Not sure where to post this but I saw something today in clinical that was just eating me up. My school has an agreement with a few clinical sites to allow students to return to clinical early, and I saw something today that made me very uncomfortable. A nurse allowed myself and another student to go into her (sedated) patient's room, and offered to let us start an IV. IV insertion is strictly prohibited and the clinical coordinator specifically told us not to even attempt it, as it can result in "major consequences". I told this to the nurse, but my classmate decided to try to insert the IV anyway. The classmate poked the patient 1, then 2, then 3.... until the nurse finally stopped her, at 7 attempts. 7 insertions, including one on a different site which was not cleaned.
The school's clinical coordinator showed up on site about 30 minutes after the event, and she asked me if we had gotten to do any IVs. I had the feeling that she knew about it, and I told her about my classmates IV attempts. It turns out that she had no idea about the event, she just happened to show up and ask. She was angry at me for reporting it and told me not to tell anyone about it, or there would be consequences. The student and I are paired to go into the ED this week, and she was going on about how she hopes that we'll have more tries at starting IVs and that she'll make sure I can do it next.
I have no idea what to do. I feel that if I report it further, the clinical coordinator will do something to take it out on me. I can't stop thinking about how that patient was sedated and didn't have any idea a student was involved in their care, the potential pain, or the risk of infection from all of those repeated insertions, including a site that wasn't cleaned at all.
May I just offer some advice about school? I wasn’t there too long ago. You will see other students do things they’ve been told not to, or even just dumb weird things. Unless it’s something blatantly terrible or abusive, I’d stay out of it. I actually think you did the most “right” and best thing as a PERSON by speaking up. But, as a student, the good ones tend to get wrapped up in these things by association and I’ve seen it happen before.
As a student you just have to get yourself through the program. Always follow the rules and if someone gets upset at you for insisting on following policy, distance yourself from them somehow. I had to do so with a person in school, I knew if I hung around her I would end up in trouble for being part of a situation unwittingly.
I agree with many other posters’ comments about ethical practice. There’s a lot of great advice and comments here about that, so I won’t touch on it.
As I recall, I remember hearing old-time stories of medical residents & other HC students practicing suturings & intubations on cadavers in the autopsy lab. I doubt there was ever any consent given.
? Bodies donated to science?? We went to the UW to see cadavers donated to science for medical students to “practice” on while I was in nursing school . We saw all kinds of things to help us understand anatomy and physiology/disease process. I have wondered if they had any idea what would be done to their body....but it was a great learning opportunity. However, on topic, never 7 sticks by 1 nurse... ultrasound IV starts anywhere else? Again asking was the IV even needed? Had proper sim lab training/ instruction been done? Ethically why would you participate in this behavior... be the patient advocate! Also I see instructors with students in multiple units... safety is a big concern! I tell Instructors that students in our ICU will be observers. Students can help with basic cares under direct observation of the RN for that patient. This after a student ready to graduate was caught trying to figure out how the NG tube syringe fits into the IV port. RN in charge had left for a moment to collect another piece of equipment. Instructor said she didn’t think her student would try to do something like that. But.... instructor wasn’t there...also available by cellphone.
I've never known of a nursing school, including supposedly 'top-ranked' ones that have a clinical instructor to student ratio of 1:1. Usually 1:8 is considered about as good as it gets
Same when I was in school, but the instructor was right there and we did very little without her at our side. All patients (and students) were in the same unit with easy access to help/advice. Instructor always there for our first time IV, NG, foley...and to check our meds (before scanners). It was like she had 16 patients, just that she didn’t do the work. Once you proved yourself to her, you earned more independence. But still knew what we were up to.
by the way, re: the post about being sedated with propofol, please remember that sedation is not equivalent to being pain medicated. The 2 should go hand in hand but pain meds are sometimes forgotten in sedated patients because they don’t complain!! Give your sedated patients pain meds!
