NURSE Dilemma
Nurse to Student Incivility
STUDENT Worksheet
Cindy Benner, 21 years old
Overview
Incivility is endemic in nursing. This
... [Show More] dilemma identifies the most common uncivil behaviors that students may experience from nurses in the clinical setting and how to respectfully address this if experienced. This activity will empower students to be the needed change so a culture of civility that honors and respects the differences of others can be realized in the nursing profession.
Clinical Dilemma Activity: STUDENT
Nurse to Student Incivility
I. Scenario
History of Present Problem:
Cindy Benner is a 21-year-old nursing student who is in the third year of her baccalaureate program at a local state university. She is an excellent student and is excited to pursue her dream and passion to become a professional nurse. She has enjoyed clinical learning and is excited to begin a new rotation on the medical unit at a local hospital. She has completed pre-clinical prep and introduces herself to Jennifer, the primary nurse of her patient. Jennifer looks at her and rolls her eyes. She gives a quick report to Cindy, does not maintain eye contact, and promptly hurries down the hall, stating she has to get to work or she will get behind.
What data from the histories is important & RELEVANT; therefore it has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Cindy Benner is a 21-year-old Cindy is
nursing student in the third year of her student
baccalaureate program lack of
She has completed pre-clinical prep experiences
and introduces herself to Jennifer, the Jennifer is
primary nurse of her patient. primary
Jennifer looks at her and rolls her nurse, she
eyes. She gives a quick report to was not
Cindy, does not maintain eye contact, kind to
and promptly hurries down the hall, stating she has to get to work or she will get behind Cindy that
limited activity with
students
II. The Dilemma Begins…
Current Concern:
Cindy completes her initial assessment of her patient, a 68 year-old woman who presented to the hospital with a ruptured appendix and is now post-operative day one. Her temperature has increased to 101.2 (last recorded was 99.5), her heart rate is 98 (last recorded was 76) and her blood pressure is 98/60 (last recorded was 120/66). Cindy just had a classroom lecture on sepsis and the inflammatory response. Though an inflammatory response is expected after surgery, the instructor emphasized that systemic inflammatory response syndrome (SIRS) is an early predicator for sepsis that could progress to septic shock. SIRS criteria include temperature >100.4, heart rate >90 and decreasing blood pressure.
Cindy approaches Jennifer to share her concern that her patient may be developing sepsis. Jennifer appears irritated, and states in an angry tone, “I was just in her room an hour ago and she looked just fine. I think you are overreacting. I’ve been a nurse for twenty years. Do you think a student knows more than me? I don’t think so! I will check on her when I get a chance.”
What data from the current concern is important & RELEVANT; therefore it has clinical significance to the nurse?
RELEVANT Data from Current Concern: Clinical Significance:
Cindy completes her initial assessment of her patient, which her temperature has increased to
101.2 (last recorded was 99.5), her heart rate is 98 (last recorded was 76) and her blood pressure is 98/60 (last recorded was 120/66).
Cindy approaches Jennifer to share her concern that her patient may be developing sepsis. Jennifer appears irritated, and states in an angry tone, “I was just in her room an hour ago and she looked just fine. I think you are overreacting. I’ve been a nurse for twenty years. Do you think a student knows more than me? I don’t think so! I will check on her when I get a chance.” Primary nurse is
against the school policy and also
shows her unprofessional clinical practice.
III. Resolving the Dilemma
1. Identifying data that is RELEVANT, what is the essence of this current dilemma?
The primary nurse did not believe the student's assessment and to recheck the patient's condition.
2. What additional information is needed by the student that would help clarify the current dilemma?
Student needs to gather more medical history of the patient, and gets more assessment of current health condition
3. What additional members of the healthcare team could be utilized in this situation? Why?
The student can utilize the primary care physician or the surgeon of this faculty member in this situation.
4. What is the priority?
Managing and treating the patient's medical condition.
5. What interventions and/or principles can be used by the student to successfully resolve this clinical dilemma? Treat the patient with appropriate antibiotic therapy and vasopressor with PCP ordered.
6. What is the expected response that would indicate interventions were effective?
VS were stabled and continuing to monitor
7. What is the student likely experiencing/feeling right now in this situation?
Self-double, Anger, Depression, Self-blame…something is wrong with me.
8. What are the uncivil behaviors demonstrated by the staff nurse in this situation?
Rude comments, untrusty because of lack of experiences.
9. Have you personally experienced uncivil or bullying behaviors? If so, how did it make you feel? No
10. What have you learned from this case study that you will incorporate into your practice?
Provide opportunities to dialogue between students and educator in open formats. This can provide needed dialogue and understanding. professional practice with health setting. [Show Less]