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 ?.
OK, so I'm replying as a fellow student. I've been working as a MAP certified direct care staff and in home care for quite some time so I've seen a few things but I'm not a nurse- graduating in January.
I wasn't there so I can't say exactly what has happened, and I'm not saying that you were all wrong or that you should not be a nurse. Not at all- I don't want you to feel like that. The errors that you have made are NOT horrifying- nobody was hurt. Unless I missed something in your post, the actual med error was underdosing the gabapentin and giving a PRN without your instructor's OK. The catheter insertion- that was no big deal, it's not easy. One of classmates is awesome in clinicals and class, but for her first cath insertion, she got so nervous that she couldn't get her sterile gloves on and the instructor had to do it. Not the end of the world- the second time, she got it just fine. I think the best thing to do when you've made a mistake is just in own up to it and not mention anyone else's part in it. It really doesn't matter- you only own your part.
From my experience, respecting and trusting our instructors is very important. I'm not talking blind faith- they want to see us capable of independent thought- but perhaps by looking up that policy, giving that PRN and mentioning your experience with the first instructor to your new instructor in the next term, they felt like you were questioning things to the point where it was interfering with learning, and maybe being disrespectful. Our instructors have a LOT of education and they have worked hard to get where they are. They're human of course, but many times we don't understand what they are doing and may think it's an error simply because we don't know what we don't know.
As I said, I wasn't there and may have missed some details. This is just a guess about the nurses, but the one that was involved with the passing of the PRN may have gotten in trouble. She may have assumed that you had cleared the PRN with your instructor- who knows but that could be why you are getting a bad vibe from the nurses.
I don't think these are reasons to quit nursing but I do think you need to be sure that this is what you want to do. It's a field that expects us to come in, do our jobs, be very careful and responsible, and pull our own weight, no excuses. That's what I expect from myself and my coworkers at my job now. People can be unkind but we're not in school or our jobs to make friends. Most people don't have it in for us and just trying to do their jobs to the best of their ability- our instructors included. And on the floor, very few want to hear anything except "OK, I'll take care of that".
Finish out school by just listening, working hard, and listening some more. Best of luck! We are both almost there! ?
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.
First of all they have to make reasonable accommodations.......you still have to demonstrate that you can safely do a job and not put others at risk. I am a nursing instructor and students are brutal when they make mistakes that threaten their success in their clinical....somehow it is always my fault. I know exactly what you were doing when the nurse expressed concerns about your med pass safety (lots of students do this and seem genuinely confused when I explain why it is not safe practice). I don't worry about students who accept feedback and change their process......but I do worry about the student who wants to focus on why there way is okay. Nursing is high stress, unpredictable, and fast paced. I don't get the sense you are truly taking responsibility for your actions or learning..... your first post was a lot of accusations and very little self-responsibility. Based on what you read......I would encourage you to consider a different field. I think a PT/OT assistance would allow you to do a more predictable, less anxiety inducing role and might suit your individual needs better. Regardless of your decision, best wishes!
First of all they have to make reasonable accommodations.......you still have to demonstrate that you can safely do a job and not put others at risk. I am a nursing instructor and students are brutal when they make mistakes that threaten their success in their clinical....somehow it is always my fault. I know exactly what you were doing when the nurse expressed concerns about your med pass safety (lots of students do this and seem genuinely confused when I explain why it is not safe practice). I don't worry about students who accept feedback and change their process......but I do worry about the student who wants to focus on why there way is okay. Nursing is high stress, unpredictable, and fast paced. I don't get the sense you are truly taking responsibility for your actions or learning..... your first post was a lot of accusations and very little self-responsibility. Based on what you read......I would encourage you to consider a different field. I think a PT/OT assistance would allow you to do a more predictable, less anxiety inducing role and might suit your individual needs better. Regardless of your decision, best wishes!
I understand what you said however, I had not made a med error prior to this and haven't since. The error was a 200mg underdose of Gabapentin which may have made the patient uncomfortable, however that was not going to kill them. I did take responsibility for the med error and learned from it. The last rotation I was on I was missing a med and noticed it instantly and requested that pharmacy bring it up. I was awkward with my first catherization and understand that I need to work on my technique and ensure that I am organized. I appreciate your feedback but I think I should try and stick this out I've done almost two years of school and have worked my tail off.
