Content That conscientiousnurse Likes

We're against it because there used to be a fairly universal belief in the western world that human life had a unique, intrinsic, undeniable value and that it was worth preserving and defending even at very high cost. Sadly the forces in our culture that want that changed are having increasing success.

Germs are everywhere! Are you a germaphobe? Do you go above and beyond the norm to eradicate germs at work or at home? Tell us your story. We all have our days - sometimes we just go crazy spraying and cleaning everything. Again. And again. I know.



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No student is fully capable. A passing grade does not mean "fully capable", it means capable to the passing standards of what is expected of students at that point. A 1st semester student would get an A for being able take VS, give bed baths and interview a patient. You yourself said that your skills are average. Average is "passing clinical"-worthy but not necessarily "scholarship recommendation letter"-worthy.

Again, I will say that I don't think there's anything "unfair" about your instructor not responding to your email with any sense of urgency. It very well may be that she didn't check her email for several days and when she logged in she found ALL of your emails.

I am glad that you have decided not to report this instructor because the school would likely react the same way the majority of the posters on here have and believe that you are angry and reacting to her denial of your request for a recommendation letter which would make your complaint less credible.

All you can do at this point is pick your head up and move on. Seek feedback from your current instructors and work on your skills.

"Uncomfortable" with your skills in terms of writing you a reference is different than giving you a passing grade in clinical. I've worked with plenty of students (and nurses) that are competent but that I wouldn't even consider writing the type of recommendation needed for a scholarship.

My point exactly.

You asked, she said no, albeit a little slowly. You were surprised by her reason even though one does not have to give a reason when being asked for a favor. I know you were blindsided but this is not the worst thing that will ever happen in your relationships as you build a career. Think about what your goals are and what it will take in building relationships to accomplish them. You will see people over and over again in places that you don't expect in your career path. Be careful how you pick your battles. When something comes up that blindsides you, take a deep breath, smile, do something nice for yourself, wait at least overnight and then decide what to do, if anything. It was a good idea to air your frustrations here before you jumped and acted quickly.

Good luck with your scholarship!

I'd like to start off by saying that I am a recent graduate (August 2011), and was lucky enough to land a competitive OR residency position in the NY metro area in January. The reason I mention this is because I was very recently in your position, and also know what lies ahead of you, so my approach is not as a seasoned nurse trying to educate you, but rather a peer sharing her experience. While you have read this from many other members, I would have to agree that you're taking things too personally. I don't think a mistake on an accucheck would be a reason to refuse to write you a letter (if you had given medication without supervision etc. then that would be another story).

From what you've said it doesn't sound like she led you on. When she said that she'd write letters, she said it to a group as you said, not to you as an individual. She said you were doing well, students are often evaluated in regards to a "standard deviation/learning curve," if you will. While I don't know what her exact comments were, from what I gather she said you were doing "well," which means that you may have earned the right to pass, but still require improvement. If she did not say that you were excelling (let's say top 10% of the bell curve) she may not have felt comfortable writing a letter. Look at it this way A=excellent B=above average/good C=mediocre, but a B will get you a 3.0 gpa. And this is not a personal insult but scholarships are often reserved for the top tier of students, this is not to say that you are not worthy of it, but that based on her assessment of your skills, she may not felt that way. Professors do care about patient safety; they put their license on the line simply by teaching us. They simply do not pass below average students, all my professor made that abundantly clear.

The other thing to consider is that once you confronted her with her quotes, she may have declined to write the letter simply based on your approach. Truthfully your response to many other post has been defensive, aggressive and borderline rude. Professors are super busy and despite their best efforts are not always able to respond immediately to emails, especially if it's not a lecture course; I don't think she was intentionally being rude to you. Sometimes emails get mixed in with so many others that they don't see it etc. It was good that you followed up, but I hope you were cognizant of you tone. During my interview I was asked what my "strength" was and I replied that I knew how to be "assertive and confident, without being aggressive and confrontational;" it's a delicate balance that I would venture to say is essential for every nurse to master if they wish to be successful in their career, and something to start practicing in nursing school. Also nursing is the successful and practical application of theory to practice. You have to know the why behind all your actions.
What I'd take away from this is to actively seek feedback and constructive criticism. In nursing there's always room for growth. If a professor, preceptor or nurse manager later on in your career provides you with a positive evaluation, inquire further. It's ok to say thank you for the positive evaluation, and then ask them what else you can to do improve. Even if it's not evaluation time, ask them--they'll appreciate your initiative. While you may not ever come to a resolution that you find suitable in regards to you professors denial, It's likely that if you seek out feedback in the future you can avoid situations like the one you experienced in terms of evaluation.

Lastly I'd keep in mind that professors, preceptors etc. do talk. Many members of the faculty are also staff members, affiliated with or know someone at a hospital. It's very important to be gracious regardless of whether or not you agree with someone's actions because you never know what situation you'll find yourself in. During my application process my former professor (who also happened to be the CNS of the hospital), went out of her way to speak to the nurse recruiter on my behalf (without my asking her to), but told me that she declined to write a letter for another applicant because she was uncomfortable recommending her. This is not to compare myself to you, but just an example to keep in mind for the future.

