Sent home from Clinical

[JuicyJem]

I am posting this in the general discussion because I would like to hear from nurses as well as students.

I am graduating (lord willing) in 1 month and 11 days. I live with my grandmother who is 75 and has a long history of CV disease. Last night she had pain in her jaw and neck, so I had my mother come and take her to the ER because I have clinicals at 6am on Thursday and Fridays. I only slept about 4 hours.

Our regular instructor for this floor was absent today and the Program Director was filling in. She was late, so our other regular instructors came from their floors to go over meds with us. I was the first one to go and I was able to answer every question that she asked, and knew the important side effects. I have given most of the drugs many times before. This particular teacher seems to have it in for me, and I have posted about that situation before.

I stuttered a couple of times and then apologized and said, "Im sorry, Im just a little tired." She asked why and I told her that I was up a little later than usual and told her the situation. She asked if I should be there and if I would put my patients in danger. I said "No, I am okay." She said okay, then came to get me 2 or 3 minutes later. In front of the Program Director and our other instructor, she said "We feel that you are too tired to be here today and you need to go home." I said "No, I am fine. I do not want to take another absence." (I took one last week for an out of town interview, and when you have 3 you're out.) She then told me that I had to leave.

I have one of the highest grade averages in class and clinical. This is not the first time that this instructor has gone out of her way to humiliate me and put my graduation date in jeopardy. I am so sick of it. I have never crossed her, questioned her, or been disrespectful of her.

I called the program director and asked for an appointment to speak with her. I do not feel that this instructor had any evidence that I would be unsafe to take care of my patients, but I felt that it would cause more damage to stand there and argue with her on the floor.

I have worked so hard to get to this point and I am so upset right now. Next week I have a critical care rotation with this particular instructor and I am so afraid that she will find some other reason to call me out and send me home, at which point I would fail despite my grades, and no matter how well prepared I am. I thought I was pretty well prepared today.

I just wanted to get this off my chest to someone that has maybe been in my shoes.

Thanks.

[purplemania, BSN, RN]

You did right to get an appointment with the program director. I might even talk to the Dean of the college, after that first appt. Write down your complaints before you talk, and make then very non-threatening, such as "I feel humiliated, intimidated, singled out, etc." Phrases like "she has it in for me" sound immature, so refrain from those. Make it sound like a nursing diagnosis: I feel this way because---

If the instructors can miss or be late, why can't you? What kind of example is that setting????

Hope your grandmother is better.

[SmilingBluEyes]

Agree with purple. Seek redress as high up as you need to go. You are human, you did NOT mistep or do an irresponsible thing. If your account is accurate, your circumstances are understandable and surmountable. Keep fighting...you are too close, like you said, to quit now. I wish you the best. Please let us know how things turn out. Go up the chain to the TOP, if you are forced to. Just don't give up! Best wishes to your Gramma as well.

[sjoe]

Just one more suggestion:

Sit down and write out everything you can recall that has anything to do with this incident since you and this instructor first spoke on the day you were sent home, including quotes or gists of conversations, Dates, times, etc. Keep this up to date as further conversations and meeting occur as you follow the advice given above by others. (And don't throw this information away when you think things have been "settled.")

You need to be prepared for the likely fallout--NO MATTER how much the dean or anyone else give you the line "it's all straigntened out now, you have nothing to worry about."

Oh yes, and welcome to the world of nursing.

[katscan]

This is amazing! And management require nurses to work double shifts! What about them?? No talk about patient safety there-only insubordination if you don't. I sincerly doubt that you would have endangered your patients, you DID get some sleep. Those double shift nurses are the endangering ones yet this practice is still allowed! Why doesn't she cut to the chase and tell you that you will probably be mandated to work in that fashion. Like she really cares...Yeah, it sounds like she does not like you. Good luck.

[Tink RN]

Bless your heart ... I am sorry to hear that! First of all, I hope your Grandmother is doing well. Perhaps the instructor did feel this was best, maybe she knew you were stressed and needed to be with your family. Or not ... based on your stating she "has it in for you". I can relate to that as well.

My suggestion would be to keep a written journal and if you see that she has intentions of interferring with you graduating, then approach the program director. You are graduating soon, your grades are excellent, and you have not missed to many clinicals - so don't sweat it yet.

Even if you feel her sending you home was a malicious intent, I'm afraid she would be able to justify this incident and convince the director that it was the compassionate thing to do. ("She just looked terrible - I could tell she had inadequate sleep" or "Her ill Grandmother had a decline in her condition and I felt her family needed her") Furthermore, you would have to disclose the fact that your previous absence was due to an interview which (no offense) indicates poor planning on your part. I understand - I realize that must have been the only time you were able to set it up ... but I remember how it was expected of you in school to put school first in everything from eating to sleep. You get the picture.

