Reflections
Clinical Simulation : Pride & Procrastination By Suzanne Dort
Iforgot to take the patient ’ s temperature . I spent a couple of days thinking about how I messed up on something so simple . It all started before the clinical simulation when we were rehearsing outside . I noticed that one of my teammates was not wearing her watch . I was so proud of myself because this was proof that I was prepared for the simulation more than she was .
I was supposed to take the patient ’ s vitals and then move on to his lung assessment . I thought this was going to be easy . I was so confident . I went up to the machine with a smirk knowing that I was going to ace this , but when I looked at the vitals machine I was lost . I didn ’ t recognize anything on it : the temperature probe was in a different place , the blood pressure cuff was missing , and I couldn ’ t find the pulse ox . Twenty seconds into the simulation and I was already starting to panic . I am a CNA and supposed to be an expert at taking vitals , but I can ’ t figure out what I ’ m looking at ! To get myself a few extra minutes to think , I ran over to the patient and started counting his respirations and heart rate . These were the only two vitals I could get that didn ’ t require a machine . In fact , I ’ m not even really counting his heart rate because I know once I can get the machine working it can pick up the rate for me . Meanwhile , my teammate knew that there was a physician ’ s order for a continuous pulse ox so she ran around the bed and over to the vitals machine to get that started .
I watch her take the pulse ox from the machine and put it on the patient ’ s finger . I ’ m mortified that she had to intervene . Instead of thinking about how she ’ s helping me , all I can think is that she is making me look bad . So before she goes back to the other side of the bed , I ask her if she can double check the patient ’ s heart rate . I didn ’ t have his heart rate so I picked a ridiculous low number , 30 . I was still in a panic and couldn ’ t even remember that the normal heart rate for an adult is between 60-90 . I knew my teammate wasn ’ t wearing a watch and so she would have to give a rate that is close enough to my wrong number to be believable . While she was pretending to count , I correctly got the patient ’ s respiration rate . My teammate finally confirms that she got a heart rate of 32 as well . The instructor says we are wrong and that his
heart rate is actually 96 . “ What !?” I laugh , as I give her a facial expressing that seems to say , “ how can we BOTH be so bad !”. Relieved that I am no longer the only team member who had made a mistake , I push the vitals machine away and move on to the lung assessment , the task where I can really shine .
I learned that I can be proud and that my pride prevented me from asking for help . I was tasked with the most basic of skills ( a task that nurses delegate to a CNA ) and when I couldn ’ t figure out how to immediately operate the machine , I panicked . I should have taken a minute or two to try to study it and figure out the button placement . I could have even asked my teammate to help me with this unfamiliar machine . Instead , my pride caused me to procrastinate . In this simulation , I procrastinated until I could shift the attention to another nurse ’ s mistakes . Maybe I was hoping that my uncompleted task would go unnoticed or maybe at this point I honestly forgot about it . But the instructors knew that data was missing , and they would not give out the next set of orders until they had all the information .
There will be times when I will not feel confident carrying out a physician ’ s orders ( whether it is to insert a new PIV , draw a blood culture , perform trach care ) and instead of procrastinating and leaving it for the next shift , I will need to ask someone to walk me through it . Just like in this simulation , if I am too proud to ask for help and instead choose to procrastinate , the physician is going to find out that I didn ’ t carry out all the interventions . The physician will confront me and I might even delay new ( life-saving ) orders , and even though I ’ ll have an excuse as to why I procrastinated , I will be held responsible and will not be delivering excellent patient care .
Equally important , I am really surprised that I did something so vindictive to a teammate . All I can think of is that I was so desperate not to be the only one that made mistakes . This is really alarming behavior and makes me worry that I ’ ll be one of those nurses that “ eats their young ” if I don ’ t correct my ways . I ’ m embarrassed that I behaved the way I did , but I am grateful that this self-reflection allowed me to process the situation and my behavior . n
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