Hospital clincals have been awesome!!!!

[~Mi Vida Loca~RN, ASN, RN]

I finished first semester not feeling very competent in my clincial skills. I felt like I didn't learn much of anything, we were at the nursing home first semester and there actually just wasn't much for us to do. The first day we shadowed the aide but most of the times after the aides were training other aides so there wasn't much help needed by us. We couldn't really give full Physical assessments or correct ones on the Pt. and I really just felt like I learned nothing. It's just a whole different environment. Not to mention, I find the care of our elderly is far under par, and the facility I was at was considered (one of the great ones) so that alone left a very bad impression on me. I was miserable there. I got close with a pt and she passed also. I did feel like I learned a lot in regards to communication though. Interaction with staff and pt's. So I can take something positive from it. But I rarely did any transfers, or turning shoot I didn't even know how to empty a catheter going into clincals this semester.

I am sharing all this in case someone is feeling the same or has. We do skills lab and I was "skilled" on Injections, but I only did it like 3 times on the little pad and not a real person so I was petrified about doing that as well. You get the picture.

So go back to Tuesday of this week, I am on my second week into my second semester. Go to the Computer training class at the hospital and it all seems so complicated and foreign and I am pretty good on computers and a quick learner. The next day was clinical orientation. We went over what was expected of us and what we would be doing and a list of tasks that we need to learn but the end of this rotation. (6 weeks twice a week and then we move on to Peds/OB (which I actually have a lot of experience with). I left orientation asking my husband would he be upset if I quit. I said I don't think nursing is for me and I don't think I am capable or smart enough. Said I hardly have any experience on anything is these small skills, let alone with bigger ones and I don't think I will get it. I called my mom and told her the same thing. I honestly considered dropping out. I decided to finish out the semester and hopefully the program because I am not a quitter.

I went into my first day of clinicals Th night so nervous. By the end of the night I had given a Sub Q injection, I had the opportunity for another one, but my friend that was on my wing as well hadn't had a chance to do one yet on a person, so I asked my nurse if she could do that one. I did a suppository as well. Far from glamourous, but again, it was another thing that I did on a person that I could check off. Passed a lot of meds, got a little practice at Charting. Now I had a very friendly nurse, but I had a few problems. My pt I could tell was in a LOT of pain. All the signs were there and it didn't take a skilled nurse to see it. It was obvious. She couldn't talk though or right. All she could do was look at me with her pleading eyes to help. Her mouth was extremely dry, to the point that I had to do her temp axillary because the thermometer was trying to stick in her mouth on the dry skin. She had a fever, 103 under arm and had transferred in from ICU. I had picked her for my Pt because she would be there for the rest of my week and my nurse only had to other patients. So I check her meds and orders and she has a 2mg morphine drip q2h prn order. My nurse tells me we will give the Tylenol suppository for her fever and pain. It was obvious that was not enough. I take her vitals again, her RR was 51 one. Yes that is FIFTY ONE. She has very labored breathing, her pulse was 137. I felt like I should use a child cuff for her BP because she was a very tiny lady and was a whopping 86 lbs and the regular cuff could practically wrap around her arm twice. I knew from school, that the clinical signs of pain were there as well. Granted infection can cause increased vitals and she did have an affection, but she was grimacing and you could just see she was in pain. Her BP was reading low and my nurse insisted we didn't need the smaller cuff that it was fine. She also insisted she wasn't in pain and the tylenol was all we needed to give. I expressed my concerns to the charge nurse as well. Not in a tattling way or even an undermining way, I waited for a good opportunity to express it to her without looking like it was going against my nurse. Again my concerns were ignored because I was just a student.

Aside from that though, the night went well. I came in tonight and had the most awesome co-nurse. I had my same pt. and my concerns were not only heard, but they were validated, this nurse was just so eager to teach me all kinds of stuff, to have me go and take my time and chart the Physical assesment, really taking my time to read all the categories thoroughly, the night before I was just told to put this and that and was very rushed to do it and it was not a busy night. In fact, tonight was busier, although still pretty mellow. Anyway, this nurse was just awesome, I felt so lucky. The nurses and aides in the nursing home I was at, were not very friendly or helpful with us. But just about all the nurses I have met and aides thus far, have been great. The aides just love us because we are doing our own pt's vitals and running to answer call lights just for the experience of it all and because the night has been slow enough that it isn't neglecting our other tasks. Shoot I even went searching other wings for a sleeper chair for a husband. So the aides here really like us and aren't rude when I ask for help. I had to ask an aide to show me how to empty the cath and he was great about it. By the end of my shift, I felt totally comfortable and needed little direction, I was charting pain assessments, I&O's. Repositioning, and so on without having to be asked or told or needing any direction.

