termination from nursing school

[cwgirl7]

i'm in a very difficult situation and would like some advice from other nurses or anyone who has experienced a similar situation. to make a long story short, i was terminated last week from an accelerated second degree bsn program, and we only had four more months until graduation. i had been having a conflict with the clinical instructor for quite some time, and she had told at least two other students that she didn't like me. she would follow me around in clinicals and look for things that she could "write me up" on, and would document everything i did, and send it to nursing admin. i have a quiet personality and she made it known that she had a problem with this, but i would like to note that my grades were very good throughout the whole program. also i feel that we were given inadequate instruction throughout the program on several skills, but an example of one skill is administration of iv medications. our skills lab for this skill consisted of the instructor having us draw up 1 ml of saline into a syringe, and inject it into a port that she had hooked up to a bottle, and that was the extent of her physical demonstration of giving iv push medications. she did not show us how to dilute iv medications or what port to inject into, etc..., but i was tested on these skills. at the hospital, when i was required to give morphine iv push, i told her that i was not comfortable with it, and needed further instruction, and i also explained this to the rn that i was assigned to. the rn that i was assigned to offered to go over this skill with me, and show me, but the instructor refused to allow her to, and said that no she had to be the one to be there. in summary, the instructor was there with me when i administered the morphine, but after i had given it, the instructor said that i had made an error, and then wrote me up, and sent me home from the hospital. i was later terminated from the program that afternoon. so my question is, do i have any recourse, and has anyone experienced anything similar? what is anyone else's experience with iv medications instruction and were you taught things like how to dilute iv medications and what port to inject into by the instructor? any feedback would be appreciated.

[steelcityrn, RN]

I would consult a lawyer. I assume you have paid this school a hefty sum so far, and your grades were good. You, being a quiet type person may have been bullied in a way by this instructor. For her to stand over top of you as you gave the morphine, then to tell you that you did it wrong, I would want my lawyer to find out was was wrong, and how could she stand there watching you perform a skill wrong. I don't know if were missing some of this story, but from what you have written it seems you were targeted to get knocked out of this class before graduation. Good Luck to you.

[Black Jade, BSN, RN]

When I was in Nursing school we used to be evaluated every week along with our careplans and our clinical instructor would give us a Satisfactory, Unsatisfactory or Needs Improvement. Three Unsatisfactory were bound for dismissal of the Nursing Program. In my last semester, I had a clinical instructor who was very intimidating and one time humiliated me in front of the other nurses because I forgot to turn my patient every two hours (my patient wasn't really bedridden) and I wasn't prepared fo an answer when she asked me what each medication was for before giving it to the patient. In front of the other nurses, she told me that she didn't think that I was ready to graduate. Well, that got me bummed out.

What I did the next day, I went straight to the instructor and asked to speak to her. I thanked her for pointing out my mistakes which I took accountability for. However, I also told her that the fact that she humiliated me in front of everybody was not professional. I was ready for her to sent me home, but I didn't care. She, in fact, apologized to me and had been nice to me ever since. When it was time for that week's evaluation, I was expecting a U, but instead she gave me a "Needs Improvement" instead. At the end of the semester, she wrote me a nice evaluation and gave me a hug.

I'm sorry that your experience didn't turn out well. But I hope that you gather enough proof and even witnesses. The fact that she said that she "didn't like you" was unprofessional. Make sure you document everything and go straight to the Dean and get yourself a lawyer. As far as you making an "error", there are a lot of nurses and students who had made a lot of errors but do not get fired or get suspended from the program; they just get a warning unless the patient was harmed in some way. If possible, get in touch with your previous clinical instructors to meet with you and the Dean. Or if you kept their evaluations show it to the Dean as proof that you are a diligent and a hardworking student whose ultimate goal is to become a great nurse.

Keep us posted on your outcome and Good Luck!

BJ

[xluescluesx]

I agree with Dazglue above. I'm sure there is an appeal process at your school and I don't see why you should be terminated unless you really hurt someone. Sounds to me like you might have a case.

[netglow, ASN, RN]

OK, so my reason for going to the top. I know that many nurses are totally bat "you know what" crazy. I am a second career nurse, and I still look wild-eyed at many in this profession in wonder why they are allowed to well, be around needy people. By taking your case OUT of the nursing department you will be able to work with reasonable people.

:igtsyt:

[jjjoy, LPN]

I'm so sorry about the dismissal. I didn't have to deal with dismissal and I still feel rather angry about the sometimes mercurial clinical evaluations and sink-or-swim nature of some nursing 'instruction'.

I agree with the others to appeal the dismissal. For myself, I'd have to try to keep in mind that justice isn't the goal, but being admitted back into program is. I would so want to show how I didn't deserve the dismissal. The instructor wasn't fair. The school didn't prepare me well enough. But making such points won't get you any closer to your goal.

