So, here is the situation. I started a DuoNeb treatment on my patient WITH my professor/instructor. Once the treatment was started we left the room and documented the treatment. I checked in on patient about 7 minutes and and everything was fine. At around 15 minutes I checked on the patient and noticed that someone had taken the face mask off the patient and turned the nebulizer machine off. When my instructor came back I reported that someone had turned the machine off. My instructor went into the room alone and reported to me that she had re-initiated treatment because there was still some DuoNeb in the reservoir. I was written up as having made a medical error because I did not personally take it upon myself to start the treatment again. My rationale behind not starting the treatment by myself is:
I wasn't sure who stopped the treatment in the first place. It could have been my instructor for all I knew.
I wasn't sure WHY the treatment was stopped. The patient may have been observed having adverse reactions for all I knew.
I do not feel that I as a student, working under another's license, should make the clinical judgement to restart the treatment on my own accord.
What do you all think is the best move here. I have a remediation meeting in a couple days.
I feel like the persons who made the medication error was #1, the person prematurely stopped the treatment and didn't document or notify anyone, and #2, my instructor who restarted treatment without knowing who stopped it in the first place and why.
Basically they upheld their decision. What did I expect out of three colleagues against one student (I was told I was not allowed to bring an attorney to advise me). I could see that the one instructor quietly sat there and didn't say a word. She's the most honest and sincere so I wonder what she really felt. At the end of the day I still get to move on to the next semester.
I wonder if there were cameras? I would tell them to roll the footage! and then we can see who took it off in the first place.
Also, in this case it is the instructor's problem as they are supposed to do everything with the student and you guys finalized the medication and put the mask on the pt and left together.
The mask coming off happens in real life all the time - could be by RT or another nurse or the pt and sometimes we have to put it back on or stop the treatment just as you mentioned in your original post. I also think you did the CORRECT thing by telling your instructor first before taking it upon yourself to put the mask back on.
Im glad you got to move on as this is so ridiculous. Good luck!
I wonder if there were cameras? I would tell them to roll the footage! and then we can see who took it off in the first place.
Also, in this case it is the instructor's problem as they are supposed to do everything with the student and you guys finalized the medication and put the mask on the pt and left together.
The mask coming off happens in real life all the time - could be by RT or another nurse or the pt and sometimes we have to put it back on or stop the treatment just as you mentioned in your original post. I also think you did the CORRECT thing by telling your instructor first before taking it upon yourself to put the mask back on.
Im glad you got to move on as this is so ridiculous. Good luck!
My instructor found out it was an aide that had taken it off. She did not disclose that information with me until the meeting. The head of nursing stated that we were in fact to stay with the pt during treatment and asked why I did not. I stated "because Professor so and so told me to come with her to document the treatement". At that point the error technically fell on her, but then they started grasping at straws to make it somehow be my fault. In the end it was determined that it was my fault because I failed up finding out who took it off the patient in the first place. However, if I had been there for the whole treatment like I should have been none of this would have ever happened.
Wow, what a shame. I am wondering how this situation got so blown out of proportion? Was the instructor at the review process? What was the story relayed to the other panel members? And were there any of your peers on the panel for review of the situation? Has there been tension with this instructor? Were staff at the clinical site involved, i.e. was it discussed with anyone on staff, if so in what context "medication error"?
When I was in ADN school we had two incidents with an instructor who targeted students. She literally got one student removed from the facility and expelled from the program. She literally had two other students in tears and afraid to come to clinical.
Since you are in your first semester do you have options for another school?
I'm sorry you were subjected to this. Based on what you've described, your actions were appropriate and you showed good judgment in having the presence of mind to ask a question and clarify. This was something your instructor should have encouraged. It was certainly not something to criticize or punish you for. This could have been an excellent educational opportunity re: medication administration safety, if they had chosen to look at it that way.
And allow me to say what they should have said, both in your clinical and in this meeting. Thank you for putting your patient's safety first and asking a question. Thank you for not making an assumption that could have proved dangerous and/or harmful. Thank you for addressing your concern with the person who is supposed to be teaching you.
It's disconcerting, but not entirely surprising, that none of these nurse educators stood up for you in this meeting. There really is no place for politics in nursing, but somehow we always manage to make room for it. I'm so sorry you ended up on the receiving end of it, let alone this early in your future career. Glad to hear that this did not impede your progress. I do wonder though, what are the chances that you'll have to deal with this specific educator again as a clinical instructor? I only ask, because the circumstances surrounding this incident seem to be, in my opinion, somewhat vindictive.
