lilfayfay

Well if you guys really must know, sadly it turns out that it wasn't an error and I have to repeat the class. After this semester, I'm not sure if nursing is a lifetime thing for me. Maybe i'll find something else that's in the health professions where I'm still helping people but without much direct patient care like those people who operate in the labs. But if I still want to continue nursing, maybe I should work up the ladder and become an LVN first? I don't know but there's so many options besides nursing. :) As an end note, I just want to say thank you to those for really taking the time replying back and giving me constructive criticism. I really appreciate it and will make use of it in the future.

Update: Hello X, I would like to meet with you after pharmacology tomorrow. Thank you. Respectfully, Professor X

Update: Hello X, I would like to meet with you after pharmacology tomorrow. Thank you. Respectfully, Professor X

Come to think of it I did have a NICU baby that was born at 28 weeks that was on a vent, EG tube, had UAC/UVC, and had lipids and TPN but the baby was able to be weaned off the vent and placed on CPAP. Also, the baby tested negative for IVH and NEC.

Thanks for the examples but these were obvious ethical dilemmas. I couldn't really think of anything obvious as the ones you presented here.

Yes I know, I'm just hoping it may be a typo because she kept my grade of 11.5/40 for awhile, a few days even, and then suddenly changed it the day before Thanksgiving.

Shouldn't she have just given me a 0 then? There's no point in giving me just 2 out of 40 points which is a 5%. If my calculations were correct, it looked like she initially gave me 11.5/40 which is a 28.75% but then 2 days later, for whatever reason because it's not showing on Blackboard, changed her mind and replaced it with 2 points instead. Idk if this is fair, but I haven't received an email or notification from either her or the head instructor.

I personally talked to my instructors and I know they were giving me so many chances. The thing is, based on my nursing school's policy, if I fail the course I fail nursing school. My instructor even told me on the last day of clinicals that I passed so that's why I'm confused.

It's been a rough semester for me. I got barely passing scores which were 73% for my Long Care Plans which consisted of 35% of my total grade. I also messed up on my APA formatting on my teaching project, worth 10% of my grade, which I lost points from and lowered my grade even further. Before I turned in my ethical dilemma, which was my last assignment to be graded, my grade was a 75.45% and during the weekend it changed to a 73.12% so based on my calculations she originally gave me an 11.5/40 which is a 28.75% on the assignment but on the day before Thanksgiving, my grade suddenly changed from a 73.12% to a 71.93% which means that she must've dropped my grade on my ethical dilemma from a 11.5/40 to a 2/40 which is a 5%.

Update: So she updated my grade again today and there was another assignment that was worth 10 points, it was my teaching project student evaluation and she gave me the full points but my grade is still at a 72.42% which isn't passing. She still hasn't replied back to my text or emailed me about this, I'm doubting that this 5% on my ethical dilemma is a typo.

I texted both the head of my L&D clinical rotation and my clinical instructor, and only the head instructor of my L&D clinical rotation responded back by saying that she'll take a look at it Sunday night since she's out of town for the break. My main clinical instructor hasn't responded back to me yet.

My grade was originally a 75.45% before the assignment and was changed to a 73.12 after she graded it so I think originally she put down 11.5/40 which is a 28.75%. But then 2 days later my grade changed from a 73.12% to a 71.93% so that means she changed her mind and gave me 2 points, a 2/40 which is a 5% for the assignment. I'm just hoping it's a typo and maybe she meant to put a 12/40 or 20/40 or just accidentally erased my grade and put down a 2 on there when she submitted it again because my grade for my ethical dilemma isn't showing up on Blackboard anymore and that was the last assignment that needed to be graded on Blackboard. Do you really think 2 points was justified? If so, she should've just given me 0 points out of 40 points for the assignment then. I also didn't receive an email from my my clinical instructor or my instructor that's the head of the L&D clinical rotation in calling my attention to this, maybe because it's the Thanksgiving weekend and didn't have the heart to tell me?

I had normal patients, I couldn't really think of anything else as obvious as your example besides this one. This ethical dilemma assignment was based on my L&D/PP/NICU rotation.