A focus on "What can I learn from this?" and "What can I do now?" is what many nursing educators are looking for in students. How could the school/instructor better serve the students to prevent such problems in the first place? It's a valid question, but beside the point and best avoided when addressing your dismissal.

If you address your concerns professionally and from a position of personal responsibility, that may be just the ticket to a second chance. I recognize that the dismissal may not have been warranted in the first place and/or was unfairly applied (ie if you did 'deserve' dismissal then so does over the half the class). I just think you'll be better served to appeal the dismissal on the grounds of showing that you have what it takes to be a nurse (a strong sense of personal responsibility, initiative and self-directed learning) as opposed to on the grounds of why you didn't deserve dismissal.

No matter how it goes, this unfortunate experience can make you a stronger person. It really *can* be a positive for you in the long run. Best wishes!

[Horseshoe, BSN, RN]

Wow, I guess I have been so incredibly lucky, both in my nursing school experience and professional life. The instructors and administration at my university were very, very supportive and nurturing. Pre-nursing school was a brutal weed out. Once you were in nursing school, they did everything possible to ensure your success. We did IV push drugs with our clinical instructor the first time or two, and then were certainly allowed to push with our preceptor RN-after all, they were there to teach us as well.

I got so stressed with working, taking care of two toddlers, and going to nursing school that I decided to withdraw from school. The Dean of the nursing school called me to her office and was very firm in stating that they were not going to let me do that-I was doing too well for them to let me get away. I quit my job and took a semester off with no penalty, then began again refreshed. I am so grateful to those wonderful people at my school. They would never have dismissed a student that close to graduation without working really really hard with her to get her up to snuff!

As far as the morphine incident, I agree with another poster. Your clinical instructor actually stood there and LET you make an error worthy of being written up? She LET you do something that could impact patient safety?! That is crazy, it's unprofessional, and a huge disservice to the patient. She needs to be reported.

Don't let this go. You've come too far and invested too much in your career to just slink off dejected.

[AOx1]

I am a nursing educator and have a few pieces of advice that I hope will help you.

First, I would look in your student handbook about any policies you can find related to clinical failure, program failure, and appeals. This will be what will guide you through much of this, whatever the outcome. You need to know their policy on clinical performance first, so you can show whether there was any deviation from their policy. For example, if it says students will be first counseled or warned and you didn't receive this, you have good grounds for appeal. I would also pull my course syllabus to look for the same things. Then I would suggest that you look at your course schedule. What type of reading was assigned regarding IV push medications? Were there any videos presented? Did you receive a drug book or education on IV push rates in your pharmacology class? I would document any/all preparation that you did prior to coming to the skills lab, and what occurred during the skills lab.

One thing that I couldn't quite tell from your post was the exact conversation you had at clinicals. From an instructor's standpoint, there is a big difference between saying "I don't feel comfortable with this skill" and saying "These are the steps as I understand them (list steps, including what your drug book says about diluting the med and how fast to push it." I always ask my students this prior to entering the room so I am confident that they know what they will be doing and that they are safe. Your teacher should have done something similar.

Also, I would gather statements from any/all witnesses that heard your instructor say that she didn't like you. This is never appropriate.

Finally, look at your appeals process. How do you file an appeal? Most of these policies are extremely specific and often have deadlines such as stating how many days you have to file an appeal. Follow these steps and keep proof. For example, if it says to file a written appeal within 10 days, mail it to them via signature confirmation or similar services so you have proof. Also, see if the school has an ombudsman. If you want an attorney, consider contacting your local legal aid chapter to see if you can get one for a lower cost or free.

[roser13, ASN, RN]

You've received good advice. I will add one thing: Do not assume that you are alone in fighting the administration and/or this instructor.

For all you know, your case might just be the one that tips the balance for the school in terms of investigating this instructor's methods of operation. Administration may be aware of underlying issues but have chosen not to investigate, or are searching for a concrete reason to investigate. You really have no way of knowing if you're the first or the 15th student to suffer at the hands of this instructor. Please do not just accept this expulsion because you feel that you are alone against the almighty institution.

[livelaughlove09]

As far as the morphine incident, I agree with another poster. Your clinical instructor actually stood there and LET you make an error worthy of being written up? She LET you do something that could impact patient safety?! That is crazy, it's unprofessional, and a huge disservice to the patient. She needs to be reported.

Don't let this go. You've come too far and invested too much in your career to just slink off dejected.

I agree with the above. Never even mind the fact that you're four months from graduation and this happened which makes me sick to my stomach to even think about.

I can almost only utter "Wow, just wow" when I read all this. There is absolutely no way in this world one of my nursing instructors would stand idly by and WATCH someone making a med error without trying to stop it and correct it. We do EVERYTHING slowly, and talk through the process before hand and answer a bunch of questions about what we're doing, why we're doing it, what effect it's going to have, what adverse effect it could have, and what we're going to do about it if it does. We also work closely with our nurses and our instructors let us do things under the supervision of our nurses if need be (if they're tied up on another procedure with another student perhaps), after all, that is THEIR patient that they're responsible for and there's no doubt in my mind that they're a little nervous about what we're doing to their patient while they're not watching. It's also a good way to show your nurse that you're not totally incompetant and you can be a big help to her, lol. Of course the instructors prefer to do it with you and not have to have the nurses answering a million questions while they're taking care of 4 or 5 other patients at the same time.

