Should I quit my program?

[cj_94]

Hello everyone,

I have had 2 poor experiences with my last clincal rotations. The first poor experience was with the teacher not really teaching as she was off the unit most of the time and we had no idea where she was. The issue with the first instructor involved a situation where she asked me to do something I didn't feel comfortable doing. I should have refused as she asked me to administer another Nurse's meds to a patient neither I or the Nurse, I was working with was assigned. The situation led to a med error as I gave the patient the correct dose of Tylenol but I underdosed his Gabapentin. The clincal teacher watched me and said nothing at the time until after I got home. The instructor emailed me to inform me that she had notified the head of the program and that I had made an error because that patient's dose of Gabapentin had been increased to 300mg that morning, I felt awful after this experience. The teacher said I would sign a CSP and we would talk more about it at a later date. I signed the sheet explaining from my experience what happend and the teacher added a couple of things to the sheet that were not mistakes. The teacher said that I was clicking off meds for my assigned patient without scanning which was not true. The other two things she said that put me at risk were putting meds in the same cup that I had already reviewed and scanned and not knowing my patient's preferences the first time I was giving her meds. The instructor said she would talk to me about this but never did she was not open with communication when I spoke to her about it she said that "I could kill a patient". I responded that I was well aware of what happ ened and that I shouldn't have been asked to give that patient's meds. I also told her that I have anxiety issues which the teacher didn't seem empathetic.The teacher said "it doesn't matter you will be a nurse in 6 months and you have to be able to anticipate issues as they arise" and essentially insinuated that I'm not cut out for Nursing. The teacher took no responsibility for that error which upsets me yes I made the error to which I took responsibility however, I am the student and she delegated that task to me so she is also responsible. I also don't know how she could insinuate that I'm not cut out for this when she was never on the floor except for when we gave meds.

The second rotation I was honest with this instructor and told her what happened and she appeared to be understanding at the time. The instructor would often sigh or roll her eyes around me and she told me to give patients with dementia full explanations as to what their meds were for. I disagreed with her on that as I have worked in a Nursing home as an aide and I understand the importance of giving simple short answers. The problem with giving full explanations to a patient with dementia is that they may not understand what you are saying to them and you may agitate them. The instructor got irritated with me for looking up agency policy for in and out catherization as I have learned in school that its required to look it up prior. I was awkward doing the procedure as it was my first time and I forgot a couple of steps with regards to setting up and was slightly disorganized. The instructor seemed irritated with me and I was not intentionally trying to irritate her I was nervous and anxious. I did manage to complete the procedure but I had to use 2 catheters because I went into the lady parts with the first catheter instead of the urethra. The teacher seemed okay with me at the time. The next day the Nurse I was with was acting weird and wouldn't let me give any of my patient's meds that I had done the research on prior to my shift. The classmate of mine who was with me on the unit told my friend that the Nurses were saying awful things about me. The classmate asked my friend to tell him not to tell me or report the Nurses for it as she "didn't want to be named or get in trouble". The patient that was in the same room as my assigned patient was uncomfortable and complaining of constipation. I asked the Nurse who was covering my Nurses break if we could check if she had anything for constipation. I checked the MAR and it turns out she had Senna PRN and it hadn't been given in 24 hours so I gave it with supervision and I pushed fluids and told the patient to stay hydrated. The Nurse I was with came back and asked me if anything happend I told her that "the patient in bed B was constipated so I gave her PRN Senna with supervision". The Nurse didn't like that I gave it as she said "you could've made a med error and killed someone". The issue with that is I wasn't doing it to upset the Nurse. I may have stepped on her toes but I was looking out for the wellbeing of the patient. The patient was uncomfortable and complaining of constipation. I was told by the Nurses on the floor that I didn't document my assessments or vitals which is not true. I went on the online documentation system and saved it everytime for tasks I did. The teacher when giving my evaluation was rude and told me that while I was intelligent I lack compassion, empathy and I don't care about the Nursing profession. The teacher then told me that my last clincal instructor was her student and she told me that I take zero responsibility for my actions. The instructor told me that I said "she forced me to make a med error" which is untrue, she was putting words in my mouth. The teacher said that "I passed you but you should've failed, you are unsafe and I'm afraid you will kill or harm a patient". The teacher said "I was planning on failing you from the moment I saw you". I didn't appreciate this so I signed the paperwork and left without saying a word.