Does this sound like an ethical dilemma? I'm not sure what grade my teacher gave me but I did my calculations on my overall grade in Blackboard and it seems like she gave me a 2/40 for the assignment. The ethical dilemma was the last assignment to be graded. Throughout this Thanksgiving weekend my grade dropped from a 75% to a 73.12% to a 71.93%. I need a 73% to pass and clinicals is over. I don't get it, my teacher told me on the last day of clinicals that I passed but I had 1 more assignment to turn in which was the ethical dilemma, worth 5% of my grade and worth 40 points. Do you guys think this might be a typo? If she only gave me 2/40 points on the assignment, shouldn't she have just given me a 0% for the assignment? Is the 2 points just writing down my name? I'm so sad, angry, and confused. I feel like all of my hard work throughout this semester was all in vain. Anyways, here's my ethical dilemma. 1. Identify the clinical setting the situation occurred in. Describe the situation and ethical conflict in detail. You will not receive full credit if you do not describe the complete clinical setting/situation along with the ethical conflict. (4 points) The clinical setting was in the Labor and Delivery Unit at X Hospital. The patient was diagnosed with Gestational Hypertension and was given Hemabate and Cytotec to control her postpartum hemorrhage. The patient was feeling nauseous, had vomited, and had constant, heavy diarrhea due to the Hemabate and Cytotec. Methergine was not given to control her postpartum hemorrhage because the patient had gestational hypertension and Methergine could have the potential of increasing her blood pressure even more, leading to a stroke. If the patient did not receive Methergine, then she would lose electrolytes and water from the vomiting and the heavy diarrhea caused by the Hemabate and Cytotec. The loss of electrolytes would affect her heart by causing dysrhythmias, and the loss of water could affect her kidneys from dehydration. The nurse gave the patient medications to control her vomiting but none were given to help control her diarrhea. When I came back from lunch and went inside the patient's room, the patient was sitting in a huge pool of diarrhea and the room smelled horrible. 2. Select the top 3 Principles/Rules of Healthcare Ethics involved and describe them in detail utilizing references. (16 points) The top 3 Principles/Rules of Healthcare Ethics involved are Autonomy, Beneficence, and Nonmaleficence (American Nurses Association, n.d.). Autonomy is allowing the patient to choose the treatment of his or her choice (American Nurses Association, n.d.). Before the patient started pushing, the patient should have been informed of the potential of a postpartum hemorrhage, and the medications available to control the postpartum hemorrhage such as methergine, cytotec, and hemabate, along with the contraindications, side effects, and possible outcomes. After the patient's education, the patient should be allowed to decide which medications to use in her treatment. Beneficence is to promote wellness in our patients (American Nurses Association, n.d.). The nurse should have gave the patient medications to help control her vomiting and diarrhea. Nonmaleficence is to avoid hurting the patient (American Nurses Association, n.d.). The nurse should have monitored and consistently cleaned and changed the patient due to her heavy, constant diarrhea to prevent skin breakdown. 3. Select the top 3 AWHONN Standard X. Ethics involved in this issue and describe them and how they specifically relate to your ethical conflict (in detail). You must utilize references. (16 points) The top 3 AWHONN Standard X Ethics involved in this issue are promoting patient advocacy and helping them learn the skills to maintain their advocacy, compassionately delivery patient care to promote their dignity, and safety, and protecting patients from unethical healthcare decisions and practices (Association of Women's Health, Obstetric, and Neonatal Nurses, 2009). Promoting patient advocacy and helping patients learn the skills to maintain their advocacy as well as compassionately delivering patient care to promote their dignity, and safety (Association of Women's Health, Obstetric, and Neonatal Nurses, 2009) relate to my ethical conflict because when I came back from lunch, my patient was sitting in a large pool of diarrhea and the room smelled horrible. The nurse should have consistently monitored the patient helped changed her chucks, and made sure the patient had her call light in reach so the patient could call for assistance whenever possible if she had another episode of diarrhea. Protecting patients from unethical healthcare decisions and practices relates to my ethical conflict because the doctors and nurses chose the treatment option for the patient instead of letting the patient choose what treatment option was best for her. Before the patient started pushing, the nurse should inform the patient of the potential for a postpartum hemorrhage, the medications available to control the postpartum hemorrhage such as methergine, cytotec, and hemabate, and their contraindications, side effects, and possible outcomes. If known, describe the actual outcome. If known, then points will be deducted for choosing this ethical dilemma. (4 points) Before my nurse and I handed the patient to the postpartum nurse, the patient still felt nauseous and had diarrhea. However, she was able to get up to the bathroom and urinate with our assistance.

