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DWelly14

DWelly14

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DWelly14's Latest Activity

  1. Yep! I'm a CNM and had a patient recently that one of the other midwives in my practice had admitted for a therapeutic rest the day before. She was 37 weeks, and had only begun care with us at 34 weeks. According to her, she was induced at 37 weeks at another hospital with her last pregnancy because she was in pain so she was demanding to be induced now because she was in the same pain. She had made no cervical change overnight and I was trying to discharge her since there was no medical reason to induce her at 37 weeks. She and her significant other sat there screaming at me that I didn't know anything and that she was in pain so clearly she needed to be induced and why wouldn't the nurse write down all the medications we had given her because they wanted their lawyer to research the medications. I should also mention that if she didn't know you were in the room, she'd be laughing and texting and seemed completely fine and then as soon as she saw me or the nurses she'd start wailing and saying she was in terrible pain. In the end I told her she was being discharged because I don't induce before 39 weeks without medical reason and that if they wanted to know what medications she had been given, they could go to medical records and get a copy of her chart. I had to call security to get her to leave. It was so lovely trying to explain to them why we don't do elective inductions early because they kept cutting me off because their lawyer (who the father had on the phone) and they knew so much better than I did.
  2. DWelly14

    Already bored in PP.. now what

    I work L&D now and if that's your end goal, I'd encourage you to go for it. At least where I work, everyone takes great care of or pregnant coworkers so you should be fine working L&D while pregnant, as much as you would be anywhere!
  3. DWelly14

    How to politely rescind a nursing school acceptance?

    This happened to me with grad school. Applied to three schools, got in to all three but number one choice didn't get back to me until I had already accepted my seat in my second choice program. Main thing is being polite. Write a concise email or letter telling them you no longer plan to attend their program and thank them for the opportunity. You don't have to give them the details about getting accepted somewhere else or anything but the politeness is the important part. I ended up getting a job at a practice several of the people involved with admissions at my second choice school are also involved with and if I had been rude or not handled the original situation well, that may have not happened.
  4. DWelly14

    Preceptor burnout

    I hear you. Precpeting is hard and thankless. I think it's definitely reasonable to ask for a break. And s to all f you saying that OP needs to suck it up because there's always work that no one wants to do, come on. Yes, that's true but she absolutely deserves to take a break for a few months. No one should have the hardest assignments every shift or always be charge. We take turns. Sounds like someone else on her floor needs to take a turn precepting.
  5. DWelly14

    Nursing Student From Hell

    I did have discussions with her along those lines throughout and the faculty was being kept up to date about what was going on. I feel like you keep choosing not to see this because it doesn't support your theory. Not sure why you consider me an inexperienced preceptor, just because I have a tough preceptee now. Do you become an inexperienced nurse again when you have a tough patient? You've made a lot of assumptions about me and this clinical rotation, that up to now I just saw let go but let's set things straight. The rotation is not a set amount of weeks but based on hours so you keep saying week 6 or 7 .... they had winter break which made things a little weirder. You also say I've had 3 or 4 students before, also wrong. Also when I worked critical care, I was the leader of a team of LPNs, NAs, and RTs .... lots of delegating, lots of leadership, and I was very good at it. You refuse to answer my question about whether you'd work with Alice because you don't have all the info but you've made huge judgements about me with very little information about me. I don't want to say I did everything right in this situation but I will not take the full blame for Alice's failings because at this point she was at in her clinical, she was getting ready to be an independent nurse. She could have secured herself a job on my floor by putting some effort in. Nursing is a very self motivated and self led profession not matter what specialty you are in so if she can only preform when she is being watched, that's a problem. That's not going to fly in the non-student world. My goal for all my students is to set them up for a successful transition into their first job no matter where that is, by showing them skills that can be translated into any specialty, time management, priorotization, communication, efficiency, etc. Contrary to what it seems you believe my goal is to build their confidence in themselves, I get to know them, let them get to know me, in fact Alice was one of the first to know about my new job. I did not start off resenting her. That came when she kept disappearing, refusing to do things, refusing to try, arguing with attending, arguing with patients. At some point my patience ran out, which is when I turned here, to sound my frustration. and since we're giving each other communication tips, it's always good to tell someone what they are doing well. Maybe you should have added something positive about me not just about Alice in your comments and then maybe I would t have been so defensive. Thank 2mint, ADN, RN, but Alice has moved on and I'm done precepting until I'm experienced enough to precept midwife students ... it's time for you to move on too.
  6. DWelly14

