clinical gripes

torchwood1 · Dec 7, 2012

I just finished my 1st semester of nursing school, and I can relate to some of your experiences.

Our first clinical sites were at local LTC facilities, and while some of the nurses were great most just wanted us out of their way. We had minimal supplies, and were given minimal information regarding patients. I understand that we needed to learn to make our own assessments, however there were times that critical need to know info was kept from us and our instructor. Another experience was in a hospital where the CNA's (one who is trying to get into our program no less) left "sick" when we showed up.

All that being said.... I was reminded by a mentor that you can learn just as much from a good nurse as a bad one. I will take that a step further and say I learned from my bad experiences as well as the good ones. I have learned to always carry my own equipment (which is a requirement for us any way), and to hit the ground running. I made it a habit to always find a way to be busy (feeding, changing, baths, etc.) without being prompted to do so. I found that I was met with a lot less resistance from the nursing staff than some of my classmates who waited to be given instructions.

I just remind myself that I am there as an outsider. I am not going to try and change them in a day. I will report any relevant findings to the nurse and my instructor, and leave it at that. As long as I do my due diligence then I have done the right thing, and as horrible as it is to say.... it's not my license.

Racer15, BSN, RN · Dec 7, 2012

I guess I was lucky. My nurses were all pretty nice and willing to answer questions, and all of the equipment was fine. I wasn't often given a ton of info on patients, but I could always ask and I also had pretty free access to their charts. Usually the first thing I did was go in and do a quick assessment, get my meds ready, pass meds, and then by 9:30 I was able to sit down and flip through charts to get any additional information.

Hope your clinical experiences get better!

ImKosher · Dec 7, 2012

so i have been a lurker for quite some time before getting into nursing school and now a first semester nursing student, so here's my first post!
my gripe is about my clinical and i'm reaching out to ask you all if you've also had the same experiences....i was super excited for clinicals and unfortunately, it has been a disappointment....let's start with the first day, orientation, the nurses on our unit gave us dirty looks, were completely unfriendly and unreceptive! we haven't even started, we were just taking a tour! that already made us all feel intimidated and we got the feeling to stay out of their ways. thus, when we were in clinical, we all could not ask them questions to learn.
2nd, the bp/pulse ox/temp machine stands don't work! so yes one of the things we do is get vitals on our patients, but the machines were just bad, the bp cuff would not inflate right unless someone helped hold the tubing onto the machine, the were no working thermometers, the one attached on the machine would not pick up anything, and we were already scared to ask anyone about this and when we did, we just got the oh well that's all we have! don't the nurses have to have working thermometers to take temperatures on patients? our instructor and some students ended up bringing their own bp cuffs to take a it manually instead!
we didn't have gait belts to help these old and frail patients ambulate, i mean is that just something they teach in school or what? the gait belt would definitely help especially since a lot of these patients have weakness and are dead weight!
i feel like we are running around like a chicken with its head cut off, my lower back is killing me because of helping move patients, neither the nurses or aides would come help, there is no working equipment, and we can't even document if there are any issues because something happened with a patient who had an abnormal assessment and we were told we were NOT allowed to put that in our nurse's note!
is this normal?

Your first expectation should always be expected. No one is going to celebrate and throw you a parade when you come on the floor. There are several nurses or na who will enjoy your company going unsaid. You cannot judge about how the staff looks at you. What if they had a bad day? What if they're worried because they don't like students following them? What if, they just look that way?

2nd, you should inform the charge nurse, facility, and instructor. If these don't resolve the issue I'm sorry. Bring your own equipment, at least you will be on point with manual BP's

The gait belts? If you need one go get one. Many facilities don't carry gait belts for use.

I wouldn't worry about minor things like these. Get your feet solid and get into any situation and learn. That's what clinical's are for, to learn the real-life applications of the skills and concepts we have learned.

Good Luck

kaydensmom · Dec 7, 2012

We are required to bring our own cuffs to clinical and always take BL manually. It may be your first day on the floor but it is not the nurses first time seeing students and their job is not to make you feel welcome. Yes I know you would like to pick their brain but sometimes you just have to get advice off of your instructor. As for the gait belts, I have never seen one at any of my clinicals. I agree that you shouldn't worry about these minor things, you will get used to things as the semesters roll on.

chorkle · Dec 7, 2012

OP--

Your comments remind me of being a new CNA in LTC.

1. My trainer (more than 15 years CNA experience) said, You will be strongly encouraged to accomplish 9 hours work in your 8-hour shift.

2. Working eqpt. was in very short supply. One working thermometer for the facility was "normal." One was left with the unpleasant "choice" of looking for the working thermometer, which could be anywhere, providing one's own eqpt., or not taking temps--which was not acceptable.

3. We were required to have our own gait belt, a reasonable expectation; but they're not expensive. Yes, the facility owned a couple, but they were as hard to find as the thermometer. (Since it wasn't "theirs," some people tended to leave one where they last used it.)

