Clinicals are much different than exams...

  1. I'm just finishing up my first semester of nursing school. We have all multiple choice exams (they try to make them like the NCLEX) and so far, I have gotten all A's on them. We started clinicals last week and I feel like I am just not prepared. I think a lot of it is anxiety. I am the type that likes to be very prepared and if I am, I will do well. If I'm not prepared, I'm horrible. Clinicals made me 2nd guess myself as to if this is the right career for me. I just felt like I was thrown into everything. My first client was blind, deaf, in wrist restraints for hitting and pulling his foley and IV out, spit thick sputum out at me (like a llama), and was obviously not cooperative. My clinical instructor checked in on my every know and then but I still felt lost. At the nurses station, there is paper work everywhere so it's hard to find what I need. Plus, when I go to look at the doctor notes, I honestly can read nothing. Why oh WHY can't they right legible? We have a lab at school where we practiced foley's, wrist restraints, physical assessment, heart sounds, etc. but real life is way different than a lab. Any advise on how to get my nerves in check and focus. You know the sad thing.....The hardest part was how the heck to change a bed w/ a person in it!

    A.
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  2. 7 Comments

  3. by   BSNtobe2009
    The handwriting part alone is going to scare me. I have no idea of what microchip they pop into the brains of RN's when they graduate, that makes them able to decipher chicken scratches, but somehow they are up there with the pharmacist!
  4. by   nurse206
    All I can say is I feel the same way as you. I just completed my first term in LPN/LVN school and WOOOW! My first day of clinical was horrible. I had no experience in healthcare and didn't know what to expect. I know all the procedures but I went totally blank. It is soooo much different than in lab. The CNA's in my class were totally comfortable going to town and there I was like a deer in headlights. Now I feel a little more comfortable but now the procedures are more invasive! I can relate to you in the fact I like being totally prepared and ready. My second week of clinical I had a colostomy to care for and Oh MY GOSH with me having no healthcare experience and never seeing a colostomy in real life, it was something!!
    That really made me question if I really want to do this and I think I do. I just remember that to be a good nurse you need to know a little about everything and when the time is right I will hopefully specialize or branch off in the area of nursing that interests me the most! Anyways hang in there and good luck!
  5. by   mysterious_one
    Take a deeeeeeeeeeeep breath, you can do this, after all this was your first glimpse and you obviously had a patient that was not easy to deal with. I promise, it will get easier, and it will get more comfortable every time you go. I agree with the chicken scratch, though,lol. Don't know what to do with that myself. But you know all the nurses started out just like we did. Don't doubt yourself guys, over going to clinicals just a few weeks, give it time, there is so much to see and so much to learn. And you will be so amazed, when your first patient tells you how much they appreciate you, and it will happen, trust me. And isn't this what we are wanting to do: taking care of the patients, making them feel comfortable in their time of need, to the best of our abilities.
    Good luck guys.
  6. by   WDWpixieRN
    I empathize....we completed our last week of clinicals this week and I just feel like such an idiot....I can do the basics (didn't have to change a bed by myself with pt in it alone, thank goodness), but don't feel real competent and I honestly had very easy pts compared to some of the other students....I have passed all my checkoffs, but when I ran across the sheet for NG tube care the other day, I thought ?!?!?! I haven't had to do one and my mind's inundated with 20,000 other things that have been thrown at me and several other checkoffs since then! If you put me in a situation today where I had to do it alone, I'd be lost!!

    It's very scary and not an easy position for those of us who like to "know what we know" to be in this situation....I'm petrified for second semester and hope I have a good CI who will work with us....I read others have RN mentors on this site....I would love to have something like that as our CI was spread thin and the RNs were too busy to "teach"....I know what a taped crackle and wheeze sound like -- but I don't have the confidence to know that that's exactly what I heard in a pt....it's a bit frustrating and has made me question my personal ability to do this as a career....
  7. by   smk1
    Quote from floridagirl0103
    I'm just finishing up my first semester of nursing school. We have all multiple choice exams (they try to make them like the NCLEX) and so far, I have gotten all A's on them. We started clinicals last week and I feel like I am just not prepared. I think a lot of it is anxiety. I am the type that likes to be very prepared and if I am, I will do well. If I'm not prepared, I'm horrible. Clinicals made me 2nd guess myself as to if this is the right career for me. I just felt like I was thrown into everything. My first client was blind, deaf, in wrist restraints for hitting and pulling his foley and IV out, spit thick sputum out at me (like a llama), and was obviously not cooperative. My clinical instructor checked in on my every know and then but I still felt lost. At the nurses station, there is paper work everywhere so it's hard to find what I need. Plus, when I go to look at the doctor notes, I honestly can read nothing. Why oh WHY can't they right legible? We have a lab at school where we practiced foley's, wrist restraints, physical assessment, heart sounds, etc. but real life is way different than a lab. Any advise on how to get my nerves in check and focus. You know the sad thing.....The hardest part was how the heck to change a bed w/ a person in it!