I really feel like I have learned and absorbed so much in 2 nights then I did all last semester. It's been a great experience. In fact I was thinking, dang won't have clinicals again until Wednesday, I wish we had them more. I love being on evenings as well.

So anyway, as you can tell I am still wound up from tonight. I figured I would come here and share, because I know many people in my class felt the same way as I imagine others will as well. If you find yourself in a similar situation that I first described, just read my new experience and I hope it helps. I know just hearing from my friend who started her clinical site the day before me, hearing her tell me about all she did and how well it went, helped ease my mind a little and make me feel a little better. I hope I can do the same for someone else.

I haven't been able to be on much lately, went on vacation and then our schedule 2nd semester has just been so busy with all the orientations and training and stuff. They are making us do all site training even if we aren't there because it's good for the duration of school and we might end up there eventually. Anyway, it's just been extremely busy. But I hope everyone's semester or quarter is going well

I hope all this made sense. It is 2:40 and my body's tiredness and exhaustion is finally taking over for the night lol

[Nepenthe Sea]

Awesome! Glad to hear its working out better for you. Last semester I had my first clinicals. We started out in a LTC/rehab facility. Of course, that first week, I was sick, and couldn't think straight. Everything confused me. I couldn't do anything right, and I usually am fairly competent. I felt like an idiot. My care plans were awful, and literally took me all night because my patients all had like 10 pathophysiologies and were on about 30 different meds. I was thinking about dropping out. A girl in my group actually DID drop out the second week. Most of my patients were non-ambulatory, so I still am not sure about how to transfer out of the bed, etc.

For my second rotation, I went to a med-surg floor at a regular hospital, and I felt much better. Suddenly, things started to click, and I felt like I was getting the hang of it. My care plans improved immensely, and I was complimented alot by my CI. I still feel a little awkward thinking about going back to clinicals, but I am hoping it will be a good experience.

Thank you for sharing, because you're right- alot of us have felt like you, and it's good to know it won't always be that bad!

[~Mi Vida Loca~RN, ASN, RN]

That is great to here the hospital went well. I have just been in shock over how non bad it has been. How quickly it is to pick things up. I just felt like at the LTC facility, the people were treated like cattle, and part of me understood, the nurses and aides are overwhelmed, they don't get a moment to breath, they have to hurry and toilet and do the care and move on. They don't have the time to sit and chat and be a lot more warm about it. It doesn't make it any easier to see, but I can understand that part. By the time the nurse was done passing all the meds, it was time to start again and she hadn't charted yet.

So I made it a point to go in and talk to pt's. Listen to them, hold their hands and stuff, give them the attention that couldn't be given. So I got confident on that stuff but wasn't on the skills at all.

[Coriander, BSN, RN]

I am so very happy for you, Mi Vida Loca. :)

It sounds like you fell right into the swing of things and are going to be a wonderful student nurse, and then a fantastic nurse!

[~Mi Vida Loca~RN, ASN, RN]

I am so very happy for you, Mi Vida Loca. :)

It sounds like you fell right into the swing of things and are going to be a wonderful student nurse, and then a fantastic nurse!

Thank you!!! It feels so great to actually feel like you are catching on and learning things. I have learned SOOOOOOOOOOO much in just my 4 days in my hospital clinicals on the medical unit. Today I actually got to assist the Dr. (which was just taking off a special cap and holding a glass bottle) who was doing a Thoracentesis.

I had the most wonderful pt the past 2 nights, it was truly an honor working with him, and his daughter was so wonderful as well, and made me feel so good by telling me what a great nurse I am going to be. We had a great rapport (sp) with each-other. My CI was coming in to watch me do a physical assessment and he promised he would behave, when I told him to take a deep breath, he made this retched sound and tensed up and acted like he was going to code, I didn't even flinch and I smiled and told him to keep it down. He started laughing as did my CI and his daughter who were all right there.

So after, I told him that when I bring his heparin shot, I was going to put it in the biggest syringe and needle I could find. Again, we all laughed. Having great patients and co nurses truly make things a great experience, even if things aren't going so great. So far I have done pretty good on having both.