was i wrong?

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Today i had nursing students for the entire shift. at the end of the shift the student told me my patient who is a fresh first day post-op hysterectomy had 380cc out of her JP. i said ok, thinking yeah thats alot but its first day post op. Well her instructor didnt like my answer i guess and made the student go back and tell me again and that she should tell the charge nurse. I ended up just saying ok ill call the doc. So I ended up calling the MD- who pretty much acted like he didnt care and said "uh ok". was i wrong?! should i have been like freaking out about the output? I feel like im so stupid 90% of the time

thanks everyone for your input. The patients vitals were all stable and it was mostly blood being drained. She had a history of cancer and had a TAH. I should have sat and talked to the student your right. I remember being a student and i really try to be nice to them. If they have questions i always try to answer them the best i can. Im a fairly new nurse myself. I guess i was just very irritated by the instructor...not the student. she did a great job

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Lissacheer-

I am sure you are a great nurse! The instructor was probably peeved about something the student did and did not handle it well.

Thanks for being so willing to take on students. I know we are a troublesome lot :-)

If you happen to have an "older" student that hangs on your every word, be good to her! hehe:D

Bblessed

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Specializes in Med/Surg.
I am an end of first year student. I have loved our clinicals, but not all the nurses. Our instructor has 6 students and can't be everywhere at once! That being said.... We are given patients that in "my" mind we are really responsible for. We are to report to the nurse who REALLY has the responsibility of that patient first-- to make sure we are doing all the care and assessments that are required. ( I really do take this serious!! I would HATE to miss something !) If I come to my nurse and say someone's JP is x amt, ( and it is not in the care plan on what is acceptable drainage) I would GREATLY appreciate her/him taking a few moments to acknowledge my concern by explaining the whys and whats of the situation.

What I have NOT appreciated is being made to feel like "I" am the idiot for asking what to "YOU" seems silly and inappropriate. I am a student! What do I really know about post-op JPs? Not much to be honest! Some drains barely register 50 ml after 8 hours. If I saw this lady with a JP nearly full, I would probably come to the nurse asking if that was normal.....( and nevermind looking in my book...I can't find any book that agrees with others!)

I think it would be great if people remembered what it was like to be a student, and cut each one of us some slack... just once that day. :D

And just for the record...When I have a nurse that really acts like she cares that I learn something.. I work my tail off for her. When I am done with my day, her rooms are spotless, urinals emptied, commodes cleaned, beds made,linen closets filled, CS orders filled, charts done,VS done, Bags ready to hang, med sheets done, bagels in the break room and happy aides for the rest of her shift.

Looking forward to being a RN and mentor!

Bblessing

Obviously, bagels are not a requirement...BUT. If you are a student, and at least where I work, the students have one patient and sometimes two, shouldn't you be doing these things anyway? It should have nothing to do with whether you "like" the nurse. It's part of your "job" as a student, also.

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Ahh CherryBreeze,

I will clarify... I just don't do it for the 1-2 patients I have, I do it for ALL the patients my nurse is assigned. Yes, we STUDENTS are supposed to be doing this! ( Not the bagels of course) And, it is just this kind of sweet note you wrote that reminds me of those second type of nurses I deal with. Thanks! :-0

Bblessed

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I now see why GNs have such long orientation nowadays. We bedsides have fix everything those instructors messed up. Seriously, I'd have a little chat with an instructor who wanted to go over my head for something like that. Sometimes it's true that "those who can't, teach."

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Specializes in Med/Surg.
Ahh CherryBreeze,

I will clarify... I just don't do it for the 1-2 patients I have, I do it for ALL the patients my nurse is assigned. Yes, we STUDENTS are supposed to be doing this! ( Not the bagels of course) And, it is just this kind of sweet note you wrote that reminds me of those second type of nurses I deal with. Thanks! :-0

Bblessed

So having an opinion based on WHAT YOU WROTE (as in, I was somehow supposed to infer you do this for patients that aren't yours?) means that I'm some raging *b* of a nurse, huh. That one post doesn't tell you a darn thing about what kind of a nurse I am. It doesn't tell you that I am asked OFTEN to precept both students and new grads, and am both thanked and praised for how I do so. It does, however, tell me how shortsighted and judgemental YOU are.

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Specializes in Ortho, Case Management, blabla.

380 isn't that much, in my opinion. The JP is just doing its job. Obviously the lady wasn't hemorrhaging. There are other nurses I work with who would probably think 380 was excessive. Its really different from nurse to nurse - how we practice, our experiences, etc.

