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Preceptor bases care on moral judgements of patients. HELP!!!

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by TexMex22 TexMex22 (New Member) New Member

TexMex22 has 30 years experience .

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GHGoonette works as a PACU RN.

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My feeling about this is that your preceptor should be teaching you about how you, as a nurse, are supposed to conduct yourself both professionally and ethically. If she is setting you an example which is both unprofessional and unethical she should not be precepting; in fact, I would go as far as to say she is in the wrong profession, and should devote her talents to politics, where her acidity would be invaluable in "dirty tricks" campaigns....

Consider what a bad example she is setting to you and to other students unfortunate enough to be assigned to her? I think you should contact your instructor ASAP and arrange for a different preceptor.

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691 Visitors; 10 Posts

Dear Gold - this is certainly unethical behavior on the part of your preceptor. I think you need to report it to someone within your school since this is the only affiliation you have connected to your studies at the hospital. The nurse may be trying to test your responses - it's hard to believe something like this would be for real! Good Luck - but don't try to work this out within the hospital - bring it forward to someone you trust in the school and document your interaction and everything that was said.

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classicdame works as a Hospital Education Coordinator and adjunct nursing.

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THe good news - you have not accepted her behavior as "normal" or even acceptable for you. I congratulate you.

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Faeriewand has 8 years experience and works as a Registered Nurse.

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I would definitely let my clinical instructor know. And if she starts looking in charts of patients not assigned to her, couldn't you just say out loud for everyone at the nurses station to hear, "Wait, that's not your patient, isn't that a Hippa violation? Looking in the chart of a patient that is not yours? The hospital could get big fines for that." or something along those lines? And perhaps mention how four nurses were fired at that Arizona Hospital where Giffords is a patient because they looked at her chart and she wasn't their patient.

(Every time there is an incident like that, our NM has a meeting about Hippa violation and do not look into any patient's electronic record/chart because they will know and then come to you and yes you will be fired if you cannot explain why you looked at their record.)

Well stay strong and just know that you will be a better nurse! :)

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4,412 Visitors; 142 Posts

Lay low, do your work and graduate. Try to focus on the good things she can teach you. You are not the moral police, and you are not going to change her. I graduated last may, and let me tell you that in the short time I have been an RN, my whole world of thinking has changed from when I was in school. I feel like I understand where you are coming from. Besides, who cares what she says anyway, so long as she is providing good care.

Good luck.

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smurfynursey works as a RN.

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I will echo the vast majority of the other responders to this post...tread lightly and take it to your clinical instructor.

As for me, I can remember a few situations where nurse I was with for clinicals did things that I found/knew/believed to be wrong. For that, I would encourage you to use them as a role model on how NOT to act (ie, when a 17y/o g1p1 who is scared seneless tells you she is in pain, saying that its a good thing and walking away without asking more about her pain level and not supporting her at all is not the best)

best of luck to you

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Chin up has 26 years experience and works as a Employment Law.

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She makes judgements about features of a p't lifestyle which are inhibiting progress toward a healthier existence?

Or ... she allows her judgements to influence nursing care?

Huge and important distinction.

Experienced nurses and doctors can often manage the two quite well.

(Though it would appear here the nurse is being judgemental ....rather than making appropriate judgement. She sounds very inappropriate)

I work with several highly experienced RNs and doctors who might state that a particular p't doesn't make progress in their health journey because the p't refuses to change behaviour.

However there is an acceptable way of saying that without attracting the wrath of the morality police.

There is an appropriate way of describing how a p'ts lack of education / intelligence / class can inhibit the p't from achieving optimal health.

Anyway, as a student I would tread very lightly here and probably not mention it at all ...unless you see p'ts care being adversely influenced. Don't forget you are not an employee and also not the nursing morality policewoman here. Better to think about how you would approach this issue later when you encounter it as an RN. This experience is a good learning experience about how not to do it and what kind of nursing culture you need to avoid when you go job hunting. She did not start doing this yesterday - likely been doing it for years

Excellent, excellent, excellent! It would behoove you, to reflect on this. Much wisdom here.

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AOx1 has 15 years experience and works as a Nurse!.

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Your instructor needs to know. As an instructor, I would never want my students paired with this "nurse," and I use the term lightly. Our thoughts are our own, but when it translates into inferior care, HIPAA violations and gossip, this is a problem. When someone feels this strongly, patients DO pick up on it. This is abusive behavior, not only to the patients, but to all bystanders who must listen to her spew hatred. The fact that she is digging in charts of patients not under her care shows that she is willing to cross lines of propriety.

Edited by AOx1

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godsgrl444 works as a Home-Health Care.

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Be very careful on who you tell about this nurse because, I went through this same situation 6months ago. My clinical teacher was not on my side at first until I proved to her through other nurses who also witnessed him. Also after he found out he tried to fail me! God was on my side so he ended up getting in trouble:yeah:. I passed my last clinical with a high (B):nurse:. You have my prayers!

