Are clinicals supposed to be like this??

  1. Hello,

    I'm a freshman nursing student and I just had my first clinical experience last night. I'm so confused!!! We went to a long term care facility. Our instructor first had us look through the charts for a while and then she gave us a select group of patients to choose from. Once we picked our patient, she wanted us to go to their room, introduce ourselves, etc. One student went to see her patient and changed his diaper and cleaned him. We have never done this in class yet, but she was a CNA so she had already done this several times. I have absolutely no health care experience whatsoever, so I was under the impression that my instructor or a nurse from the facility would sort of walk us through some patient care. Or at least watch us while we do it to make sure we're doing it right. But that's not the case. My instructor is just sort of letting us decide what should be done. Is this the way the first day of clinicals is supposed to be? I'm not a lazy person and am very eager to learn actual patient care, but I'm very apprehensive about taking it upon myself to decide what the patient needs since this is my first time ever doing this. Any thoughts or advice would be greatly appreciated.
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  2. 16 Comments

  3. by   nursemike
    At the end of my first semester, my clinical instructor (whom I now think was brilliant, albeit peculiar) remarked, "I don't feel like I've had much to do, this semester. None of you ever came to me for help..."

    We all looked at each other and thought, "We could ask for help?"

    In a later semester, I commented to another instructor that we'd sort of felt tossed in to sink or swim first semester, and the current was sort of similar, but now I liked it. She suggested that as a nurse matures, he or she appreciates greater autonomy. And it's very true.

    I do think starting clinicals is going to be an anxious time, regardless, and most of that comes from the student. I'll go further--if you aren't scared, you're taking it too lightly. However--you can go to your instructor for guidance. This is a learning experience, and you won't be penalized for not knowing what you haven't been taught.

    You're going to hear it a thousand times: There are no stupid questions. I say, go ahead and test that hypothesis, because, in the end, it is far better to look stupid than to be stupid. Prepare as well as you can, but realize that there will be times, in school and in practice, when looking stupid or being stupid will be your only options.
  4. by   fultzymom
    My first clinical teacher took the students who had worked in health care before and paired them with the students who had never been in health care before and we did partners for the first two weeks. It worked out really well. I was one who had never been in that situation and my partner had been a STNA for 5 years. I loved it. Remember that your instructor is there to help you and guide you with any questions that you may have.
  5. by   Boston-RN
    Good advice about asking the instructor, they are there specifically for that purpose.

    This may be a silly question but didn't you have a lab before starting clinicals like how to properly transfer / roll / wash patients, hand hygiene etc....?
  6. by   puggymae
    To keep this from happening all of our students must attend CNA class and be registered.
    Never hesitate to ask your instructor anything - that is what you pay him/her for.
  7. by   CT Pixie
    Quote from MAnurseHopeful
    Good advice about asking the instructor, they are there specifically for that purpose.

    This may be a silly question but didn't you have a lab before starting clinicals like how to properly transfer / roll / wash patients, hand hygiene etc....?
    I was going to ask the same question..no skill lab to show you the proper ways to transfer/roll/perform personal care etc??

    We were shown in lab, then we went to clinicals. Same thing, LTC. However, even w/CNA expereince, we were NOT allowed to toilet, ambulate a patient if they were a 2 person assist with two students even if both are Certified by the State. Meaning, one of people helping w/toileting/ambulating had to be a staff member.

    Maybe your classmate took it upon herself to toilet the pt, but was she supposed to?

    The best thing to do is let the instructor know you're aren't quite sure what you are supposed to do and how to do it. Let her know you have zero health care experience. I'm sure if she's a good instructor she'll be happy to explain exaclty what is expected of you.

    First time clinicals are nerve-wracking even for those of us w/experience, I cannot even imagine how scarey it must be for those with no experience.