Drainage can even vary from surgeon to surgeon. We used to have one surgeon that would do a knee replacement and his patients would always bleed like crazy postop (we used to call him "the butcher" behind his back). There was another in the same ortho group that would do the same procedure and it was rare to have any drainage whatsoever - one time I asked him about it and he compared bone surgery to creating a work of art. Interesting guy. They both did fantastic work, they both used the same exact DVT prophylaxis, same order sets, same dressings, etc...why the difference? Maybe one was more attentive to hemostasis/cauterizing? I don't know those details. Its not like I'm gonna ask them why the heck their patients bleed so much. Hey, someone just had surgery, they're gonna bleed...In the end the results were the same, and everyone was happy.

Perhaps the nursing instructor was used to working with surgeries that didn't bleed as much, and that's why she was freaking out, its hard to know without knowing the instructor's background.

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Specializes in Emergency Dept. Trauma. Pediatrics.

The student was probably told that x amount of Ml's is ok and that is to high. She probably just needed some real world information if that really was fine, not what the text book said. But I don't think you did anything wrong except maybe address her concerns and explain. Sometimes that is all it takes.

I remember in the nursing home having a patient that had a BS of like 260 and I was all worried and the nurse was like, "Oh honey here in the nursing home we worry when they are over 400, she is fine". Not sure how true that is or not but I did go with what she said.

That said, another time, my second to last clinical shift this past semester I was caring for a PP mom and baby and I knew baby was not ok. No one would listen to me though, it wasn't until the very last 30 mins of the shift the Co-nurse I was with saw how concerned I was and since she was new to the unit herself she finally decided to investigate further. My CI was the nurse manager of the unit as well and we were in Post Conference and my CI was listening to my worries as well. (it was during this time the co-nurse went to charge and went to get another opinion on baby). When I went to leave she called me and said that Charge went and looked at baby and agreed with my findings and they were going to start a withdrawal protocol on baby. It was to bad they couldn't do a MecStat anymore because they baby already had 5 meconium diapers and didn't have anymore.

Sometimes students are blown off because they are just students even though they aren't always new to life. I knew babies and I knew something was wrong.

At the same time sometimes students can overreact and because things are fresh in our head we tend to see it in everything when it might just be OK.

It's a fine line that can be hard on the co nurse and the student because things are so contradictory in the real world compared to school.

I rarely saw my CI when I was on my Med/Surge rotation. My Peds and Maternity I saw all the time because it was a specialized unit we all were on and both happened to be the nurse managers for that unit.

But my med/surge one there were 8 of us spread through 3 different units, we had her pager if we needed her and if we did page she was prompt (if she wasn't in the middle of helping another student) but she didn't hover either. It was nice.

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Specializes in Emergency Dept. Trauma. Pediatrics.
Obviously, bagels are not a requirement...BUT. If you are a student, and at least where I work, the students have one patient and sometimes two, shouldn't you be doing these things anyway? It should have nothing to do with whether you "like" the nurse. It's part of your "job" as a student, also.

Yes we should be. Well I have never done half the stuff that poster just posted because 1) I am always at nights and things are different for the tasks that need to be done and 2) not all of those things are in our scope and some require the Co Nurse to watch over.

But I always try to do everything I am allowed to do when I am with my co nurse whether she is really friendly or not. Shoot if she isn't friendly it's sort of my mission to break her down (not in a bad way) by the end of the shift and smile or something so I try even harder LOL I try to show her although she was stuck with a student it can be helpful. But as a student the best way I am going to fully know what it's like to be the nurse, is to try and do everything I possibly can alone. (that I know how to do right) and if it's stuff more of CNA work I will ask them if I need to be shown something instead of going to my nurse. Shoot the Aides love when us students are there, they get a nice break. I have encountered MOSTLY nice Aides and nice Co nurses.

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Specializes in Emergency Dept. Trauma. Pediatrics.
I now see why GNs have such long orientation nowadays. We bedsides have fix everything those instructors messed up. Seriously, I'd have a little chat with an instructor who wanted to go over my head for something like that. Sometimes it's true that "those who can't, teach."

I think I despise that saying just as much as "Nurses eat their young" and "I pay your salary"

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Specializes in Ortho, Case Management, blabla.
At the same time sometimes students can overreact and because things are fresh in our head we tend to see it in everything when it might just be OK.

It's a fine line that can be hard on the co nurse and the student because things are so contradictory in the real world compared to school.

I don't think its contradictory, I just think there is a huge grey area that students don't get sometimes. The old booksmarts vs experience argument.

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Specializes in Emergency Dept. Trauma. Pediatrics.
I don't think its contradictory, I just think there is a huge grey area that students don't get sometimes. The old booksmarts vs experience argument.

I am meaning sometimes what we are taught in school is contradictory to the way things run in the real world. The real world will completely go against what we are taught. Not everything, but I have seen quite a few test questions that go against what really happens. Nothing that has to do with booksmarts vs experience IMO

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