Disappointed in my clinical rotation..

Esme12, ASN, BSN, RN · Jan 24, 2014

I've started my clinical rotation in medicine, and I'm really disappointed in the unit i've been placed in. All my friends are in hospital with a variety of seriously ill, acute patients. My medicine floor is mostly older adults, with CHF, pneumonia, etc. I'm not trying to say that these patients are any less valuable or anything like that, but I hope to work in the ICU or emergency when I graduate, and I would do anything to get more learning opportunities than will be available on my floor. How can I get the most out of my rotation?

You mean....Your clinical rotation on a medical floor. Are you a med student? What semester are you?

While your DREAM will be ICU or Emergency medicine...it is difficult to get a position a a new grad. The patients in these areas will present with CHF, Pulmonary Edema, pneumonia so it would behoove you to know these diseases.

How do you get more out of it...? look up and study every disease process, understand the physiology...not just the pathology...the disease and why does it develop. Look up every co-morbidity and how it may or may not contribute to the disease process. Look up every med. Find out why it is given, how does the medicine work, how does it alter the physiology and how it affects the patients outcome. What nursing care would these patients need? why? What should you look for? what would indicate a worsening of their condition and why? What should you focus your assessment on? HOw can you teach them to better their quality of life at home?

I think there are plenty of ways to benefit your education. CHF while a chronic disease have acute episodes. How do you determine an acute episode of a chronic disease? How does pneumonia affect the elderly? How does being elderly affect their recovery?

I think there is plenty to learn.

krisiepoo · Jan 24, 2014

When I had that rotation, I kept busy by following nurses, helping aides, and talking to the doctors. I told them that I was here to learn/see/do as much as I could and would appreciate if they'd show me different things. I got to help with things that my co-students didn't because they saw I was serious about learning/seeing/doing. when others had down time, they sat around talking while I was answering call lights, helping with turns, cleaning pts, getting them toileted, etc.

It is up to YOU to make the most of it. There are valuable things to learn on EVERY rotation, no matter how whitebread you might think it is

NICUmiiki, DNP, NP · Jan 24, 2014

I totally get your frustration. Last semester, some of my friends were on the surgery/trama unit or a step down while I was on a Med/Tele unit (all patients have med problems with some patients who have additional tele issues). I saw a lot of Med problems like sepsis, pneumonia, and chronic conditions like CHF, diabetes, and COPD. I had an awesome instructor who really facilitated my learning of patho, pharm, assessment, and TIME MANAGEMENT. I also work in an ER and have realized that many of the patients in the ER are the patients on the med floor. Where do you think the patients on the Med floor come from? Even in the ICU, many patients have the same conditions, so don't think that the assessment skills you practice and meds you learn on the Med floor won't be valuable in the ER or ICU.

SunshineDaisy, ASN, RN · Jan 24, 2014

What semester are you in? If you are a new student they will not throw you into an ICU setting right off the bat. You have to build up to that. For instance in our school our first semester was in LTC facilities and sub-acute care places, then we moved on to mental health facilities and med surge. In med surge we did everything for the nurses that we could. There were 6 of us students on the floor, so we took care of every IV start, cath, wound dressing, etc. We also rotated to the ER, Pre op and OR at least once. The next semester was OB and Peds and then the last semester was med surge 2, or critical care. That is where we got to go to all the different ICU settings, trauma and ER. Some students that got lucky and got to go to the better hospitals got more experience in different ICUs (nuero, CVTU, surgical) than others. Clinical is what you make of it. Do everything you are allowed and learn, learn, learn!

That Guy, BSN, RN, EMT-B · Jan 25, 2014

I wish I paid more interest to stuff in school that "bored" me or wasnt part of my "dream job" Turns out all those peds clinicals would have come in handy. Make the best of every situation. Not every person you deal with is super sick, dead and or dying. You better learn that real fast especially if you want to go into ER

ICULINDA · Jan 25, 2014

I was hired in ICU right out of nursing school. And just this week both my patients were PNA with CHF. I'm so glad I paid attention and seeked out opportunities during my med surg rotation otherwise I would've been clueless when it came to my critical care rotation. Med surg is your foundation. No ICU will let you jump in and do things unless you've done them before. There's a reason critical care is the last semester. If your bored ask the other nurses if they need help or if any patients need a foley placed, NG/OG tubes, IVs started and get some practice.

Had to plug in ipad....anyways like previous posters have stated take advantage and learn about the drugs,patho, treatment etc..

RunBabyRN · Jan 25, 2014

You will want to know CHF, pneumonia, and all of those other "boring" things when you get to ICU like the back of your hand, and this is your opportunity.

Nursing school is what you make it. You have a lot of opportunities to learn about how to be a nurse AND about the kinds of conditions you'll see if you ever get into critical care. Plus, the ICU rarely hires new grads. Get your foundations in med/surg first. Soak up the opportunities to really get to delve into these diseases in lesser complicated states than you'd see in the ICU. You'll get to know the disease processes, and talk to patients about their lives with the diseases. These are really helpful to know when you DO get a patient that can't tell you about their experiences because they're on a vent or unconscious.

Plus, even if you are in a different unit, you'll have a lot of crossover from other units. I can't tell you how many psych patients I've cared for in L&D, ED, and med/surg, and my lactation and mother/baby experience came in really handy when I had a NB with apnea come into the ED, and the nurse had NO idea how to care for a NB or a lactating mom, who wasn't feeding often enough and was having trouble latching. I was able to do more than he was. Or the girl I had in med/surg with newly-dx diabetes who miscarried because her BG was so high.

Take this opportunity to learn about the nursing process and diseases here and now. When you get to your acute care rotation, you'll have a better grasp on this stuff.

RN9742 · Jan 25, 2014

My plan is to go into critical care, that being said I just spent a week of clinicals in ICU, and missed being on a medical/surgical floor the entire time. Reason being, on the med-Surg floor I was in last semester I had the opportunity to spend more time learning about my patients and connect all the dots so to speak. I really learned a lot about their diseases, potential complications, why they may have several different diagnosis, why they take what drugs etc etc. In ICU I was so busy doing complete care, meds, bathing, turning, etc etc I never had that opportunity. Nursing school is about learning as much as you can, not focusing on specific types of patients.

psu_213, BSN, RN · Jan 25, 2014

Sure it's not as "glamorous" as the ER or ICU

And, trust me, the ER is not as glamourous as TV makes it out to be!

meanmaryjean, DNP, RN · Jan 26, 2014

And, trust me, the ER is not as glamourous as TV makes it out to be!

Ain't THAT the truth! :)

NurseOnAMotorcycle, ASN, RN · Feb 11, 2014

I agree with a previous poster. 90% of E.R is old people with CHF or pneumonia. How do you think they get into the hospital to begin with? First they come to the E.R.