I was taking care of a patient who had liquid diarrhea. I was not able to get to my med pass because of this. The patient's family was complaining about everything. I was getting no feedback from my instructor until she decided to make me go home. When I asked her what I did wrong, she said, "What didn't you do wrong?" I still dont' understand why she made me leave. What do you all think I should do given the situation?
She said the family complained about me being flustered and then she said what didn't you do wrong when I asked for specifics.
Ok...this is why she threw you out...it didn't have anything to do with the med passes.
This is a huge issue at our school, especially with the younger students.
Body language is very important. It tells quite a bit of how you feel about the situation and you don't have to say a word. If you had a disgusting look on your face, if you were doing a lot of "sighing" when you realized you had to clean the patient again, if you weren't taking steps to talk the patient through the situation like, "It's ok! You're sick! This is why we are here, to help you get better." and engage in other chit-chat to make the patient or the family feel more comfortable.
The family complained that you were "flustered" because it comes across as being either angry, mad at the situation or not caring.
I understand you were overwhelmed, but you can never appear overwhelmed. If you need help, remind the family, "I'm a student. I want make sure everyone has the best care but I think I need to step out for a second and get some help, I'll be right back, I won't be gone long."....how can they possibly have a problem with that?
Your instructor wants you to work on time management and prioritizing. You only had one patient and you should be able to provide care to them; even if they are total care patients.
Go into clinical early, verify your patient doesn't have any new orders, or meds that you don't know about and need to look up. Get out some paper and write out a little graph with a block for every hour you are there. Write in the box when the meds are due, and then on the side write a list of everything else that needs to be done for a patient. (AM care, linen change, etc.). At most hospitals you can give most meds up to thirty minutes before or thirty minutes after they are due and they are still considered on time. Make sure you are prepared by knowing your meds and how to adminster them- meds are the priority- not cleaning up diahrrea. That is important but not the most important. Your attitude is very important. Patients and their families want competent people working on them-even if they are students. You need to be confident and prepared. Even if you aren't completely sure how to do something- others are there to help you; but you have to have the confidence, be prepared and follow through.
BTW,You should report the diahrrea to your nurse, it could be a side effect of the meds, or the patient may need to be checked for a fluid/electrolyte imbalance due to excess fluid loss.
First semster is the time to grasp basic concepts of time managment and priortizing. You can do this- focus on the big picture of what is most important for the patient- you're training to be a nurse and that requires thought and problem solving.
Go into clinical early, verify your patient doesn't have any new orders, or meds that you don't know about and need to look up. Get out some paper and write out a little graph with a block for every hour you are there. Write in the box when the meds are due, and then on the side write a list of everything else that needs to be done for a patient. (AM care, linen change, etc.).
LOVE these ideas. I have clinical this evening and I am going to do this! Thank you!!!
I see this as a priority problem as well. Just because your a student doesn't mean that you have lack of resources to help you do your job. Rather than deal with a low priority skill on your list, you should have delegated the diarrhea and ill family to a CNA and went on with your top priorities. Nursing is all about time management and priority and although I can't hear the other side of the story and the instructor responded harshly, it is your job to take what you learn in class and apply it to real life situations. This takes practice and is hard when you have always had someone to lean on for help. She wants you to take responsibility with what she has placed in your lap to the best of your ability and not whine when you get "flustered". Everyone gets flustered at one time or another so when it happens, take a second, catch your breath, realign yourself and get back out there. Clinical time is all about learning and it seems you know why she sent you home but your having a hard time dealing with why the instructor treated you so harshly. One of the first things I learned when in clinical was not to take everything so personal and learn from the experience. If, after you have had time to lull it over and still don't understand, request a meeting with the instructor to discuss issues in your nursing technique. I learned quickly that clinical time requires assertiveness and special technique for "feeling" out the different teaching methods of the instructors. Some are there to help you make your way while others are there to make you learn the hard way. You can learn from both. What they can't help you understand will require many nights of studying to learn what you don't remember or weren't taught after you leave the clinical or the job later on. It's all good and your gonna get it so hang in there and take it all in stride. :)
Hoping that the OP was able to return to clinical, get her questions properly answered by the CI, and perform satisfactorily. Getting thrown out of clinical is the fast track to being dismissed from the program and we certainly don't want that to happen to this student.
