Unsafe student in clinical

[maridion1]

Looking for some input regarding medication administration in the clinical setting.

If you have a student who continually does not know the medications they are giving (even after they have been told they can write it down and have a cheat sheet), when do you say enough is enough?

After remediation and an improvement plan, the student continues to follow the same unsafe behavior. They are passing medication with a preceptor, but have not clue what the med is or why their patient is taking it. For example, one of their patients had Cordorone hanging and they informed the instructor that their patient was on it for "seizures."

Doesn't this expectation of knowing the medication come under fundaments of nursing? How long should this behavior be allowed without failing the course? Does your school have a policy built in place that states this is unacceptable behavior?

[lkwashington]

What semester is the student in? How long have the student been passing meds? Where exactly you all at in the semester? Is it at midterm? This is unexceptable for a student and it looks bad on the instructor in my opinion. Continue to provide the wrong information on drugs that the patients are taking can endanger the patient totally. I would not want this student taking care of me. It seems to me the student is not looking up the information. How is the student performing in the other areas of clinicals?

[caliotter3]

This one is easy. Unacceptable. Document warnings and corrective action as well as expectations for remediation. Boot at end of semester with no guilty conscience.

[llg, PhD, RN]

It seems pretty clear-cut to me. You tell the student what she is doing wrong. You set clear expectations. If she fails to know the meds, she gets an "F." That's what "F's" are for.

If you have a question about the number of chances she gets, etc. ... talk with you immediate supervisor. The school may have a specific procedure you are supposed to follow when failing a student.

In the meantime, you might forbid the student to give any medication (even with a preceptor) until they have demonstrated to you that they know what it is, etc. Until you give the "go ahead," she gives no meds.

[maridion1]

Thank you for the feedback.

This is occurring in the final semester of an ADN program. This student had some of the same issues in a previous attempt of the course.

It is scary that she does not see the importance of knowing the medications that are being given to the patient.

[lkwashington]

This is her final semester, yes I agree it is unexceptable performance in clinicals. So what is going to happen fail or pass?

[Annieb2]

Unacceptable behavior. This student is unsafe. You have warned her, spoken with her, and written her up. Do everything by the policy of your institution. If that means fail her then so be it.

[laughing weasel]

If the nurse does not know what the meds are for then how can they assess for reactions and effect? If you let them by some where down the line some one may die. Teaching common sense and prudence is very difficult.

[BigBadInstructor]

What does your clinical evaluation say? Has this behavior been documented, particularly since this is a recurring behavior that has been remediated and not improved upon? I believe the student feels there is no reason to do better because what she has done has passed her along. At this point if she has not successfully completed the objectives of the clinical, and not successfully passed the medication portion of the clinical evaluation, she should be failed. I would make sure you have your documentation done well, and proceed.

Good luck.

[ebear, BSN, RN]

It is unfortunate that the student has progressed this far in her studies. Surely previous instructors were aware of this situation. They didn't do her any favors by passing her along ( I agree with the above poster). She obviously isn't putting any time or effort into studying this very important aspect of nursing. I would have to fail her..but she really failed HERSELF.