My Heart is Broken

Nursing Students LPN/LVN Students


Specializes in Hospice.

In our 12 month program, we clock upwards of 2,000 hours of clinical time. We go through 3 levels at which point, we graduate. I graduate in August. (yay!). I'm currently in the 2nd level of my program, during which we spend 2 7 hour shifts per week in the clinical setting. This rotation is being spent on one of 3 med surg floors at a very large local hospital.

Wednesday, we had a patient who was being monitored for compartment syndrome while waiting for an ORIF. He was wearing an open cast splint on his LLE, and was experiencing pain d/t pressure on his heel. An order for lambs wool was pending, and in the meantime, the guy was in awful pain. He had already developed blisters on his shin at this point and Ortho had yet to be called for some reason that wasn't directly explained when the RN was asked about it.

This patient's nurse went to lunch, and as I was walking down the hall past his room, he called out to me. I went into his room and he was bent over at the waist attempting to pull his own toes up out of his cast. I asked him what was wrong and he said that he felt like his heel was on fire and he was trying to help himself w/out bothering anyone but the pain was quote "hell". I told him that I'd be right back and went to talk to my instructor. I explained the situation and asked what sort of relief I was allowed to provide at which point she told me to go talk to his nurse.

The nurse that was covering for his nurse while she was at lunch stared at me from behind the desk and the conversation went something like this:

me: Hi, I had a question about twenty se...

nurse: yes. 27. what do you want.

me: I was told that you're the nurse covering for his nurse and was wondering what we can..

nurse: he has an order for lambs wool

me: ok well it doesn't appear that his lambswool is here yet and..

nurse: I'm not his nurse. and I already know.

me: So would it be possible for you to..

nurse: no.

and then she stared at me from her chair until I left. She seriously interrupted me and refused to hear anything, or do anything at all for the patient.

I went back to the patient and the guy was crying. I told him that I'd be right back and I went and talked to my classmate that was assigned to him and she said that he was a very sweet, nice guy. Pretty young. No problems, doesn't complain. So we both went back in the room and he's begging us to do something to help him. His leg WAS able to be moved as the splint was open, but obviously you CAN'T DO THAT. We knew it, told him we're looking for a solution and went back to our instructor again.

Our instructor went to the nurse covering, told her something had to be done so the jerk got up, went to the patient's room, stood IN THE HALLWAY OUTSIDE THE DOOR and said "you've already had all of your PRN pain meds, we can't give you anymore" and went back to her seat.

SHE LIED. SHE LIED TO THE PATIENT. He had meds ordered for breakthrough pain and had had none, and had never gotten any of the morphine that had been ordered Q4H either. WHY? WHY WOULD SHE DO THIS?

She refused to call ortho. She refused to do anything but sit in her seat, ALL DAY. She would get up every few minutse or so, but did nothing. NOTHING. She wasn't the charge nurse, she had patients. And was ignoring her own patients as well.

The patient's shift nurse came back from lunch, at which point the lambswool finally showed up, and she shoved it down inside of his cast with spoons and was standing at his bed holding his toes up out of his cast to relieve the pressure. The regular RN wouldn't call ortho seemed like this guy needed a window in his cast. Everytime myself, my instructor and the other student who was assigned to him asked why his MD wasn't called, no one would give us a straight answer.

This patient was assigned to me on Thursday, and I was ecstatic that I could directly care for him as my own patient. He still had tremendous pain, and ortho finally showed up at 0000 prior to our arrival at 0640 at which point necrosis was found on his leg, and 2 separate spots were excised.

I know nothing about anything, I'm just a student.

But this guy broke my heart. Why was he left like this for so long? What am I missing? Why did this happen? Is this what's SUPPOSED to happen?

The cover nurse that was sitting behind the desk from after report at 0630 to the moment we left the floor Wednesday afternoon did the same thing Thursday afternoon. She got up once to look at the printer, and as we were leaving she was complaining that she had yet to chart assessments on any of her patients and was going to use the student assessment as her own.

To let a man get to the point of tears, and then lie to him...

I just don't understand it.

I know no one can give me much insight as you haven't seen his chart, but in accordance w/what I have shared, I'd like a little insight if at all possible.

Thanks y'all!

I've been a nurse for 16 years and have worked from ER, med surg, L&D, NBN and now in home health. There is ABSOLUTELY NO excuse for that to happen to any patient. However, it happens more than you know. As more and more people loose jobs you see them going into the "medical profession" b/c there will always be jobs there, right? and the money is good, right? Needless to say long story short some people go into nursing to "make money" and not to care for patients. That nurse has a supervisor and there's always a DON- part of being a good nurse is being a patient advocate- sounds like you did everything you knew to do. Hang in there and take this as a learning experience and a view of the "real world."


