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
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.
My thoughts exactly. there will be days when you "fall apart" even after you graduate. You will not be expected to take a full patient load in a few weeks. If you are expected to, run, don't walk to find an employer that is more accomadating to new grads (and has workers that are understanding too!)
My thoughts exactly. there will be days when you "fall apart" even after you graduate. You will not be expected to take a full patient load in a few weeks. If you are expected to, run, don't walk to find an employer that is more accomadating to new grads (and has workers that are understanding too!)
I'm precepting a new grad and the expectation is that after 4 weeks he manages a four-patient load with my assistance. After that we still have 8 weeks together at which time he is expected to be totally independent. We certainly don't expect any new grad to be ready when the graduate, on the job training in the real world, oriented to the hospital is the way we do it.
I also precept students and those about the graduate are taking 4 patients, but certainly not independent of my input, guidance and teaching.
Specializes in Education, Acute, Med/Surg, Tele, etc.
Okay I am trying to clear this up a bit here...OKay so a Dig was not given by the RN...and she was still there when you questioned it??? OKay what about her going to give it, or circling the MAR and saying "not given, discharged" on the back???
Then the other meds..the pt declined...so you should have circled your initials on the MAR and wrote on the back..."med declined, being discharged" and I would have charted (I would have found the chart or completed a nursing note to be put in later by the unit secretary) about the conversation you had with the patient and daughter.
Any instructor that tells you that a discharge is easy has their own waking up to do! Discharges are like a murphys law deal...if something can be seriously messed up, it will be at discharge! The instructor should have been there with you helping you out with this discharge and helping you quell the situation! Yes, you need to know what is going on, but having adequate instruction when you need it is also not that much to ask...it could have stopped this situation from happening!
Sounds like a trial of errors that you were expected to cover and try to work out on your own. Something I wouldn't let a student do without an instructor right there! I would have insisted the RN fix the situation, or have my instructor there saying "I am confused about this aspect, and need some guidance".
Failing you...sounds harsh for this situation...as important as this is with medications...someone should have been there for you since you are NOT an RN yet!!!!
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.
You're right - and I learned this the hard way
But it is still a lesson learnt. "NEVER AGAIN" I say! Once is enough for a lifetime :stone
He's probably not coming back...I know I wouldn't if I was being reprimanded the way he is by some of the posters here. He needs to be supported right now, not torn down. Once someone points out the fact that he made a mistake (which he has already admitted himself), I don't see any sense in other posters repeating the same things over and over to him in such a harsh tone. I would understand if he was saying, "what's the big deal, I didn't do anything wrong." But he's not. He's going through a lot right now, and needs some compassion. My heart hurts for him. I guess I just don't want to judge him because - first of all, it's not my place too...and second, I am FAR from being perfect myself and I know I make mistakes now and will when I become a nurse.
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."
I'm confused about the instructor's role in this. Did the instructor tell you to give the meds too? And did this same instructor report this and get you kicked out of school?
He's probably not coming back...I know I wouldn't if I was being reprimanded the way he is by some of the posters here. He needs to be supported right now, not torn down. Once someone points out the fact that he made a mistake (which he has already admitted himself), I don't see any sense in other posters repeating the same things over and over to him in such a harsh tone. I would understand if he was saying, "what's the big deal, I didn't do anything wrong." But he's not. He's going through a lot right now, and needs some compassion. My heart hurts for him. I guess I just don't want to judge him because - first of all, it's not my place too...and second, I am FAR from being perfect myself and I know I make mistakes now and will when I become a nurse.
I think even those of us who were trying to be real showed some compassion. I reread this thread looking for all those harsh tones, and perhaps there might have been one or two, but a couple with some harshness ended with "I feel for you...etc.".
His last sentence asked for advice. I realize that every single day, the same could happen to me any minute and my career could be over and my license taken away. The human in me appreciates the human in others.
I would appreciate some understanding and compassion if the same happened to me. But don't stop there. Give me some real, practical advice. Because lawyers, bosses and the stateboard aren't going to full of such understanding.
Also, we really don't know the history of this student this last year. This might have been the last straw, as opposed to an error that sponteously ended a brilliant nursing career. Nonetheless to have come so far is indeed heartbreaking.
I think even those of us who were trying to be real showed some compassion. I reread this thread looking for all those harsh tones, and perhaps there might have been one or two, but a couple with some harshness ended with "I feel for you...etc.".
His last sentence asked for advice. I realize that every single day, the same could happen to me any minute and my career could be over and my license taken away. The human in me appreciates the human in others.
I would appreciate some understanding and compassion if the same happened to me. But don't stop there. Give me some real, practical advice. Because lawyers, bosses and the stateboard aren't going to full of such understanding.
Also, we really don't know the history of this student this last year. This might have been the last straw, as opposed to an error that sponteously ended a brilliant nursing career. Nonetheless to have come so far is indeed heartbreaking.
Sorry, off topic. I enjoy your posts.
Hi Tweety,
You are right, a lot of the advice isn't harsh. But some of it is...I guess I was just flabbergasted with what I read from a couple people, and what I said came across as my being disguisted with everyone. Sorry about that. As a matter of fact, when I read your original post, Tweety, I did say to myself, "that's what needs to be said." What you said was informative, but compassionate at the same time.
I shouldn't have taken my frustrations out on everyone. Thanks for bringing this to my attention. :)
actioncat
262 Posts
My thoughts exactly. there will be days when you "fall apart" even after you graduate. You will not be expected to take a full patient load in a few weeks. If you are expected to, run, don't walk to find an employer that is more accomadating to new grads (and has workers that are understanding too!)