Making the most of Clinicals Part 1: Turn negative experiences into positive learning

nursefrances, BSN, RN

Every nurse remembers their first day of nursing clinicals. I would like to share my first day with you.

We were a group of ten brand new nursing students. Dressed in all white, some had excited expressions of anticipation on their faces. Others had the "deer in the headlights" look. I was blessed to have a wise seasoned nurse as a clinical instructor and she could see that some were leery of this first day of being on a real hospital unit. Much different then our cozy little lab.

She decided to pair us up, two students to one patient. We were assigned to a med-surg unit. My friend, we will call her Ann, and I were assigned to a patient who was aphasic after a stroke. Prior to her admit, she had fallen and had a full leg brace on one leg. We went to her room to meet her, do vitals, get ready for bed baths. The usual first quarter tasks one would do. We found our patient covered in her own vomit, the previous nights beef stew. It was obvious it had been there for at least an hour or two. She was cold, uncomfortable and looked upset.

As we cleaned her up, she was trying to tell us something she wanted. She was aphasic so she would say "I want....." and then get stuck. We tried to have her write it, again she wrote "I want" and was stuck. We couldn't turn her easily because of the full leg brace she had on.

It was a very long morning. And one that Ann and I never forgot. I learned from that expererience to always check on the patient at shift change and make sure they are ok when receiving report. I also researched communicating with aphasic patients and learned different techniques in body mechanics and how to turn a patient more easily.

During nursing school clinicals, there are many challenges a nursing student will encounter. You are dealing with patients. Each patient has their health problems, they don't feel well. They each have ways they want to be communicated with, ways they learn and retain better. Some patients are more friendly and patient, others are impatient and demanding. Some patients won't even let a student in the room to perform any nursing care on them. If this occurs, you must respect the patient's wishes and ask to be assigned to another patient. There are also the challenges of dealing with or working with the family of patients. This could be a different article in itself.

Then there is the challenge of working with hospital staff. Some will treat you well. They will teach you and utilize you in positive ways. Others will not be so nice and will think you are in the way and give you meaningless things to do. I knew a male nurse who would ocassionally send a new student on a wild goose chase. He would ask the student to go to the attic or the seventh floor to retrieve a certain supply. We did not have an attic or a seventh floor in our hospital.

Just remember that you, as a student, are a guest on their unit. They may be having a bad day, they might be very behind or have a heavy load and don't have time to teach a student.

When I was a student there was a nurse who did not seem to like students. We were in the way. I was already in my mid 30's when entering nursing school so I had developed good social skills. I would say good morning to this nurse and keep walking by. She would have a look on her face that said, "what's so good about it?" I did not take this personally. And you shouldn't either. I learned from this experience. I learned that this was how I did NOT want to be when I was a nurse. I took her negativity and turned it around. I learned from it.

As a nurse, you will never stop learning. There will always be something to learn every day. Remember this. If you encounter something negative, ask yourself how can I learn from this? What could I do differently next time to make this easier? What could I have said differently to make this better?

Don't knock yourself down and think you don't know anything while you are in a school. I see threads like this all the time. There is so much to learn while you are in school. You will NOT know everything when you are done.

When I was in my last quarter of nursing school, our professor asked us what we were concerned with as we were completing school. I raised my hand and said "I have been here three years and I am about to go out into the real nursing world and feel like I don't know anything." Almost everyone in the class nodded their heads and concurred with my statement. The professor said that this is how we should feel, we knew just enough to be dangerous. We all got a laugh out of this. He encouraged us to keep learning and growing.

In conclusion, I want to remind you all that you are entering a challenging, fulfilling field. There will be times during clinicals where you will have experiences that are tough or difficult. You might make mistakes or not know the right answer. This is why you are in school, to learn. Utilize your instructors and the nurses that are there with you. If you are not sure of something, research it or ask someone. If you make a mistake, learn from it and go on. The key is to learn from it. Make it something valuable that you can carry with you through your nursing career. You will be better nurse for it.

Making the most of Clinicals Part 2: You're on stage-Make a good first impression

Making the most of Clinicals Part 3: Building a good rapport with patients

Making the most of Clinicals Part 1: Turn negative experiences into positive learning

About nursefrances, BSN, RN

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