tied. I'm not a nurse. I don't work on that floor. I expressed that I was concerned, she said she wasn't and that's it.

Sad, but true and I'll just know that when I'm an RN, I won't let my pts. slip through the cracks.

RunnerRN, BSN, RN · Apr 15, 2006

I feel like we're starting to beat a dead horse here (and we haven't yet heard from the OP again) but I wanted to include my $0.02. I'm not too far removed from nursing school, but I agree that there are two ways to question an RN - first is outside the pt's room, in a "learning" endeavor manner...."Can you explain why you gave the Zofran before the Morphine? I've always had problems figuring out which IVP med to give first." The second would be the "questioning" question...."Why did you give the Zofran first? Maybe pushing the Morphine first would have relieved the pt's pain, then he wouldn't feel as sick." Etc Etc Etc.

Staff Nurses generally DO NOT enjoy having students on their heels. Especially on the floors, and especially as beginner students, you are more of a liability than a help. These nurses have many other patients and many other things going on than helping you to remember which end of the enema goes into the rectum. Plus, it is one more worry on their plate - not only do they have to do their work, they have to CHECK your work, and that can take much more time. I remember our first Med Surg clinical. 10 green nursing students on top of the nursing staff, taking over the med room, using the glucometers, crowding the break room during report, hanging in the hallways (because 6 hours is too long for just basic care for 1 patient).

I precept students in the ER, and love it....but I am a nurse first and a teacher second. Because these SNs are working under MY license, I am extra careful to be sure they are working to my standards. Anyone can tell you that to do it yourself takes 5 min, to teach someone else to do it takes 15. I had a student 2 weeks ago who was wonderful - she had good judgment, good assessment skills, and a comforting attitude with patients. In short, she was there to learn and asked me tons of questions, but always very respectfully and in the right setting. Then I had one of her classmates this week, and this girl kept asking why I let Annie do so much more than I was allowing her. The answer is that the second student seemed like she was just passing time until she could go home. Each time they put a new patient in my rooms, she would groan and say "another?" She did many things incorrectly, and I would teach and correct her, but there comes a point when you just throw your hands up and say "you'll be observing for the rest of the shift instead of practicing." But I digress. The point is the same as all the above posters.....take a look in yourself, figure out why you want to be an RN, and figure out why these 2 schools kicked you out. Contact some old teachers and ask what you could do to improve yourself. As was pointed out above, your style may have worked in your previous careers, but nursing is often a career and calling of finesse.

Good luck. I hope you can figure this out!

steelcityrn, RN · Apr 15, 2006

The only thing I find, and maybe I am reading too much into your answer about how you were thrown out of these programs, is that maybe you corrected, or made strong suggestions in front of the patients? Thats not a good thing because then the patient can see and hear the battle going on right in front of them, thats not good for the hospital because if anything negative happens, they are going to put blame on the fact two healthcare professionals were disagreeing on a procedure. Im just wondering if that might have occurred?

carolinapooh, BSN, RN · Apr 15, 2006

I also saw nurses (and doctors) do a lot of things I didn't necessarily agree with while I was a student. One incident which I will never forget was witnessing an intern trying to insert a foley catheter into an elderly woman's
bladder. He dropped it into feces-soiled linen, then picked it up and put it in as if nothing had happened. Although I was horrified, I knew better
than to say anything, fearing that I would get kicked out of school....

I'm sorry, but I think I would leave the room if something like that happened and find my instructor.

If I had ever seen a nurse touch my father without first washing his/her hands while he was in intensive care, or if I had ever seen anything like this Foley incident, you can BET that, even as a lay person, I would have opened my mouth - directly to the nurse.

Why on earth a student can't say, uh, shouldn't you wash your hands, is beyond me. I don't think there's any excuse for not following basic procedures. If you go in a restaurant on a Friday night, and it's very busy, would you want to know that your server, overworked and underpaid, was in such a hurry that they didn't stop to wash their hands after hurrying out of the bathroom - AND THEN THEY PICKED UP YOUR FOOD TRAY, POURED YOUR TEA, AND PUT YOUR PLATE ON THE TABLE? So why would you not wash your hands before touching a patient? Eeeewwwww.... Or better yet, used the bathroom, didn't wash, and THEN WRAPPED YOUR SILVERWARE on a busy Saturday night? Double EEEEEWWWWW....

I mean, isn't that weird? Heck, isn't it gross?

Go ahead, chew me out - it really doesn't bother me. But think about it - if someone wipes themselves, doesn't wash, and then touches your food, is it any different if a trained professional doesn't follow basic procedures?

I don't know if I'll stand for a nurse - regardless of who they are - not washing his/her hands, or inserting a Foley after it's been dropped in fecal matter. You can bet I'll find an instructor and quick, because to me that's inexcusable. I don't really care how busy it is - what if it was YOUR mother, or husband, or child - or YOU that that was done to? Eeeewwwww. No excuse.

Sheri257 · Apr 15, 2006

Staff Nurses generally DO NOT enjoy having students on their heels. Especially on the floors, and especially as beginner students, you are more of a liability than a help. These nurses have many other patients and many other things going on than helping you to remember which end of the enema goes into the rectum. Plus, it is one more worry on their plate - not only do they have to do their work, they have to CHECK your work, and that can take much more time.

I don't think a lot of students understand this. They tend to only look at it from their own perspective. This is why I think telling the RN's how they should do things just makes matters worse. I also think it's particularly bad when they assign students to new grads, who are still learning the job themselves.

:typing