    Nursing Student From Hell

    -OP, given that Alice was likely your 3rd or 4th preceptee, I and a few other saw immediately to question your communication skills and leadership abilities. I'll elaborate as I go. Not sure why you immediately question my leadership skills but ok ... -Good observation and efforts on your part. The point was that in the first half of her rotation I was right there with her holding her hand and watching her. Alice is by no means ignorant or incapable, in fact, she is quite capable. She has a bad attitude and is lazy. That's the issue I tried to get at later .... -Communication/Leadership: Wk1 thru Wk 6 she was "improving"--what is less than "lazy"? Moving on...on day 1 solo, did you re-iterate the expectations of her? See next comment. Alice started out with the stereotypical student big eyed terror look when you hit the floor for the first time without your nursing school buddies. The first time we walked into a patient room she could barely speak let alone do an assessment or anything else. So I taught her to deal with that. And I taught her the work flow on my unit, how to do an admit, how to prioritize, how to do a targeted assessment, how to interpret a fetal monitoring strip, how to place the fetal monitors, how to start and IV. So by midterm, she had calmed down, she could talk to the patients. She was still nervous and had a bit of an attitude but I thought it was still nerves. That's the improvements I saw. Every single shift when we were walking from the locker room where we met to the nursing station where we received our assignment we reviewed what the expectations for the shift were. Was it an observation day? Was she to be primary with me as a resource? At no time should she have had any question in her mind what her role was in relation to me. -On day 1 solo, you lose nothing by re-running through the process for her, as in, first lets do H2T assessment, then we start IVs, etc. especially when she voices her poor IV skills to you in front of the patient (imagine her embarrassment, that's why she said this 'Alice tried to blame me for not making her feel welcome and for "pushing her too hard."') This was not her first day solo. We don't always start IVs, sometimes they come from triage with them already in place, sometimes we come in to a patient who has been admitted by another nurse, it was one example I was using of her refusing to take advantage of a learning opportunity. On her rubric it clearly states that if the opportunity is available to practice skills such as IVs, did the student take advantage of it? At that specific point she had maybe 6 shifts left and she had yet to independently start an IV. I wanted to see if she would even try, as I didn't know I felt another chance would even happen. I'm sorry I wasn't clear enough for you. Perhaps you're right that my communication on an online chat board wasn't clear enough. Fast forward to when the patient is complete. Alice is nowhere to be found. I'm in pushing with her and the charge nurse has to find her.” -At this point, you were rightly frustrated, but how is it that she left the room without you knowing? That's a major disrespect which likely stems from lack of communication and leadership abilities...on your part. (Please refer to my first comment above). We don't stay in the room with the patient, we watch tones from the desk at times. She had many opportunities to wander away, as admit to pushing specifically for this patient and for many patients is often hours apart. And my first priority is my patient. Even my students that have functioned well left the room to run and grabbed needed supplies and didn't feel the need to inform me every time. I've confronted her on it and she always makes excuses, and I've now emailed her faculty.” -You confronted her multiple times? Did you once sit down with her to discuss she might be on track of failing this portion of her program? She makes excuses because throughout this 7-week relationship, she simply doesn't respect you (it takes two to tango). YES!!!!!!! It didn't always start with confrontation. We had many discussions which eventually led to confrontations,if I was going to detail the entire interaction from start to finish no one was going to read it. It would have been too long. I was hitting the highlights. ...she only has 3-4 shifts left with me and I'm getting really frustrated with her...of the behavior I've observed. I feel like she's skated by through her whole program somehow and now she's finally having to actually do it and she can't.” -Those who lack good communication skills do experience more stress in life in general. Your resentment of her ("she's skated") likely manifested in your speech and body language => instant or further disrespect of you. TL;DR: OP, you had "easy" first 2 or 3 preceptees, now you got a "harder" preceptee and d/t your lack of experience you did not know how to interact with her, ultimately leading to neither respecting either. I'm boarding in MS, going to ER training soon, so I'm big with communication skills and leadership abilities. No matter how you define leadership, the main focus of a leader is to get the most out of his/her people. And the first step is to get to know your people so I'm curious, would you work with her? Based on everything I've seen from Alice, she's going to continue to do this until someone makes her stop or she's made to leave the field of nursing. I for one would not feel comfortable being her coworker because I'd feel responsible for her patients and mine because I'd wonder if she was paying attention to them or even on the floor. The words "patient abandonment" ran through my head a lot with her because literally if I was not directly supervising even the most basic task (read taking a temperature) she was gone. Even if I have the worst communication and leadership skills on the face of the planet, you cannot place 100% of the failure at my feet and I still can't see how you think you can deduced all these terrible shortcomings of mine from my post.
  7. DWelly14

