Yesterday, during a med/surg clinical, a fellow student of mine went into their patient's room and took a BP. It was low at 88/44. The student then went out to get the patient's AM meds and asked the nurse if she should go ahead and give the patient's hypertension meds. The nurse said yes (!!!) and the student gave the med.
I bet you can guess what happened next? The clinical instructor came around and the student told her what she did. Of course the instructor FLIPPED out on the student and told her that she may have just failed clinical (and said she didn't trust the student anymore).
But the student feels like she did her best by checking with the RN before giving the med. Oh man! This is just one of those instances of not THINKING, ya know? (We have all been told to call our instructors when we question stuff...yet, she DID ask the nurse, as Sean in a comment pointed out.)
So, another one bites the dust, it looks like. The instructor is going to think about things before deciding about failing this person, but the student had already been written up for a med error so it looks like this is the end of the road for her. Sad but unavoidable.
And I feel like I learn a lot from these other people's misfortunes! What NOT to do...
Meanwhile another classmate of mine was on her toes in clinical and caught an MI as it was happening in a 99 year old patient. Pretty cool.
3.31.2007
Uh-oh
Posted by Prisca: at 2:46 PM
Labels: Classmates
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5 comments:
88/44 is definitely fairly low. Was there an order to hold the med if the BP is below a certain level? If so, then it was definitely a med error. Otherwise, it is perhaps a lapse in nursing judgment.
Thankfully I had fair nursing instructors throughout my education. If I had discussed the med with the RN and her instructions were to give it...and I did...they wouldn't have held it against me. Althought, they may have gone through the issue and used it as an teaching opportunity.
As a nursing student you are so incredibly vulnerable to the decisions of those around you. If you ask an RN if you should give a med, you tend to trust the answer they give. The fact that she even asked showed that her clinical judgment was sound.
Man...I hear so many stories like this coming out of American nursing schools. Stuff like only 25% of those that start the programs start...that's insane! No to mention unjust.
When do the schools start taking responsibility for educating nurses? Instead they just continue to set them up for failure, and seemingly take pride in doing so.
*sigh*
I think I will blog about this tomorrow.
I don't think clinicals are all THAT different. However, the horror stories are few and far beetween. On top of that, failing wouldn't get you kicked out...you would just repeat the course/clinical.
The only real big difference is that in Canada, nursing schools are almost exclusively Bachelor's degrees from university. Diploma programs are almost unheard of...and there's no such thing as ADNs.
Also, there's more of an emphasis here on public health nursing, nursing research, and psychosocial issues.
Otherwise...nursing is nursing...doesn't matter where in the world you go. So we all have to learn the same skills in clinicals.
I just think our nursings schools seem so much more kinder and gentler than the American schools I hear about. About 95% the 150 nurses that started my year finished. Those that didn't were because they moved or decided nursing wasn't for them. Sure, it was tough, but nobody lived in fear that they wouldn't one day be an RN
I can see both sides... I see that the RN told her to give the med, that's a great point. But I'd like to think that a BP that low would have caused me to call my instructor first. At the very least, I would have told the RN that I was uncomfortable and have her give the med.
As nurses, we are the last line of defense against any kind of order error. We have to use our brains to ensure patient safety, and not just follow someone else's orders. We're all responsible. All easier said than done, I realize.
I feel bad for your classmate, I hope everything works out for her. I don't necessarily think she should be dropped from the program you're in. This will definitely be a learning experience. And a good reminder for me too!
I love your blog! Best of luck to you!!
Wow, my nursing school (accelerated BSN) isn't as strict as this. If we mess up, and it takes alot, then we just fail the class and have to retake it. You don't get kicked out! Sheesh. And I think thats a big problem with nursing students today. Too many worry too much about others. Just take care of yourself and do a good job.
Hi guys,
Thanks for the comments.
I do want to clarify that in our program you get two failures before you are kicked out. Then you have to wait two years to reapply and have to start all over.
Anyway...
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