4. Some things required two people to do, but help was often hard to find, i.e., time-consuming. And time was smth we didn't have, & couldn't buy.

morte, LPN, LVN · Dec 7, 2012

legally, all measuring devices need to be supplied by institution. Unless you are going to maintain records on your own devices, to verify they are accurate. Gait belts should not be used by those not instructed in their use.

BloomNurseRN, ASN, BSN, RN · Dec 7, 2012

We had to take our own cuffs with us to the LTC facility during our first clinical rotation. There were rarely pulse ox's that worked well and sometimes it was hard to find thermometer probe covers.

All that being said, clinical is what you make of it. Yes, some nurses and aides may not be 100% happy with you being there. Don't worry about them. Focus on the ones that are glad you are there. When you are done caring for the patient you have been assigned, go find an aide and ask if they need help. You will be there new best friend and probably get to see a lot more than people who don't ask.

Good luck!

CrimsonAlchemist · Dec 7, 2012

I guess my clinical experience was phenomenal, then. My nurses were, for the most part, willing to let us ask questions, very helpful, etc etc. Our equipment worked and, although we had to share it on the unit, as long as you didn't hog it, there wasn't a problem. The hospital also loved having my school's students, though. There was only one nurse that I remember, that didn't do well with students. I had her once, though, and as long as you showed enthusiasm and that you weren't an idiot, she loved you. I learned A LOT that day.

Gait belts should always be used to transfer at-risk patients. It's basic safety. That's something I learned in my CNA class and it's not difficult to learn. We got in big trouble if we didn't use one. That included the nurses as well. Hospital policy.

Bottom line, the equipment you need to do your job safely should be provided by the facility. Talk to your advisors and see if anything can be done to fix it. Not having proper equipment can put patients at risk and we all should be working to prevent that.

lemmyg · Dec 8, 2012

I find that first placements (usually LTC) are always the worst. The placement I had there was no hot water. I had to let the tap run for 5-10 minutes before I could bathe my 90 year old resident and most days it was still cold (I ended up using the kettle, which I got in trouble for) We also did not follow best practice in medication administration such as education and not crushing (as was the agency norm) We were also not allowed to even take vitals for some reason, even though trained, and most patients were ambulated in ways not outlined in their kardexes by the OTS and PTs.

My point is, It will get better. But also there will always be inconsistencies between what you learn in scholl and how things actually are. I would definately bring the non-working machines forward to someone there. That is extremely unsafe for patients/residents.

loriangel14, RN · Dec 8, 2012

so i have been a lurker for quite some time before getting into nursing school and now a first semester nursing student, so here's my first post!
my gripe is about my clinical and i'm reaching out to ask you all if you've also had the same experiences....i was super excited for clinicals and unfortunately, it has been a disappointment....let's start with the first day, orientation, the nurses on our unit gave us dirty looks, were completely unfriendly and unreceptive! we haven't even started, we were just taking a tour! that already made us all feel intimidated and we got the feeling to stay out of their ways. thus, when we were in clinical, we all could not ask them questions to learn.
2nd, the bp/pulse ox/temp machine stands don't work! so yes one of the things we do is get vitals on our patients, but the machines were just bad, the bp cuff would not inflate right unless someone helped hold the tubing onto the machine, the were no working thermometers, the one attached on the machine would not pick up anything, and we were already scared to ask anyone about this and when we did, we just got the oh well that's all we have! don't the nurses have to have working thermometers to take temperatures on patients? our instructor and some students ended up bringing their own bp cuffs to take a it manually instead!
we didn't have gait belts to help these old and frail patients ambulate, i mean is that just something they teach in school or what? the gait belt would definitely help especially since a lot of these patients have weakness and are dead weight!
i feel like we are running around like a chicken with its head cut off, my lower back is killing me because of helping move patients, neither the nurses or aides would come help, there is no working equipment, and we can't even document if there are any issues because something happened with a patient who had an abnormal assessment and we were told we were NOT allowed to put that in our nurse's note!
is this normal?

First of all you seem to be reading a lot into how people look.Nurses see students all the time.What did you expect? A big hug? Why would you interpret a look as "dirty"? Maybe they had a stressful day and a lot on their minds. Don't take it personally.

Secondly , yeah equipment breaks down and it takes forever to get stuff fixed.That's reality.You should be doing manual BPs anyways, not relying on the machines.

Gait belts? Yes we read about them in our books but nobody actually uses them.It is possible ambulate without one.

Running around like a chicken with its head cut off and your back hurts? Sounds like a typical day.

Yes this is normal.

sassynerd · Dec 11, 2012

Thanks everyone! This was helpful! Glad to hear that this is "normal" and I just need to adapt and not worry about those nurses! I am there to learn and should focus on patient care. If a nurse ever happens to talk to me and give me advice that would just be icing on the cake!

Our instructor also ended up bringing gait belts too with the BP cuffs so I will utilize them for clinical.

Thanks!