how to pick a pt. for clinicals?

  1. We started clinicals last week and our instructor picked our patient for the first week. Starting tomorrow we have to pick our own patient. We go to the hospital on monday and pick a patient for the clinical days (tuesday and thurdsay). I'm on a med-surg unit right now. What type of pt. is "easy" to work with? What age group? Male/female? How many days post-op? Any other things I should take into consideration? Thanks!
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  2. 25 Comments

  3. by   KatieBell
    One way is to speak to the nurses and ask which patient might be good to work with.
    I'm sure you didn't mean you wanted an "easy" patient, but if you did- Don't look for the "easy" one. Since you only have one patient, you have time to deal with some difficulty. One of the best clinical experiences I had was to take care of a patient who was near comatose, on tube feedings, hourly glucose checks, insulin, iv push meds, piggyback antibiotics, nervous relatives, etc....

    It sure beat hanging around the nurses station with the other students. It's your time to learn.

    Don't pick a patient that is far out post operatively, because they will likely be discharged home...
  4. by   Fun2, RN, BSN
    For a second patient (or client) I wouldn't pick an easy one, but one that will challenge you to learn.

    I realize that you don't want to over do it and be too stressed, but remember the more you see in clincals, the more you will be prepared for later.

    Good luck!
  5. by   MonkeyRN
    Go for the pt that will let you practice as many skills as possible. Make sure you talk to the nurses to make sure that pt will still be there on your clinical day. I also ask the nurses to recommend a good pt for me as a student.
  6. by   caroladybelle
    Why are you "picking" your clinical patients? Your instructor should be doing that.

    Virtually every week on this BB, there are comments from new nurses/orienting nurses/students complaining that the floor nurse are not receptive to them, or don't like working with them, or even worse are new/floats/agency who barely know their way around the facility and yet have a student dropped onto their assignment without warning to complicate their job.

    Not all nurses are good with students. As such the assignments should be made by the Instructor or nurse manager, to avoid overburdening the new nurses, orienting nurses and to insure that the student is placed with a nurse that is receptive to students and teaching, and knows ahead of time that s/he will have a student with them.

    By allowing students to pick their assignments regardless of which nurses will be associated with/oversee that assignment is a recipe for problems.
  7. by   nursemommyof3
    We go every Sunday and pick our pt. I try to get one each week that has a new diagnosis for me, so I can learn about each one, and develop my care plan. This last week, our hospital had a low consensus, so I ended up with a pt who had hept C, but was young (in 20s). I was SO BORED all day. The pt was able to get up and do thier own thing, so there really wasn't much for me to do. I'd try at least once, to get a pt who is a total care pt, that way you've had that experience. I do try to get a pt that can communicate with me at least, but have learned that is harder at times, if they become delirious(sp) then it's pointless, kwim? Don't take the easy way out, as the pp said, this is your time to learn.
  8. by   LauraLou
    Some schools have instructors pick pts, others have the students do it. It just depends on the program.

    For your second week of clinicals, pick someone with one major issue, like surgery, cardiac or respiratory problems. Don't get someone just about to go home, it will be really boring. But don't pick someone with mutiple major organ failure, you will be overwhelmed. Avoid pts in isolation for the first few weeks. That requires organizational skills you still need to develop.

    My first semester I took care of patients with spinal surgery, pneumonia, pancreatitis, cardiac surgery, COPD and a prostatectomy. They were good learning experiences and it was easy to find good nursing diagnoses for care plans.

    As for what type of patient is easy to deal with, sometimes older patients are good because they like to talk, but it really depends on the person. I usually pick a couple possible pts and then ask the nurses which one they think would be best for a student. Good luck!
  9. by   mitchsmom
    Quote from caroladybelle
    Why are you "picking" your clinical patients? Your instructor should be doing that.

    ...Not all nurses are good with students. As such the assignments should be made by the Instructor or nurse manager, to avoid overburdening the new nurses, orienting nurses and to insure that the student is placed with a nurse that is receptive to students and teaching, and knows ahead of time that s/he will have a student with them.
    By allowing students to pick their assignments regardless of which nurses will be associated with/oversee that assignment is a recipe for problems.
    We also pick our own patients, although many of us ask the charge nurse for recommendations (for various reasons but in large part b/c we don't want someone who is going home). Our instructor doesn't even go to the hospital the day before, just us. Knock on wood I've never been with a nurse who seemed put out by me, though some have been more "teachy" than others. We seem to have a pretty good bit of liberty as to how close or far we stay with our patients' nurses though (obviously we have to keep them posted on the patient, but you know what I mean). The staff where we are right now is awesome!!

    On our patient worksheets we have to write why we picked our patient. Our instructor told us some things to look for at the beginning of the semester (for example, our hospital is the only one in the area that does kidney transplants so she told us it would be a good experience to get one of them if possible).

    Sometimes I get one because the charge nurse recommends it, sometimes she asks what I'm looking for, like one day I wanted to go to the heart cath lab & she gave me someone who was going. They always know the scoop on everything so it is helpful (probably for everyone, as caroladybelle mentioned).

    Last week I got a post-CABG (bypass) because we just studied that and it corrolated well & I got to practice what we learned.

    I try not to get a bunch of the same thing, keep getting something different so you are always learning - clinical time is so short.

    Then again, you could just find the person with the fewest drugs to write up. Just kidding!!
  10. by   nursemommyof3
    Oh yeah, ALWAYS see if your pt will be going home soon! LOL! I've had them go home on me, and have to re-do my diagnosis card, drug cards, and assessment on a new pt. It's so much easier to do one set a week, rather than two! Now, if you are that ambious, then go ahead!
  11. by   sonja77
    Thanks for all the replies so far!
    Of course I didn't mean easy as having nothing to do all day but more along the lines of cooperative. One of my friends introduced herself to her pt., went home and did her plan of care. When we got to the hospital the next day the nurse told her that the pt. said he didn't want a student. Another patient told a classmate "you can go now, I'll call you if I need you".
    That's something I really want to avoid, going there in the morning, being assigned another pt. and not having done any research on his/her condition and meds.
  12. by   sonja77
    Quote from LauraLou
    Some schools have instructors pick pts, others have the students do it. It just depends on the program.

    For your second week of clinicals, pick someone with one major issue, like surgery, cardiac or respiratory problems. Don't get someone just about to go home, it will be really boring. But don't pick someone with mutiple major organ failure, you will be overwhelmed. Avoid pts in isolation for the first few weeks. That requires organizational skills you still need to develop.

    My first semester I took care of patients with spinal surgery, pneumonia, pancreatitis, cardiac surgery, COPD and a prostatectomy. They were good learning experiences and it was easy to find good nursing diagnoses for care plans.

    As for what type of patient is easy to deal with, sometimes older patients are good because they like to talk, but it really depends on the person. I usually pick a couple possible pts and then ask the nurses which one they think would be best for a student. Good luck!
    Thank you sooo much LauraLou, that was exactly what I was looking for!

    Last week I had a pt. with DJD, who had a total right knee replacement. She was great, very sweet and talkative. I wish I had a pt. like her all the time.
  13. by   sonja77
    Quote from caroladybelle
    Why are you "picking" your clinical patients? Your instructor should be doing that.
    You know, I wish my instructor would pick the pt. for me! But that's just not the way they do it here, nothing I can do about that.
  14. by   klone
    At this point in my schooling career, I would pick the patient with the fewest number of meds that I'll have to look up and write down. But this semester, we aren't assigned to patients, but to a nurse. So we get all the patients s/he has (usually 4-5).
    Last edit by klone on Oct 16, '05

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