Student RN needing help!

Katie803 · Sep 29, 2011

Does it absolutely have to be a working RN? I am a student in my second clinical semester, but I have a REALLY good example of ethical dilemma that I encountered during my first semester. I was working in a state nursing home that had a lot of patients that were either veterans or had to be at this place due to court orders. They weren't necessarily dangerous, but several residents were there because they were unable to stand trial due to mental impairment. I was at my clinical site and received a large, bulky file for the next day's patient. I opened it up and was surprised to see that the first pages were official letters and statements explaining the the patient's family refused to maintain contact and had asked that no more letters be sent. I was stunned and a little upset. It was sad to think that this man's family wanted nothing to do with him. But then I saw a typed letter from the man's sister explaining why. Apparently the man had a history of mental illness that a psychiatrist thought might be partially related to a stroke the man had had many years before. The woman's letter was very strongly worded and my curiosity got the best of me, so I decided to read the whole thing. The letter explained that the man had been placed in this institute because he had been declared unfit to stand trial for the crime of child molestation and 1st degree rape and sodomy. As I read on, I was shocked and appalled to discover that the man had been accused of committing this crime on his two young daughters. He had begun raping his oldest daughter when she was 7 and his other daughter when she was 4. This apparently continued for several years until somehow it came to light when the oldest daughter was 12.

At that point I stopped reading because I so upset. How could I possibly care for a man who had raped his own children? As a mother this hit me especially hard. I could only think of my own daughter and what my reaction might be if something like this happened to her. After gathering the information, I was still very upset and conflicted. I pulled my teacher to the side and told her about my concerns. She was sympathetic, but told me that as a nurse this would NOT be the first time I was confronted with such an ethical dilemma. Upon deciding to enter the field of nursing, I had made a vow to treat EVERYONE with the same compassion and equality. I didn't have to be his buddy, but I did have to treat him with the same kindness and quality of care that I would anyone else. As I cared for him the next day, I felt torn. I smiled and was pleasant, but made little conversation. This man I was caring for had done something that was totally unacceptable and terrible. The hardest part was when I had to give him peri care. Awful thoughts kept going through my mind as I cleaned him, and I was tempted to give him a good slap on his...man parts. But I did my job and got out of there as quickly as I could.

As a nurse you will face all sorts of dilemmas, some terrible, some heartbreaking and sad. But in the end it is your job not to discriminate regardless of the situation. It may be VERY hard (TRUST ME) but you are bound to do your best. if you have any more questions, feel free to send me a message. Good luck with school!

Student411 · Sep 29, 2011

She did say the question was to interview a nurse

Esme12, ASN, BSN, RN · Sep 29, 2011

I think when nursing students are asked to interview nurses it is meant to be face to face. In this electronic world we live in.....face to face etiquette and interviewing skills are becoming obsolete. Face to face interviewing is a vital skill in the nursing process of caring for a patient. Tons of information can be gleaned from body language in a face to face interaction that as a nurse you need to read to best care for your patient. In this electronic age we exist in, face to face interactions are rarer and rarer but remain vital to the assessment process.

Go to CVS and talk to the nurse practitioner running the clinic, make an appointment with your PCP to speak with his nurse, talk to your local board of health in your town and their nurse practitioner, check the health stop on campus, go to a local urgent care, call the local school and ask for an appointment with the school nurse. I really think perfecting interview skills is vital to the nursing assessment process. :heartbeat

I know:rolleyes:, I get the...."My instructor said it was fine" but ethically I believe that if you deal with the public, have to do very personal things for a complete stranger, and obtain very intimate information for this stranger is a short period of time.....that you need to become accustom to talking and approaching complete strangers.

Good luck!:redpinkhe

locolorenzo22, BSN, RN · Sep 29, 2011

second that. You need to become comfortable talking to people. Call a local hospital, health department, etc and explain you are a student looking to interview a local RN. I know if I got a call and was asked, I certainly would talk to a student face to face.

