I just started nursing school, took me like 2 years to get in getting prereqs done and then I wound up on a waiting list, getting an AS and becoming an RN. I also have a panic attack disorder that I take medication for, it's essentially under control, I certainly don't feel I'm a danger to patients in the least but we start clinicals next week. All this was disclosed on my medical release, health status, what meds I was on and then I took time to talk to some of the faculty to let them know I had this issue and whether it would be a problem, they told me no but that when clinicals rolled around I should tell me clinical instructor about it just in case I wasn't feeling well and needed to leave the unit for a few or something.
Today was clinical orientation and I did as I was asked and told my clinical instructor about my disability and he got seemingly all bent out of shape about it, what does that mean? and he said had known ppl who would have panic attacks and just lay on the floor and curl into a fetal position (now I've personally never seen anything like that or heard of that happening to someone having a panic attack) and then asked me what meds I was on and I told him I was taking 4mg's of klonopin a day (all my medications and health issues were disclosed on my medical release) and he was telling me he didn't know if he'd trust me to be around patients.
if I had epilepsy would they worry I was going to sieze while transferring a patient, dropping them on the floor and killing them or what? I feel like I'm being singled out, as of now it's a "well we'll play it by ear" but I immediately feel like I have a huge strike against me and I'm just getting started
Anyone have any thoughts about this? maybe advice on how I should handle this situation? bad enough I'm stressed out as it is now I'm already behind the 8ball and we have barely even started.
I'm wondering if I should try and get out of there and get my money out as I feel I am going to be discriminated against, I can't afford to drop 10,000 dollars to flunk out of school, I've been working towards this for 3 years and in one 5 minute moment today I had it all seemingly shattered in front of me.
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Anonymous - hey - sounds like you're not having a lot of fun in school right now. I want to address your issue directly, but first I'll give a little bit of background re my own nsg school experiences thus far.
I almost didn't go into nursing b/c of the nightmares I'd heard others had gone through. There are a couple of people I know who have either lost careers or lost their ability to be reimbursed by third parties, and one who ended up in diversion w/o having a substance abuse charge or incident. Each of these cases were complicated, however, I wondered what their part in them was, and I decided that I wanted more than anything to help others with mental illness in the role of a nursing professional, so I went for it.
There are many developmental hurdles to jump in school for anyone, and for me, some have been related to psychosocial factors/differences that mental illness brings to some of us, even when we're stable. These experiences have been tough, but worth it, and I've grown a lot. Having gone through "stuff" that some people would have felt "victimized" by, I have recognized my own active role in the difficulties, and strive to have insight into the ways my illness affects my relationships and behavior. I want to understand how problems develop and how I might avoid them; sometimes I don't do such a great job, but I care and I'm improving, and I'm especially fortunate to have such kind professors who invest in the personal development of students and approach this seemingly w/o judgement.
Personally, I am open and honest with others re my illness (bipolar w/ GAD, mild OCD and trichotillomania) on campus, and I do a lot of advocacy work and public speaking, though for the first 6 mos in school I was silent. I found, after awhile, that I felt I was leaving too much of myself at the door ea day in my efforts to keep an important part of myself from others, so I started a monthly informal dinner/support group for fellow nsg students w/ mental illness, and started to share my "secret" with others I cared about.
I am fortunate that I have yet to encounter such poor treatment as you have, but I also have not been open about my illness in clinical placements/with my clinical instructors, where people aren't as educated or open-minded as they are on campus. Student mental health is openly discussed and valued at my school, and it sounds like your profs are pretty cool as well, but clinical has been different in my experience. I have heard discriminatory talk and misinformation from employees at my clinical placements, seen pts w/ psychiatric illness get poor care and be derided by the staff, and seen other clients be "pitied" by well-meaning staff. I'm pretty buttoned up at clinicals, where making lasting relationships is not my goal, and being 100% me at "work" isn't really an issue.
So to address your situation: one of the first things you might consider, if you have not already, is to get yourself covered: become registered at your school as a disabled student. Your MD oor NP writes a letter, a file is placed for you, and the office of disability will fight for you if your status as a student becomes jeopardized. This is tricky, as having a mental illness is not equal to being disabled; we are only disabled when we are symptomatic. My advisor at our office tells me to make others aware well ahead of time if I am experiencing symptoms; that they are less understanding if you wait until you are very sick to tell them you won't be able to fill a school responsibility or requirement on time. I've been asymptomatic for >2 yrs now and am have been disabled for close to a yr when I have become ill, so this applies to me. With panic d/o, you deal w/ your illness on a weekly basis, most likely, so your mileage may vary. Anyhow, having the file protects your status at school.
Perhaps accommodations might be made for you, such as the ability to make up hours that you may miss if you are not feeling well, which is what a friend of mine w/ panic d/o did last year. Her episodes didn't resolve quickly, so when she had an attack, she was sometimes out of commission for several hours to a day. Perhaps you are more fortunate and missing entire days wouldn't be the issue? Anyhow, having this drawn up lets both you and others know what the expectations are. It states that they are formally supported by the school, lends structure and legitimacy to any differences btwn your clinical experience and that of others, and gives you a leg to stand on. It also represents you as being assertive, being organized and having forethought, and #$&%!@s like your CI are either less likely to mess with this or perhaps won't get away with it.