I was awkward with the in/out catherization yes but that was my first time doing it. I am well aware that I need to work on my skills as they are weak and have had limited practice due to missing clincals from Covid. I know that I need to work on maintaining sterile technique. I am well aware of what the consequences are regarding not maintaining sterility. The classmate of mine then told my friend that the instructor "put me in my place". The Nurses on the floor made excuses for this student, this student was doing tasks without asking the instructor for supervision. The Nurses and the instructor said that was okay which it isn't as that is against our schools policy. The instructor has to perform a task with you once before you are allowed to perform it with your Nurse. The classmate was also clueless regarding medications as half the time she couldn't answer when the Nurses asked her what they were. The classmate would look to me to answer, she didn't even know when to withold Dogoxin and we are close to starting IP but im apparently the one who is "dangerous". The Nurses even made excuses for her saying it was okay that she didn't know the medications. I am still frustrated even though this rotation is over. Due to these experiences and previous instructors who liked me will no longer talk to me. The fact that I have been told I'm incompetent and a danger to patients makes me want to giveup and has shattered my confidence. I don't even want to continue on with my IP or disclose my issues for fear of judgement. I have strabismus of my left eye and thus only see out of my right eye, I also have fine motor issues from being born at 25 weeks and I suffer from anxiety. The two previous clincal instructors have contributed to my anxiety getting worse, I feel like I have no support.

I am considering leaving this profession for OT/PT assistant or EA as I still desire to help others. What would you do in this situation?

These experiences have been disheartening, I really don't feel like I'm safe or competent anymore. I did want to be a Nurse but now I'm not sure I can or should be based on this. I really want to make a change in other people's lives, I was working as an aide before this and entered Nursing to try and better myself. I have an enormous respect for the Nursing profession and I owe my life to the Nurses that saved me in the NICU. I just wanted to give back but it appears as if it won't be the case ?.

 

[cj_94]

I want to continue Nursing but if this is what Nurses and my colleagues are like, then I have no interest in continuing. The Nursing profession is supposed to be a caring one and neither of these teachers, Nurses on the floor or my classmate demonstrates that they care. The Nurses were acusing me of pulling IVs and NG tubes which is untrue. I never touched a single NG tube or IV, I merely flushed my patients IV port if they had one and the flush was ordered.

[Emergent, RN]

It's very difficult to judge all this from an internet post. I will say, many others have had experiences like this in nursing school. I had an instructor question whether I could ever be a nurse because I bent an insulin needle while drawing up the insulin for the first time.

One mistake I think  I am picking up on from your account is that you were argumentative with your teacher. It also sounds like you made excuses for yourself because you have anxiety issues, you are born early, etc.

It might be that the other nursing students, who you say are making similar mistakes, are performing better in the kissing the instructors backside department. It took me many years to realize how important brown nosing is in the nursing field. The sociability factor is huge. When someone has power over you, it is very important to be deferential.

[JBMmom, MSN, NP]

No one can tell you whether you should quit or not. It's always hard to give advice based on one side of a story. It sounds like a few odd things have happened to you, I've never heard of instructors having students give meds on a patient not assigned to them. That's an issue you might bring up with your school because it would be easy to prove that was not your assigned patient and the teacher had you administer medications.

The dementia patient thing is the school world/real world thing. You are still in school so you need to do it the "school world" way to be successful. And your explanations are probably for the instructor to evaluate your knowledge more than for the patient at this point. 

Of course you're new and learning, everyone gets better with things over time.