Wow, what a shame. I am wondering how this situation got so blown out of proportion? Was the instructor at the review process? What was the story relayed to the other panel members? And were there any of your peers on the panel for review of the situation? Has there been tension with this instructor? Were staff at the clinical site involved, i.e. was it discussed with anyone on staff, if so in what context "medication error"?
When I was in ADN school we had two incidents with an instructor who targeted students. She literally got one student removed from the facility and expelled from the program. She literally had two other students in tears and afraid to come to clinical.
Since you are in your first semester do you have options for another school?
I was not allowed to bring an attorney or anybody on my side to advise me during their questioning. I did have a few instances throughout the semester with this particular professor. Minor things that I did point out because I thought she handled the situation completely wrong and she didn't like that. For example, one of my patients was combative and A&O x's 1. I spent about 15 minutes trying to get a pulse ox while the patient (who was 100 years old) kicked, scratched, punched and bit me. At that point I decided that getting a pulse ox at that time was not a good idea. The patient was on room air and very feisty and calling me names. I reported back to my instructor and she told me if I was a real nurse that I would be fired for not being able to obtain a pulse ox. I basically told her that I was not fighting was somebody who was a hundred years old and the patient was becoming more combative and it wasn't in the patient's best interest and that instead I felt the best way to determine the patient's respiratory status was by observation until the patient calmed down.
I'm sorry you were subjected to this. Based on what you've described, your actions were appropriate and you showed good judgment in having the presence of mind to ask a question and clarify. This was something your instructor should have encouraged. It was certainly not something to criticize or punish you for. This could have been an excellent educational opportunity re: medication administration safety, if they had chosen to look at it that way.
And allow me to say what they should have said, both in your clinical and in this meeting. Thank you for putting your patient's safety first and asking a question. Thank you for not making an assumption that could have proved dangerous and/or harmful. Thank you for addressing your concern with the person who is supposed to be teaching you.
It's disconcerting, but not entirely surprising, that none of these nurse educators stood up for you in this meeting. There really is no place for politics in nursing, but somehow we always manage to make room for it. I'm so sorry you ended up on the receiving end of it, let alone this early in your future career. Glad to hear that this did not impede your progress. I do wonder though, what are the chances that you'll have to deal with this specific educator again as a clinical instructor? I only ask, because the circumstances surrounding this incident seem to be, in my opinion, somewhat vindictive.
I know that next semester she is not my clinical instructor just my lecture and lab. I am praying that she has integrity and does the right thing. She did give me fantastic scores on my care plans and even after this occurred she did tell me that she thought I would be a great nurse. I'm hoping everything just blows over by next semester.
On 11/27/2019 at 4:35 PM, Shannon Dull Dunlevy said:
I know that next semester she is not my clinical instructor just my lecture and lab. I am praying that she has integrity and does the right thing. She did give me fantastic scores on my care plans and even after this occurred she did tell me that she thought I would be a great nurse. I'm hoping everything just blows over by next semester.
It truly sounds like she overreacted massively. This was a silly error that in the real world no one would even notice, and as a student nurse I think it’s smart judgment to not administer a medication unsupervised **even if you are turning it back on**.
If the write-up is on an actual documented form, I would write a rebuttal stating EXACTLY what you wrote in this post. You are neither assigning or accepting blame. You document exactly what happened and let whoever reads it decide.
Instructors are not without fault but it would go badly if you accused them of a med error vs licensed staff accusing them. I've overheard and seen many instructors over the years be wrong but as a student the school could double down on you rather than admit the instructor was wrong. Sometimes you just gotta grit your teeth and say what you learned.
This makes me sad and is a reminder of how much I HATED my school clinicals. I documented and hung out in my patients' rooms as much as possible to get through them. I loved the instructor comments like "why are your medications 1/2 hour late?" I couldn't say exactly what I thought which was "Duh, because you are the only one who has keys to the med room and I can't give them without you!!!" Lay low and interact with your instructors as little as possible. Thinking back, they made many mistakes that didn't seem right to me, but I just kept my thoughts to myself.
I've had no problems keeping up since I've worked as a RN. If you want to get through nursing school you'll have suck it up and endure the ridiculous BS that goes on there.
Shannon Dull Dunlevy
16 Posts
Basically they upheld their decision. What did I expect out of three colleagues against one student (I was told I was not allowed to bring an attorney to advise me). I could see that the one instructor quietly sat there and didn't say a word. She's the most honest and sincere so I wonder what she really felt. At the end of the day I still get to move on to the next semester.