Put down by the seasoned nurse

[sweetsmuckers]

Yesterday, I was at my clinicals in a hospital. I was up there by 7 to listen to report. There were 3 nurses working on the floor and 1 CNA at the time (1 CNA arrived later). The two nurses in the report room were taken by my classmates. I could not find the other nurse so I asked my classmate if he knows her. He pointed me out to her and asked her if she didnt mind working we a student. She said no. So i went on and tagged along with her. I then proceeded to pick my 3 patients and I told her from that time till 0900, I am taking information on the patient that I picked. So while I was taking info on my patients, she asked if I could start an IV. I of course said yes. I couldnt pass up that opportuniy. I assessed that patient and removed his old IV. Not realizing the time, I told her I wouldn't be able to do the IV because I havent even finished getting info on my first patient. You can see on her that she was ticked-off. She asked me what else I can do. I said I can pass meds, draw blood, start IV, PICC dressing, etc..So after I got all my info for my 3 patients, me and my classmates start packing up to head to our pre-conference downstairs and I let my nurse know that we will be back after the conference. She told me that by the time I am up there, everything will be done. So I told myself I am sure there will be other meds to pass later. So we went downstairs, gave report to our instructor, and went back. When we got back, I went into one of my patients room to introduce myself. After I did that, she called me and started asking me what is wrong with that patient. I told her exactly what I know but it wasn't enough for her. She wanted me to look it up which I did and still wasnt convinced at what I told her. I even put it in my own words that I can understand it but still she didnt like it. So that whole time I was there, she wanted me to be next to her and watch her how things ARE supposed to be done. I asked her if I can go assess my patients. She told me I couldnt because I dont know what my patients have. In my head, I said I have the info here so I have a general idea why my patient is here. Then she proceeded to ask me what Have I done so far...I said to her that not much besides introducing myself to the patient. She said thats not good enough. She asked what block of nursing I was in and said block 3. Then she told me I should be able to do more since I am so far along. I wanted to answer so bad but I kept my mouth shut. I calmly told her if I can go ahead assess my patients now. She said no. So i got stuck next to her or when there is a nurse doing something she thinks I havent seen, shell tell me to go to that nurse. Then few minutes later, she pulled me to the side and told me exactly this : 'If an employer interviews you, do you think you'll get hired based on what you have done so far today?' I told her no. But in my head I told myself 'its because you wouldnt let me assess my patient so I can take care of them. Was it her place to tell me that? After that I couldn't take it anymore so I told her i am going to lunch and talked to my instructor downstairs. I found out she also talked to her about me not wanting to do anything. I was like WHAT????? I asked her if i can do this and this but she wouldnt allow me. My classmates that were with me saw the whole t hing too so my instructor knew I wasnt lying. I told her everything that had happend and then I broke down. I couldnt take it anymore of what she told me. I pretty much vented on my instructor and my other classmates. I felt bad but I rather take it out before I head back upstairs. My instructor said she should not have said that I am un-hirable base on my work today. That was not her place to say that. So to fix things up, she placed me on another unit with my other classmates. I went up there and I was able to do more like PICC ressing change, IV d/c and some other things that that nurse wouldnt let me. I felt better towards the end of the day. My classmates told me to not let it get through me. Well it did for a bit and I just cannot seem to let it go. It is almost playing in my head constantly what happened that day. Can you guys tell me on what I should do with this kind of situation. Any response will be helpful. Thank you for listening to my venting.

[SolaireSolstice, BSN, RN]

I think there may have been miscommunication from the get-go on this.

I always tell the nurse what my schedule is so they understand what they can expect of me when.

Maybe: "I'm here to hear report, and gather infomation on my patients. I'll be back on the floor at XX:XX to start my assessments. I can pass medication, do IV, change dressings, etc... during my floor time, and I leave at XX:XX."

I think she thought she had you by her side from the time she was introduced to you. I do agree she was unneccessarily hard on you, and I'm glad your instructor put you on a different unit.

I also hate when moments like that ring over and over in my head like a bell. "What could I have done differently? What if I had said this? What are they thinking about me doing that?" Truth is most of the time, you are thinking about it more than anyone. Brush this one off.

[LibraRNinNY]

I agree that the nurse probably wasn't clear on what your role was that day... At least now you know how to avoid these misunderstandings in the future! Good luck, I hope your next experience goes smoothly!

[sweetsmuckers]

Thanks guys.

