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I did not mention it but of course I mentioned it to my clinical instructor and the charge nurse (I considered it obvious) I was just wondering as a student, were my interventions appropriate, but thank you all for your answers!

Yeah, a consult was already asked for this patient because his dysphagia was really serious. And the possibility of an aspiration pneumonia was brought up by the day shift. He was on antibiotics at the time of the events. BPOC is actually how we call the chronic obstructive pulmonary disorder in my country. Naturally I didn't only took his sat and said okay everything's good, bye bye, but what made me think my patient was out of danger is that he had spit the spoon of yogourt that caused him to choke, he was not using any accessory muscles to breathe, his sat was okay, no cyanosis, respiratory rate a bit high but got down later and I heard secretions in his lungs but it's normal with an advanced case of chronic obstructive pulmonary disorder. I was wondering what other thing I should have assessed at the moment? (I don't want to repeat the same mistake of course) And the thing bothering me is that when I heard the gargle I thought it was my patient trying to spit the yogourt, because he only made that noise while coughing. Im doing my clinical homework and I thought, what if this was secretions and I should have suctioned him at the moment? Even though he did not show any signs of embarassment until the time I walked past his room when I left. Im trying to understand what I should have done differently

Hello everyone, I was in clinicals this week and had an elderly patient with BPOC who came back from a hip surgery. The thing is that the patient came back from his surgery terribly dysphagic. The evening I was there, his family gave him some yogourt and he choked on it. (like more than ever). I was in the room, so I told him to spit everything he could and took his SpO2. It was still in the normal ranges for him since he had BPOC (it was at 90 and we were targetting 88-92%) and his respiration was at 24/min but in the context I thought it was normal, I checked again 30min later and it was at 16/min, SpO2 still at 90. When he was coughing, trying to spit the yogourt out he made a sound like he was gargling with the yogourt/secretions, trying to get it out. When that was over I listened to his lungs and it sounded like a bad car engine, but I assumed it was normal since he had BPOC + he was recovering from a surgery + his SpO2 was in the normal ranges. There was no other incident during the evening, but at midnight when I left I heard him doing the gargling noise again and it makes me wonder, should I have suctioned him?? (because they did at midnight) I knew he had secretions from what I heard with my stethoscope, but his vitals were completely normal 30 min after he choked and he did not had any trouble breathing after that, but I am seriously wondering if what I did was appropriate or not enough?

Actually the meeting was just a mistake, the lady thought I was somebody else 200kg of bricks just fell off my shoulders!

The meeting is tomorrow! Thanks to this post, I was able to relax, but the stress is coming back now... I'll Tell you how it goes!

thank you very much for your answer it truly helps :)

Actually It helps to see that people think I am overreacting, but this doubt I am going to get fired constantly haunts me and it probably Will until I have my next appointement with her

Well I sincerely hope it is just a signature And I immediately thought negative because I was fired at the end of my probationary period from one of my previous non-nursing jobs and I don't think I completly recovered from that..

Hello everyone, I decided to post here to get a little bit more answers since I am freaking out. I was hired by a hospital in May to work in LTC and I loved it! Got nothing but good comments, and I really really loved my job. I was in my 90 days probationary period until monday this week (I met a nursing counselor who looked at my performance reviews with me and told me that I passed my probation period). But today I got a call from the same lady telling me she wanted to see me again to " finish " the meeting we had monday. I try to think of all the things I did wrong since then and I honestly do not know what to think about this, because to me, it does not look good. I remember that wednesday evening I was watching a patient (constantly watching him because he was a elopment risk). The nurse in charge of the patient told me that the Once, he got up and started searching for something in his bag, so I got closer to him (I was 1meter behind him and I could see what he was getting out of his bag). He told me he was looking for his wallet, but at the same time the charge nurse told me to look closer... maybe he had something dangerous in his backpack??? The only other thing I could think of is that one week in LTC I was given new residents to take care of and the charge nurse was a little bit more severe with me (she wrote on my performance reviews that I was doing really good but that I could be faster). And during my meeting monday, I noticed that the nursing counselor did not had the performance reviews of this week in her file. Maybe she wants to talk about that? I'm so confused right now and I don't know if the first incident is a motive to get fired.. what do you all think?? I love this job so much and I don't want to lose it :'(

It's probably because I am too dependant of my phone! As soon as I will have my locker l 'll it in it to prevent another event like that from happening:up:

I'm a nursing student currently working in LTC as a CNA this summer. The policy is that we should not carry or use or cellphones at work. I personnally feel uncomfortable if I don't have those 3 things on me while I am not at home: my keys, my wallet and my cellphone, because if anything happens I'll probably need one of these things, so I always carry them in my pockets. I put my phone on do not disturb so it won't ring or vibrate. I'd NEVER use it or look at it while im on the unit, only during my break ofc. But today (third day of orientation), it fell off my pocket while I was picking something on the ground and there was like 4-5 CNA around me and an ergotherapist. The ergotherapist was " ooooh you should keep that in your locker!! " and all the CNA's were really cool about it and told her that the hospital could call me ANYTIME (and they can), etc. I just hope I won't be reported for a thing like this. Is it REALLY such a big deal to carry your cellphone even if it's turned off? I totally agree that nobody should use them, but I don't see what's wrong with carrying them.. What do you all think?!

Hey everyone! Recently I made a vent post about my clinicals mentioning that I was very good at theory and clumsy when it was time to perform skills. I had 90% on the last exam when the average was 67 and I didn't find the exam that hard, but I need SO MUCH practice before being confortable performing skills it's crazy. For example, last year we were learning how to prepare an injection in group (all at the same time, in a circle in the lab). Others were going so fast and it seemed so easy for them and there I was, all clumsy dropping the vial and desperately trying to get one air bubble out. Luckily, our teacher gave us some material so we could practice at home. I practiced a lot and finally, I am good at it now. Anyway, I was wondering if any of you were like me? or the opposite : really good with skills but struggling with theory? And how did you finally got good? :)

Wow! I didn't expect to get so many responses! Reading those really nice comments and good advices made me feel a lot better, so thank you all! I think I am blessed to have this particular clinical instructor because she's giving patients that gives us the chance to work on our weaknesses. I also completed a self-evaluation and I'll see monday what my clinical instructor thought... Next week I'll be better!

Thanks for the kinds words it's really encouraging :) Today was a little better : I made some more little stupid mistakes concerning things I know, but I made a right call and it made me feel a bit less incompetent!

*this is a vent post* Today was the 6th clinical day of my med-surg II rotation (2nd year of a 3rd year program) and I'm starting to think that maybe i'm not good enough to be a nurse?? I really love learning about pathophysiology and I'm really good in theory, I even had the best grade of my class on the last exam. When it comes to clinicals it's a little bit different. I am not the best of course, but the comments I get are always good. But today was just rough and I can't see myself being a good nurse in the future. Today was our first day with a new clinical instructor (she is soo nice and calm but I found her very intimidating) so 4 students of our group of 6 (including me) only had one patient. Mine was admitted for hematuria (with a foley at home) and he also had chronic renal failure. Since it was our first day on this unit (with really heavy cases), we started at 10 instead of 8. The thing was that my patient was leaving for hemodialysis at 13h30, so I had to do everything I had to do before 12h30 (the time we're taking lunch break) During those 2 hours I probably looked so dumb and incompetent.. At 10 I had to go change 2 dressings on the feet of my patient because he had two seriously infected wounds (probably caused by his diabetes). Anyway, I only bring 1 IV cath to plug on the syringes, but I needed to have 2. Also, I should have brought an extra pair of pliers to manipulate the sterile material with, so my instructor had to go get one. Okay, I forgot material it's one mistake, not so bad. The thing that is bothering the most is that one of the two wounds was on a heel and after cleaning it and applying silvadene, I tried to apply the dressing (which was like a sticker if I can say) and it wasn't adhering to the skin very well. So it ended up very ugly with a lot of little folds, and I even had to put some adhesive tape so it could stay in place It was basically the ugliest dressing I had ever seen. After that, I started to make a lot of little mistakes : washing hand of the patient with soap and water instead of using an alcohol swab before a blood sugar??? (we've been teached both), in my meds, I forgot to check that I applied " dermabase " cream in my meds, I didn't wrote the right amount of Humalog units that I gave in my charting (I wrote the dose who depended on the blood sugar result, I didn't add the regular dose), I almost forgot to write about neurovascular signs in my dressing note, etc... I thought I was A LOT more disorganized and slow today with one patient than 3 weeks ago with two. I always had more difficulties to be good with performing skills and I think i'm scared I'll never be good at IV's, blood samples, dressings, etc. Also, I was always told my communication with my patients was my strenght but today I didn't felt it was so good, due to my stress. How am I supposed to be a good nurse someday if i'm running like everywhere like a headless chicken with only one?? I know this is probably a longer post than it should, but thanks to those who took the time to read :)