I agree that OP should be organized, and prioritize better, but why kick her out of clinicals? That's a bit harsh, and CI's answer of "What didn't you do wrong" is certainly NOT helpful at all. Yes, we can get flustered, and really that is OK, as long as we can recognize it and think logically through it. I'd make darn sure that I sat down with the CI and instructor and got specifics for improvement in writing, as a dismissal from clinical can lead to a dismissal from a program. You deserve a fair chance to learn from your mistakes.
I dont understand clinical instructors. I feel like pretty much all of them are the same, that I have seen/heard about: obnoxious, condescending, intimidating. We are there to LEARN. Not want to go home crying and want to quit. I feel like the way they approach us about things does not help us become better nurses, it makes us afraid to ask questions. Is it "Tough Love"? I dont know... Just wondering.
I'm sorry you've had such bad experiences with CIs, but please know they're not all like that. I had WONDERFUL instructors all thru NS...they were dedicated to preparing us to be the best RNs we could be! I only had one CI that was less than wonderful and that was with another student (long story). One out of all the instructors isn't "pretty much all of them" thankfully.
Uhh... there's difinitely things that you intentionally left out of your story. A nursing instructor doesn't tell you to go home with out a really good reason. She did not throw you because you were flustered. Oh my goodness! 99% of students would be eliminated if that were the case. Unless you were so flustered that you just stood there and did nothing.
Specializes in Critical care, neuroscience, telemetry,.
Sorry to hear you had such a rotten experience in clinical.
I don't know enough from your story to understand exactly why you were sent home. I don't think anyone in my BSN program was ever sent home from clinicals. We were taken aside and privately reamed by the clinical instructor for our sins of comission and omission.
Mine were numerous, and yes, I was an hour late with meds on my patient one day. I was also flustered a good bit, cried on occasion and usually pulled Cs on my care plans. I dangled near the bottom of every clinical group I was in until psych, and I hated nursing school.
I really wanted to be a nurse, so I just did the best I could. I didn't shine in clinicals, but I was always there on time or early and had my books and assignments with me. Frankly, I didn't understand a lot of what I was doing and I BS'd my way through some things. Just keep trying. Ask questions.
Another thought: Don't just sit there and take everything that's thrown at you. I had an instructor accuse me of not knowing how to give an injection the first time we did it in lab (well, duh - I was 20 and a nursing student!), but I had read the chapter and I spouted the info right back at her to let her know that I had read the material and was doing the best I could. Surprisingly, she backed down. I'm not suggesting that you become a know it all, but sometimes a little assertiveness makes others perceive you in a more positive light.
I do think you should have had more help from folks, though. It's not easy to have a patient who's pooping up a storm. I think your instructor should have been more present to you in that situation.
There is usually a 1-2 hour time frame in which to get your med passes done. There should have been a regular CNA or tech assigned to the patient that should have been able to help take care of the loose stools while you got to your med pass. Part of nursing is learning to delegate responsibilty. We all made mistakes in school AND out of school!! Try not to let it bother you and start tomorrow like yesterday didn't happen!! Good Luck!!
I think that a nursing student in clinical could certainly be flustered, and appear that way as well without realizing it. I thought that the clinical experience was supposed to also be a learning experience. Granted, I don't know the history between this student and the instructor, but I would think that if the instructor had taken her aside and provided some instruction and guidance then she would have learned a lesson she wouldn't have forgotten, and would have the opportunity to improve instead of being humiliated and scared of her next day at clinical. Just my opinion.
BabyLady, BSN, RN
2,300 Posts
Ok...this is why she threw you out...it didn't have anything to do with the med passes.
This is a huge issue at our school, especially with the younger students.
Body language is very important. It tells quite a bit of how you feel about the situation and you don't have to say a word. If you had a disgusting look on your face, if you were doing a lot of "sighing" when you realized you had to clean the patient again, if you weren't taking steps to talk the patient through the situation like, "It's ok! You're sick! This is why we are here, to help you get better." and engage in other chit-chat to make the patient or the family feel more comfortable.
The family complained that you were "flustered" because it comes across as being either angry, mad at the situation or not caring.
I understand you were overwhelmed, but you can never appear overwhelmed. If you need help, remind the family, "I'm a student. I want make sure everyone has the best care but I think I need to step out for a second and get some help, I'll be right back, I won't be gone long."....how can they possibly have a problem with that?