I just want to say though that I DID tell her, when I was assigned to her, that from 0700-0900, I am taking info on my 3 patients. Then at 0900, I have to be downstairs to give report. I clearly stated that to her. And she even asked me what things I can do so I told her those things i mentioned earlier. So I clearly told her what I can do. I am just amazed how she almost didn't care if i came back to the unit after my preconference with my instructor...because she said to me that by the time i get up there, things would be done. I am SURE there are more things to do when I get back but she wouldnt let me get off by her side. She would insist that I look this disease up that my patient has and shed constantly ask me why or what is this and why is your patient on this ceratin medication. I would tell her the patho of the disease and a the background as to why my patient have this. but shed ask more like why is this med for that or why is she taking this. I asked her nicely if i can look it up on my drugbook really quick but she insisted I should have know this by now. I am not a pahrmacy, pharmacist, nor a drug book. And if they so know the drugs very well, why would they have drug books all over the nursing station...So when shed ask me what is this med for, I would just say what it is and I would even put it in my own words that I can understand and explain it to her but still, she wouldnt accept my answer.

I know I should let this thing go but it is just hard for me to get it off my head. I have to get it out somewhat by venting on here. But anyway, I didnt even get much done...I mean I wasnt even able to assess any of my patients so I have nothing to go by because she wants me by her side to listen to her. But anyway...My instructor told me that day that we have one more week for the med-surg rotation so next monday, I am going back to that unit, and if shes there, I would just smile and ask her if she needs any help...if not, move on. I am sure shes gonna want to talk to me then and I think I would just listen unless she really wants to hear what I think about her treating me. She did tell my instructor yesterday that she felt bad but have to see that for myself.

So..now I have vented it off here..I do feel much better. and thank you for all those who responded.

[Moogie]

Yesterday, I was at my clinicals in a hospital. I was up there by 7 to listen to report. There were 3 nurses working on the floor and 1 CNA at the time (1 CNA arrived later). The two nurses in the report room were taken by my classmates. I could not find the other nurse so I asked my classmate if he knows her. He pointed me out to her and asked her if she didnt mind working we a student. She said no. So i went on and tagged along with her. I then proceeded to pick my 3 patients and I told her from that time till 0900, I am taking information on the patient that I picked.

As a student, you choose your own patients? I take it that each student was partnered with a floor nurse---and you each picked three from that nurse's patients. No instructor input? And dang---0900 is LATE in starting patient care. I think with report and pre-conference, the student should be on the floor no later than 0800. (When to look up? You'll see...)

So while I was taking info on my patients, she asked if I could start an IV. I of course said yes. I couldnt pass up that opportuniy. I assessed that patient and removed his old IV. Not realizing the time, I told her I wouldn't be able to do the IV because I havent even finished getting info on my first patient. You can see on her that she was ticked-off. She asked me what else I can do. I said I can pass meds, draw blood, start IV, PICC dressing, etc..So after I got all my info for my 3 patients, me and my classmates start packing up to head to our pre-conference downstairs and I let my nurse know that we will be back after the conference. She told me that by the time I am up there, everything will be done. So I told myself I am sure there will be other meds to pass later. So we went downstairs, gave report to our instructor, and went back.

I see a huge problem, not with YOUR time management but with the way time is set up for your clinical experience. As an instructor, I would go in the evening before clinicals and make out the assignment. The students came in early---sometimes as soon as I had finished the assignments---to look up their patient's diseases, drugs, and determine potential needs. On occasion, something might happen that would require me to change an assignment. Those times were infrequent. If a patient assigned to a student was dismissed near the end of clincial, I'd have him/her do the dismissal and teaching and then have him/help the rest of the class. We had a quick pre-conference before report---though sometimes we'd do report, do 0800 assessments , tx and meds and have pre-conference in a private dining area in the hospital cafeteria.

Regarding the nurse getting huffy: even though students are on the floor, getting things done is still the responsibility of the nurse for that shift. I can't blame the nurse for getting upset when, in her mind, you students should have gotten your paperwork done before coming to report. That's how it is in many programs. Again, it isn't you but whoever has set up the clinical day (your instructor or maybe his/her supervisor) is whack!

When we got back, I went into one of my patients room to introduce myself. After I did that, she called me and started asking me what is wrong with that patient. I told her exactly what I know but it wasn't enough for her. She wanted me to look it up which I did and still wasnt convinced at what I told her. I even put it in my own words that I can understand it but still she didnt like it. So that whole time I was there, she wanted me to be next to her and watch her how things ARE supposed to be done. I asked her if I can go assess my patients. She told me I couldnt because I dont know what my patients have. In my head, I said I have the info here so I have a general idea why my patient is here. Then she proceeded to ask me what Have I done so far...I said to her that not much besides introducing myself to the patient. She said thats not good enough.

This encounter sounds like a head game to me.

