Sent home from clinical :(

[Heylove, BSN, RN, EMT-B]

I failed one of the easiest courses in nursing school my first semester and felt like the worlds biggest dummy, and also thought that my world was over, not to mention heart broken, but I kept pushing and now I'm a Registered Nurse. You will be ok hun. This too shall pass.

I failed my first semester, too. It felt like the end of the world at the time. It took me over a year to get back into my program, but I did it! Looking back, I'm glad that it all worked out the way that it did.

[caliotter3]

It stands to reason that a 'for profit' nursing program is going to charge extra for make-up clinical sessions and that instructors will be well-versed in finding reasons to collect that extra fee from certain students. One would assume that at least part of the fee is going to go toward the salary of the instructor who gets to work that extra day. However, it would make more sense if the instructor had selected the student who missed four interventions on their care plan to make that $400 donation. Less room for credibility issues there.

Have read before that people attending make-up clinical sessions had to pay a fee, but as I recall, it was more like $50, something more in the realm of reason from the standpoint of a student.

[NurseRoRo]

I have never been sent home from clinical, but I have been made to burst into tears during a clinical day. TWICE. We had a tough professor who also happened to be the onsite clinical instructor at the hospital where I did clinicals. I was chosen to review my careplan with her before I walked into the patient's room. Of course I missed a nursing diagnosis b/c I spent all night doing dosage calculations for titrating heparin drips. The patient pushed the call light and we went inside, flipped on the lights, and her face was covered in blood. Turns out she had a nosebleed from non-humidified O2. The instructor pulled me aside and pretty much said, "THIS is why I ask about your careplan....you do not want a patient covered in blood who is on a heparin drip." 17 yrs later, I know she would not have bled to death from dry nasal passages....but that was so crushing at the time.

A few weeks later, I got yelled at by the nurse of my patient in progressive cardiac care because he was quizzing me about various drips the patient had going. Apparently I answered the question wrong because he said loudly in front of the patient and family, "I am not going to risk my license for you to potentially overdose and kill my patient."

[TriciaJ, RN]

A few weeks later, I got yelled at by the nurse of my patient in progressive cardiac care because he was quizzing me about various drips the patient had going. Apparently I answered the question wrong because he said loudly in front of the patient and family, "I am not going to risk my license for you to potentially overdose and kill my patient."

There is a name for someone who acts like that, but it would violate TOS to say it.

[Ben_Dover]

One thing I know for sure is care plans are totally subjective. One nursing instructors tells you his or her way... then the next one tells you something totally different.

[Apple-Core, ASN, BSN, RN]

I know as a student nurse just starting out, this is something that I fear too! I would be very upset initially also. However, after allowing myself a day or two to feel upset, I'd try and find anything in the experience I could learn from. I can say that in my current position, during trainings we have sometimes had people who ask a ton of questions and it can come off as obnoxious and as if they are trying to prove how much they know....."humble-bragging" in the form of a question, so to speak.

I obviously don't know whether this was the case with you, but it may be something to consider. A genuine and eloquent question in the right place, at the right time, is great; a barrage of questions that interrupt the flow of a training/teaching session and serve more to showcase the asker's prowess than ask a legit question is quite another....

This post is meant with kindness, so that hopefully you can reflect on your contribution to what happened

[NurseNinja1990]

Deep breaths, I had to retake a clinical rotation when I was in school. I've since been a nurse for 3 years now and am pursuing an advanced degree. It's not the end, try to learn from your mistakes and keep going. I'd also recommend talking to your instructor as to what constitutes as unprofessional behavior in regards to why they sent you home; be non-confrontational in how you ask though. It's important to be on the same page so you don't get sent home again for the same thing. You'll be okay, keep working hard like you're doing.

[djh123]

I'm sure you won't get support from some on here, but I'll just say (and I have to admit I only skimmed your post) that 1) you got bashed because you missed an intervention in your care plan ... I don't even remember having to do that, or if we did, I don't remember clinical instructors being so particular. And 2) you asked 'too many questions'? How in the heck are you/we supposed to learn? If I ever get an opportunity to be a preceptor or have a student shadowing me or whatever, I will tell them first thing that there are no stupid questions, and that there is no such thing as too many questions.

[JBudd, MSN]

"Failed clinical on my record forever"

Nah, after you pass the NCLEX, no one will ever know unless you tell them, or care.

Survive and pass.

[C0SM0]

Wow, and I thought I'd heard it all. $400 to make up a clinical!?!? That's like....a million dollars to college students. But seriously, I wonder if these instructors might have some sort of quota to meet for failing students at clinical. If I was an instructor knowing that students had to shell out that kind of money to make up a clinical, I don't think I'd have the heart to fail them unless they did something REALLY bad during the clinical day. I feel your pain. During my second semester I had a clinical instructor that would go out of her way to make my life a living hell. I'm in my mid 30's, male, a combat veteran serving two tours of duty in Iraq and I would literally be in tears almost every time I was driving home from my clinical. Keep your head up, there's a light at the end of the tunnel and you'll get there.