So basically, you're saying that this unit if full of incompetent and insensitive lying nurses--and one who would risk her license and use a student's assessment for her charting?

Personally, I wouldn't accuse anyone of something unless I was absolutely sure and willing to go to court over it.

Specializes in Hospice.

Thank you. I felt like I was overreacting. I didn't get emotional or cause a scene. But I did what our director taught us, I went through "the chain of command" and it got to the point that it was clear that nobody cared about this guy, and in nursing, the one thing I've learned if I've learned anything at all, is that that very attitude is so, so dangerous and contrary to everything we're being taught. I still can't get over seeing that happen, and we've already seen quite a bit.

It's like I'm being eroded from the inside out. This particular hospital uses PN's to the maximum ability within the scope of board rules and state law, so we're allowed to do quite a bit as students. But in the back of my mind I realize that I don't know anything at all yet, so I'm torn. I keep seeing situations like these almost every rotation we have and it's eating me alive. I don't know anyone does this for a living at this point. Lasting 16 years is pretty amazing to me considering what I've seen so far as a student. I don't know how I'm going to handle it once I graduate and I'm seeing it every day.

Specializes in Hospice.

So basically, you're saying that this unit if full of incompetent and insensitive lying nurses--and one who would risk her license and use a student's assessment for her charting?

Personally, I wouldn't accuse anyone of something unless I was absolutely sure and willing to go to court over it.

That's why I'm so upset. I guess I'm pretty emotional because it scared, and shocked the hell out of me. As I said, we've seen quite a bit already at the various hospitals and floors we've been to and on. But the lying is what ate me alive. And because I don't know anything yet, I really wanted some insight before I go to the director of our school and tell her how disturbing this was.

Specializes in Hospice.

And, I'm not accusing anyone of anything. I want to know why this happened. I'm very unemotional when it comes to dealing with conflict. I don't tolerate drama very well.

I just need to understand why I'm continuing to see this sort of attitude and if it's just me.

During report after the day that this happened, our instructor told us that this is part of the "real world". And that we did the right thing by going through the appropriate channels.

This hospital LOVES to hire graduates from our program. There are even a couple on this particular floor. But, if this is the real world, I want no part of it.

SHE LIED. SHE LIED TO THE PATIENT. He had meds ordered for breakthrough pain and had had none, and had never gotten any of the morphine that had been ordered Q4H either. WHY? WHY WOULD SHE DO THIS?

She refused to call ortho. She refused to do anything but sit in her seat, ALL DAY. She would get up every few minutse or so, but did nothing. NOTHING. She wasn't the charge nurse, she had patients. And was ignoring her own patients as well.

Thanks y'all!

This is a direct accusation. I'm saying that if I felt strongly about a situation to the point of stating an action or inaction on the part of a licensed professional, I would be willing to take it to the top and back it up with proof. That is all. :twocents:

Specializes in Hospice.

And I'm saying that there is no accusation. It's a verifiable fact. My goal isn't to accuse anyone of anything. If I wanted to do that you better believe I'd be getting that nurse in all sorts of trouble, and I'd make sure she thought twice about ever behaving that way in my presence, ever again. I'm not scared of standing up and opening my mouth if that needs to happen, and if I do decide to do that, I'm not going to play games. I'm going to state the truth, ensure that it's understood correctly and action WILL BE TAKEN TO MAKE THIS STOP.

I stood RIGHT THERE, not 2 feet away from this RN and listened to her stand outside of his door and tell him that he had already had all of his meds. He had had NONE that shift, and by apx. 1100 when the nurse decided to finally get up after being confronted by our teacher, the pt. still had not had any of his ordered pain medications. She stood there and LIED and it confounds me to no end.

Other than 2 other students and my teacher standing and listening to the nurse tell the patient that he had already had all of his meds, and a subsequent gentle reminder to the nurse that he WAS able to have his morphine and asking if it could be given at which point she rolled her eyes and went back to her beloved seat, I have no proof.

I went to the nurse that she was covering for, and told her, and she was very angry when she got back from lunch and found out what happened.

I then went to my instructor who informed me that I'd done enough and to leave it be.

But it's still bothering me. It's not an issue of an unwillingness on my part to tell someone what went on in order that it never happen again, it's an issue of me being highly disturbed over what I saw, and questioning if I'll be able to handle this sort of thing on a regular basis.