If you visit, the disability office, find out what you are and are not req'd to disclose at a health exam such as you describe: I believe they are not allowed to ask re mental illness, and you do not have to disclose if you choose not to. You are expected to be truthful when they ask questions, but this is a don't ask don't tell sort of deal, from what I understand. You can revisit this next time when you apply for a job if you decide not to disclose.
Re this clinical instructor, he's especially unprofessional and I can't imagine he models good pt care if this is how he behaves towards a student. By mistreating you, he's violating Provision 1.5 of the ANA's Code of Ethics for Nurses: he is quite objectively stigmatizing you, and no one could see that differently. Have you talked w/ your profs re this (I'm sure you have)? Sounds like they have been helpful and caring toward you, and perhaps they will not allow you to continue to work with this person? I can't imagine, even if he were good at his job, that he is a kind and patient instructor and that, under the circumstances, you can be expected to learn and to develop professionally under his tutellage.
By the way, yes - people do stigmatize healthcare workers w/ epilepsy for exactly the reason you list. I also have a friend w/ a difficult-to-treat case of asthma who was not only stigmatized but practically stalked and taunted by another student who said she shouldn't be in school w/ us. Another student - one who is usu v kind and equanimitous - sits on a board that helps to further develop the program. She stipulated that there should be a notice made re the rigorous nature of the program (we get an RN in 1 yr; I did this last yr and am now working on my MSN) and that students w/ "special requirements" who couldn't "handle stress" should carefully consider before applying!! She referenced (to me) the student w/ asthma. This woman is usu quite kind and understanding, and did not consider her statement to be stigmatizing. People are pretty freaky. Always consider your downside.
Re listing your meds: remember that with sensitive subjects, it's often best to say as little as possible. When someone asks what you take, you can counter nicely "why do you ask?", which lets him know he can't really mess w/ you, and that further questioning basically ain't going to fly. When people ask personal questions, esp if they don't know you, they are likely testing your boundaries, vulnerability and ability to be manipulated, if you know what I mean. I understand he probably caught you off guard, and when you're anxious it's so hard to think a step ahead, so holding your own is easier said than done, esp w/ a superior. Meds can be misunderstood, as you know - people think that if you take lithium you must be very sick/crazy, they think pain meds and benzos are drugs of abuse, etc. It's your right to choose benefit vs risk when treating your illness effectively and tolerably, and it's none of anyone else's business.
You say, "I feel like I'm being singled out, as of now it's a "well we'll play it by ear" but I immediately feel like I have a huge strike against me" - you are and you do. By your CI. With just your brief description of the situation, I would say you aren't going to get anywhere with this person, and if he treated you this way on day 1, it's not going to get better. But you already know that. One thing I've done time and again (and probably will a few more times) is push a situation that clearly isn't working until it blows up in my face. I tell myself that I have 3 options in any tough situation: to stay 'til it blows up, to stay in it and reframe it to create a positive, or to leave. If this were me, I would talk to my profs and be really clear that you don't have the option of improving things and that, even if you did, the time and energy this would take are not listed as requirements by the BRN, though quality clinical hours are.
You say "I'm wondering if I should try and get out of there and get my money out as I feel I am going to be discriminated against, I can't afford to drop 10,000 dollars to flunk out of school, I've been working towards this for 3 years and in one 5 minute moment today I had it all seemingly shattered in front of me." I think anyone would feel that way after your experience! Look at that objectively, however. You've worked hard, you're a good student, you don't have a track record of a quitter or of one who fails, and you care re the quality of your work and re your pts and want badly to be a nurse. Don't let this experience take that from you. Try to see this as a gift. Seriously - I know that sounds weird, but if you'd had this experience in your first job, it could have been disastrous. School is the best time to try these things out. They can be good things. Above I spoke re "reframing" a situation to improve your ability to perform within it; you can do this also in how you handle the situation within yourself. My Mom always says, "it's how you hold it". you can learn tons from this experience re what you might do and not do in the future, re how to protect yourself, re what messages you may have sent to this person that told him he could treat you this way (which he may have done in any case) and how you can analyze that and grow from this experience. Try to make this a positive.
Last yr I was on contract and almost got dropped from my program. I found out 2 days before finals that I was allowed to progress to the next year. Yeah, this was a stressful process, but I learned some really deep-seated things about myself and my relationship to the world that I otherwise may have missed, and ultimately it was completely worth it. I conisder myself in much better shape to approach a new career as a result. Bad stuff can be really good. Talk to your profs - they'll help you out - then think about what you can get out of this experience.
Best - Cara
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I feel your pain. I am bipolar and when I went to nursing school I was terrified that if someone found out I would be tossed out of the program. I waited until I was halfway through nursing school to disclose. You are in a different situation as your cat is out of the bag.
