[philosophical]

Hi,

I'm currently evaluating if I am cut out for nursing school. I have a BS in Psych and am taking my NS pre-reqs. I have so many questions! I think after graduation I want to try to find as low stress a job as possible (I know, I'm dreaming!) and become a Lactation Consultant, School Nurse, or do Disease Management. My question concerns clinicals. What has your average student: patient ratio been in clinicals? Does the instructor stay with you the whole time? I know I don't want to get into bedside nursing as I don't think I'm that great at multitasking without my work suffering. Is anyone else the same?

Thanks!!

Rhonda

[MB37]

I have a BS in psych and am currently in an accelerated BSN program. Clinical experiences really vary between schools, so for details you should talk to someone in your program. In mine, we had a "match day" last summer where each hospital gave a presentation and we all ranked our top 2-3 choices. Then we were assigned to one hospital or group of hospitals for the duration of the program. We also have the same clinical instructor for the entire program - there are actually 2 per 12 students, 1 who also teaches our lab and is a school employee, the other in also a nurse manager at the hospital and coordinates the clinical activities with my school.

We do preceptored clinicals, which means we meet for 15 minutes in the morning all together, then go to our individual assigned floors for the rest of the day. Our instructor does not come with us. We report to the charge nurse, and he/she assigns us to an RN for the day. We listen to report with the RN, and together we select 1-2 patients for me to work with that day. I'm in Fundamentals, so I only need to take 1 patient, but sometimes if my nurse has two in the same room and they're both low acuity so I take both. We don't pass meds until next semester, so my nurse is still in and out of my patient's room all day. I'm responsible for vitals and accucecks as often ordered, bathing that the patient can't do his/herself, bedmaking, I get coffee/ice/water as requested, and I work on my assessment skills. I also give my preceptor a card each morning that lists all the skills I've been checked off on, so if any of his/her patients need, say, a Foley put in or taken out, he/she will know to come get me. I don't feel like there's really any multitasking involved with 1-2 patients, at least not yet, but I've been a bartender and/or waiter for the last 10 years so I'm used to having 40 things in my head at once.

Oh, our instructors do make rounds. Some days I see both of them, other days just one. They move from student to student, pull us aside for about 10 minutes, and ask how we're doing. We also have their cell and/or beeper numbers, so we can call if we run into any problems. Other schools have all the students on the same floor, and there instructor has to be there for everything. Our school puts all the nurses who volunteer to work with us through preceptor training, so they are qualified to check all of our skills, med passes, whatever. If you don't know anyone at your school, try posting in your state's forum. Good luck!

[AnnaN5]

In our program we generally get 1-2 patients up to this point. In our last 2 rotations we will be assigned 3-4 patients since that is our last opportunity to learn before taking our boards and getting thrown out into the real world with a higher patient load. We have 7-8 people in a clinical group with 1 instructor. Our instructor is on the floor the entire time but not necessarily with a student. We have to be with our instructor to do a med pass or a skill we are not checked off on but other than that we are on our own. We are responsible for baths/hygiene, bedmaking, accuchecks, vitals, head to toe assessment, meds, discharges, etc.

[mysterious_one]

I am in my 3rd semester of an ADN program and will have 4 patients next week. Your skills, tasks change (get more extensive) with each semester, depending on what you have checked off in lab. The instructor is not with you at all times. She will come to check you off on certain skills, or show you things you haven't done before. ( Our's is responsible for 10 students).

[emtb2rn]

patient ratio been in clinicals? Depends on your program. I'm in 2 yr diploma program. We started with 1 pt in the beginning of the 1st semester and was up to 2 pts by the end of the 1st semester. Started with 2 pts in the beginning of the 2nd semester and some of us had 3 pts before long. 3rd semester is psych/peds/ob, so it's being handled differently with anywhere from 1 to 4 pts per student depending on the student and acuity of the pts.

Does the instructor stay with you the whole time? Again, it depends on the student. We're working under the CI's license. We get assigned to the pt, not the RN who has the pt. Once the CI is comfortable with your skill level and ability to know when to seek help, some of us are pretty much on our own. My school has a very good rep in the hospitals where we do clinicals, so the RN are happy to see us.

[amyk_ncsu]

I am in the "intermediate" portion of my program. I have only had 2 patients once so far. I dont think anyone can get more than 2, thats too many patients and students for the instructors to handle. We do clinicals as a group of 8 students with one clinical instructor. We all go to the same floor and get report from the RN and do everything for our assigned patients. If a nurse has a patient that needs a skill done, sometimes they will let us do it (thats how I ended up doing a foley). In the last course of the program before we graduate, we do half semester of preceptorship, and I believe they get a full load (4-6 depending on floor) that they do with their preceptor. I think they get to pick, or at least request, where they want to be placed (i.e., med/surg, peds, ob, etc).

[Megsd]

Generally in my clinicals I had 1-2, but in my preceptorship now I am up to 3. I am on a unit where the patient load varies between 3 and 4 (sometimes 5 if things are really busy), so lately 3 patients is a full load.

[CapeCoralNurse2be]

1st Semester: 1 patient for each of us. Clinical instructor was only with us to perform tasks that required observation/supervision...i.e.. medication administration, dressing changes and anything invasive...foley cath insertion..etc...

2nd Semester: 2 patients...again clinical instructor is only with us for invasive procedures and medication admin. And at this point they only have to watch us do invasives one time, get checked off on it if you did it well and then from that point on you can just do those tasks with the RN assigned to that patient. But Meds are always passed with the instructor.

3rd Semester: 3 patients...same as above.

4th semester: up to 6 patients, and we begin training with a preceptor in the med/surg area of our choice.

We meet first thing in the morning as a group, then go off to the floor we are assigned to that day. We have the CI's cell phone number to call him/her when we need their assistance or need them to watch us perform a task. For meds there is a 2 hour time window and they just make their rounds and you need to be ready w/ the medications when they show up for your turn. Then at the end of the day we meet and have post conference and talk bout what we did that day.

Most of the non-bedside nursing options still require you to have some bedside nursing experience such as med/surg for a year or more. Keep that in mind when making your decisions. I think multi tasking and organization can be a learned skill, so don't sell yourself short.

[Conrad283]

I don't even want to say. I am a senior in advanced med/surg and I had one patient this past week. I was actually kind of annoyed that I only had one patient. And to top it off, I had to split the patient with another student. I told the teacher flat out that this is boring and that I want to be challenged.

I've never had more than 2 patients at one time. I'm not too happy about this either, but such is life.

[BoonersmomRN]

So far 3 and we will have 5 by the semester end ( last semester)