Question about clinical experience

It was good of the charge nurse to point that out to you, but I don't think you made a big mistake by answering her question. Are you guys passing meds yet? Because when we pass meds, every dose has to be double checked with our instructor before we actually pass, so if she made a calculation error, the instructor's job would have been to catch it. If you guys aren't being double checked before passing, that's definitely a dangerous nurse and I would point out to the instructor privately that she may want to be cautious and double check this student very carefully. Just my . Good luck with clinicals- I'm in the same boat :)

Also, to answer your other question, I probably would have done the same thing you did without thinking twice- you were just answering her question and didn't mean to inadvertently do anything. :)

Yep we have been passing meds since last semester, and have had two pass only dosage exams already under our belt. Thanks for the reply, I am questioning myself, and think next time I might nicely send her off to the instructor, but yes, the instructor is still to be double checking our meds and doses before we pass meds. It just sticks in my head that one of our instructors told us "passing meds is not a group activity, you need to do this on your own." I might privately pull instructor aside and ask her what she would want to know or for me to do next time, I sure don't want to get in trouble for helping someone out.

Thanks again

Don't beat yourself up for sure. Have you heard the saying "nurses eat their young" yet? It seems that way to many nurses forget that they were once a student themselves. You answered a question, and you did the right thing by explaining to her how to get the answer (instead of just telling her what the answer was). I do not want to make excuses for the student but perhaps she is not good at math (not good in this job, but we do have calculators for a reason), or simply forgot how to calculate the correct dose. As long as she is actually checking her math (with someone), asking questions, and not giving medications alone she is practicing safely in her scope. However if she is not doing her checks or 5 rights, then it needs to be brought to the attention of the instructor, before a error occurs.

The charge nurse is jumping the gun.

When you are in nursing school....and all through your career, you will always be learning. As one experienced nurse put it, "The day you think you know it all is the day you'll probably kill someone."

Yes, it was a simple question, but the student could have been exhausted, we have all had those days where if you had to add 2 and 2 you aren't really sure that you would get 4.

Granted, she should have asked the instructor, but had it been a REAL situation, you wouldn't have covered for her...you would have been collaborating with a colleague and there is never anything wrong with that.

All the charge nurse did was discouraging a student to ask...and that is more dangerous than anything that the student that had the "simple question" ever did.

I don't think the charge nurse was out of line....a simple math problem like that shouldn't *have* to be a collaborative effort. Personally I think it's scary that that student is passing meds and doesn't have the basic math skills to know that 0.25 is half of 0.5.

Asking questions is one thing...being safe with meds is a whole different ballgame...jmhexperiencedo.

Yeah I have to say I think that the Charge nurse did over react a bit...yes the other student should know this but she is a STUDENT and is there to learn.

And another post pointed out that all of us have been in the spot where you are exhausted, rushed in an emergency or what ever and ask a nurse for a second check for saftey-- When I get weird doses I sometimes get a second check or for my little kids I always get a second check just purly for safety as it is really easy to harm a small child. Not that I think I have figured it wrong but like I said to make sure for safety-- our psych ER takes kids down to age 4 so I like to be careful with them that little. Same as we do with insulin. two check always for every patient. No harm in double checking if your not 110%sure. Maybe suggesting that she review her dose calculations would be good.

Depends on the philosophy of the instructor on the floor. Some instructors have a "learn. do, teach," attitude, some are very controlling and want to do all of the instructing themselves. I am very concerned also that this student could not easily figure out this dosage.

Thanks everyone for your input, I guess the only way for me to know what this instructor would want me to do would be to ask her. And as someone pointed out, each instructor is definitley different in their approach to things, I have had three different ones thus far and each has expected different things from us.

Ok, so who thinks I should ask the instructor what she wants me to do if faced in the future with this type of situation.....

Or, who thinks I should just try to avoid said student and avoid the situation? I only have three more clinicals with this group and instructor then I will be moving on to new instructors and hopefully a different set of fellow students.

Thanks again all of your input is very helpful and gives me more to think about, when I ought to be studying, ha.

I would definitely talk with your instructor. Make sure your are able to keep things confidential. I don't mind helping out my fellow students, but the ones who have no clue what to do and just seem below par SHOULD be redirected to your instructor. This is an excellent ethical issue. Remember your steps to solve them and your goal of nonmalficence as a nurse.

Thanks, and I don't know if these things are even relevant to the issue at hand or not, but this particular student also asked me on Tues. to come and see why her pt.s feeding tube was leaking. So I went in there and began assessing the tube from site to pump. Site was fine, the clamp was still shut with the pump on, and it made quite the mess.

Also, I had to help her reposition same pt.. when I lifted the top sheet to grasp the pull sheet, I noticed he had had a messy BM and told her and she had said she didn't have time to clean him up and she would tell the nurse she couldn't. She could have cleaned him, I just think didn't want to and the nurse didn't seem too happy with her. Thoughts on pertinance?