I can tell on anyone till the day is long. But that's not going to change the pervading attitude that seems to be all over the place. It hurt me very deeply to watch this happen. This isn't about getting people in trouble. I'm not here, or ANYWHERE to fight with people and be snarky. The incident was reported to the patient's regular nurse and that's what needed to happen.

I need to clarify again, this isn't about telling on people. It's about seeing this attitude all over the place and I haven't even graduated yet and I'm disgusted.

I don't know if I'm being dramatic or overlysensitive or not, so I thought I'd ask people with more experience.

If I am understanding your post correctly, you are searching for answers, not a lawsuit. I am not clear on why others keep bringing up, "don't make accusations unless you are willing to back it up in court."

I, too, see the same exact type thing every time I have clinical. It is difficult and our hands (as students) are tied. I think the instructors feel that if they make waves at the hospital, it will jeopardize the program so that students can no longer work there. In my situation, THAT would be worse because it seems that we are the only ones who really do care.

The only suggestion I have for you is this.....I am assuming you are a Christian because of your screen name. Pray. God led you to nursing school for a reason. When I see things like this, my anger often gets the better of me and I have to take a 10 second time out to take a deep breath and pray. God always gives me the same answer, "When you are the one wearing the RN badge, DO IT BETTER."

That is exactly why I'm here. My brother and my mother were both treated terribly in their respective hospitals. I KNOW I can DO IT BETTER. Even if that only means to hold a patient's hand or make one extra phone call to a doctor. I understand the time constraints and the work overload. If they are unhappy, they need to go elsewhere. But you can't do anything about that. When it is your time....DO IT BETTER.

God blesses your heart of compassion and I believe He will intercede for these patients as you say your silent prayers. There is both good and bad here.....the bad is that your hands are tied, you CAN'T do anything about the laziness and cruelty in the hearts of others. The Good news is that you have a higher source! Let your heart be broken and never forget you can and will......DO IT BETTER!!

Specializes in Hospice.


You are absolutely right. I don't tend to talk openly about my faith because from my perspective, talk is cheap. But I'm so glad you were able to see what I'm saying.

My faith tells me that our Father will always provide for us, this isn't about the money I will make. It's about honoring the heart of the Father and shining, like a city on a hill. :D I find myself praying constantly for the people we see every day. The idea of being present with another human being in such an intimate way, and helping them to know the love of Christ is what moves me.

It's the meanness that hurts me so deeply, and it's starting to kill me because I don't know how to deal with it. I just ignore it, and for some reason this particular situation was the one that broke me. I don't know how to deal w/it in terms of Christ, and I feel like I just want to walk away.

I really, really appreciate your response. You blessed me immeasurably today. Thank you so much!!

Thank you for your kind response. Christ wanted to walk away, too, as His heart was broken over those that didn't accept Him. His heart is broken daily by people that choose to be mean (and it IS a choice). The only way you can deal with it in terms of Christ is to give it over to Him. Don't hold it in and don't hold onto it. Picture yourself actually holding these people (both the patient and the nurses) and placing them in His arms. The hurt may not let up..but that can be a good thing. Again, it will remind you later to DO IT BETTER.

One quick tip that I've found very helpful in dealing with patients in pain: yes, I know time is so limited with families, housework, school, work, studying....but do a brief study on using alternate methods of pain control for these patients. Before I went to nursing school, I worked in a job with a lot of young, pregnant women who had very little, if any, emotional support. Many of them asked me to be with them in the delivery room. I began to educate myself on using relaxation techiques, imagery, etc to help them through the pain of labor. Many of them went all the way to delivery with NO PAIN MEDS. It's not that hard and it can be very helpful to those patients that can't get the relief they need.

Please don't walk away from nursing because of the way others act. Think about those patients....they need nurses who have the compassion and are willing to advocate for them. If you walk away, think of all the hundreds of patients that you will miss out on being a blessing to!!

Feel free to email me any time. It is nice to have someone who shares my seems they are fewer and farther between these days!!:redpinkhe

Specializes in Community Health.

OP I feel for you...It is so hard to come in to an establishment as a student nurse, see something going on that you KNOW is wrong and be powerless to stop it because you are "just a student" and obviously know nothing :icon_roll I had my first clinical yesterday and saw so many things that I thought should be done differently with just the one patient I was assigned to but when I brought it up to my instructor I was told to keep my mouth shut and not step on any toes. The scary thing is, my clinical site is considered one of the best...I'm scared of what I might find at some of the other sites :o

Just take it as a learning experience...once you are licensed and in a position where you DO have a voice, I'm sure you will never take that responsibility for granted!

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