I want to encourage you not to quit. I’m a LPN and I’m currently In nursing school to become a RN. I know how tough it can be. You can do it don’t be so hard on yourself. You can’t take any of those things back that happen such as the issue with the meds or bad clinical experience. However, you can just try to make the best out of the time you have remaining. Tell yourself now “ I can do this.” Do not hold any grudges against the instructors or the nurses on the floor. It will take time to build your confidence but I know you can be a great nurse one day. Have you graduated yet or how much time do you have left to graduate?
I understand what you said however, I had not made a med error prior to this and haven't since. The error was a 200mg underdose of Gabapentin which may have made the patient uncomfortable, however that was not going to kill them. I did take responsibility for the med error and learned from it. The last rotation I was on I was missing a med and noticed it instantly and requested that pharmacy bring it up. I was awkward with my first catherization and understand that I need to work on my technique and ensure that I am organized. I appreciate your feedback but I think I should try and stick this out I've done almost two years of school and have worked my tail off.
So, It sounds like you have made up your mind. That is great! In this post I hear more determination (though I wouldn't recommend down playing a med error ....simply you learned from it (we have ALL made one) . That determination is what you need to be successful. What I would recommend is from here on out, make the decision that you will take ownership for your learning. Don't focus on how others are doing you wrong...focus on what you need to do to get where you want to be and what you need to do to get there. This is what serve you best. Good luck!
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
First I don’t think that you should necessarily quit the program but I have some concerns on both sides. As a student you gave a med to a patient who was not assigned to you when that patient’s nurse was on break? Though it sounds like you took the right steps, waiting until the patient’s nurse returned would not have harmed the patient. Unless this was specifically delegated to you, you over stepped your bounds. Reporting the complaint would have been the right thing to do. And I think that this was essentially your complaint in the first scenario in your post. You were asked to give meds to a patient who you did not know (with your instructor). Although giving scheduled meds is different from giving a PRN, you still need to know basic history and treatment plan. So back to your first complaint, you stated that you were essentially pulled in to give someone else’s meds. Why? I guess I don’t understand that. The patient’s nurse/student should have given them even if running a little late. Second thing I don’t understand about that is you said the dose had been changed that day....was the order placed before or after med admin? Do you have an electronic med dispenser (Pyxis or such)? The new order should have populated, and only allowed removal of the correct dose & the scanner would have caught the wrong dose (you did say that you were accused of not using the scanner at some point). Also, instructor would be responsible for the med error if she let you give the wrong dose...ie did not stop you. Did she know about the dose change at that time or find out later?
You also posted ”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.” What paperwork were you asked to sign—that you made an error or that you shouldn’t have been passed ? There are programs that keep instructors who have a goal of failing a student a year/semester. There are steps you can take to report this, but be sure you have documentation, and don’t whine! State the fact, show the evidence, and if necessary ask for a third party to attend meetings between you and the instructor. Prove her wrong! Be ultra prepared, and yes, as frustrating as it is, they have the power, so kill them with kindness!
Unfortunately, there are those who persist in “eating our young”...though you haven’t even hatched yet
Best wishes as you continue your educational journey.
Just remember going forward OP, you are a student, you are not a nurse. I would be upset if a student made a decision to give a PRN medication to my patient while I’m on lunch. You have this notion that you were being the proper advocate for this patient. The nurse is the patient advocate, not the nursing student. And while this outcome was fine, you don’t know all the details about the patient like their nurse does. You were wrong and you need to acknowledge that.
With the gabapentin, while yes your underdosing wasn’t going to kill the pt in this instance, if it had been another drug, you could have. That’s where I’m finding your disconnect. It is a big deal. Also, if you were scanning your meds properly, how was this error not found? Did you not read the order before scanning and administering? All nurses make med errors, but they should be very rare. You are being talked to because it’s so very important.
The catheter thing is not a big deal. I’m sure it wasn’t to your instructor either. I thinks it’s a cumulation of things and I will also say you seem quite argumentative.
Put your head down and get through the next semester. I’m sure you can do it, but you need to readjust your focus. You are a student. Truly, you know nothing yet. It’s not a knock on you. Nobody in nursing school knows anything. When you are a couple of years in as a nurse, you will realize what I’m saying here.