As far as medicating the other patient, just NO. You could have passed along that the patient is uncomfortable to another nurse, but looking up a PRN and administering without knowing more about the patient is not something I ever would have done. May the patient is a poor historian and has been having bowel movements. Maybe they have abdominal pain from something else. There's too much going on for you to focus on other people. You need to keep your head down and worry about your patients and practice.

As far as the people, yes, you're going to come across these personalities for the rest of your career. You're also going to come across great fellow nurses that you love working with. It's just like every job in the world. Good luck deciding what you want to do.

[Davey Do]

35 minutes ago, Emergent said:

It's very difficult to judge all this from an internet post. I will say, many others have had experiences like this in nursing school. I had an instructor question whether I could ever be a nurse because I bent an insulin needle while drawing up the insulin for the first time.

Yeah- I was put on probation in my third semester for an innocuous med error. Working full time, doing clinicals, changing residences, and going through a divorce really had me stressed out.

Just another piece of life's adversities with which we have to deal.

[cj_94]

On 12/20/2020 at 10:05 AM, Emergent said:

It's very difficult to judge all this from an internet post. I will say, many others have had experiences like this in nursing school. I had an instructor question whether I could ever be a nurse because I bent an insulin needle while drawing up the insulin for the first time.

One mistake I think  I am picking up on from your account is that you were argumentative with your teacher. It also sounds like you made excuses for yourself because you have anxiety issues, you are born early, etc.

It might be that the other nursing students, who you say are making similar mistakes, are performing better in the kissing the instructors backside department. It took me many years to realize how important brown nosing is in the nursing field. The sociability factor is huge. When someone has power over you, it is very important to be deferential.

I wasn't trying to make excuses though I was merely trying to share things about myself that I struggle with in hopes of getting support. I took responsibility for being awkward and needing to improve with my skills and I took responsibility for my error. I think the first instructor was the one not taking responsibility. I did make the error yes and I made a mistake in not refusing in the first place.

[cj_94]

28 minutes ago, JBMmom said:

No one can tell you whether you should quit or not. It's always hard to give advice based on one side of a story. It sounds like a few odd things have happened to you, I've never heard of instructors having students give meds on a patient not assigned to them. That's an issue you might bring up with your school because it would be easy to prove that was not your assigned patient and the teacher had you administer medications.

The dementia patient thing is the school world/real world thing. You are still in school so you need to do it the "school world" way to be successful. And your explanations are probably for the instructor to evaluate your knowledge more than for the patient at this point. 

Of course you're new and learning, everyone gets better with things over time.

As far as medicating the other patient, just NO. You could have passed along that the patient is uncomfortable to another nurse, but looking up a PRN and administering without knowing more about the patient is not something I ever would have done. May the patient is a poor historian and has been having bowel movements. Maybe they have abdominal pain from something else. There's too much going on for you to focus on other people. You need to keep your head down and worry about your patients and practice.

As far as the people, yes, you're going to come across these personalities for the rest of your career. You're also going to come across great fellow nurses that you love working with. It's just like every job in the world. Good luck deciding what you want to do.

Agreed I probably shouldn't have done it but I was in with the patient on the bed pan and she was having difficulty passing a bm. The next day the patient had 2 large BMs and was far less agitated and was feeling better. I did look up her MAR with the Nurse who was filling in.

4 minutes ago, Davey Do said:

Yeah- I was put on probation in my third semester for an innocuous med error. Working full time, doing clinicals, and going through a divorce really had me stressed out.

Just another piece of adversity with which we have to deal.

What was yours for? I'm not the only one?

[cj_94]

32 minutes ago, JBMmom said:

No one can tell you whether you should quit or not. It's always hard to give advice based on one side of a story. It sounds like a few odd things have happened to you, I've never heard of instructors having students give meds on a patient not assigned to them. That's an issue you might bring up with your school because it would be easy to prove that was not your assigned patient and the teacher had you administer medications.

The dementia patient thing is the school world/real world thing. You are still in school so you need to do it the "school world" way to be successful. And your explanations are probably for the instructor to evaluate your knowledge more than for the patient at this point. 

