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Under the Influence

December 23, 2012

This week is the end of a module in our nursing program. As a clinical instructor, I must give the students their final evaluations, a sometimes painful process in which I sit down with each one and tell them whether or not they’ve passed the clinical rotation.

For the most part, giving and receiving evaluations is a happy, even fun, experience. Students are truly excited and proud to learn they did so well. They are spending a lot, both in time and money, and they are busting their tails to succeed. They have a lot at stake.

If you ask each student why they chose nursing,  you’ll get a different answer from each one. But often there is one theme that runs like a vein through every answer: someone in their family–usually their parents–wants them to become a nurse. It wasn’t the student’s idea, but they are going along to make their parents proud.

This rotation one student did not pass the clinical. She was one of the weakest in the rotation. Unable to transfer theoretical knowledge into the clinical setting, she can’t give rationales for her answers to NCLEX review questions, and she struggled and failed to pass the math and dosage calculation tests. I worked with her, tutored her, and offered assistance with her care plans, but ultimately none of this helped. She simply didn’t rise to the level expected.

There was something else: she wasn’t coming to me for help on her own. Other than the times we had mandatory math tutoring, I never saw her. Also, she didn’t seem upset about the fact that she was doing so poorly. She wasn’t resigned, she was indifferent.

When I sat down with her and explained why she did not pass, a single tear leaked out of her left eye and trailed down her cheek. Then she said, “Okay.” That was it. Nothing else. It surprised me that she wasn’t more upset, but I can never gauge exactly how a student will respond to failing. I assumed she was a little stunned and that’s why her reaction was so minimal.

Later that day, she went and spoke with my Program Coordinator. After the student left the office, I sat with the Coordinator and asked about her conversation with my clinical student.

“Well, her tears dried quickly when she told me that she doesn’t want to be a nurse.” What? I thought. I had no idea.

My Coordinator continued. “I asked her why she enrolled in the program. She said her mother wants her in nursing. I asked why she thinks her mom wants her to do this. She said, “My mom wants me to have the title.”” Clearly, this is not what the student wants. After hearing this, her indifference made sense to me.

Nursing is a hard profession, but it’s especially hard if you don’t want to do it, if you’re just appeasing someone else. Are you willing to deal with all of the unpleasant aspects of nursing: the smells, the long hours, not being able to go to the bathroom for hours on end, not being able to eat for hours on end, and unappreciative patients and doctors? If the answer is yes and you love what you do, you can work around the other stuff.

What you can’t do is allow others to influence what you choose for your life’s work. That decision is too important, so base it on your passion to do a certain type of work and your belief that it is your calling.

If you do that, everything else will fall into place.

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