I got most of my IV experience when they assigned me to the phlebotomy nurse on her rounds. She wasn't my technically instructor (I had done one with the real instructor) but she let me draw blood/start IVs on the patients she would have done. Yes, they were told I was a student, but I think over the few days I did this, there was only like two who turned me down.
I thought I got pretty good at it, but now I never use that skill (don't know if I'm losing it or not). I never expected to do foleys (only did two in training), but now I do several a month.
..... This after a student ready to graduate was caught trying to figure out how the NG tube syringe fits into the IV port. RN in charge had left for a moment to collect another piece of equipment. Instructor said she didn’t think her student would try to do something like that. But.... instructor wasn’t there...also available by cellphone.
Crazy things CAN happen! One of my LTC/NH pts had the funky-est urine I had ever seen in her SP tubing. Then I noticed how VERY CLOSE the SP stoma was next to her GT stoma! I REALLLLLY suspected that another person may have connected the enteral feeding into the SP catheter! I remember reporting it, but no one else seemed too concerned. (That urine was like opaque milky tan. Nasty looking.)
I've never known of a nursing school, including supposedly 'top-ranked' ones that have a clinical instructor to student ratio of 1:1. Usually 1:8 is considered about as good as it gets. This means that yes, it is the floor nurses the students are assigned to that are supervising the students, and in this case the patient's nurse was apparently supervising the IV attempts.
No, I get that. But from reading the OP's posts, it sounds like their clinical instructor floats through once in a blue moon.
The 7 attempts notwithstanding, I think you are a little troublemaker and you should only stick your nose where the aroma won't offend you. You are a student, do what you are supposed to learn and mind your business.
Just thought your screen name and this post went really well together.
Crazy things CAN happen! One of my LTC/NH pts had the funky-est urine I had ever seen in her SP tubing. Then I noticed how VERY CLOSE the SP stoma was next to her GT stoma! I REALLLLLY suspected that another person may have connected the enteral feeding into the SP catheter! I remember reporting it, but no one else seemed too concerned. (That urine was like opaque milky tan. Nasty looking.)
When I was in school, one of the students drew up Robitussin, apparently planning to give it IV. Luckily we had amazing instructors...”almost” only counts in horseshoes and hand grenades, right???
Specializes in Mental health, substance abuse, geriatrics, PCU.
1 hour ago, LC0929 said:
When I was in school, one of the students drew up Robitussin, apparently planning to give it IV. Luckily we had amazing instructors...”almost” only counts in horseshoes and hand grenades, right???
I believe a large bag of oranges is in order...?
I heard a story once about a nurse crushing up oxycodone, mixing it with water, and administer it through a patient's PICC line ?
I intervened with a nurse that was trying to administer TPN with a kangaroo pump once, that one was interesting.
15 hours ago, amoLucia said:
Crazy things CAN happen! One of my LTC/NH pts had the funky-est urine I had ever seen in her SP tubing. Then I noticed how VERY CLOSE the SP stoma was next to her GT stoma! I REALLLLLY suspected that another person may have connected the enteral feeding into the SP catheter! I remember reporting it, but no one else seemed too concerned. (That urine was like opaque milky tan. Nasty looking.)
My heart sank when I read this, I think your suspicions are probably right, sadly.
0.9%NormalSarah, BSN, RN
266 Posts
May I just offer some advice about school? I wasn’t there too long ago. You will see other students do things they’ve been told not to, or even just dumb weird things. Unless it’s something blatantly terrible or abusive, I’d stay out of it. I actually think you did the most “right” and best thing as a PERSON by speaking up. But, as a student, the good ones tend to get wrapped up in these things by association and I’ve seen it happen before.
As a student you just have to get yourself through the program. Always follow the rules and if someone gets upset at you for insisting on following policy, distance yourself from them somehow. I had to do so with a person in school, I knew if I hung around her I would end up in trouble for being part of a situation unwittingly.
I agree with many other posters’ comments about ethical practice. There’s a lot of great advice and comments here about that, so I won’t touch on it.