Passed out at clinicals

JustBeachyNurse, LPN · Jan 6, 2012

Follow up with your primary health care provider to ensure that you are in good health and to discuss your concerns. Unfortunately members of allnurses cannot offer medical advice as per the terms of service.

Whether you need to be concerned or this will resolve are questions really better suited to discuss with your PCP who knows your background and history.

Best wishes as you go forth in your studies.

caliotter3 · Jan 6, 2012

As a preemptive move, I would visit your doctor and get checked out. Serves two purposes: 1) make certain there really is nothing wrong with you physically; and, 2) a doctor's note can be given to the school should they question your medical condition. Don't offer the note, just keep it in case you need it. Doubt there is anything serious here. Now if it happens again, you will need to investigate.

McAndRN2b · Jan 6, 2012

Thank you for responding. I was sent to the ED after this happened and everything checked out. However, my concern is that I have some sort of phobia that I was previously unaware of and am wondering if that is something that anyone else has dealt with?

nurseprnRN, BSN, RN · Jan 7, 2012

this isn't medical advice but i can tell you tha your experience with a first stick is a verrrrrry common phenomenon in new healthcare workers. next time.... do not hold your breath, do not lock your knees, and remember that it doesn't hurt the patient much at all. :clown:

Hope2bPicuRN · Jan 7, 2012

Thank you for responding. I was sent to the ED after this happened and everything checked out. However, my concern is that I have some sort of phobia that I was previously unaware of and am wondering if that is something that anyone else has dealt with?

Hello McAndRN2b,

When I read your post all I could think of was... Oh wow... I'm not the only one. I do suffer from a phobia, but to be honest I am still unable to determine exactly which phobia I have. Unfortunately, I have had many incidents where I have blacked out because I saw or even heard something that didn't sit well with me. I've actually been dealing with this since I was very young and it may have to do with a previous head injury I had. I can tell you that do not give up your passion for nursing because of this. Mind over matter! I once thought that I could never pursue my dream of becoming a nurse because of this issue. Just so I don't get in trouble I want to make it clear that the purpose of me writing this is for support and I am not giving any type of medical advice. I will say that I went to 2 different psychologists to see if this was something I could overcome. One of them specialized in clinical hypnosis for phobias. I can't say that it has "cured" me, but it has definitely gave me the confidence that I never had. I do believe that my case is a little more severe than yours because like I said this is something that I have been dealing with since I was about 9 years old and I am about to turn 29 now and it still happens. In all honesty, it happened to me recently... 3 times in the last 3 months. I never actually pass out (except once from pain) because I have learned how to control it, but I basically go "blind" and get very nauseous. This is due to a dramatic drop in my blood pressure so I have learned how to raise it when need be.

My point is don't stop and don't let it overpower your drive and passion to become a great nurse! I just applied to a nursing program for May 2012 because I am not giving myself the option to fail. I refuse to let my own self prevent me from doing what I want to do and that's become a PICU RN. I will admit that I also have the same concerns as you so you are not alone. And I am more terrified of having to face my fears in clinicals than the fear of entering an extremely challenging program where the graduating rate of students is about 50%. I hope that I was able to provide you with some comfort and just know that you are not the only one in this journey facing this challenge. I wish you nothing but the best and you will be a great nurse some day soon!!!! :nurse:

NCRNMDM, ASN, RN · Jan 7, 2012

As Grntea said, it isn't an uncommon reaction in new providers/students. I've been blessed in that I have never been bothered by IV insertions, traumas, surgeries, or ICU patients. I sort of have a stomach of steel, and it takes a lot to rattle me. My previous ICU and ED experience definitely helped me when I started nursing school. When you've seen burns, traumas, codes, etc, IV starts and bedpans don't really bother you. Even though things checked out in the ED, you may still want to go to your primary care provider just to be double-sure that nothing is physically wrong with you. Also, this is nothing to be embarrassed or upset about. You are not the only person that this happened to, and it's a pretty common occurrence. It does not make you a weak person, nor does it make you unfit for nursing.

I will give you an example from my personal experience in clinical. I remember the first injection I gave as a nursing student, and I know I always will. It was first semester (we learned every skill during first semester so that we could hit the ground running in clinical), and we were on a post-surgical floor that also accepted ICU step-down and medical overflow patients. My patient had undergone a major abdominal surgery, and she had three JP drains, a hemovac, and a wound vac. I had emptied all her drains, emptied her foley, given IV meds and IV pushes, helped her onto the bedpan, and cleaned up after her all day with no problem. I hadn't felt faint, all that nervous, or really unsure. I felt fairly confident with my work, and was actually feeling like I was doing a half-decent job for a first semester student. Then came the time to administer both heparin and insulin injections to the patient. Sure, I had a good deal of experience prior to clinical, but it was CNA experience. Now I was faced with the task of actually inserting a needle into someone's body and giving them two medications that could be rapidly fatal if I didn't do everything exactly right. The reality of the task at hand set in on me as I withdrew the medications from the Pyxis. My heart began to race as I heard myself tell my instructor what medications and dosages I was removing. My palms became sweaty as I discussed the medications with my instructor (and not because I fear pharmacology). My stomach tied itself into knots as I retrieved two syringes. As I pulled the medications up, I took a deep breath and tried to focus on ensuring that the dosages were correct and that I didn't have any air in the syringes. I gathered my other supplies, and slowly pushed the medication computer cart to the patient's room.

