Well, I've done about everything I know to do and I need advise from anyone who can help. I was scheduled to be pinned, ADN RN, on Aug.2 and have finished all classes. I had 6 preceptor days and a couple of clinical days left. A few days ago, I reported to clinical on a floor at the hospital and was given 4 patients. I was only to have had 3 patients, but the "new" clinical instructor said I could take the fourth patient because she was going to be discharged that morning. It was 0630 and I checked the MAR on all patients and was to be responsible for IM, PO, SC, and non-IV push meds from 0800-1300. The extra patient I was given was to receive digoxin at 0730, and the RN did not give it to her. I asked the RN about it, and she said the lady was going home. I proceeded with the other patients and at 0900, the extra patient's MAR was not available. The patient was marked D/C on the nursing board and the chart was not in the file with the other patients. I made sure that the other patients had their 0900 meds, which I had to check off with the instructor. When I got through with the other patients, I asked the instructor about the woman who was being discharged. I knew that the RN had not given her the digoxin at 0730 and was trying to do the right thing. The RN and the instructor nurse looked at each other and the RN said, " Oh, well, go ahead and give her the meds." Now, the patient has already signed the discharge papers and was dressed, and her daughter told me she was going to get the car and they would go home. The RN had to go to the patient's room and get all but 2 medications which were home meds that were brought to the hospital with the patient. There was only Asacol, and Flagyl in the medicine drawer. To make this long story shorter, I was asked to give a discharged patient medication. The woman refused to take the Flagyl and another med, but I made sure she took the digoxin. The discharged patient said she would take the Flagyl when she got home, but she wouldn't take it then. I went back and forth with her, and finally she ended up taking the med home with her. She gave it to her daughter when they went to her car and the daughter came back up and asked if her mom should take the medicine now. I know I made a mistake and signed that the woman had taken the medication, but I have been given a failure for the entire Nur 221 class and will not be allowed to be pinned.
I need to say that the morning that all this happened, I passed a large kidney stone, and my garage was flooded by a broken water line. The next morning after all this happened I was hospitalized for 7 days. In the last 3 years, I have been through a divorce, a parent's death, the other parent's stroke and nursing home admission, I had Whipple surgery and spent 2 months in the hospital ( pancreatic blockage and divism), viral meningitis, raising a 6 and 3 year old, and going to school full time. It has not been nice.
I was in no shape to go in that morning, but I still say that I should not have been asked to give the medication to the patient if she has already been signed out and discharged. By the way, I had another patient who at 1300, was to receive meds. The RN for that patient signed the MAR that she had given the meds, and when I asked her about it, she volunteered that she had "not" given the patient rhe medication, she was going to. So, she signed that she gave it, before she did. Please give me something that may help. I am the only man in my class and I swear that it seems that several of the nursing department persons wanted me to fail, and its not just me saying that..other students said the same thing.
I had a nursing department person tell me that I would have been better not to have given anything to the patient. The only medication that was not the patient's home meds, and that was not taken in front of me was one Flagyl pill. If I had not been thinking about making sure the old lady got her digoxin, my world would not have come to pieces. I have passed OB/Peds, and psych. Some LPN transition students said I should be able to take the LPN boards. I think the instructor and RN know that they should not have told me to give the medications to the discharged patient and the nurse knew she had not given digoxin at 0730, not to mention the other nurse who signed the MAR and admitted she had not given the medication yet. Any suggestions for a guy in SC who is just about to loose my mind
As much as it pained me to read your post, I believe Tweety's post has a few grains of truth.
I feel really bad after reading your post. I got hit in a somewhat similar fashion at the end of last semester. I got an "F" and it derailed a whole bunch of things - I lost my internship, lost the money I could've made from the internship, have to pay exorbitant amounts for summer school, have to scrable and pick up extra hours at my two jobs to pay for all this, and as an added bonus, can't go home for the summer to attend my brothers wedding.
I felt like shooting myself. I felt utterly miserable and devastated.
But I took stock of the situation. Went upto my Dean and assessed my performance objectively. I owned upto my shortcommings (no matter how seemingly trivial) and pleaded my case. They are letting me do the course in the summer again (they didn't have to) and I'm determined to prove to them that I'm an asset to the school.
Again, I honestly don't mean to preach - but you've had a real real real real rough time so far. Nursing school is hard enough without those added misfortunes that you've listed.
All I can say is:
"Believe in yourself, stand tall
Another day it's in your hands
You could be the winner, in the end
No pain no gain"
I wish you faith and courage :) That which doesn't kill you, makes you stronger.
