#nublr

Had a young man as a patient for my first Med Surge clinical. Over the weeks that we visited that hospital he was still there.

He didn’t know what his diagnosis was. All he knew is that he was in pain and the pain medication wasn’t working.

A few hours after getting report my preceptor pulls me to the side and tells me that the CT revealed metastatic cancer and that I had to keep it to myself because the doctor had to be the one to tell him.

Okay. I can do that. The doctor has to come in today to tell him right?

I’m in the patient’s room and the doctor comes by and quickly briefs the patient about a biopsy that he will do.

I figured that they were waiting for the biopsy to confirm so that they could be sure before they told him, despite telling me it couldn’t be anything else.

We came back the next week and he was still there. Weaker. The pain made everything unbearable and he slept as much as he could when he wasn’t in pain. I asked him if he knew anything about his condition yet and he didn’t. He as frustrated.

The week after I saw him again. Still no news. Frustration about the unchanging condition. He cried in my arms from the pain.

And the week after he was gone. I didn’t get to see him since we only go to the hospital once a week but I still don’t know what happened to him. I hope by now he knows and that he’s doing all he can to live as best he can.

I know that the doctor wanted to be absolutely sure despite finding multiple nodes and that the history lined up with the type of cancer he had, but staying quiet while trying to comfort him was so painful. I just wanted to let him know because he was so frustrated but it wasn’t my place. My job was to keep him stable and keep his spirits up as we both went through that journey. Three weeks of the staff knowing what was wrong with him.

What were outcomes to Interventions?

Did you implement anything new to help them meet goals?

Abnormal vital signs? What did you do or who did you notify?

Codes: what is your facility guide for how to document?

Transfers: how were they transfered method and mode? Vitals. Physical. Reason for transfer....

Shift change make sure anything new or changed is documented.

When calling doctors avoid general statement. Did you talk to him? Are there orders? Are you waiting a call back....

Pre-exam studying. Successfully obtained 92% 

Hello there future nurse!

This is a pretty good question but quite honestly I feel a little bit conflicted on it. You are asking about constructive criticism but then going on to ask how you deal with feeling guilty about not knowing..

Here’s the thing about “constructive criticism” – it should NEVER make you feel bad or guilty for what you don’t know. It should be communicated in a way that let’s you know that maybe you could have known the topic better, the skills to complete the task could be more developed etc but it should never make you feel down or guilty. This is why it’s called constructive and why the term criticism means something different.

If you are feeling disappointed or less than you were before the conversation than I would consider the individual is plain out criticizing you.

I used to work at a call centre and I had this manager who used to call out every weakness I had and make me feel horrible when I would struggle with tasks, such as sales. I would leave our 1 x 1 meetings feeling disappointed in my performance and utterly worthless/useless in my role. Then I was placed with another coach who never put me down. Instead then conversation led with “maybe this isn’t your strong suit but we will work through your issues and feelings to help you become more acquainted. You could start by strengthening your approach as it isn’t very strong currently”. My other manager would say “you’re doing this completely wrong. None of this is satisfactory and at this point I just don’t know what to do with you”.