The other response you received from Cara had some great advice...mine will differ a little. It is hard to give advice without knowing the entire situation, but I will say I think you may be screwed with this clinical instructor, to be blunt. My next step would be to talk to the professors who know you and your good work and make sure they have your back. Then go to the Dean. Request a different clinical instructor because this one will not be impartial and a prejuidiced clinical inst. can be all it takes to get you onto the road out of nursing school. It is a sad but true fact that many of these people are very biased about a variety of things, and mental illness is a biggie. There is still a heck of a lot of stigma out there, and I have found that nurses can be some of the least understanding people about this. You can be a terrific nurse with a mental illness if you have plenty of insight into yourself, your condition and your behavior. You need a good friend or family member to help you monitor yourself to make sure you are with it and not goofing up unawares. Obviously, Klonopin can be sedating and there will be concerns about whether you will make mistakes d/t the sedative factor. If you have been on it a while this is probably not an issue for you, but someone who doesn't know you won't know that. You must get those professors to back you up and have the Dean reassign you to a different clinical group. You must think hard about disclosing information in the future, even though it may seem dishonest not to. Sometimes what people don't know doesn't hurt them. If you are stable and can make it through clinicals then why expose yourself unnecessarily? Did your instructor disclose his health history to you? Sometimes it's just better left unsaid until you have a solid reputation to back you up. It may help to have objective letters from other students backing you up as well.
The other part of this is to be totally honest with yourself. Are you completely stable on your meds? Will you be unable to get through a clinical day or workday as a nurse without a meltdown? If you can't, maybe this isn't the time to finish nursing school. Think about who you want to be as a nurse. Think about which nurse you want taking care of your mom. Can you be that nurse? If you didn't disclose, would anyone be able to tell you have a mental illness? If not, you should fight to stay in school. If you can't get through a day of class or clinicals without freaking out, then maybe you should reconsider whether to remain in school at this time.
I don't want to offend you or sound harsh, I just want you to really think about yourself and nursing in an honest way. If someone is epileptic and has seizures three times a day, nursing may not be for them. Even with a disability you need to be able to perform the job, do you know what I mean? Patients are depending on you and mistakes in nursing can mean lives lost. It is a serious business. If I had a relapse with my bipolar I would take a leave of absence, even if I didn't want to. The only way the stigma of mental illness for nurses will go away is if there are plenty of us out there, stable, responsible, pulling our own weight and letting others see it can be done. I was at the top of my class when I disclosed, and everyone was stunned. It changed some minds about what a person with a mental illness can do. If you are stable, stick to your guns, go to the Dean, and fight for your right to become a nurse. Your illness gives you a special background, a special compassion and understanding, and an important role to play in nursing.
Good luck. Write me privately if you like. Cary
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Having been a nursing instructor my advice to you is run do not walk to your counclor and document this conversation. Also I would arrange a meeting between myself, the instructor and your counclor.
Its possible you caught your instructor off-guard. I can understand some of the response
only because you practice in clinical under their supervision and license. The instructor should have been told about this prior to the first day of clinical by their superviser.
It might help to have them contact your prior instructors and be reassured about your clinical performance.
Good luck.
please let us know what happens
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First off to cary I suppose, no, if I hadn't mentioned it noone would even be able to tell I was having a panic attack or anything, I really think ppl misunderstand what it is, what it means, I worked plenty while having anxiety, I've driven having panic attacks, I didn't crash. and if I was "melting down" like really having a bad panic attack I would be able to get someone to cover for me while I went and relaxed for 20 minutes. but it's very under control now. I've thought about this plenty, in conjunction with therapists, psychiatrists, doctors and vocational rehab/social workers with tests and all kind of junk they all thought I would be fine and not be a danger to anyone or impaired in any way that would cause riwsk and I agree or I wouldn't be there either. someone who is epipleptic and has seizures 3 times a day loses consciouness uncontrollably, I don't just go out of control and run down the hallways screaming, it just doesn't work like that what happens is I just start not feeling well, it usually starts slow and gets worse over time, I can feel it coming on. and during a panic attack your not out of touch with reality or something.what if I were a diabetic? should I not be a nurse because I could get impaired due to glucose problems? I Really don't see my problem as any different.
my first clinical day was last week, no problems at all except with the instructor again... that meaning during preconference after we had presented our case summaries, whatever you'd like to call them, and everyone was getting up to leave, all of them were exiting the room at one side and I walked up to him to ask him a question, he was writing in a notebook and I just said "excuse me, I had a question about" whatever it was, I wanted to know if, since he had already told us not to inform the clients relatives of *anything* vitals, nothing. I wondered what we should tell the patient themselves if they had a question about something and he looked up at me with, literally, like rage on his face, if he could have shot lasers out of his eyes he would have, it was freaky and he said "are you addressing me?!?! you will address me properly!"
2 ppl saw/heard it and came to me afterwards going "wtf was that all about? how the hell does he expect us to address him" and wondered why he went off like that because I was being "so polite".
I also don't have instructors I can go to to back me up, this is my first year in nursing school, I have no prior clinical experience. if I'm impaired though my grades don't reflect it, my first nursing exam, which took place the weekend where I disclosed this issue to this guy so I was all stressed out about it, only studied the night before for like 8 hours and then went in with about 3-4 hours of sleep and still got a 91 on the exam.
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