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.
You are right. There are many students experiencing great stress right now. However, the expectation for all students should be the same. The reality is that whether you are 20 and living at home with your parents or a 40 year old single parent working full-time with three kids, your expected minimal performance on exams and in clinical is the same. There are some part-time programs or programs geographically closer which are better suited for some students. It is up to you to decide if you need a change.
Hi! BSN student here. I can relate to some of the stress OP's feeling in the clinical setting... My first catheter insertion also didn't go well. I ended up using three catheter kits. The charge nurse was ranting about me to the other nurses.
Interesting perspectives on this post. I agree that it's hard to know the full picture based on one post from one side of the story. However, based on what I've read, I think it sounds like the OP could take more responsibility for her own mistakes but at the same time not be too hard on herself.
I can see the reasoning behind giving the PRN, but I think the previous posters were correct to criticize that decision. Overall, OP comes off defensive instead of accepting of constructive criticism.
I think it's important to recognize your mistakes and work to prevent them. But also, even if you think you did nothing wrong, often, you're better off agreeing with the prof/nurse and thank them for helping you. They may have noticed something you did wrong that you didn't recognize yourself... Or maybe, yes, you did nothing wrong, but it could still be better to try to avoid conflict and draw attention to what they perceive as your mistake.
Anyway, it sounds like you do want to finish nursing school. So do it! You could always try to work outside the hospital setting, if you think it's a bad fit for you.
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 will also build on this, in a positive way. In my experiences, I've been anxious to the point of making mistakes and errors. Did I ever blame it on my anxiety? No. You know why? Because I still caught myself and fixed it.
You can't hide behind excuses forever. I know because I've done it. ? It's something you grow from, both as a student nurse and as a person in general. Own up to your mistakes, and know that IT IS OKAY TO MAKE MISTAKES!
Gosh, if I got dinged for every second foley or IV catheter I had to get or something I dropped and it became unsterile and had to get another, etc... I'd go nuts. As long as you don't harm the patient, the facility will deal with the "shrinkage." You'll get better over time, but you're never going to be perfect.
FashionablyL8, CNA, LPN
142 Posts
OK, so I'm replying as a fellow student. I've been working as a MAP certified direct care staff and in home care for quite some time so I've seen a few things but I'm not a nurse- graduating in January.
I wasn't there so I can't say exactly what has happened, and I'm not saying that you were all wrong or that you should not be a nurse. Not at all- I don't want you to feel like that. The errors that you have made are NOT horrifying- nobody was hurt. Unless I missed something in your post, the actual med error was underdosing the gabapentin and giving a PRN without your instructor's OK. The catheter insertion- that was no big deal, it's not easy. One of classmates is awesome in clinicals and class, but for her first cath insertion, she got so nervous that she couldn't get her sterile gloves on and the instructor had to do it. Not the end of the world- the second time, she got it just fine. I think the best thing to do when you've made a mistake is just in own up to it and not mention anyone else's part in it. It really doesn't matter- you only own your part.
From my experience, respecting and trusting our instructors is very important. I'm not talking blind faith- they want to see us capable of independent thought- but perhaps by looking up that policy, giving that PRN and mentioning your experience with the first instructor to your new instructor in the next term, they felt like you were questioning things to the point where it was interfering with learning, and maybe being disrespectful. Our instructors have a LOT of education and they have worked hard to get where they are. They're human of course, but many times we don't understand what they are doing and may think it's an error simply because we don't know what we don't know.
As I said, I wasn't there and may have missed some details. This is just a guess about the nurses, but the one that was involved with the passing of the PRN may have gotten in trouble. She may have assumed that you had cleared the PRN with your instructor- who knows but that could be why you are getting a bad vibe from the nurses.
I don't think these are reasons to quit nursing but I do think you need to be sure that this is what you want to do. It's a field that expects us to come in, do our jobs, be very careful and responsible, and pull our own weight, no excuses. That's what I expect from myself and my coworkers at my job now. People can be unkind but we're not in school or our jobs to make friends. Most people don't have it in for us and just trying to do their jobs to the best of their ability- our instructors included. And on the floor, very few want to hear anything except "OK, I'll take care of that".
Finish out school by just listening, working hard, and listening some more. Best of luck! We are both almost there! ?