When I got to the room, I heard myself speaking to the patient. I was introducing myself, explaining what I was going to do, and discussing the procedure and injection sites with my instructor. The experience seemed so surreal, and I could hardly believe that it was happening to me. I confirmed my patient's identity, and scanned her wristband. As I saved her information in the computer and donned gloves, my heart kicked into overdrive. I could hear my pulse thumping in my ears, and I felt like my heart was going to beat out of my chest. As I swabbed the skin with alcohol and removed the cap from the heparin syringe, my stomach felt as though it was trying to jump out of my mouth. I closed my eyes for a millisecond, took a deep breath, and steadied my hand. I heard myself telling the patient that I would inject on the count of three, and that she would feel a slight sting. Before I knew it, I had counted to three, and the needle was in the patient's arm. I remembered not to aspirate the heparin, and I pushed the drug into the subcutaneous tissue. I removed the syringe, activated the safety, and realized that I had been holding my breath. I sighed a long exhale and laughed to myself. The injection itself hadn't been that big of a deal, but I had been absolutely terrified. As I moved onto the insulin injection, I was much more comfortable. This time I conversed with the patient as I prepared the injection site, and did my best to ease her anxiety. This time I wasn't shaky, I wasn't terrified, and I injected with confidence.

Now when I give a subcutaneous injection I find it hilarious that I was so terrified in the first place. I still recognize the seriousness of administering a medication, and I always triple check the patient, the drug, and the dosage, but I find it funny that I was so upset over a little thing like a subcutaneous injection. The same is probably true for you. The initial shock of seeing an IV for the first time was too much for you. You know that eventually you will be putting IVs in, and that reality scares you, as it should. If you are a responsible and safe nursing student you recognize the gravity of everything you do, and you do feel fear the first, or even second and third, time you do a skill. That doesn't mean you are weak or unfit, it means you care and value patient safety. The shock value should wear off as you are exposed to procedures more and more. You should find yourself becoming desensitized to these things, and you won't feel faint anymore. It probably won't even take all that long.

The stress of the moment, the knowledge that you will soon be responsible for the task you are witnessing, the stress of nursing school, and the overwhelming feeling of being a student can combine and form an incredibly strong reaction in your body. Next time you feel faint, take some deep breaths, sit down if you need to, and focus on calming yourself. The IV start isn't hurting the patient too much, and it is something that will benefit them greatly in the long run. If you feel that you are going to faint, and there is nowhere to sit, put your back against a wall, and lean on it. If you have to, sink down to the floor and sit for a moment. It isn't the best thing to sit on a dirty hospital floor, but it's better than falling from standing height and busting your head.

If I'm right in my thinking, this should go away with time (not medical advice here). As you see more and more procedures, learn more and more skills, and do more procedures yourself, you will become more confident and less sensitized. The first time you give an injection, place a line, or do anything else will be terrifying, but you will be a stronger person because of it. Don't fret over this situation, and don't be hard on yourself. Get yourself checked out by a doctor, and if everything checks out, don't worry. It will get better. Good luck as you proceed with your nursing education!

mpoppym · Jan 7, 2012

I passed out while watching an IV insertion today. I don't know if it was blood or the needle or something else. I didn't think that I was bothered by either of these things. I ate breakfast and am in good health. Is this something I should be concerned about? I am hoping I will just get used to it and the problem will pass. My concern is that this will be a continuing problem and that I will not be successful in the completion of my program and ultimately unable to be a nurse. Has anyone else ever dealt with something like this? Did it ever resolve?

Try researching vaso-vagal syncope and neurocardiogenic syncope. It is inherited, so probably you know one of your parents has passed out in the past. As you have learned in nursing school already, certain things can trigger a vaso-vagal response and anxiety in a medical situation is a popular one. Try to remember how you felt before you passed out so that you can recognize the signs when if it is about to happen again in the future. There are things you can do to avoid passing out if you can catch the feeling early! If you are standing for a long period of time, such as observing, try squeezing your butt cheeks repeatedly (I am NOT making this up!! :) ) and it will get some blood back up to your head. Of course if you feel the signs of "impending doom", you need to get out of that situation or take a seat! If you are past "the point of no return", then you know you need to lay yourself down on the floor quickly where you are to avoid injury from a fall.

It is my understanding that the sooner and more often you re-expose yourself to the same situation, you will become less anxious and not have problems in the future. Observe again at your first opportunity and this time, plan a way out. Knowing you can exit during observation will be the first step to preventing it from happening in the future! Hope this helps....

Esme12, ASN, BSN, RN · Jan 7, 2012

Make sure you are ok....see your MD. BUt as you can see, it can happen to anyone. Do as Grntea said....BREATHE, concentrate and breathe....I used to pinch the web between my index finger and thumb to remind me to breathe and obviously it got better. I have the hardest time in the OR:bugeyes:......Once I contaminated and entire instrument table:eek:.....it does pass.

Good luck!

BellsRNBSN · Jan 8, 2012

About halfway through nursing school, a classmate of mine fainted while observing a routine procedure. The unit made a scene about it at the time, but it only happened once, and she is now a happy, practicing RN. It can happen to the best of us, and it doesn't necessarily mean that you have a phobia or even that it will happen again! Try not to dwell on it, if possible, as this may make things worse and moving on more difficult. Best of luck to you!