Just yesterday I asked my nurse to watch me administer tube meds in case I had any questions regarding them, and I'm glad I did, because I had never seen that type of tube before and would much rather ask a question and have direction than to risk doing something wrong. And that's exactly what I told her. She said she'd much rather have me ask a question than to do something wrong. There's just NO WAY they'd stand there and purposely LET me do something wrong. I'm appalled that any nursing instructor would jeopardize a patient's status, their own career, and a malpractice suit just to find a way to dismiss a student they didn't exactly adore.

All that being said, we do have a procedure at our school to appeal anything, and it's in our handbook. We also have a review panel consisting of administration, instructors, and also students who were voted upon to sit on that committee if we don't like a decision that's handed down from whoever it is that makes that particular decision. I would certainly refer to your student handbook and follow the appeal and grievance procedures.

I'm still shocked.

[labelle777]

As a student your professor is supposed to guide you through the process if necessary, not wait for you to make a mistake and then try to get you out of the program. That is not a basis for termination. Did you fail any of your nursing courses (Clinical or Lectures)? Usually, if you fail 2 classes in nursing school ("C" or lower) then that is a basis for termination from the program, not making a mistake in clinical. Even the best nurses occasionally make medical errors, it does not sound fair.

[cwgirl7]

Thank you to all of you who have responded to my post. I will take all into consideration as I prepare to meet with the school this week and will post the outcome of the meeting. Thank you again.

[backatit2]

wow - i REALLY feel sick for you. four months from graduating and this happens? ugh!

i agree with the person who said contact an attorney. you've worked too hard for too long to take this lightly.

BUT as an alternative - is there an instructor who you've bonded with or you really trust that you could go to? i have a teaching degree, and when i was doing my internship/student teaching i had an issue with my mentor teacher whose classroom i was in every day/all day for several months. my supervisor who was employed by the university to come evaluate me which consisted of observing my lessons AND meeting with my mentor teacher practically tore me apart after our second meeting. i had never met this woman as she was newly hired and most of the student teacher supervisors were instructors and actually KNEW the students they were observing/supervising. basically, my mentor teacher (an early 60s woman) who seemed to hate her job - (you know those teachers you had who you wondered why they ever became teachers) - had said that i seemed stressed out and "snappy" - not with the students, but with her. she said i was wonderful with the kids and academically i was doing great. i told my supervisor that was NOT true! i told her i might seem uptight because my mentor was so strict with the kids that it made even ME uncomfortable and i felt like i was walking on eggshells and i always had a judgemental eye on me. she basically told me that i needed to change, it was my fault, etc. i had brought this woman breakfast numerous times, bought her an "appreciation book" for being my mentor, and would always come in and say hello with a smile (even though she wouldn't look up from her desk half the time). it was not ME who needed to "try harder."

i was devastated. i thought, "this bytch is going to ruin everything i've worked so hard for." in reality, i think she HATED it bc the students loved me so much and i was EFFECTIVE without being evil like her. i knew if my supervisor knew me that she would know this was the case, but she didn't know me - and she held my success in her hands which she was basing on this witch's opinion.

i immediately emailed a former professor who i knew and trusted to set up a meeting. i told her everything that happened and she was shocked. she knew me enough to know that i wouldn't be "snappy" to my mentor even if i wanted to because i'm too smart to be snappy to the person who holds my future in their hands. basically what happened is she contacted another professor who knew me well along with the head of the department and told them the situation. she told me (off the record) that they weren't surprised at all about the account i gave of my mentor teacher and i was right that my supervisor was new and didn't know ME so she was of course taking this "old, veteran teacher's" opinion as the truth.

i don't know if anyone ever confronted my supervisor (and i really don't think they did) but the professor i confided in kept in contact with me and supported me throughout the rest of my internship and so did the 2nd professor she told about the situation. i never actually spoke to the head of the department, but she DID have to go over our evaluation records and sign off before we could graduate - so if there was anything negative at all (and i'm sure there was) she was at least aware of the REAL situation which could've determined if i graduated or not. now, of course i took this action at the first sign of a stinch - and it's a little too late for you now, but i think when you first heard that she was telling other students "she didn't like you" it would've been wise to take a similar route. unfortunately, when you wait until something really bad actually happens - it can look like everything you say is an attempt to just get out of the ugly situation.

i know, that's not helpful to you NOW. but if you DO have a professor or former professor you feel you can confide in, it may be wise to take that route. professors usually know all the other professors in the department and won't be surprised by what you say if it's accurate.

if that's not an option - then again, get an attorney. this is way too serious and you've worked way too hard to let this go.