Update: So she said I passed but my overall grade in clinicals went from a passing grade to a failing grade during this Thanksgiving weekend. It went from a 75%, to a 73.12%, and now it's a 71.93% which isn't passing. The minimal grade I need to get is a 73%! I feel like all of my hard word and efforts were all in vain.. I don't understand, last week she said that I passed, maybe I got a failing score for my last assignment that was worth 5% of my grade? It was an easy assignment, it was to write about one ethical dilemma that you experienced in clinicals, worth 40 points and I calculated my grade and it looks like she must've given me a 2/40 which is a 7%. If I did that bad on the assignment, she might as well have given me a 0% unless it was a typo? There was no other assignments left for my grade to drop that drastically.

Do you know the schedule of what a typical PP day will be like? This will be my first time in PP

Here's my SBART format: S-S.Z. is a 21 year old female who has gestational hypertension. She is full code B-She came in with a high BP 140/91 and was feeling mild regular contractions. Her dilation was 3.5, effacement: 50, and station: 0. FHT 125 and UC 3, 50, and mild. Her doctor is Dr. H. She came in to r/o labor. She is 40 weeks pregnant. She had a cholecystectomy 2011. She is G:1 P:0. Her MPV lab was high-11.7 with a low platelet count of 25.1. Albumin and A/G labs were low. They were 2.8 and 0.8. Her Alkphos was high, 208. She has ketones, protein, leukocytes, and squamous epithelial cells present in her urine. They were 2+ for ketones, 1+ for protein, trace for leukocytes, and 1+ for epithelials. She's on LR 125 mL/hr and oxytocin 2munit/min. She has a R ante cubital saline lock. She's on continuous FHTs/UC, BP, HR monitoring and pulse oximetry. Her daily meds are acetaminophen hydrocodone Norco 5/325 for pain, Docusate sodium for constipation, and ferrous sulfate for iron deficiency. A-Her pain is 0/10. Patient received an epidural, she can move her legs but cannot feel them. She's on bedrest, fall risk precautions, and on a clear liquid diet. Teaching needs are breastfeeding and newborn care. She is a.o. x4, PERLLA, her lung sounds were clear to all lobes bilaterally, heart sounds S1 and S2 present, cap refills were R-continually assess and massage fundus and note rubra every 15 minutes, check baby's vital signs/heart sounds/respirations every 30 minutes. Assess for diarrhea, clean and change patient. Hold docusate due to diarrhea. Assess for any pain, nausea, and vomiting. Give meds for nausea and pain. Assess if patient still feels numb in legs due to epidural. Assess characteristics and record amount of vomit. I texted this to my teacher and she said to change it to either PP or Labor b/c I had a mix of both.

Okay thanks!

So instead of using SBAR, use SOAPIE?

Thank you everyone for your feedback. I am reading both sides and am keeping an open mind.

These were her previous negative feedback but they weren't as harsh as this week's. Nothing that was below a 3 to catch my attention. "Lacked basic needs for PPROM patient, struggled with appropriate terminology." It was during post conference that I got confused between PROM and PPROM so she erased the 5/5 my nurse I had that day with a 3/5. I don't know what she meant for basic needs for PPROM cause I looked through my 40 page packet under L&D and it's not even mentioned on there. "Lacked appropriate terminology, lacked ability to communicate assessment findings without moderate prompting." I don't know what she meant by this my nurse was okay with me that day, I should've asked her what she meant by that. 3/5 "Do not leave any grades blank unless in NICU with a non-normal newborn." 0/5 -> 3/5 "Continues to struggle with terminology and concepts, however she is improving every week." 5/5 -> 4/5 "Struggled with foley placement in OR." This was my first time inserting foley catheters in a live patient. During my Med Surg rotation, we didn't have that much opportunities to insert foley catheters. I only took one out and it was from a male patient. 4/5 -> 3/5 (even though the nurse that was with me that whole time wrote a 4/5, my instructor wasn't even in the OR with me). "Needs to work on confidence in communication" I charted physical assessments, manual vitals like oral temp and respirations, and documented them for my nurse. 4.5/5 -> 3.5/5 I did have a problem with a previous clinical instructor but that was because I wasn't practicing my skills in the skills lab like the IV meds when we first learned how to work the pumps and give IVPs through the line. Now it's something completely different-it's the DTRs and clonus that we never practiced during skills lab for orientation. They only talked about that topic and showed the class about it briefly. I'm actually doing work, it's not like I'm slacking. Maybe there's a miscommunication on both my part and my clinical instructor's part. Maybe I do need to review the medications on my packet every night before clinicals if that's what I have to do but there's too much medications on there. Like this week I was in L&D but she marked me down on the erythrocyte med that was listed under NICU and the methergine med that I didn't even give-it was what the Dr. was probably talking about briefly during the delivery but I don't even remember b/c I was watching the delivery since it was my first time seeing a lady partsl delivery. Yes, this was my first bad day on my clinical rotation. And thank you so much for understanding my situation. You are the true embodiment of what a nurse should be!