Of course you're new and learning, everyone gets better with things over time.

As far as medicating the other patient, just NO. You could have passed along that the patient is uncomfortable to another nurse, but looking up a PRN and administering without knowing more about the patient is not something I ever would have done. May the patient is a poor historian and has been having bowel movements. Maybe they have abdominal pain from something else. There's too much going on for you to focus on other people. You need to keep your head down and worry about your patients and practice.

As far as the people, yes, you're going to come across these personalities for the rest of your career. You're also going to come across great fellow nurses that you love working with. It's just like every job in the world. Good luck deciding what you want to do.

In terms of me telling the school, I already tried that and its my word versus the instructor's.

[JadedCPN, BSN, RN]

3 hours ago, cj_94 said:

I want to continue Nursing but if this is what Nurses and my colleagues are like, then I have no interest in continuing. 

Regardless of who was right or wrong, just know you are going to encounter people and situations like this many times as an adult regardless of what career field you go into. I say that to say prepare yourself for it and how you will handle it, because the only thing you can control is yourself and your reactions. That being said, if nursing is what you want to do then don't let a few negative experiences discourage you. Good luck!

ETA after seeing your other post about the glucometer - give yourself some grace, don't be so hard on yourself. You are still learning and that's okay! Take each experience, whether negative or positive, as a learning experience and push forward.

[Emergent, RN]

On 12/20/2020 at 10:37 AM, cj_94 said:

I wasn't trying to make excuses though I was merely trying to share things about myself that I struggle with in hopes of getting support. I took responsibility for being awkward and needing to improve with my skills and I took responsibility for my error. I think the first instructor was the one not taking responsibility. I did make the error yes and I made a mistake in not refusing in the first place.

I don't think you're getting my point, it doesn't matter what your intent was, what matters is the perception of the instructor. I'll bet anything you are coming across the wrong way. I speak from experience because that area of life is not a natural strength of mine. 

You say that you want to share areas of your life in order to gain support. I wouldn't try to overuse the sympathy card. It has its limits. It might be viewed as an innate weakness that you have coordination problems due to your prematurity as an infant. Not everyone is going to want to give you a break because of it. 

[beekee]

On 12/20/2020 at 11:10 AM, Emergent said:

You say that you want to share areas of your life in order to gain support. I wouldn't try to overuse the sympathy card. It has its limits. It might be viewed as an innate weakness that you have coordination problems due to your prematurity as an infant. Not everyone is going to want to give you a break because of it. 

To build on this:  This will sound harsh, but no one cares why you made a mistake, are awkward, have poor social skills or clinical skills, etc. The focus is on the patient. No matter what is going on with you, the priority is patient safety. No one is ever going to sympathize, give you a break or support you if you compromise patient safety.   

If you can’t provide safe care, you need to ask for help. If you don’t, that’s on you.  I get the sense that you are fairly young with minimal to no work experience. You will learn much by listening and watching others instead of criticizing them. 

[Davey Do]

1 hour ago, cj_94 said:

What was yours for? I'm not the only one?

I had two full days of clinicals at Anomaly Memorial Hospital on med surg, back in 1989. The first day, I was Cracker Jack, running around dealing with four patients with IVs who required direct care, and I identified a problem situation with a patient. I alerted the RN and got kudos for my observation and actions.

The second day, I had two patients, totally self care, no IVs, and one was being discharged that day. I gave them their po meds and noticed that I had switched their meds!

I informed the nursing instructor and, as they say, all Hell broke loose. The nursing instructor and I did all the necessary things- reviewing the meds, informing the Doc, generating an incident report, med variation and such.

The Doc, who I worked with later on in OR, said, "It's not that big of deal- the patients were on almost exactly the same meds".

But it was a med error, and I had to deal with the consequences- being put on probation, the feelings of incompetency, and the like.

BTW: that Doc was the only surgeon that I ever worked with in OR who would stay and help clean up after the procedure. What a guy!

Good luck and the best to you in dealing with this situation, cj!