    Oh, and for the first couple of weeks in clinical our instructor teamed up someone w/experience and someone without. Then when the unexperienced one felt more comfortable and the instructor felt the student could handle it, he/she was then to take a patient by themselves. But my classmates and I always tend to act as a team..as one unit. If you have an easier pt, and are done with pt care, we always seek out those with a more difficult pt. One hand washes the other type thing. Because one day, you might be the one with the tough pt and might need some help.
  8. by   EricJRN
    I moved your thread to the General Nursing Student Discussion. I'm sorry that you got thrown in like that.
  9. by   emptybee
    I'm a first semester student too...and sometimes, things will come up during clinicals that you haven't done in lab. When that happens, ask! Ask a CNA that's cared for that patient before to show you, or ask the RN thats in charge of that patient. Last week, my patient had a feeding tube and I had to administer my drugs through it, unfortunately, i've never seen a feeding tube til then. We didnt go over enteral/parenteral feedings til this week! Well, that day my instructor was nowhere near my pt's room but the floor RN was there so I asked her to show me how to crush the pill and irrigate the feeding tube. It worked out!

    I say...if you feel uncomfortable about doing something...you need to say something! If you're unsure...like the previous posts....just ask!
  10. by   DaFreak71
    As another poster said, we had to practice these skills in lab before we ever touched a patient. I can't imagine being given a patient and having no clue as to how to care for them.

    In our clinical, we were always encouraged to team up with another student so that two of us would bathe my patient and whatever other care was needed, then I would go help him take care of his patient. The only thing we did independently (with instructor oversight) was dispensing medications.

    In my experience, the CNA's that work in LTC are an invaluable resource. If you have a patient that needs to be cleaned up, softly approach the CNA on your wing and say "Mr. X needs his brief changed, but I've never done that before. Can you either help me do it or show me how?" Don't expect all of them to jump up and help, but it can never hurt to ask. But of course, ask your instructor for assistance first.

    Another suggestion would be to go to the person in your class who is a CNA and ask her if you can assist her with toileting a patient or changing a brief the next time she has to do it. That way you'll how and will be able to do it on your own next time.

    Good luck!!
  11. by   svno7659
    I know EXACTLY how you feel! I just had my first clinical today and I also have never had any experience in health care. We only had orientation today and just introduced ourselves to the patient we were assigned to, but I am still freaking out. Yes, we had lab, but we only did the procedures for about 15 or 20 minutes, doesn't seem like long enough for us that have never done it! I don't even know the basics, like when do I change the bed? When do I feed the patient? Where do I take them in the wheelchair? AAGGHH I was almost on the verge of tears today, wondering if I can do it or not...we WILL do it, lets keep in touch!

    ~laurie
  12. by   MikeyJ
    I had an excellent clinical instructor for my first clinical; however, her way of teaching was to basically throw us into the patients room with no prep or help and let us go at it. It was very daunting and intimidating at first, but we quickly learned! If we ever needed help, she was always there though. I actually like that learning style because I think students learn a heck of a lot more if they are forced to use some critical thinking skills... however, it can also be very dangerous at the same time.
  13. by   krazy_coconuts
    At my school, we were "front loaded" the first two days of clinicals (first two weeks of the semester). We were taught all the basic things we needed to know once we were at the actual clinical site ie. vitals, bed baths, transferring, glucose checks, etc.
  14. by   APBT mom
    Our first clinical rotation was in a nursing home and we did CNA work. Our instructor told us what we were allowed to do with or without her plus checkoffs that we were required to have. After that she left us with our partner and would come by once every hour or two to see what we were doing.

    I would ask the instructor what you are allowed to do. She/he is there to help you when you need it. I would also ask if it is ok if you can partner up to do things. Bed baths and changing bed bound patients is much easier when you have two people.

    I would look in your fundamental book for procedures on bed baths, feeding, oral care, changing patients, feeding patients, etc. basically whatever a CNA does and make some cheat sheets and stick them in your pocket so you can look at them before you have to do something.

    As for what the patients need just ask they usually more than willig to tell. Good luck it gets much easier.

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