Thank you so much! It's 2 clinical warnings until a failure and I have a B. Should I ask my faculty advisor if I can switch clinical instructors?

Hi guys! I'm on my 2nd year, 3rd semester of nursing school for the OB/Psych rotations. I got a failing score for my OB clinical grade yesterday and I'm very worried I'll fail clinicals. I feel like my clinical instructor is watching me like a hawk compared to my other classmates and since I'm not as outgoing as my other classmates I feel like she's targeting me that I'm not doing my job as a student nurse. I feel like she was not as understanding as my clinical instructor that I had during the first 2 weeks of this semester (she was supposedly to be our clinical instructor but had to focus on grading our theory/lecture grades since she's the only one this year teaching) and I feel like my new clinical instructor is purposely giving me nurses that aren't friendly or helpful towards students. Anyways, here's my situation: I had a pregnancy induced hypertensive patient that was in labor and when the patient was able to deliver, my nurse asked if I wanted to give the meds to the baby. I asked if she wanted me to give the meds with her or my instructor and she said "Whatever you want, I'm kind of busy with charting." My nurse wasn't very helpful and only wanted me to do things if my instructor was with me. From the beginning, she wasn't willing to teach me what was going on with my patient. I told her that I'll get my instructor after I was finished assessing the mom's fundus and baby's vitals since I was supposed to assess the fundus q15 mins and baby's vitals q30 mins. When I was done, I went to my instructor if she can give the baby's meds with me and she said that the nurse has to get the medications first. So I went back to tell my nurse if she got the medications out already and she said that they were sitting on the table. I went back out to get my Basic Needs packet to look up what each med was given for the baby but before I could do anything to look it up, my clinical instructor asked me if I was ready and I said let me look up the meds really quick to make sure I know what i'm giving. She said that I'm supposed to know all of my basic meds before coming to clinicals and that I should've looked them up earlier/before going to clinical. I had another clinical instructor this semester that taught during the first 2 weeks of clinicals before my current clinical instructor took over and I remember her saying that "If you don't know a med. then that's where you look it up on your Basic Needs packet. I don't want you to give any meds w/o knowing what they're for." When she quizzed me on each med I was able to list almost all what the purpose was for and route except for erythromycin. I told her that it was an antibiotic prophylaxis placed on the baby's eyes to prevent them from getting an STD. She marked me down because I didn't specifically say which STD-it was gonorrhea and chlamydia. She also marked me down for not knowing what methergine was for. My patient had a complicated labor and wasn't progressing with the delivery because the baby was facing the wrong way so the Dr. had to come in and help reposition the baby. My instructor said to just observe how the doctor was helping the patient deliver the baby. I didn't give methergine but she asked me what's the purpose of it during post conference/lunch and why didn't the patient receive methergine-it's for the uterus to stop hemorrhaging/because the patient was hypertensive. She said, "don't you remember the doctor talking about it during the delivery?" I was only observing the delivery like she told me to-it was my first lady partsl delivery so it was interesting, and I don't remember the Dr. talking about methergine when I was there so I just took a wild guess and said because it might affect the fetus. She also marked me down for not giving an accurate and cohesive report on my patient to her and my classmates during post conference-she just told me this time that she wants me to start from the beginning so I'm guessing I'll use SBAR next week when I'm at post conference but she only told me about this now; what about the previous 2 weeks that I had her? So during the post conference when it was my turn to speak about my patient, I started with the main problems of my patient-how she was having severe SEs of diarrhea from the meds she was given (she was given hemabate + cytotec) and had 2nd degree lacerations. I said everything about my patient (i.e. what's her diagnosis, G/P/A/L, when she ruptured, what was her cervical dilation when I came in this morning and when did she receive an epidural, when did she start laboring and when she delivered the baby) except for why the patient came in the hospital. I forgot because I was going to write it down on my careplans before leaving the hospital/didn't know she would grade me so harshly during post conference for that one problem-it was a very busy day, there was so much to assess and chart (I had a difficult patient-even my instructor agreed), and I'm still slow and trying to get used to charting on the computers so I guessed that she came in for labor when my instructor corrected me and said she came in to r/o labor. She marked me down for using wrong terminology, I said the patient came in for pre-eclampsia