Clinical experiences

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    I'm just wondering what other students clinical experiences have been. I'm in 2nd semester ADN, doing med-surg. We have a large class, with 8 clinical instructors. Each instructor is assigned a group of students for the semester. It is the instructors choice to have her students perform the skills that we have checked off on, or not.

    Last semester, there were three groups where the instructors had their students give meds every clinical day, shots and PO's. In other groups, each student was assigned one med day. I was in a group that assigned one med day, and most people in those types of groups only got to give PO meds.

    This semester the instructor I have expects us to do all of our pt's meds, and I feel terrified! I have discussed it with my instructor, and she says that once I get my feet wet, I won't have as much anxiety about it. She wants us to be proficient by the end of the semester because in the summer we will be doing pediatrics. Although I am scared, I am glad that my instructor understands the need for us to perform these skills to be proficient.

    A friend who was in my clinical group last semester, who also has only done one day of PO meds, has an instructor this time that will only be giving each student one med day. She is upset because she feels that it is not fair that other students will be proficient in giving meds by the end of the semester, and she feels that she will not get the same clinical experience. I think she has a valid concern, but some of the instructors get a bit defensive if you question their way of doing things, so she is afraid to voice her concerns.

    Last semester, we basically performed CNA skills, physical assessments, and towards the end, we got to do some dressing changes. That was it. I was a little disappointed, because I thought we would be doing more.

    This semester we are more nursing focused, but it is hard because we are supposed to perform the skills we learned last semester but never performed, and the skills we are learning now.

    What skills are/were you doing in your first semester or second semester, and did all of the clinical groups in your class do the same types of things?
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  4. 0
    Hi!
    I am in my second semester of an ADN program.
    This semester we are performing care for 2 patients... that is, head to toe and focused assessments, all meds, any necessary treatments such as dressing changes, neuro checks, in and out/retention catheter insertion and removal, basically anything they need with a few exceptions. We can hang IV primary and secondary bags but we cannot start IVs or give meds IV push (those are second year skills). We can change tubing, d/c IVs, that sort of thing... empty drains, care for PICC lines (no central lines yet, though), etc. Each clinical day we also create care plans for each patient, for at least 2 nursing diagnoses with 3 interventions each for each patient. We are currently on an orthopedic and oncology floor. (No chemotherapy or blood transfusions, of course)
    For this rotation, we have a client profile and care plan paper and a therapeutic communication paper due, plus journal entries for each clinical day, self evaluations, etc.
    (Oh, did I mention this is only a 6 week rotation?)
    Our other rotations are community health nursing, pharmacology (which is *just* giving meds in a nursing home for 2 days... that'll get ya used to the 5 rights of med administration), and 6 weeks in OB. (And a boatload of other papers!)
    I feel really good about the progress I've made so far and all the things I can do....
    The single most important thing you can do is be proactive. Let your primary nurse and all of the other nurses know that you are eager to learn new skills and will help them in whatever way you can. They will seek you out for interesting things that you may not have seen. For example, last week I went with a nurse while she was accessing a portacath and administering blood to a cancer patient. She found me because she knew I was interested in seeing as much as I possibly could.
    The only thing you can do to feel more comfortable is perform the skills more often. If you don't feel like you're getting all you need from your clinical instructor, TELL THEM. After all, you are paying for this experience.
    Good luck! :roll
    (Sheesh I had a lot to say)
  5. 0
    I have had the same clinical instructor 2 semesters in a row... and I'll say she's pretty conservative. We are doing OB rotation. We give meds and injections and of course assessments and charting. But the instuctor pretty much OK's everything before we do it. We are supposed to be doing foley's and IV's this semester... but I'm not holding my breath.

    However, the instructor I have next semester lets (makes) you do everything. My friends say they are changing colostomy bags. IVPB, dressing changes, IV's, NG tubes... everything.

    I'm not looking forward to the next rotation because I know I'm not going to be prepared. But they are right in one regard... I think once you get your feet wet we will have to learn to swim... either that or drown!!! LOL

    Much Luck,
    I know I'm gonna need it!
    Paula
  6. 0
    originally posted by mspurp
    hi!
    i am in my second semester of an adn program.
    this semester we are performing care for 2 patients... that is, head to toe and focused assessments, all meds, any necessary treatments such as dressing changes, neuro checks, in and out/retention catheter insertion and removal, basically anything they need with a few exceptions. we can hang iv primary and secondary bags
    man rebecca! you're doing so much more than me right now and i'm 2nd semester. we have one patient which is fine by me right now, although i want them to give us more so that when i graduate, i won't be shocked out of my mind when i get like 8 patients! lol we don't learn to hang ivs until two weeks from now. we give meds now and sq and im which is cool. haven't given an im in clinical yet, just a sq. sqs don't scare me as much as ims do. it's exciting, but let me tell you, a long day on the floor makes me think i was on there for 48 hours straight!


    zach
  7. 0
    Hey Zach:
    don't be afraid of IMs, you'd be surprised how easy the needle goes in.
    I'm glad to be doing a lot in clinical... I bore easily and am always looking for new and different things to do/observe/learn, etc.


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