Student Errors in the Clinical Setting: Time for Transparency

Mistakes happen.

When I was working as an ED nurse, we often had nursing students assigned to the area. One day we had an elderly man with asthma in one of the treatment rooms. The physician ordered aminophylline suppositories. After reviewing the “5 rights”—right patient, right medication, right dose, right time, right route—I directed the student to administer the suppositories. All seemed well.

Imagine my surprise when the student proceeded to insert the suppository into the man’s nose! She explained that since it was a breathing problem, she naturally thought they would be inserted nasally. It never occurred to her that these were rectal suppositories and it never occurred to me to ask if she knew what to do with them. We all had a good laugh and that was that.

Undocumented errors.

Another day, another patient, another faux pas: a physician said to “cut the IV,” which everyone knew (that is, we assumed everyone knew) meant to discontinue the patient’s IV. One of my colleagues intervened when she saw a determined-looking student, with bandage scissors in hand, approach the patient’s room, ready to “cut the IV.” We again marveled at the student’s interpretation of the phrasing, and that was that.

And that’s the problem—that was that. There was no documentation of these as “near-miss” errors, and while some of […]

How I Spent My Summer: Funding the Cost of a Nurse’s Education

Photo by Julianna Paradisi/2017

At a neighborhood grocery store, I picked up a few items for dinner, one of which was a preroasted chicken still warm and juicy from the heat lamp display.

After ringing up the total, the checker began bagging my purchases. Before placing the chicken in a bag, she put a rubber band around the container to prevent it from accidentally opening, and then wrapped it in a separate paper bag as a further precaution against leakage.

I thanked her for the extra care. No one waited behind me, so we exchanged a bit of small talk. It was a weekend, and she asked if I had plans. “No, my husband and I work in health care, and it’s his weekend on,” I said.

“What area of health care?” she asked. I told her I’m a nurse and work with cancer patients. Expecting the cringe I usually get from laypeople when I say this, I quickly added, “It sounds sad, but I really love my work.”

Her face lit up. “I’m a nursing student! I’m taking exams to become a CNA so I can work with patients while I finish my BSN.”

Her news delighted me. I have strong intuition, and I felt sure she would make a terrific nurse. I congratulated her on her career […]

2017-08-22T15:07:48+00:00 August 22nd, 2017|Nursing, nursing students|2 Comments

Stop the Eye Rolling: Welcoming Future Nurses to the Profession

Rosemary Taylor

One perennial topic that comes up among nurses on social media is the extent to which many nurses have been treated unkindly by colleagues at some points in their careers. New nurses and nursing students are, for obvious reasons, particularly vulnerable to rudeness and other forms of unprofessional conduct. The Viewpoint in the January issue of AJN,Stop the Eye Rolling: Supporting Nursing Students in Learning,” by Rosemary Taylor, PhD, RN, CNL, assistant professor of nursing at the University of New Hampshire, makes the case that nursing students often face an “unwelcoming introduction” to the profession when they venture out of the classroom for clinical instruction.

Writes Clark:

Nursing students are often targets of the kinds of incivility that can be classified as vertical violence. The majority of these incivilities are “low risk,” as described in Cynthia Clark’s “continuum of incivility,” with eye rolling (“low risk”) just below sarcasm on one end of the spectrum and threatening behaviors and physical assault (“high risk”) on the other.

Citing her own students’ sometimes disheartening experiences, as well as Cynthia Clark’s book Creating and Sustaining Civility in Nursing Education, Taylor makes a convincing argument that “eye rolling, a seemingly trivial gesture, is in fact a particularly hurtful form of nonverbal aggression.”

Yet, says Taylor, these and other forms of incivility […]

2016 Nurse Faculty Scholars/AJN Mentored Writing Award Winner

AJN0916.Cover.OnlineAnd the Winner Is….

We’re pleased to announce that the winner of the 2016 Nurse Faculty Scholars/AJN Mentored Writing Award is Denise M. Eckerlin, BSN, RN, a predoctoral fellow at the University of Washington School of Nursing in Seattle. She won for her CE feature article published in the September issue of AJN,Military Sexual Trauma in Male Service Members.”

Eckerlin coauthored the article with her mentor, Andrea Kovalesky, PhD, RN, an associate professor in the School of Nursing and Health Studies at the University of Washington Bothell, and Matthew Jakupcak, PhD, a clinical psychologist and researcher at the Northwest Mental Illness Research, Education, and Clinical Center in the VA Puget Sound Health Care System, Seattle. She will receive an award certificate and $500. […]

A Room with A View: Physical Environments and Healing

By Betsy Todd, clinical editor, MPH, RN, CIC

Illustration by Janet Hamlin for AJN. All rights reserved. Illustration by Janet Hamlin for AJN. All rights reserved.

Computers, alarms, automated drug dispensing, complex medical protocols—the ways in which we provide care have changed a lot over the past 30 years. Has forced multitasking made us forget that, buried beneath the printouts and data, there is a human being in need of support?

In this month’s AJN, author Joy Washburn shares the story of David, a man with advanced Parkinson’s disease whose medical condition results in his transfer from a cheerful rehab setting to a long-term care bed in the same facility. While his old room in rehab overlooked gardens and a children’s play area, the new room faces a parking lot. To make matters worse, no one seems to have prepared David for the move, and many nurses erroneously assume that his advanced physical disability means that he is also cognitively impaired.   […]