    Nursing Student From Hell

    For all of you suggesting she wasn't interested in L&D, you are incorrect. She chose L&D and wanted to be hired on our floor after this rotation. I am a new grad CNM and am finishing my time as a bedside L&D RN, she is not being asked to do anything advanced or beyond the basics. Mostly vitals, head to toe assessments, electronic fetal monitoring, IV starts, foleys, and repositioning as well as some patient eduction and medication education with my direct supervision. She has observed all of this for the first half of her clinical with some guided participation and voiced confidence in each portion before she was asked to do it independently. I am always in the room with her for her to ask questions. For an IV, she gets one poke. If she doesn't get it I take over, same rules I use with all my students. I have been in communication with her faculty about my concerns and we did have a meeting in which Alice tried to blame me for not making her feel welcome and for "pushing her too hard." Her faculty member literally told her that what I was asking of her was the basics and that she could have been asked to do more. Alice was told last night that she failed her practicuum and would have to repeat it with another preceptor and in another area. I have never seen such a tantrum thrown by an adult before. I know for sure now that all my suspicions were true about Alice. She skated by in group clinical as never drawing attention to herself. I pity her future patients and hope no one I love ever comes into her care if she ever becomes a full fledged RN. At least I know that I did not take part in passing her along.
  8. DWelly14

    Nursing Student From Hell

    I guess I don't understand what you are saying at all. No patients have been harmed. I have made sure of this. My student is just not performing and needs to be failed. I'm having a hard time with this because it is never easy telling someone that they are not able to do something that they have put so much time and money into (I'm not going to say effort because it does not appear she has put much effort into it). I'm not a heartless jerk who can just casually do that. I know that I need to fail this student because of the behavior I have witnessed. I was hurt by your originial comment which I interpretted that I somehow needed to be evaluated because I was a poor preceptor or teacher. I'm thoroughly confused by your more recent comment and how it applies to my student.
  9. DWelly14

    Nursing Student From Hell

    The school I'm working with it is my call to make as her instructor is not with her during this rotation. I am. I evaluate her and ultimately make the call as to whether she met the criteria to pass her clinical portion of her capstone. She can absolutely fail if she is refusing to perform the duties assigned to her. I honestly wouldn't fail her for anything else but there have bee 4-5 times that I literally have not been able to find her. If this were her job, I would classify that as patient abandonment. That's pretty serious stuff.
  10. DWelly14

    Nursing Student From Hell

    Expectations have been discussed multiple times with her. The biggest issue is that she just laughs it off when you call her out on disappearing. So I'm walking in to go push with the patient and I saw her in an empty room opening a can of bleach wipes (she later told me she was in the bathroom) but I didn't have time to call her because the patient was about the birth. Later when we had a chance to talk and I said "why did charge have to come find you when our patient was complete and pushing?" she laughs and says "oh I was in the bathroom and didn't know where you were. If I had known where you were I would have been there." I was in our room for almost an hour before she finally showed up.
  11. DWelly14

    Nursing Student From Hell

    Why do I need to be evaluated? I tried to give her the benefit of the doubt and be a good preceptor. I'm not her school. I'm not her program. I bent over backwards teaching her. I know I have to fail her but I know it's going to suck. Thanks making me feel even worse.
  12. DWelly14

