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 ?.

 

[Been there,done that, ASN, RN]

We are kindred spirits. I also can only see out of my right eye... and I was anxious during my first few years of nursing, as I think most of us are.  You had some instructor issues... most of us have.  You only have one more rotation to get through to earn your degree. Don't give up now.

[cj_94]

On 12/20/2020 at 11:22 AM, beekee said:

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. 

I understand what you are saying however there are supposed to be supports in place for students who have disabilities. The school is supposed to set it up and the agencies that have us for placements are supposed to accommodate. During my first hospital placement there was a unit manager that came to us and told us that if we needed accommodations or assistance to let her know. The last 2 placements no such thing has happened. The first two placements I had great instructors who were there to teach, and provide their knowledge and assistance as needed I was not afraid to ask for their help. The last 2 instructors I have had made judgements about me and my fit for this profession without knowing me or actually being on the floor seeing me provide care. Neither of which have been supportive or offered any legit constructive criticism. I understand I make mistakes and I am willing to learn and watch if provided the opportunity.

[Emergent, RN]

I'm fairly old school, and in my day if you were not physically able to do a job you were not given special treatment. Maybe the instructors that you feel have prejudged you are in that school of thought. Not everybody agrees that people with limitations should the accommodated for a physical job such as nursing. One prerequisite for a nurse is mental and physical toughness.

[JBMmom, MSN, NP]

19 minutes ago, cj_94 said:

I understand what you are saying however there are supposed to be supports in place for students who have disabilities. The school is supposed to set it up and the agencies that have us for placements are supposed to accommodate. During my first hospital placement there was a unit manager that came to us and told us that if we needed accommodations or assistance to let her know. The last 2 placements no such thing has happened. The first two placements I had great instructors who were there to teach, and provide their knowledge and assistance as needed I was not afraid to ask for their help. The last 2 instructors I have had made judgements about me and my fit for this profession without knowing me or actually being on the floor seeing me provide care. Neither of which have been supportive or offered any legit constructive criticism. I understand I make mistakes and I am willing to learn and watch if provided the opportunity.

The level of support and accommodation will vary between schools, programs, places of work, and people in charge of providing them. You have already seen a difference in your previous semesters and current situation. Likewise, future employers will be required to accommodate certain disabilities, but it can still work against you. Right or wrong, sometimes people that approach a situation expecting changes to be made for them, valid or not, are viewed as starting out on the wrong foot. You are going to be a nurse and emergencies happen. There's no room for excuses when lives are on the line, so while it may seem harsh and unfair, you'll have to navigate with what you have. Good luck. 

[cj_94]

3 hours ago, beekee said:

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. 

The issue is they only knew of one instance at each where my skills needed work and both could be used as learning opportunities. The majority of feedback given by both was neither constructive nor helpful. The one teacher even said she was planning on failing me before she even saw me work. I have asked my coworkers at the Nursing home I worked at if I'm incompetent and they disagreed they actually suggested the opposite. I have made a couple of errors, however throughout my journey through Nursing school I have never once put the safety of patients in jeopardy. I also never put the safety of patients in jeopardy at the Nursing home I worked at in fact there were countless times that I advocated for resident safety or tried to advocate for them regarding care.

[cj_94]

17 minutes ago, Emergent said:

I'm fairly old school, and in my day if you were not physically able to do a job you were not given special treatment. Maybe the instructors that you feel have prejudged you are in that school of thought. Not everybody agrees that people with limitations should the accommodated for a physical job such as nursing. One prerequisite for a nurse is mental and physical toughness.

That is true, I hadnt done catherization prior to this past rotation and haven't had much practice. I understand that due to my issues it will make things more difficult however this would be the case for any career I could have chosen. There are workarounds for my issues so yes they shouldn't be used as an excuse and I need to try and continue. I have gotten this far so why quit now

[cj_94]

13 minutes ago, JBMmom said:

The level of support and accommodation will vary between schools, programs, places of work, and people in charge of providing them. You have already seen a difference in your previous semesters and current situation. Likewise, future employers will be required to accommodate certain disabilities, but it can still work against you. Right or wrong, sometimes people that approach a situation expecting changes to be made for them, valid or not, are viewed as starting out on the wrong foot. You are going to be a nurse and emergencies happen. There's no room for excuses when lives are on the line, so while it may seem harsh and unfair, you'll have to navigate with what you have. Good luck. 

Thanks for your feedback and I agree! I think dealing with my anxiety might go a long way in helping me as there will be workarounds for the other issues. The great thing about Nursing is there are lots of places to work with varying levels of knowledge and skill base that is required based on job description or area of employment.

[Emergent, RN]

11 minutes ago, cj_94 said:

That is true, I hadnt done catherization prior to this past rotation and haven't had much practice. I understand that due to my issues it will make things more difficult however this would be the case for any career I could have chosen. There are workarounds for my issues so yes they shouldn't be used as an excuse and I need to try and continue. I have gotten this far so why quit now

That's the spirit!

[cj_94]

Thank you everyone for your feedback it is appreciated! I have decided to try and continue to become a Nurse. I have other options if I am unsuccessful.

On 12/20/2020 at 3:53 PM, cj_94 said:

Thank you everyone for your feedback it is appreciated! I have decided to try and continue to become a Nurse. I have other options if I am unsuccessful.

@Emergent @JBMmom @Davey Do @beekee @JadedCPN @been there,done it

[Nunya, BSN]

Stick it out.  Do some of the suggestions here.  I hated school but loved/liked the job.  

[crosstrainer878]

I would like to share the following musings, some are tongue in cheek. 

Just put your nose to the grindstone, be vigilant and precise.  Keep your mouth shut, unless it is to ASK for further instruction or help.  Old school here.  I speak from experience. Patient safety first, get and keep your credentials, and yes as one poster said, kiss-kiss-kiss as much hinder parts as you can stomach.  Nurses, love it, physicians crave it!  Be respectful to the healthcare team.  Watch what you say, and who you say it to.  If you need support, seek it outside of school.  Eventually you will be able to engage with a friendly senior nurse willing to share information and guidance to a new nurse.  Also cover your assets, document the charts appropriately, and watch your back!

Do not give up! I hope this is useful.

Merry Christmas!

[Newishnurse1995]

Girl I still accidentally miss the urethra and go into the lady parts and I've been a nurse for two years. It happens. So what. Nursing instructors can be supportive or absolutely horrible. No in between. I quit my first program because of it and at the time I regretted it. Applied for another program two years later and met a some horrible clinical instructors as well. They don’t go away. It’s unfortunately the culture of nursing school. I had one instructor who did an end of the semester evaluation of me that lasted one hour even though she never saw me do anything. She didn’t know me as a person or what I was capable of so please don’t let the opinions of others get to you if they don’t truly know your character. I would seek therapy for your anxiety. Nursing can be cut throat at times and you often can’t wear your heart on your sleeve. I’m the same way and had trouble with the same thing.