First Day of Clinicals....Disaster - page 4

by WILLBEANRN

Hi everyone, I just wanted to share about my first day of clinicals. It was awful. :crying2: We had partners to take care of one patient. Our patient was 95 and her daughter was glued to her side. I was to start vitals. The... Read More


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    I have been a nursing instructor for a long time, and would never do what your instructor chose to do. Brand new students are expected to be slow, clumsy, and unsure. I have extremely high expectations for professionalism and preparation for my new students from day 1, but that is about it! They have to learn the rest when we are at the clinical site. One of the first things I have them do is to go in to a patient's room, introduce themselves, look about, then report back. I will then ask them a series of questions. Does your patient have an arm band? Any allergies? Where is the IV site? Is there a foley? Any guests in the room? Who are they? What does the general survey tell you?

    Almost none of them can answer even the most basic questions on day one. I ask them if they feel a bit stupid, and they admit that they do. I then tell them that this is NORMAL. You are in a strange environment, learning new skills, a new language, where things are, and what the expectations will be. I expect errors in judgment and in performance. I am always near my first semester students, especially in the first few days. I model the assessment we have learned in lab. I then ask them to go perform a general survey and perform vitals. They slowly build their skills. Odd mistakes will happen. Students will upend bedpans on the patient or themselves. They will fail to unlock the wheelchair wheels and wonder why it won't move. They will be less efficient and less fluid at every skill than I am. This is NORMAL. It took me years to get where I am. They will not be nurses overnight.

    I increase my expectations over time. I expect professionalism, kindness, and caring from the beginning. The rest will only come with practice. You made a small mistake. No one was harmed or died. I would bet that you learned from it and will not do the same again. You seem to care about your patient and want her to receive the best care. Work in the skills lab to practice vitals over and over until your proficiency increases. Don't let negativity burn out the caring side of you. Keep improving and keep challenging yourself. You can do it. You seem very thoughtful about the whole process and to want what is best for your patient. I would have enjoyed having a student with your motivation in clinicals.
    nursel56 likes this.
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    Esme, you are my new friend.
    Esme12 likes this.
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    Life is about challenge and rising up. If you never had bad days how would you know a good day? USE those days to learn. You will learn how to be organized, how to cluster your care, how to do assessments. The number one thing I got out of my 2 years med/surg was awesome assessment skills. I do psych now and have for 5 years, but those assessment skills STILL help me.

    Use that day and learn from it. It is life. It is how you become a good nurse. Dealing with stress and intense situations builds you into a tougher person. I have walked into rooms with blood all over and had to deal with things THAT SECOND. You will appreciate these days and how it makes you stronger.
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    It doesn't sound like your instructor did much instructing. I really do feel for you. Just make sure you try to keep a clear head, even when things go awry. I think that you ran into trouble when you panicked. Next time just try to stay calm and ask your instructor for help immediately. As far as the instructor saying you should feel bad for making mistakes, I think that is really unfair. You are a student, you are there to learn. You are not a well seasoned nurse. I do not understand how she does not expect you to make a few mistakes. Even nurses with lots of experience make mistakes sometimes, we are only human. Granted you did make an "uh oh" as I like to call them (you've got to keep some sort of humor during all this madness in my opinion. I do it by making corny jokes and calling my mistakes uh oh's, haha), but it was not a life threatening uh oh. You are not a failure, you are far from it. If anything, your instructor failed you, but you didn't fail her. Learn from your mistakes and try again. Please don't give up!

    p.s. OP, I will pray for you, if you'd like. I've gotten a lot more religious during nursing school. I would highly suggest getting in touch with your spiritual side, whatever side that may be. I don't have one set religion, I'm kind of a drifter, but it gives me strength to feel like I'm connected to something greater than what I can comprehend. In those times when I feel hopeless, it helps to give me hope. I also make a point to pray during good times as well and reflect on my accomplishments. It's very humbling. Just a thought. I hope you find inner peace and the strength to meet all of your goals.
    Last edit by missk88 on Oct 2, '12 : Reason: adding on
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    I am sorry you had a rotten experience. Things will get better. You learned some valuable lessons today and you will not make those mistakes again . I think your instructor was a bit harsh. She sounds like the "lay down the law type". Unfortunately, you will likely have to work with her, but if you encounter a serious problem, where she for example, was berating you on a daily basis no matter what you did to try and please her, do not hesitate to bring it up with your school.

    Sometimes we have a blooper moment during clinical, and I think that was yours this semester. Put it behind you and go back to clinical excited. I was nervous when I first started as well. When I had a tough week, I reflected and then I went back the next week motivated to have a great shift! You will have good experiences that outshine this, and you will laugh at yourself for what happened on the first day of clinical in the future.

    Best of luck future nurse!
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    really liked this whole thread - especially the step by step explanation of the basics - which I know looking back seem maybe obvious (and they will later I promise) but at the time - oh my god the things I didn't realize, notice etc - but then that is what it means to learn right? I owe everything to my good compassionate, perceptive and constructive clinical instructors. To this day the one that I had for my first med surg - which I'm sure some would claim was helping me prepare???? (and seriously anyone able to show me a study linking abuse and humiliation to better outcomes for learning and better skills development - I am all ears) - well luckily she was the exception. I hope things are going better for you - and thank you to all who wrote such measured thoughtful responses...
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    On my first clinical day I stayed in my patients room almost the entire day because she had dementia and would scream when you left. Finally she fell asleep and I left. I had done everything I could do for her, but for some strange reason I forgot to get her respirations. I went back in with my instructor and counted her respirations and they were normal.

    All of a sudden, my pt stops breathing! For no reason she went into respiratory arrest and I had to call the code. She was not on any kind of monitor so no one would have known! 15 minutes of CPR later and many other things, she was revived and sent to icu. This was just a fluke and I actually got praised for forgetting the respirations!

    It will get better-trust me! When you get to do something like that you feel good about all of the other stuff! Good luck!
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    Esme, i love these forms, especially the report sheet. It's more organized than the forms provided by our college. Thanks so much!!

    Quote from Esme12
    This thread is two years old but it is always good to hear you aren't the only one. Organization is key....

    take a look at these brain sheets you may find one to help

    mtp med surg.doc 1 patient float.doc‎
    5 pt. shift.doc‎
    final graduate shift report.doc‎
    horshiftsheet.doc‎
    report sheet.doc‎
    day sheet 2 doc.doc

    critical thinking flow sheet for nursing students
    student clinical report sheet for one patient

    i made some for nursing students and some other an members (daytonite)have made these for others.....adapt them way you want. i hope they help
    Esme12 likes this.
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    Please use them! Organize where you can to contain the chaos.


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