    Nursing Student From Hell

    So I need help. I've been a nurse for 6 years now. I have a BSN & an MSN and am also a CNM. I've worked 4 years in critical care and the past two years in labor and deliver at a large suburban hospital. I've precepted several students and have always had positive experiences with them. I was not planning on taking another student this semester as I finally am transitioning into full scope midwifery practice but the local nursing school was desperate so they talked me into taking one last student. So in January, this student, let's call her Alice, started with me. When Alice first started she seemed very unsure of herself. She's a student though so not unexpected, even though this is her last rotation before graduation. But I got my teach on. We discussed anatomy and physiology of pregnancy and labor, walked through procedures at least 10 times, I stayed after every single shift to work with her, and she always went home with printed out policies and articles to read up on so we could discuss on our next shift. I felt like I was seeing improvement but I was always right there with her helping with her during the first 6 weeks of her rotation. When we had her midterm evaluation with her faculty member, Alice was told she was to take the primary role and I was to back off. So that's what I've been doing. Unless safety is in jeopardy, I've kept my hands off. And Alice is crashing and burning. To the point where I'm not sure how she's made it this far in her program. She is lazy, refuses to do basic nursing tasks such as starting IVs, and will just go hide to get out of things. We admit a patient. I go in to the room with Alice, she just stands there. I say "Ok, go ahead and get started." She says (in front of the patient mind you) "well, I haven't done many IVs so why don't I watch you one more time?" I say " you only have 2 weeks left, you only have so many chances left ... " Patient chimes in "I want you to start my IV please DWelly14!" .... opportunity lost. Fast forward to when the patient is complete. Alice is nowhere to be found. I'm in pushing with her and the charge nurse has to find her. Several of my coworkers have commented on her behavior to me, I've confronted her on it and she always makes excuses, and I've now emailed her faculty. My question to all of you is do you have any tips for what to do? I feel bad just recommending that she not pass but at this point she only has 3-4 shifts left with me and I'm getting really frustrated with her. I'm really not willing to take her for any longer than the originally assigned amount of time because of the behavior I've observed. I feel like she's skated by through her whole program somehow and now she's finally having to actually do it and she can't. Help!
  13. I do highly recommend getting the bedside experience .... it's invaluable down the line. It's what makes NPs different from PAs is our time spent at the bedside. If you are set on not getting the bedside experience, perhaps look at going the PA route.
  14. DWelly14

    Lied to in Interview

    Yep, when interviewing for my current job, I asked what the weekend commitment was because my husband works weekdays so I wanted to know how much time we'd get together. I was going to take the job no matter what because it was a perfect fit for me and in labor & delivery. I was told I'd be working every third weekend. Get hired, start work, guess what? I'm actually assigned to every other weekend just like all new hires and then we are moved to every third as the staffing matrix allows based on seniority. The manager had no reason to lie to me but did anyway and now a year and a half after starting I just now finally got moved to every third weekend. Very frustrating. OP, I'd take that dialysis job you mentioned. Tell the rehab floor in your resignation letter the reason you are leaving is that they pretty much immediately violated the work terms you outlined (and they accepted it seems) in your interview. There's an orientation period for a reason. If you didn't end up being a good fit at the end of it, they'd let you go. I think it's fair that that work in reverse. This job isn't a good fit for your desires so if you have another job available, move on.
  15. DWelly14

    Hospital that bans family members

    I've been on both sides. On the patient side. My father in law had a brain aneurysm rupture and spent 2 months in ICU after. My mother-in-law stayed with him the whole time as he was mostly out but randomly he'd have lucid moments and would be terrified if his wife wasn't there. My mother-in-law stayed out of the way of the nurses, insisted on taking care of herself, and was always polite and I truly believe that her being there with my husband's dad was vital to his full recovery (if you met him today you'd have no idea he'd had any issues). conversely, I work L&D and there are times I want to quit because of family members. I will never understand why primips bring their entire families with them for their inductions which are scheduled to start at 9pm at night. And even after I tell those family members that the baby won't be arriving that night and they can go home and rest up, they get mad at me that there is no room for them all to lay down and rest when nothing happens immediately. Which inevitably leads to 10 family members laying on the floor meaning getting to the patient is like an obstacle course. Cue the decels and fetal distress and now we have an emergency on top of upset family members who are now being told they have to get up and leave because their sleeping space is needed by medical personnel to take care of the mother and baby. My unit has a policy that states that the patient can have 4 people in the room for delivery (which is too many if you ask me ... the sterile field pretty much ALWAYS gets contaminated) but the number of people allowed during labor is not addressed and it needs to be. Family members can absolutely be a key part of the healing team but they can absolutely be a hinderance as well. I think in light of this, policies can be helpful but can not be strictly enforced across the board without taking the patient into consideration.
  16. DWelly14

    You know the shift is gonna be a hot mess when ...

    Labor & delivery nurse here ... I know it's going to be a crazy night when it's raining and it's a full moon and I walk in and triage is full with more patient's being seen in our NST room and the waiting room is full ... sounds like a night where people will be getting epidurals in triage and probably birthing there too! Or the other night when I get to the board for report feeling pretty good as there's only 5 patients admitted only to find out we have no scrub tech and the ORs are all down because they're doing maintenence on our air flow system and the off going charge says "don't worry! we've never had to do a c section off this floor." sure enough, not only do we get a contracting repeat section come in not an hour later but also a hemorrhaging 30 week previa. It was a mess!