**LaurelRN, MSN · Sep 29, 2011

i'm a first semester rn student and i need to interview a currently working rn to write a paper for class. i need a complete story of an ethical issue you've encountered (relating directly to patient care), the steps you took to resolve it, and the final outcome. it must be an issue you've faced as a nurse, not the doctor's issue. thank you for your help, i appreciate it!

all i have to say is wow!!! i do believe it says interview...yes, that does imply face to face- yet as a student who worked fulltime, managed school, and had children- i understand the possibility that you don't have time to "schedule with your pcp" or the neighborhood clinic. just my :twocents: , so please no one take offense.

ethical?? there are so many. as a nurse, i deal with issues daily. a big one. dnr. our facility does not recognize a signed state dnr once the patient is past the emergency room. so, this mid 80's gentleman comes in- sob, in chf exacerbation...admit to icu...duh! what??? hello...dnr- signed by him!!! nope- policy says md must sign a dnr order and have a consulting md agree...ugh!!!! no!!! that is not how a signed dnr is handled. this went back and forth for like 30 minutes...of course, while we put this poor guy on bi-pap, lasix gtt, foley, aline- levophed- whole works...he ends up needing to be tubed- and of course no active signed dnr by 2 md's in place...you guessed it- he gets put on a vent. i tried to have ethics come and intervene to no avail. family got there and kept him on the vent for 10 days. he gets pegged and trached...very sad...he ended up dying 3 days after the peg and trach....

i did what i could do. i stood up for my patient and told the docs this was worng...no one listened.

i called house sup...no one listened...

i called ethics...they didn't get there in time...

there are times as nurses- we stand up to an ethical dilemma and no matter what you do, it is not going to change the course of action. however, knowing in your heart that you did the right this does matter!

SeeTheMoon · Sep 29, 2011

OP, Please forgive me for highjacking your thread but I just need to say this.

1. The poster's name is JuliannaH. In her title, she put "student RN." This does not in anyway imply that she is attempting to call herself an RN. It is clear to most people in any general population after reading her statement, that she is a "STUDENT RN." Meaning, she is a student going for her RN. I could not agree with Bortaz's post more.

2. She is not asking someone to do her homework. her assignment was to interview a nurse about an ethical dilemma they have dealt with. Can someone please explain to me how her asking this question, is asking someone to do her homework for her. She did not post "please answer this question for me." Would it be better to interview someone in person? Probably so. But can we please have a little sympathy for a mother, who is in nursing school (remember how hard it was for you??) Can we please get off this "do it on your own, tough it out" mentality?" No man is an island.

I see this attitude all the time towards students on AN, and frankly, I just don't understand. Yes I am only a student too, so maybe my two cents are irrelevant. But I just don't understand why so many experienced nurses want to find any and every way to attack the student nurses when they reach out for help.

From reading this post, I do not in any way get the impression that the OP is the nurse who will "sit at the desk while the rest of the nurses work." I get the impression that she is a student who is looking for information for her paper. Which she was asked to do.

I really hate to say this, but I'm starting to understand where the phrase "nurses eat their young" comes from.

No doubt I'll get flamed, but I just don't care. I know all the experienced nurses on AN are not like this. Please understand, that in many ways you are all we've got. Even on a forum. Instructors are great, lectures are great, but no new nurse will learn from these the way she will learn from his/her experienced colleagues.

Esme12, ASN, BSN, RN · Sep 29, 2011

This is a common complaint around this forum, but I think the reality is that a large majority of the people who do this do not do it as some nefarious scheme to fool someone into thinking they're a nurse. It's just not an issue that people just starting in nursing school even consider or understand.
A new nursing student calling herself a "student RN" or "getting her RN" isn't trying to steal any of your thunder, and sure as hell aren't breaking any laws. It's semantics, pure and simple, and it is ridiculous how offended some of you get over this issue, IMO.

I'm not offended at all but I understand her point. To be registered you must pass a test and recieve a registration number from the state that certifies that you have passed and can practice nursing. Technically speaking they are student nurses in a nursing program. Have you noticed that they are all Schools of Nursing and NOT Schools of Registered Nursing? that's because you can't be a Registered Nurse until you are registered.

There are many states if not all states that restrict BY LAW who can call themselves "Registered Nurse" so yes it is unlawful to call your self a RN when you aren't registered.