[kp2016]

Your story reminds me of a nurse I went to school with. She was always prepared for lectures and tutorials having done all the prereading and pre work, she graduated first in our class. She also failed several clinicals and had difficulty getting a job despite having a 4.0 grade point average.

In her attempt to fully understand everything being taught she asked "a lot" of questions. Many of our instructors, preceptors and the nurses on our clinicals seemed intimidated by this person. This meant that even though she was working incredibly hard she had many conflicts.

You mention being called unprofessional on a previous clinical as well as being sent home from this clinical. Please do not take this as criticism as I really am trying to help.

I would suggest that the main reason you were sent home from the clinical was not for missing a point on a care plan. Most experienced nurses wouldn't get every point a text book would list. It seems to me that you need to look at how you are expressing yourself and how others are perceiving you. I would suggest you should make an appointment with your clinical instructor to ask for some honest feedback regarding your overall performance on this clinical and some pointers on how to do well on the next one.

[Ruby Vee, BSN]

Today, I was sent home from clinical. I missed 1 intervention on my careplan, and was sent away. Another student in my group omitted 4 problems from his care plan and was able to stay.

I was identified last clinical as "unprofessional" for asking too many questions, but I just wanted to make sure that I understood what I was doing. But I guess even after asking so many questions, I am still just an idiot and just as confused.

We're only hearing your side of the story, and I'm sure that there has been much left out of it. Two things stand out to me. In the interest of helping you figure out what you did wrong and how not to do it again, here are my thoughts:

First, don't compare your situation to the situation of another student. The one intervention you left off of your care plan may have been the one most important intervention, while the other student simply failed to address some secondary issues. The other student may have had only a few hours to make his care plan because his patient had to be changed. The other student may have reacted better to being corrected than you did.

Second, contrary to popular opinion, there is such a thing as asking too many questions, asking questions of the wrong person, asking questions in the wrong place and at the wrong time and asking dumb questions.

Too many questions -- have you asked the same questions over and over? Carry a small notebook and write down the answers. No one likes answering "What's the code for the glucometer?" over and over or "Where is the blood bank?" for the seventh time in a shift. Are the questions you asked relevent to what was going on, or just nervous questions? "What was he in jail for?" when you have an incarcerated patient is not the question to ask. "What happens if he's got handcuffs on and he has to be defibrillated?" could be important to know.

You don't ask the charge nurse where to find the bathroom -- charge nurses are inundated with questions all shift long. Ask someone else -- almost anyone else. You don't ask the unit secretary "what's a normal potassium?" or for the code to the med room. But you might ask her where to find the bathroom.

You don't ask the physician where to find Foley supplies, and you don't ask the CNA why the patient is on Lasix. Make sure you're asking your questions of the appropriate person. Also, make sure it's a reasonable time to ask the question. I once had a student ask me if I could help him calculate a drip rate -- the question would have been entirely appropriate and I would have been the correct person to ask -- if I hadn't been doing CPR at the time. Another student followed me into the bathroom and shouted questions at me through the stall -- not appropriate and unprofessional! Don't pester someone who is obviously busy with something else.

As far as dumb questions -- there's a big difference between asking "Mr. U'Rine needs a Foley. What do I do?" and "Mr. U'Rine has an order to replace his Foley since he's been unable to void for the eight hours since the previous shift removed his Foley. I've read through the procedure and gathered the supplies listed, but I've never done this before. I've been checked off in the skills lab, and I'm allowed to place a Foley. Could we talk about it before we go into the room?"

You don't ask questions in front of patients or visitors if it can be avoided -- unless it's something like "Where would Mrs. Wackadoo's family get a family parking pass?" or "Mr. Hambake just asked me for directions to the cafeteria, and I afraid I can't answer that. Is there a family handout with that sort of information?" You certainly wouldn't ask "Mrs. Wackadoo is bat$hit crazy -- can you help me tie her down?" in front of either family or anyone else, for that matter.

Here are other dumb questions I've been asked by students: "Has he/have you been saved?" "How many times has he been admitted to psych?" (The patient was immediately post-op from his valve replacement surgery, still sleeping and on a ventilator.) "Do you have a tampon?" Asked by a MALE student, in front of surgical rounds. And my personal favorite, asked in front of two patients and a roomful of visitors -- "You DO know you're going to hell, don't you?" (He had asked if I was married; I said I was divorced. The first question was inappropriate all on it's own given the time, place, situation and audience, and bad enough. The second got him dismissed from clinical.)