    A.
    Ok so the first thing to do, is to start carrying a small notepad in your pocket to start writing down questions that you have that may come up again. Also make a list of all of the abbreviations that you can decipher and find out what they mean. Realize that at this point you don't have to be able to understand the whole chart. Focus on the typewritten portions to guide you to areas of the chart that need a closer look. If you don't know what something says, say so and find out. Yeah you might be bugging the nurse, but in reality, if it is information that you need to know and can't get anywhere else, then so be it. (obviously use common sense and find a time when they aren't super busy). If you are stressed out about ADL's, find a CNA and ask to observe how they handle _____. Ask them to help you now, so that you can find a way to accomplish these procedures by yourself later. The CNA's can be a great asset and resource. Set a goal for yourself to master one or two tasks for the week and volunteer to do them if they come up over and over again if you have time. This will be difficult at first, but it will help to get rid of your anxiety for that task. Remember the reasons behind why you are doing things. The important things for ADL's are privacy, safety, infection control and comfort for the patient. It is not always necessary to do things in a step by step order the way it you may have seen it demonstrated. It is however important to make sure that they way you are performing the task addresses the issues that I mentioned above. Take the time to get your hands on the equipment that is available at your clinical sites, make sure you know how to use the particulary brands and types of lifts, beds, restraints, anything that you will be working with. You will get more comfortable with time, find ways to help that process along. Good luck!
  8. by   GratefulHeart
    Quote from floridagirl0103
    I'm just finishing up my first semester of nursing school. We have all multiple choice exams (they try to make them like the NCLEX) and so far, I have gotten all A's on them. We started clinicals last week and I feel like I am just not prepared. I think a lot of it is anxiety. I am the type that likes to be very prepared and if I am, I will do well. If I'm not prepared, I'm horrible. Clinicals made me 2nd guess myself as to if this is the right career for me. I just felt like I was thrown into everything. My first client was blind, deaf, in wrist restraints for hitting and pulling his foley and IV out, spit thick sputum out at me (like a llama), and was obviously not cooperative. My clinical instructor checked in on my every know and then but I still felt lost. At the nurses station, there is paper work everywhere so it's hard to find what I need. Plus, when I go to look at the doctor notes, I honestly can read nothing. Why oh WHY can't they right legible? We have a lab at school where we practiced foley's, wrist restraints, physical assessment, heart sounds, etc. but real life is way different than a lab. Any advise on how to get my nerves in check and focus. You know the sad thing.....The hardest part was how the heck to change a bed w/ a person in it!

    A.
    (((((floridagirl0103))))) This too shall pass!
  9. by   kimber1985
    I think the first clinical rotation is the hardest. It's a bit shocking and you feel like a complete idiot. I think most nursing students doubt themselves at some point.
    Here are some tips. If you have a difficult patient, don't bother changing the bed or bathing them alone. Buddy up with one of your fellow nursing students, or be really nice to your CNA. If they are in any way allowed to sit in a chair, put them in it and change the bed then. CNA's are goddesses! They are often glad you are there and usually will give you a hand. Just watching them will give you skills, even volunteer to help your CNA do another patient.
    Secretary's can read Doctor's handwriting that looks just like Arabic. Just ask, and always look for typewritten pages. Learn where things are in the chart.
    It gets easier, you make less beds and do less bed baths. But then you have the anxiety of passing meds. Just do the best you can and never make a med error.
    Use the Lab. Find a lab teacher to work with on anything you are uncomfortable with.
    Get use to feeling a little unprepared. It is hard to feel prepared when you are doing things for the first time. Instructors will usually talk you thru whatever you are doing.
    Be aggressive! Take every opportunity to do whatever you can. Make sure to ask your nurse to see or participate in any procedure possible.

    Good Luck,
    I am also in Florida, where do you go to School?
    Kim

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