You are expected to be able to practice on your own in a few short weeks and instead fall to pieces with a 3-4 patient assignment.
This is not true.
No new grad that I know of comes straight out of school and into a full patient assignment on their own.
I think the story is still a bit unclear. I think passing harsh judgements does not serve this individual well. Let's try to help him, not spank him.
Another question, OP. Have you ever discharged a patient before this incident? Please answer my other questions on the first page of this thread as well.
Sorry I don't have any real advice but Im sorry this happened:( Try not to beat yourself up to much, I know it will be hard but you will make it through!!! Good Luck!
He admitted his mistakes, realizes what he did was wrong...however don't you feel he was left out to hang but the RN and Instructor. A thought to consider...you send a student to clean up a licensed prof. mess? To me I feel what he did was wrong, however kicking him out of the program is inappropriate, esp. considering the previous mistakes made by the RN and Instructor.
I feel he should be counseled on his poor choice, purhaps do a paper or required to x amt. of additional clinic hours...however he should not be kicked out of the program.
I think what you said was a bit harsh and unrealistic esp. when considering the whole story.
Obvious this man is someone who cares about patients...after all he went to clean up after the RN who didn't give dig...
Annette
In response to Underwater girl,
I'm sure the young man knows all his wrongs,,what I believe he is also asking from us seasoned nurses is,,"COMPASSION" & UNDERSTANDING
When I was a new nurse,many,mnay moons ago,I made mistakes,& any nurse worth their salt will also admit their mistakes,however,the thing to making a mistake,is to turn it into a postive & learn from it.
He knows what his mistakes are/were.
In response to the male nursing student,
I suggest you strongly contact your advisor,& the head of this program.
Your instructor & the other ''RN'',were very much in the wrong as well.
First of all, you NEVER give a med to a patient to take home. That is dispensing medication without a license. Second, you never sign that a person took a med if they did not (which is what it sounds as if you did with the Flagyl). if you gave her the Digoxin and she took that, then you sign that she took it.
I feel that you made a lot of mistakes. I am sorry to say that but by now, you shuld have learned that. I am sorry for all your medical and emotional troubles but they don't really give you an excuse in this instance. You did not use good judgement. Nursing and medicine are all about good judgements and critical thinking skills, neither of which you used.
You will need to learn that you have to leave home troubles at home when you come to do patient care. You have to separate home from work before you can be an effective and safe nurse. If you need help, there is always EAP (Employee Assistance programs). These are designed to help people when they are hurting.
Ops....I'm sorry to Underwater girl,I replyes to the male nursing student about to be pinned,with the med errors,,I meant that reply too Betsrn.
No new grad that I know of comes straight out of school and into a full patient assignment on their own.
.
This may be a regional thing, but many new grads are expected to pretty much be on their own within 4 shifts after they graduate in Canada if they are going to be working on a regular floor. Students in their final practicum where I went to school have a full patient assignment and are supposed to manage it themselves, using the RN as a resource.
I would echo Tweety's post. Try to admit to your mistakes without giving any background stories about how bad you were feeling or anything else. Simply tell them what you've learned from the event and ask to be permitted to redo the course. I would be concerned as your instructor if you were so close to graduating, yet still thought it was ok to lie on your charting, but I don't think that means you shouldn't have the opportunity to prove yourself once more.
I agree with those who think the instructor and the RN were wrong to tell you to "go ahead and give it anyway." What was that teacher thinking? Please let us know what happens!
Regardless of what the instructor told this student to do, it was still wrong and that does not undo the mistake. Actually, the student is practicing under the instructor's license. I am surprised that the instructor would not be more cognizant of what was going on.
If a student does not learn what is and is not acceptable while in school, how is that person going to be a safe practitioner?
This may be a regional thing, but many new grads are expected to pretty much be on their own within 4 shifts after they graduate in Canada if they are going to be working on a regular floor. Students in their final practicum where I went to school have a full patient assignment and are supposed to manage it themselves, using the RN as a resource.
I would echo Tweety's post. Try to admit to your mistakes without giving any background stories about how bad you were feeling or anything else. Simply tell them what you've learned from the event and ask to be permitted to redo the course. I would be concerned as your instructor if you were so close to graduating, yet still thought it was ok to lie on your charting, but I don't think that means you shouldn't have the opportunity to prove yourself once more.
According to a Human Resources person I know at a local hospital here, Canadian grads are far MORE experienced because they do have full patient assignments their last semester in nursing school. I wish our grads were as well prepared.