To see the Moon......yes I do remember what is was shen I was in school and that I had to find the time to interview someone face to face. I am distressed with some of the graduate nurses and their timidness and unwillingness to interact with patients in a non techincal setting and are extremely uncomfortable in the admission process and any process that requires face to face interaction.

I stand by my original statement that

I think when nursing students are asked to interview nurses it is meant to be face to face. In this electronic world we live in.....face to face etiquette and interviewing skills are becoming obsolete. Face to face interviewing is a vital skill in the nursing process of caring for a patient. Tons of information can be gleaned from body language in a face to face interaction that as a nurse you need to read to best care for your patient. In this electronic age we exist in, face to face interactions are rarer and rarer but remain vital to the assessment process.

Go to CVS and talk to the nurse practitioner running the clinic, make an appointment with your PCP to speak with his nurse, talk to your local board of health in your town and their nurse practitioner, check the health stop on campus, go to a local urgent care, call the local school and ask for an appointment with the school nurse. I really think perfecting interview skills is vital to the nursing assessment process. :heartbeat

I know:rolleyes:, I get the...."My instructor said it was fine" but ethically I believe that if you deal with the public, have to do very personal things for a complete stranger, and obtain very intimate information for this stranger is a short period of time.....that you need to become accustom to talking and approaching complete strangers.

I am not trying to make her life miserable but ethically I feel obligated to encourage her to get out there and talk about this face to face with nurses and start getting her interview skills in order. I am not doing this to be mean I really feel it's as much of a skill as taking a blood pressure and one she will nedd the rest of her career.:)

mazy · Sep 29, 2011

What's great about talking face to face with people is that an interview becomes a dialogue. The student can ask probing questions, go into detail about the nurse's frame of mind, the kind of person he/she is, get a sense of who they are as a person as well as just a nurse. There is a lot of a person's history, background, experiences, belief systems that go into forming an ethcial decision. It's not just something that can be summed up in a paragraph or two.

It also doesn't take that long for that kind of exchange to take place -- half an hour, an hour maybe.

There is a back and forth that can help a student understand who they are and how their own experiences will be shaped, and are in fact being shaped in the moment of the interview. It is not just about learning about an example of a situation that occurred to someone else, it's about having a conversation about how people become who they are and how that affects the way they do the job.

Something like that cannot be conveyed if someone just writes up an experience and hands it over. It shortchanges the nurse, the student, and the experience itself.

And of course, that kind of dialogue between two different people in two different places in their lives is essential to the work of being a good nurse.

Student411 · Sep 30, 2011

To OP, good luck in finding someone who is willing to help you :)

JulianaH · Oct 1, 2011

Wow, I'm a little overwhelmed here. I didn't realize my post would cause such a stir. I'm actually really upset. I didn't mean to offend anyone, I understand that I'm not a RN, and I'm not trying to convey that I am one. I know that I have to put in the work and pass the boards before I can have that title. This was my first post ever, and I caught my mistake, but couldn't fix it, so I'm sorry to those of you that have a problem. Secondly, I'm not LAZY to those of you that implied that I am looking for my paper to be handed to me on a silver platter and that I'll be a "desk nurse"...I work very, very hard. I've worked very hard to get to where I am, so please don't assume you know my work habits simply because I asked for help on a forum. I have 3 young children, I work, and I go to school. Once I get the ethical dilemma from an RN, then it is my responsibility to research articles regarding the issue, and write an analysis/synthesis. The interview is just a starting point. And yes, my instructor did encourage us to come to these forums for help, so that's what I did. I agree, that face-to-face interview is the best, and I am certainly not afraid of interviewing anybody. Spare time is not something I have a lot of at this moment. I debated even responding here, considering my time crunch, but I feel like I do need to stick up for myself, since some of you so easily beat me down. I won't be looking for anymore responses here, so if you feel the need to belittle me some more, don't waste your own time. Thank you very, very much to those of you that offered support and help. I truly appreciate it!

dancinglamb · Oct 1, 2011

Juliana-

Would you be willing to send me your email? I am happy to discuss a dilemma but not on a public board.

Thanks!