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Thanks so much for the responses in the past. Your posts have brought me to tears just knowing I am not alone and that others have struggled and went on to accomplish there goals. I am so grateful.

2 more clinicals left and I am so happy. I basically have 1 S in Critical Thinking for the whole semester (8 clinicals). Last week she actually gave me my 3rd and final U on my paperwork because I didn't finish it all w/in the 6hr clinical.

In 6hrs we are expected to do assesments, 2 sets of vitals, I & O' s on 5 patients (to be handed in written on forms), AM care (baths and linen change) for all 5. Then on one we are to pull and EKG strip and interpret, prepare a care plan on one with 4 nursing dx's, and write down pertinent medicines and lab values and how they pertain to the patients disease. Then two people a week also give meds for the day and any procedures needed (dressing change, iv starts).

So last week I had medications and a dressing change that took 45min w/ the aid of the instructor and another student. So of course this pushed me back by at least an hour/hour and half. She gives me a U for being late with paperwork. So basically I've failed, but she doesn't tell me to go home. She gives me a load of 5 patients for the day

So I'm kinda baffled that she didn't send me home, but I just sucked it up and did my work. I finished up on time and I had one of my better weeks, but I didn't have meds and any procedures for the day. I also just learned that we can delegate baths to the CNAs if we need help. If I had only known that last week. Really seems like this teacher wobbles back on forth on what is acceptable.

Anyway I am the only one still doing the careplans. I asked a fellow student if I could use her old ones to study. What is really getting up under my skin is that one week I got a NI for using Altered Mental Status for one of my dxs and she wrote, "you can not use this because it is a medical dx". My fellow student had use the same dx and got a S with no comments. What the heck?

I also use one week, Decreased CO r/t COPD e/b low blood pressure. Is this no good?Another week I put Sensory Deprivation r/t extended hospital stay with the assessment of patient has been in the hospital for 2 weeks. She said that the assessment data was weak.

A student said to me the other day, "I don't know why she gives you so much trouble. She really seems to be harder on you than the rest of us".

Regardless, I know I have a lot to learn. I have a 73 in lecture with one more test and a final to go. It is so going to suck if I pull up my lecture average and then fail for clinical. Does anybody come back to finish last semester after failing clinical?

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You should have time to complete your paperwork after you leave clinical. That's how it worked at my school at least. Sounds tough! Definitely go in and talk to the dean of your nursing school about your worries and what will happen if you fail clinical. I'm sure you're not the only one who's gone through this.

Best of luck!!! I hope things turn out well for you. ::hugs::

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Specializes in Hospitalist Medicine.

I'm confused by "Decreased CO r/t COPD aeb low BP". Usually COPD causes an increase in BP d/t lower oxygen levels & decreased activity level.

I could see Activity Intolerance r/t COPD aeb SOB, dyspnea upon exertion.

My suggestion to your other issues is to plan your time management at the beginning of your shift and stick to it closely. Be sure to budget time during each hour to accommodate extra tasks, so you're ahead of schedule. That way, you won't be playing catch-up at the end of the day.

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There is no such nursing diagnosis as "Altered mental status." It's not necessarily a uniquely medical diagnosis, but it's not an approved nursing diagnosis either.

Decreased cardiac output is a real nursing diagnosis and lists possible six related (causative) factors, but not one of them is "COPD." (p 235-236 in your NANDA-I 2012-2014)

There is no such nursing diagnosis as "Sensory deprivation," either. Even if there were, saying that it's because someone's been in the hospital for two weeks doesn't convince me of anything.

So you may feel put-upon and treated unfairly, and you may have a partial point on that, but your nursing plans of care are not making the grade, at least as you describe them.

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I appreciate your honest evaluation of my situation!!! I was not aware that the nursing dx had to be Nanda approved. We aren't allowed to bring books to clinical, but maybe I can memorize some of them.

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Specializes in PACU, pre/postoperative, ortho.

No books allowed but she wants it turned in at the of clinical? Wow.

Maybe copy some of the most frequent used dx from your book to take with you. I used to have a brochure-size card with common Nanda dx given out at school from some sponsor/distributor; quick to refer to & easy to carry.

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It's nuts that your faculty doesn't allow you to use that book, because it's the only place to get approved nursing diagnoses. if they expect you to make them up, they've got it all wrong.

If you are allowed to use a Kindle or iPad, you can download it to that. Or maybe your and your classmates could buy the book ($29 at Amazon, free 20day delivery, or $25 for Kindle) and donate a copy to your clinical floor for the semester, and it will always be there for you.

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No books....really?! Are you expected to memorize each and every NANDA approved diagnosis? Maybe I'm just lucky in my program but in my 2nd semester (MedSurg I) I only have 2 patients and 48 hours after clinical to complete the paperwork which is usually about a 25 page form per patient. I don't understand how they expect you to learn anything if you're rushing to get so many tasks done in such a short time. I understand that as a nurse you will be responsible for that but you're not a nurse yet.

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I agree. It would be so much easier and I definitely think I would be getting more out of it if I could do the careplan at home or have time to use the book there. She said that here clinicals are not run that way. I think she is trying to get us ready for dealing with a workload of 5-7 patients when we get out on the floor. You really run the whole 6 hours and chart on paper as you go. A little here a little there. OH, and I forgot we do a morning and closing note on all 5 patients also and we write them on paper and then have to get them signed of before entering them into the system. I struggle to get it all done and then by the time I get to start jotting down a careplan it is pretty rushed. And yes, I have to pull it from my brain so I need to memorize some good dx's. Thank goodness we only have 2 of these left. You guys, we have 43 people and only 16 people passed the last test. We started with 46 and so far it looks like the graduating class with be about 20. So nuts.

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Specializes in Forensic Psych.

I'm glad you're still here, snowwhite. Hope everything works out well for you and you do end up passing the semester.

I'm going to be honest...I'm so tired of care plans and concept maps that my eyes glazed over your nursing Dx issues, but I defer to the brilliant people here, without whom I'd be lost :)

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