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TexMex22 has 30 years experience.

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Lay low, do your work and graduate. Try to focus on the good things she can teach you. You are not the moral police, and you are not going to change her. I graduated last may, and let me tell you that in the short time I have been an RN, my whole world of thinking has changed from when I was in school. I feel like I understand where you are coming from. Besides, who cares what she says anyway, so long as she is providing good care.

Good luck.

Lay low? I'm not the "moral police?" Really? You've been an RN a year and you sound like her already. Yes, I can tell your world of thinking has changed already. You sound like your heart has started to harden already. :o

"Who cares what she says anyway?" --- gee, I don't know when she's violating HIPPA, giving substandard patient care (because low class patients don't "deserve" the same care as the private pay, full insurance patients) and running around the unit gossiping about patients LOUDLY where anyone and everyone (including other patients and family can hear).... call me a naive nursing student, but I do care. It's inappropriate on every level. It's shameful, it's embarassing. Change her? Nah. I'd like to see her fired truthfully. But at minimum I do want to make sure she is not around any more students. But that's not my decision. All I can do is stand up for what I know is right even if no one else -- staff, students or other instructors is willing to do it with me. I'll be able to sleep knowing I did the right thing.

But for you to say "who cares" and you've been an RN for only a year is really scarey. This crap is like high school. If you are in the cool group, you hang out, chat, gossip and talk nasty about the patients and their families. If you're a nerd, you don't play the gossip game. If nursing is THAT BAD, get out. Seriously. :mad:

I'm a nerd and proud of it. I've been over high school games for a long time. This is unprofessional behavior. I realize some of the nurses are barely above high school age, but discussing a patient's family, personal or social history is wrong and inappropriate -- unless it's DIRECTLY related to their illness and/or care plan.

It's not up to us as nurses to make moral judgements about our patients' life choices and then adjust our nursing care accordingly. Just as it would be inappropriate to give a patient different care because they are of another ethnic group, social group, whatever. Here's what I've picked up so far and it's VERY disturbing: :crying2::crying2::crying2:

1) Low class/trashy patient/poor life choices (no insurance or Medicaid): minimal care, ignore call lights, minimal pain meds (they are all fakers and whiners). Move FAR away from desk as possible.

2) Ethnic groups, illegals, weird religions, people with names you can't spell or pronounce, people with funny accents: minimal care, ignore call lights, minimal pain meds (they are all fakers and whiners). Again, put in no mans land and hope they give up.

3) Teen moms and their families: minimal care, ignore call lights, minimal pain meds (they are all fakers and whiners. Besides they deserve it (pain and suffering. It'll teach them a lesson. Maybe they won't come back so soon).

4) Elderly with multiple diagnoses, transfers from long-term care, obese (especially morbidly obese), needy, whiners:

minimal care, ignore call lights, minimal pain meds (they are all fakers and whiners).

5) Normal people (i.e.: regular middle or upper class people with good insurance, short-term admits that don't require much work like overnight admits -- but have good insurance): first class care, super polite, butt kissing, yes ma'am/no ma'am, yes sir/no sir, super pain control, SUPER care!!

The class system is alive and well in the USA. My eyes are wide open. :eek:

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hiddencatRN works as a Registered Nurse.

29,060 Visitors; 3,408 Posts

In my OB clinical, I was with this one nurse who completely wrote off one of her laboring moms and the mom's partner because of their less than pristine history. My nurse spent as little time in the room as possible, which actually gave me the opportunity to spend more time talking to them by myself.

Taking care of this new family and feeling like I had something I could offer them independently not only became my first AHA! moment in nursing school where I realized that I could actually be a good nurse, but it also gave me a strong anti-role model in the form of the judgey nurse. I've had a few situations as a new nurse that remind me to keep an open mind with my patients, to not get too jaded to quickly, not write anyone off based on how I feel about their background and past choices.

I spoke with my clinical instructor, and mostly we just talked about the situation, what I learned from it. Because assignments in that clinical were more about getting students with a patient likely to give birth before the clinical was over, it's possible that other students would still be placed with this nurse. But it helped me come to terms with the situation, decompress I guess. If you talk to your instructor, I'd approach it in a non-accusatory way, that you want his/her input on how to handle this.

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TexMex22 has 30 years experience.

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I spoke with my clinical instructor, and mostly we just talked about the situation, what I learned from it. Because assignments in that clinical were more about getting students with a patient likely to give birth before the clinical was over, it's possible that other students would still be placed with this nurse. But it helped me come to terms with the situation, decompress I guess. If you talk to your instructor, I'd approach it in a non-accusatory way, that you want his/her input on how to handle this.

Thanks. I'll keep everything you said in mind. :yeah:

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