Clinical Confusion?

[PoppyCorn99]

So I'm a fresh Nursing Student. My first clinical was last week in a nursing home, and my fears were realized when:

(1) we had to decide what to do ourselves

(2) no partners

(3) everything the patients asked for I had to ask the tech whether or not it was okay, who was always missing (e.g. can the patient get out of bed/get into bed, which every time the tech said "No")

(4) other than getting a glass of water, nothing the patients asked for I actually knew how to do, or was qualified to do (e.g. we were never taught how to put clothes or adult diapers on a bedridden patient, and I had no idea slide boards for moving patients to wheelchairs existed). We didn't even know where things were until the official tour around the building three hours after we started working.

I found myself completely clueless for maybe 85% of the 6 hours I was there, literally walking back and forth down the halls either trying to find a tech or looking for clean linens and towels, which were always conveniently low in stock or just out of stock altogether.

Are clinicals usually like this, or did I just get a raw deal? Is there any advice someone could give me? This has really left me discouraged and afraid for the future.

[BeachsideRN, ASN]

It gets better. The first one is always the most difficult.

[BeachsideRN, ASN]

Ask for guidance from your nurses/techs in advance. Now that you know things that might be asked by a patient. Ask the nurse/tech when you start. Who can get out of bed, if anyone is NPO, any special considerations to be made. Ask the techs to show you how to change briefs and/or watch skills videos. Ask where clean linens can be found.

You're new. You aren't supposed to know everything yet. You just don't know what you don't know.

[thimba]

Were you not assigned a nurse to follow? My very first day at clinicals I was at an LTC facility and I wasn't given a nurse to follow, but that never happened again. Usually you should be paired up with a nurse at the beginning of the day.

What do you mean by no partners? Do you mean no fellow student to be partnered up with? I have never been partnered up with another student, I have always just been by myself with a nurse.

Before the shift starts you should receive report on all the patients you are helping take care of, so you know which ones can ambulate by themselves, which ones need assistance, etc.

I have never gotten a tour of the clinical facilities I have been at. I always have to figure out where everything is myself. Usually when I'm first walking down a new hallway, I will start looking at the labels on doors to get an idea of where things are. Then as I'm walking to and from patients' rooms in other hallways I am always still looking at door labels.

Clinicals are hectic. When I was at the LTC my first semester, we weren't allowed to do much at all. So I found things I could do-- like refilling towels in patient rooms, making sure there were enough clean laundry bags in the rooms, making sure the precaution rooms had adequate stocks gowns and/or masks, going into rooms and asking each patient if they needed their water filled up, asking the techs if they need any help taking vitals (I would split the patient load with the tech, she would take half and I would take half), also feeding the patients meals helps out a lot as well. Just think of what could be done to help the techs and jump in

Edit: before you feed the patients meals, ask the CNA or tech if they're an aspiration risk. Also make sure the patient isn't NPO before getting them water.

Edit 2: also even just sitting and talking with the patients is a wonderful thing to do (work on those therapeutic communication skills!) A lot of the patients are lonely and are tickled pink if you lend them an ear for 10-15 min.

[vintagemother, BSN, CNA, LVN, RN]

Only in CNA school was I given a partner.

I really can't remember what I did/didn't do on my 1st day of LVN clinicals.

I do recall that I learned to be a very good CNA through my LVN clinicals. HaHa! What I mean is that we were allowed to do ADLs and bed making. (And vitals and blood sugars) I got a ton of practice at that! In my school, not sure if this is the norm, we could only do "nursing skills" such as pass meds and give tx/shots if A) our clinical instructor was with us or B) if the nurse took on responsibility and the clinical instructor approved of the arrangement.

Because the clinical instructor had approx 10 students, this meant we spent a lot of time doing "patient care".

And we had better not complain about it!

I learned to make the best of the situation. I developed really good pt care skills, really honed in on therapeutic communication and spent a lot of time, term 1, perusing charts and using the info gleaned to research the common dx and meds.

I think my experience may have been different if I was in an RN program for term 1 & 2.

As it was, I learned enough to pass my NCLEX PN boards and eventually get accepted to an RN program.

I'm scheduled to graduate in less than 2 months.

Therefore, I'd say for you to try to make the best learning experience out of your circumstances.

[HouTx, BSN, MSN, EdD]

Where the heck is OP's Clinical Instructor?? Nursing students must be supervised by a qualified CI - & working alongside a qualified preceptor who has been approved by the CI & place of employment. Unlicensed techs CANNOT serve as preceptors. Sheesh. This type of practice will jeopardize the nursing program's accreditation status.