I, along with several of my coworkers, have had physicians and instructors personally offer to complete recommendations for graduate school applications only to have them not complete them by the deadline. I didn't take it personally, I just went down the list and enlisted another colleague or professor. A couple of my coworkers were denied entry into programs because their applications were not complete due to the missing recommendation. Were they disappointed? Sure. Was it inconsiderate, even rude on their part? Absolutely. Not one of us, though, took it personally. Why? People get busy.

Maybe she was busy and by the time she got around to checking her email she had received another unintenionally aggressive email from you. Maybe she sat down to write it and thought about your level of defensiveness when criticism was offered in the past. Clinical instructors value their reputations. The bad ones do not get "good" assignments for their students. An employer will often take a clinical instructor's recommendation as a gold seal of approval. Employers want new nurses who are open to constructive criticism. She may have been afraid that you would not be open to criticism as graduate nurse and became reluctant to attach her name to you professionally.

There is a big difference between being a bad clinical student and one worthy of a recommendation. Many people reserve recommendations for the best students, colleagues, employees, etc. Maybe she felt that a recommendation would categorize your clinical skills superior when they were not. Try not to take it personally. Just because she did not feel comfortable providing a recommendation does not mean that she thought you were unsafe. I'm sure if she thought that, she would have failed you. She could have just provided a negative letter in a sealed envelope if she had it out for you. Instead she simply declined to provide the recommendation.

Please let this go. The last thing you want to do is enter the nursing world with a chip on your shoulder, expecting experienced nurses to eat their young. Everybody will pick up on it and you will run the risk of being labeled toxic. Show this instructor that you can handle her feedback like a mature professional. Avoiding her will not serve your best interests. There may be many nurses in the world but it is a small profession, so to speak. Everybody knows somebody that knows somebody. I had a friend who was fired from her 1st nursing job and her director knew people in all of the other hospitals. It was years before she was able to secure another inpatient nursing job. Don't burn your bridges, it is not worth it.

I was going to say something, but I have already said it and others have said the same numerous times. Her being uncomfortable writing a letter of recommendation does not equal you doing anything wrong, or her failing to do her job for pointing out any wrongdoing. At this point you are basically stirring up trouble because she didn't give you a LOR. It doesn't matter whether or not that is true, that is exactly how everyone will see it.

Edit: Just read that you won't file a complaint , so disregard my last sentences about it.

You might not have been doing things wrong in clinical, just average, and with more practice it could become like natural. You're still a student, you still have the opportunity to become a great nurse, but letting one teacher make you anxious about your ability with one word might be a bit of an overreaction. Take your current teachers advice and work harder, study longer on skills, and try to buddy up with one of your type A peers who can offer honest, constructive criticism about your skills.

I tend to agree with the others that there is a difference between good and letter of recommendation worthy. You may have been good enough to pass clinicals, and that might have been reflected in your grade at the end of clinicals, but you might not have been great which could be her requirement for a letter of recommendation. She might feel uncomfortable with your clinical skills when comparing them to the level she would write a letter of recommendation for.

Also when did she tell the group of students that she would write the letter, towards the beginning of the semester or end? It makes a difference that she didn't tell just YOU that she would write the letter, but a group. She might have been willing to write towards the majority of that group, but not every person.

Your writing style or tone, does seem aggressive as mentioned previously. This might have come across in the subsequent emails to your professor when you didn't get a timely response. I know that sometimes my writing can take on an edgy tone or somewhat of an indignant one when I'm not pleased with something. This tone might have been what caused her to give a harsher response than what she may have originally thought of you as well. Before you go into that meeting, if there is one, you might want to role play with a peer to prepare yourself to keep your emotions in check. Getting angry or flustered during this will not help you get your point across to your teacher, but will make you look foolish and too emotional.

I really hope this works out for you and that you find some sort of resolution or peace in this matter.

Again, maybe she felt you are good when it comes to where you should be for your level of education and skill, but not good enough for her to write a letter of recommendation. It hurts, I know, but there isn't much you can do about it. Most people are average, that's why it's called the average. Wanting to be more than that is a wonderful thing. Take this experience as an opportunity to learn and grow and you'll be great!

Excelling clinically means different things at different levels. In your first semester if you can take vitals and give a bed bath, you're doing great. If that was all you could do in your last semester, you would be terrible.

I also don't understand the dichotomy between excelling clinically and in theory. To be a good nurse, you have to be good at both. It's not an either/or proposition. You can't be good clinically without being good at theory.

Thanks. I try not to compare myself to others because there will always be someone better, and it can be self-destructive if you are constantly comparing yourself to other people and never as good, ya' know? But I will keep that in mind.

Anyway, thanks to all of those who gave me some constructive criticism. I won't file a complaint, and I am thinking about avoiding this teacher entirely for the rest of my years at the program and not give a second thought.

conscientiousnurse........I appreciate your comments. It is great that now, since you are in a teaching position and are responsible for instructing others how to provide spiritual care, you are indeed being a conscientious nurse and wanting to discuss how to provide this type of care.