I am truly sorry for all the mishaps you have recently gone through. I think that you need to sit down and talk to the head of the nursing program. First sit down calmly and document everything you remember in detail in your personal journal. I would then sit with the head of the nursing program. I am sure that something less drastic could be done. It is absolutely unfair to punish you so severely for something minor. I wish you the best of luck. Please keep us posted on the outcome of this :)
I am truly sorry for all the mishaps you have recently gone through. I think that you need to sit down and talk to the head of the nursing program. First sit down calmly and document everything you remember in detail in your personal journal. I would then sit with the head of the nursing program. I am sure that something less drastic could be done. It is absolutely unfair to punish you so severely for something minor. I wish you the best of luck. Please keep us posted on the outcome of this :)
The problem becomes the fact that what happened is NOT minor. False charting is illegal. Giving a med to take home is dispensing without a license. The student did not use good clinical judgement. Clinical judgement is the basis of our profession. You have to watch your back all the time, not only to protect the patient but also to protect yourself as the practitioner.
While I would certainly agree that there was little harm done in this case (as far as harm to the specific patient), one cannot overlook the potential severity of what could have happened. Who is to say if this student does this now, that this same student will not make similar errors in judgement in the future as a graduate nurse? The nursing school has to take a stance or they would have large numbers of students feeling that this type of action is "no big deal." Nursing school is to teach you guys how to be safe practitioners, not to show you guys how you can skate through and cover your tracks.
I would agree that maybe this punishment is far too harsh. But by the same token, I do not feel that this student should graduate now. There is far too much at stake.
I also feel that this particular instructor should be reprimanded for her part in this. Both she and the RN in question are not setting good examples for this student. It is my humble opinion that some instructors are far too lax and therefor, give their students a false sense of security (as is the case here). The last thing a nurse needs is a false sense of security. You have to be on your guard all the time to make sure that you are practicing safely.
This example points up the fact that this particular program needs some intense scrutiny. Are they preparing their students adequately? Is this particular instructor safe and competent?
What bothers me most about this post is that the student who wrote the above is thinking this is no big deal. It could have been a big deal. The point of school is to make us safe, competent practitioners. The object is not to just slide through. I think the response is pretty representative of a lot of the student (and actually practicing nurse) mindset today.
No new grad that I know of comes straight out of school and into a full patient assignment on their own.
I think the story is still a bit unclear. I think passing harsh judgements does not serve this individual well. Let's try to help him, not spank him.
Another question, OP. Have you ever discharged a patient before this incident? Please answer my other questions on the first page of this thread as well.
I think it probably depends on where you begin as far as how big your initial patient assigments are.
Sadly, I think that there are probably some hospitals that are not very kind to their new grads: too bad, too.
As much as it pained me to read your post, I believe Tweety's post has a few grains of truth.
The basis for what I'm saying is people I know who have gone to the state board over events, or sat in on meetings. Things like "the patient ratio was too high that day", "I was feeling real sick that day", "the charge nurse has it in for me", "I was overwhelmed and busy" etc. etc. doesn't fly one bit.
Things like "the instructor has it in for me", "I sick that day", "I was tired from clinicals and doing care plans all night", "my kids are sick", etc. etc. doesn't fly with educators either.
Best to leave all that stuff at the door and own up to an honest mistake, as fergus said acknowledge lessons learned, state how you will do better and not repeat the mistake the next time, and beg for mercy.
Roy Fokker, BSN, RN
1 Article; 2,011 Posts
As much as it pained me to read your post, I believe Tweety's post has a few grains of truth.
I feel really bad after reading your post. I got hit in a somewhat similar fashion at the end of last semester. I got an "F" and it derailed a whole bunch of things - I lost my internship, lost the money I could've made from the internship, have to pay exorbitant amounts for summer school, have to scrable and pick up extra hours at my two jobs to pay for all this, and as an added bonus, can't go home for the summer to attend my brothers wedding.
I felt like shooting myself. I felt utterly miserable and devastated.
But I took stock of the situation. Went upto my Dean and assessed my performance objectively. I owned upto my shortcommings (no matter how seemingly trivial) and pleaded my case. They are letting me do the course in the summer again (they didn't have to) and I'm determined to prove to them that I'm an asset to the school.
Again, I honestly don't mean to preach - but you've had a real real real real rough time so far. Nursing school is hard enough without those added misfortunes that you've listed.
All I can say is:
"Believe in yourself, stand tall
Another day it's in your hands
You could be the winner, in the end
No pain no gain"
I wish you faith and courage :) That which doesn't kill you, makes you stronger.