As for only 4 hours of sleep being "unsafe" ... please! Wev'e all went to work on 4 or less hours of sleep - so don't let her make you feel as if that was a lapse in judgement. If anything, this proves your dedication. I hope all works out for you! Keep us posted!

[teece3]

Another thing...you said it was a clinical...isn't there a staff nurse on the floor also assigned to care for the same patients? That's how we did it when I was in school and that's how we do it now. The students have to report off to the staff nurse responsible for the patient. I imagine the staff nurse would have been available if you needed help. And I don't know any nurses who haven't worked doubles or come to work after sleeping only a few hours. I wish they'd send me home!!

To repeat what others have said, it's very important to be as calm and non-judgmental as possible. As soon as the program director feels "threatened" or defensive, you've lost the battle. Best of luck. At least you were conscientious enough to show up for clinical! Sounds like my kind of nurse.

[hoolahan, ASN, RN]

May I add another thought? I was once a target of a spiteful charge nurse in a former job. I decided to confront her about her behavior. I had specific examples of how she had humiliated me, and how she could have handled things in a more professional manner if she really did think I had a problem.

I was shaking like a leaf to be alone w this intimidating woman, but I asked to speak to her privately and I started it out like this, "Do you have a problem with my nursing care?" She was absolutely flabbergasted! She stammerred and everything. She never once thought I'd have the cajones to call her on her behavior.

I made no threats to report her etc. I simply said I preferred to air things out in a mature way from one adult to another.

If you do this, I wouldn't tell her too much why you want to talk w her, just that you'd like to ask for some feedback on a personal issue. You don't want her to be too prepared, you need a little element of surprise.

After we had our chat, she said she didn 't realize she had made me feel like that (not sure I buy it, but she said it, and there is some satisfaction in hearing it out loud) and I never had a problem with her again.

Sometimes you have to confront the bully to let the air out of their tires, to let them know they don't intimidate you. I agree w using objectiove statements and not emotional ones like "she's got it in for me." When you/she does ________, it is humiating to me."

And don't give her any ammo. Do not let her know of any weakness, being tired, ill, etc.... bullies can zone right in on an achilles heel, including your own fear of them.

Personally, I would make an ppointment with her first. You can still meet w your higher ups, but tell the mean one that you are doing so, having her higher ups take her by surprise would only work against you in my opinion.

I hope your grandma is well.

[CCU NRS]

You have already recieved many good responses. Purple is right go in with your notes if you have to and make your points in clear mature manner. Explain that this is not the first incident you have had with this instructor. You should explain that you were fine and that you have been active on less sleep after hard nights studying. The biggest problem with nursing school is that they want to try to teach ideal, and perfection, when the real wold does not work that way. You sometimes have to play their game to get through. Next week in Critical Care explain to your nurse early that this instructor has been a little hard on you and that when she is around you would like to stick very close to her and be very inquisitive. This does two things 1. It keeps you up and busy and away from the instructor so that she can not easily single you out. 2. It shows the instructor that you don't think you know it all (I secretly suspect she is jealous of your ability to pick things up quickly and do well in adverse settings which she might see as arrogance or she might just be a real ***** with envy issues)and are still attempting to better your skills.

[bluesky, BSN, RN]

Here's my advice- this could end up well with a personal discussion with the instructor as suggested above. Yet if she's psycho heffer the whole thing could get real ugly real fast. Personally, I would go to the administrator and ask to switch to another instructor for the last couple of dates based on your strong academic record and stable relationships with other instructors.

It might also help to recruit other students who might be willing to "testify" if you will about psycho heffer's behavior.

[Todd SPN]

In school, we also had the 3 absence rule held over our head. What a few students found out was there was a board of nursing instructor's that you could go before and plead your case should you happen to get the 3 strikes. Neither was booted from the program after going before the board. You are pretty far along in your program and I would speculate they would not choose to drop you now. But, as sjoe points out, write everything down so you can recall all the details should you need too. Good luck.

[JuicyJem]

Thanks so much for all the replies!!!!!!!!!

I'm still waiting to hear from the program director. I will probably talk to both of my other teachers tomorrow at post conference in the manner that you all have suggested. Since the program director was standing right there throughout the whole thing, I still want to talk to her. The three of them were totally tag teaming me. They all tried to look sympathetic to my "tiredness", which was probably sincere from all but the "psycho heffer" mentioned before.

anyways, thanks. I feel much better.

PS-Grandma is in CCU on telemetry awaiting a stress test and Echo.