When meeting the spiritual needs of the patient, we always need to take our cues from them and never impose our religious beliefs on them. We need to assess spiritual needs just as we are to assess physical and psychological needs. Many times patients are going through spiritual distress as they are dealing with overwhelming health challenges. As a nurse, we must try to meet those spiritual needs, either directly or through the help of another person such as a chaplain, clergy, parish nurse, priest, etc.

If the patient requests prayer, then either the nurse, if he/she is comfortable doing so, or another, such as the chaplain, should provide prayer. It is fine, as part of the spiritual assessment, to ask if the patient has a religious affiliation or is a member of a religious community, or would like someone from a religious organization to be contacted. You can ask the patient how they would like you to address their spiritual needs in their healthcare, or how you can assist them in their spiritual care. The patient and family to whom religion/spiritual issues play an important role in their lives will be very glad that you asked them to share their beliefs and asked how you might best meet their needs.

You might want to read some of my blog entries in my allnurses staff blog, Body, Mind, and Soul where I discuss other aspects of spiritual care in nursing.

Congratulations on your new job! Just as in any job, there is a learning curve with this new position, so cut yourself some slack. Some strategies I employ with my foundation lab to keep the students busy during check-off or performance eval time are the following: assign skill stations or specific tasks for students and give them a list of items to complete, give them a test to complete with items that they must look up from their lab textbook, or give them an article with CE exam (on such relevant subjects as bathing a patient, taking a blood pressure, etc) and require them to complete the CE either individually or as a small group sitting at a table. Best wishes to you and keep us posted

scenario 1: you have divided students into 4 groups to practice hands-on skills. two of the groups are spending more time talking than practicing. asking them to get to work hasn't worked. what would you do?
my answer: i would ask those groups to show me the skills they were supposed to be practicing, and tell them the deficiencies. i would then ask them to practice it better so they'll be able to pass the next exam. i would comment that too much talking may be keeping their whole group from learning the skills they need in this class, which is not fair to all the participants. it's up to them to practice or not practice, and accept their own consequences from whatever they do or don't do, as long as they aren't disturbing others. i think what you wrote is super, and also think you could invite them to leave when they're finished and if they're being disruptive.

scenario 2: one student is not paying attention and is being disruptive in class. you ask them to participate in an exercise. the student reacts, "i'm only here because i was told i have to be here. all i want from this class is a certificate. leave me alone." what would you do?
my answer: i would have a break for the class and ask the student to meet with me privately. i would tell them that i am concerned they will not be able to learn all the content required to gain the certificate if they continue not participating in class. i would ask them also to please not disrupt the learning that is needed by the other students, or i may need to say something in front of the class. i do not want to have to embarrass them this way, and hope to gain more cooperation in the future. your maintaining of the privacy of the student is admirable. what you say you'd say to her is good too, and very caring. it's appropriate. if the misbehavior continues, my advice from #1 holds here. a question for you...can students fail this course? if not, you're not going to have any impact on students who aren't motivated to succeed. will your administration back you if you need to fail someone? if not, it's not an instructor-valuing environment for you, and might be just a money-mill for the owners. consider that in deciding if you want to work or continue to work there. a disruptive student is seeking attention. i would try sticking close when possible and standing nearby when she is sitting and standing between her and the students she's interacting with. get in her space and block interactions, either by just being there or saying something while there. talk to her often about what you see going on (in private). don't dance around it. confront it. you might also assign seats and put the disruptive student at the back so others don't have to see her being disruptive.

scenario 3: five students in the class have english as their second language, and all sit at one table. one of the students appears to be quietly translating for the others during the class. another student complains about being distracted by the "talking."

my answer: i would say that i think that they may be translating, and would gladly let this student be seated in front, away from that group, if it would help. but that i would talk to that student and find out the real situation. i would find out if it is really a matter of translation. if so, i would make sure they sat in the back and talked quietly so as to disturb fewer students. also ask the students who are part of the translation about it, since you're not sure they're translating. tell them the concerns. maybe they're disruptive like the scenario 2 student, but you just don't know it since you don't know their language. if they're not intending to be disruptive, i'm sure they'll try to avoid seeming disruptive. putting them in the back would help, since others wouldn't see them as they look toward the front. however, don't just do it without explaining it to them, since it could seem as it you're not culturally caring otherwise.

in this job, which is a private cna school, the course lasts 3 weeks, with the last week being reserved for clinicals. i also found out that there are no office hours, but teachers can be given an email address through which students can contact us. does anyone else have experience with this type of cna teacher position, and any advice to give? thank you in advance for any and all posts![/quote]

do you have time before and after class when you could make your own "office hours". i've found schools don't assign them, but instructors decide the hours themselves. do you have an office or a spot you could just be in, in case the students want to talk to you personally, outside of class? how about that email address? how about phone contact (not with your home phone)?