and she said it was hypertensive induced pregnancy but I asked her if they were similar since she gave me a sheet at the beginning on how to take care of mom's with preeclampsia/other hypertensive disorders of pregnancy. Since my patient had hypertensive induced pregnancy, I had to do DTRs and clonus. She marked me down for not knowing how to do DTRs and clonus. I told her that I only remember being introduced to that for a brief moment during orientation but we didn't practice that during the skills lab in orientation (we only practiced the main things like: putting on tocomonitors and US on pregnant mom's tummys, reading strips, listening to FHTs, lung sounds, APGARs/Ballards, holding/changing baby, IVs, and foley/IV catheters). I was practicing all of that during my free time in the skills lab and I told her that I'm doing my best and I'm usually the only one that frequents the skills lab. She also marked me down how I assessed for edema on my patient-she said I'm supposed to press down on the long bone for 5 secs but I squeezed both sides of the calves for a few secs. I told her couldn't you do either one and she said no. Based on all of this, she gave me a 1/5 for preparation, 1/5 for medication, 0/5 for communication, 1/5 for assessments, and 2/5 for maternal-child care (b/c "I was unable to provide care processes w/o moderate supervision and prompting" and "unable to look beyond tasks at bigger picture for patient,"-idk what she means by that but all I know she was watching me the whole day. I did struggle a little bit putting on the ID bands on baby and getting the baby's temperature once or twice on the first attempt but that's b/c it was just delivered or either crying and that was it; and that she had to orient me on what I should be assessing for my patient who had pregnancy induced hypertension. She didn't give me time to read the sheet she gave me that morning-after she gave me the sheet, I went into the room to see if the nurses were giving report since it was 7 minutes within the start of clinicals but instead the anesthesiologist was giving the epidural to the patient w/ the help of the night nurse so I observed while waiting for the day nurse to come in to get report; after the epidural was given the day nurse walked in and I was helping both nurses fix the IV lines/epidural lines on the medication monitor since they were tangled up, when we finished my clinical instructor came in and I was still reading/taking in the information on the sheet she gave me-it was a lot of information + my nurse was cold/wasn't helpful/didn't orient me to the client either-I felt like I was alone this time. For example, I asked my nurse if it was okay if I can chart the assessments for her since I know she's busy but she said "Idk, doing the assessments are my responsibility-I told her that I did some of the assessments and charted them for her with my instructor earlier and she said as long as you only do it with your instructor. This is my 5th week and this was the first time my nurse didn't want to do anything with me-all of my nurses I had previously this semester including the 2 other nurses before her that were strict wanted me to do assessments for them but they had to be there just in case the student was doing it right since we don't have licenses. I just wanted to do something with that nurse that day since they're responsible for grading us and I even offered to do/chart VS for her but she said they're automatically recorded on the chart from the monitors by pressing "t" for time except for temperatures and respirations; Idk maybe the nurse thought I would slow her down since I'm a just student). So what do you guys think? Shouldn't clinical instructors be understanding, encouraging, and create an environment conducive to learning for students? I feel like she's watching me carefully and grading me harshly. Should I tell the head of the nursing department about my concerns? I didn't harm the patient or baby and I maintained aseptic technique during the foley insertion/cleaned and changed the patient's chucks since she had constant diarrhea due to the SE of her medications (the hemabate and cytotec)/I emptied out her dirty linen and trash bags when full. I did everything that I could-it's not like I sat in the nurses' station all day finishing up my care plans.. Any advice?

Hi guys, I'm just wondering what to expect? Will it be the same as Medical Surgical and Telemetry clinical or something completely different? I would like a list of what to expect. Based on my clinical experience as a nursing student in Medical Surgical and Telemetry, I've noticed there's a certain pattern of how I took care of my patients: (some examples from the top of my head are #1. get report #2. take vital signs, #3. head to toe assessment, #4. check labs, MAR, physician's orders).

Dear OP, please listen to us and do not have a baby with your waifu until you are done with Medical school. If she won't go back on the pill seriously try to keep it in your pants for at least 2 more years which isn't that long to be honest. If you do not realize that you are being played and give in to her, you've lost all of our respect for you. Sadly, you've married a sociopath and it seems she has a hold of you in her web. She's very manipulative or you're just plain stupid/naive.