She asked what block of nursing I was in and said block 3. Then she told me I should be able to do more since I am so far along. I wanted to answer so bad but I kept my mouth shut. I calmly told her if I can go ahead assess my patients now. She said no. So i got stuck next to her or when there is a nurse doing something she thinks I havent seen, shell tell me to go to that nurse. Then few minutes later, she pulled me to the side and told me exactly this : 'If an employer interviews you, do you think you'll get hired based on what you have done so far today?' I told her no. But in my head I told myself 'its because you wouldnt let me assess my patient so I can take care of them. Was it her place to tell me that?

Chomp, chomp, chomp, buuuuuuuuuuurp. I think another nurse ate her young. Seriously, I do see the nurses' POV if her clinical experiences at that level permitted her more autonomy and gave her more time to finish the paperwork. Is she a new nurse to that floor, maybe new to the shift students are there? Is she inexperienced herself? Does she treat all students in such a manner or is it just you? BTW, it was WAAAAY inappropriate that she told you that you're unhirable. Is she going to interview you herself?

After that I couldn't take it anymore so I told her i am going to lunch and talked to my instructor downstairs. I found out she also talked to her about me not wanting to do anything. I was like WHAT????? I asked her if i can do this and this but she wouldnt allow me. My classmates that were with me saw the whole t hing too so my instructor knew I wasnt lying. I told her everything that had happend and then I broke down. I couldnt take it anymore of what she told me. I pretty much vented on my instructor and my other classmates. I felt bad but I rather take it out before I head back upstairs. My instructor said she should not have said that I am un-hirable base on my work today. That was not her place to say that. So to fix things up, she placed me on another unit with my other classmates. I went up there and I was able to do more like PICC ressing change, IV d/c and some other things that that nurse wouldnt let me. I felt better towards the end of the day. My classmates told me to not let it get through me. Well it did for a bit and I just cannot seem to let it go. It is almost playing in my head constantly what happened that day. Can you guys tell me on what I should do with this kind of situation. Any response will be helpful. Thank you for listening to my venting.

Good for your instructor to listen to you side of the conflict and support you. But I know, a bad clinical experience can haunt you. Try to improve on your organizational skills---ask the instructor if assignments could be posted the evening before clinicals so you have the chance to check on your patient and not waste valuable time on the floor?

I truly hope things turn out right for you.

[LibraRNinNY]

Thanks guys.

I just want to say though that I DID tell her, when I was assigned to her, that from 0700-0900, I am taking info on my 3 patients. Then at 0900, I have to be downstairs to give report. I clearly stated that to her. And she even asked me what things I can do so I told her those things i mentioned earlier. So I clearly told her what I can do. I am just amazed how she almost didn't care if i came back to the unit after my preconference with my instructor...because she said to me that by the time i get up there, things would be done. I am SURE there are more things to do when I get back but she wouldnt let me get off by her side. She would insist that I look this disease up that my patient has and shed constantly ask me why or what is this and why is your patient on this ceratin medication. I would tell her the patho of the disease and a the background as to why my patient have this. but shed ask more like why is this med for that or why is she taking this. I asked her nicely if i can look it up on my drugbook really quick but she insisted I should have know this by now. I am not a pahrmacy, pharmacist, nor a drug book. And if they so know the drugs very well, why would they have drug books all over the nursing station...So when shed ask me what is this med for, I would just say what it is and I would even put it in my own words that I can understand and explain it to her but still, she wouldnt accept my answer.

I know I should let this thing go but it is just hard for me to get it off my head. I have to get it out somewhat by venting on here. But anyway, I didnt even get much done...I mean I wasnt even able to assess any of my patients so I have nothing to go by because she wants me by her side to listen to her. But anyway...My instructor told me that day that we have one more week for the med-surg rotation so next monday, I am going back to that unit, and if shes there, I would just smile and ask her if she needs any help...if not, move on. I am sure shes gonna want to talk to me then and I think I would just listen unless she really wants to hear what I think about her treating me. She did tell my instructor yesterday that she felt bad but have to see that for myself.

So..now I have vented it off here..I do feel much better. and thank you for all those who responded.

It does seem that your clinicals are set up a little oddly... As Moogie said, it makes more sense to have preconference first, then devote yourselves entirely to patient care. It's not your fault as a student though, so it's a shame it turned out the way it did.

I'm glad you're feeling better after venting! Good luck in the rest of your program, it can only get better now!

[DrNugg]

Sounds typical of what happens every day in hospitals around the country. Some bitter nurse, realizing that the rest of her life will be spent changing bandages and doing midlevel tasks, decides to take it out on a student. My advice to you would be to stand up to her next time (many nurses are playground bullies of the healthcare field). If you're smart enough, I would suggest you consider medical school if you're planning on a long term career. Otherwise, make yourself clear when dealing with cohorts and don't take any guff from anyone!