Well. Well, then.

This is going to be a bad day for somebody.

You remember Weepy, right? The student nurse who didn't know where the lumbar area is? The one who asked me to "refresh" her memory when it came to taking a blood pressure?

Well, I fired her yesterday. Her and all the other student nurses in her group.

More than that, I filled out an evaluation form for her, and I was not nice. It's not just that she lacks basic A & P knowledge, or that she's a little rusty on some skills: she argues, doesn't do what she's told, and doesn't do her research. She doesn't come prepared. (And I'm not meaning to sound like a despot; there are some times when you simply should not argue and you really ought to jump when somebody yells "jump". There are times when there's not time to ask why.)

I finally went to the Idiot Instructor myself after seeing what some of the other students in the group were up to and told her, essentially, "they're fired." This after a patient one of the students was caring for vagaled out and fell over, and the student a) never showed up in the room after being called and b) didn't check up on her patient later.

And this was the student who is already an LPN. Not a very good one, I'd bet.

I'll admit that I'm pretty demanding when it comes to teaching. If a patient has one pupil that's blown to ten millimeters and another that's reactive and four millimeters, I expect you to notice that during your assessment. I really do expect you, despite whatever fairy tales you might've heard, to do some research on neurosyphillis and know what it does to a person. And if somebody's getting a nasty chemotherapy drug for dermatomyositis, I expect that you will know enough about that nasty drug not to want to handle it with ungloved hands. Especially if you're of reproductive age.

But I really, really did try to cut Weepy some slack. I gave her mad props when she did something right, and I put down on her evaluation form that she's got excellent interpersonal skills. She does. I understand that the finer points of assessment, like interpreting what the hell that breath sound is, will come with practice. And I know what it's like to do stupid things like reaching into a trash can with an ungloved hand, because I've done that myself, so I didn't count some of that against her.

Still, I had to fire 'em. I told our education director "This is it; I ain't takin' no more o' them students" because I'm not safe when one of them is around. I have to literally follow whatever student I have every minute of the day, which leaves my other patients vulnerable and un-looked-in-on.

I spent last evening feeling like I'd kicked a dog. A small, yappy, not very bright and not very likeable dog, but a dog nonetheless. With this poor of an evaluation, Weepy will not graduate. She's spent the last four years getting a BSN, and she will not, now, at the midterm of her last semester, get to see it through. It's not like I have Phenomenal Cosmic Powers when it comes to making or breaking students, but the instructor really can't ignore a two-page written evaluation in my crabbed and tiny handwriting.

Still, she's not safe. That's the bottom line. She simply does not have the basic knowledge or the chops to keep up, even in a small community hospital. I think she's trainable, but it would mean starting from square one. That is not my job.

The instructor--and this is the weirdest part of all--was venting to me about how eight of her ten students are, in her words, incompetent. She couldn't understand why she'd been saddled with a cruddy group, and was sure that somebody somewhere must hate her.

It took me until after dinner last night to realize that the reason I felt weird was that the instructor was treating me *as a peer*, not as a recently-graduated student or a still-attending student. Like I'm actually a nurse, you know?

I guess I am. And I guess part of that whole others'-lives-in-your-hands thing is having the absolutely shitty job of saying "I'm sorry, but you're just not good enough" once in a while, if it means saving other people from something worse.