Protecting yourself

Nurses General Nursing

Published

I was at the methadone clinic today as part of my community mental health experience. One of my tasks is to obtain urine samples from clients. I've already had a run-in with one client. This afternoon another client left the clinic for a cigarette after being informed he was to provide a sample. The nurse supervisor told me to pat him down when he came back, to look for an artificial bladder or supply of someone elses urine. The client is 6 foot, 250 lbs. My immediate thought was: he's not going to like this, how dangerous is he, what kind of position am I putting myself in. I'm a male student by the way, and nowhere near this mans size. My nursing instructor could see I was well out of my comfort zone, and said "This is nursing."

Question: Am I out of line to be concerned for myself in these situations? Is there something wrong with wanting to be a nurse and wanting to be safe at the same time? I really need some feedback about this, because my instructors comment made me question whether I am "cut out" for nursing.

Specializes in Corrections, Psych, Med-Surg.

"There are no written policies regarding this issue, that I am aware of. "

There NEED TO BE, in order to protect your school of nursing, the clinic, its employees, the students, AND the clients. This might be a good project for you (or you and a group of students) to do for a class. At least suggest it strongly to a suitable instructor and the dean and whoever is in charge of the clinic.

Specializes in Nephrology, Cardiology, ER, ICU.

Your instructor needs her head examined! Get a grip - that's what police do, not nurses! BTW I work charge in an inner city level one trauma center and security and police both have a place in my day.

Why in the world would she let that guy go out for a smoke if a urine sample was to be taken? He couldn't wait a few minutes? If you ask me...that should have been addressed to the patient.."Mr. SOand So, the policy is that we need to get a urine sample from you before you step out that door..otherwise I cannot not give you your treatment today because I would get in huge trouble for not following procedure" Of course this is said in a non-threatening , matter-of-factly, non-condescending type of way.

I guess it was my responsibility to tell the client that, and I didn't. I was startled when he said he was leaving for a cigarette, and honestly I was afraid to tell him he couldn't. As I said earlier, he gets to give his sample alone (yeah, I don't get that one either). He didn't come back afterwards (whew!) but I am still having trouble wih this one. I am thinking I don't have the guts to be working with this population. I am also wondering why the clinic made exception for this one client. Was there an incident with this patient? Good question to ask next clinical day.

I looked through the standards of practice for nursing in this province and found this: "The goal of nursing practice is the best possible health outcome for the client, with no unnecessary exposure to risk or harm." I guess the point is that to be a nurse in this jurisdiction, you have to accept this kind of risk.

I know I have to assert the authority I have to do this job. I also have to accept the risk that assertion will put on me. It doesn't look like there are other options.

PS: One thing I noticed, and you guys can tell me if this is normal. There are several points in the standard which define improper conduct of a nurse towards a patient. I didn't find any which define the opposite.

Specializes in Renal, Haemo and Peritoneal.

All I can say is that you are a nurse NOT a warden! NEVER place yourself in a positon of danger. The nurse that was with you on that day was way out of line. If someone was going to give a tainted/suspect sample of urine, let them. Your safety is paramount! Security searching (pat down's are a responsibility of security staff). You can always plead :"I have not been trained in this procedure" In this day and age of litigious society by just performing the procedure (without proper education) left you without a defence (other than naievity).

I hope nothing like this eve happens to you again. Good luck with the rest of yor study.

Specializes in Renal, Haemo and Peritoneal.

Another thing! Don't beat orself up about this! You did know worng, you were shafted by your suervising nurse. If you are going to work n the sam area agian then familiarise yourself with the policies etc so that you are one step ahead of the rest but would it not be true that as a student at the time you are or should not be liable for the patien'ts outcome, particularly in a situation such as this? Good wishes

When I was a student my instructor made me sit in a padded room and listen to a psychotic sex offender tell me what he wanted to do to me. ((((shudder))) I had nightmares for weeks and almost failed my psych clinical because of my response to the trauma....PTSD in 20 20 hindsite.

Some of these instructors are indeed on power trips and like to expose students to the worst of the worst...I don't think it's necessary personally. I'm sorry she did this to you. If you are asked to do something outside your comfort zone it's OK to say so, IMO. I wish I had.

Also wish I HAD told my director about this incident, because the instructor knew what she was getting me into. Yours did too...so please consider reporting it. (maybe anonymously after your rotation) ;)

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