Nervous about clinicals! What to expect?

phuretrotr · Jun 26, 2013

How do you know which patients you will be working with?
How much does the nursing instructor supervise you? Or the patient's nurse?
What is a typical clinical like from beginning to end?
In general, how are you treated by the hospital staff?

1. Whatever rotation you are in (i.e. Med-Surg, L&D, Oncology, ICU, etc.), that will be the population you will be working with. Some floors, like Med-Surg floors are a combination of many different types of patients, kinda like a general floor. Your specific patient for each weeks clinical day(s) will most likely be assigned the day before in order for you to pre-lab or it may be assigned the day of, depending on what your school does or if a patient goes home.

2. My clinical instructors usually only observed me when I was doing a procedure or administering medications. You probably won't see you clinical instructor for the majority of the day because they have you and the other students to supervise and teach. The patient's nurse will be who you will be talking to for the majority of your time. Although, the nurse may be present when you give meds or do a procedure, it is not necessary, but your clinical instructor is, at least at my school.

3. A typical clinical for me was get to the hospital in the wee-hours of the morning and conference with your clinical group and instructor about your patients, talk about what you will be doing today, what meds are scheduled or pen, ect. for about an hour. Then we go up to the floor to get report from the nurse. Once that has been done, usually about 0800, I go into my patients room, introduce myself, take vitals, do an assessment, give them breakfast if the is the nurses job (some places have a kitchen staff that delivers food to the patients rooms, but some places have the nurses do it), and ask if there is anything else I can do for them right now. Usually around 0800-0900 some from of medications are scheduled so I snag my instructor if there already isn't a line of students for her. After giving the meds, there is usually some down time between 1000 and 1200 so I use that time to either talk to my patient, do a procedure, do some charting, or if nothing else, get some of my care plan done. At 1200, some places have vitals so if so, I would do those, give the patient their lunch (if needed), any procedures or meds with my instructor. Then again from about 1300 to 1500, more down time. Then around 1530-1600, I do my last set of vitals, an assessment, meds, and ask my patient if they need anything and then say goodbye. At 1600, I give the nurse my report and finish charting. Then we usually conference afterwards with the clinical group about things we did and our experiences. And then we can leave. Starting off, you may not have this long of a clinical day, so you might not do all of these things. You'll realize soon that certain times of the day, it gets really busy. However, on your down time, after you chart and maybe talk to your patient a little bit, you can ask the nurse if they have any other patients that need procedures done, and you might be able to do them or watch them, depending what you have learned so far in school. Also, be sure to ask the nurse if you can do anything for them!

4. I am generally treated very well by the hospital staff. If you can help the nurse out, the nurse will help you out. The hospital staff know you are a student and are not out to get you. Just be courteous. Don't be afraid to ask questions, it just shows you want to learn and you want to hear whoever your asking's knowledge (However, ask questions at appropriate times.).

I hope this helps you!

SilverOwl · Jun 26, 2013

This is great thanks for sharing!!

RubberDuckieLove · Jun 26, 2013

Sunflower nailed it! Well for me anyway. I know every program is different. In my program, each of us gets the opportunity to go to the OR for the day. Kinda gives is a free bee when it comes to the mounds of paperwork that comes with having patients. Right now I have one patient, but I hear as we progress we will have two or three at a time.

In addition, my instructor is very strict on meds. We need to know everything about it, from memory. If we don't know it, we can't push it. We get our assignments the morning of, so after I do assessment, I immediately jump on my meds and begin to learn about them (or refresh my memory, depending on if I have come across it or not).

Clinicals are my favorite part of school.

bsartor · Jun 26, 2013

Sunflower-thank you for the awesome response and the taking the time to ease my worries. I def feel much better

CNorman- Thank you so much for the additional information about the OR and knowing everything about your patient's meds.

These responses were very helpful to me and hopefully others too!

chrissylovegood · Jul 1, 2013

I'm starting school in fall as well thanks for the post I'm very anxious and excited. I hope your semester goes great :)

Madras · Jul 1, 2013

SUNFLOWER gave the perfect response! That is definitely your general day, it may vary slightly depending on the time of day and on what day you have your clinical, which your at the mercy of the instructors scheduling! I've had clinicals in the am and pm during my semesters. Dependent on your skill set you will be assigned a pt and sometimes more than one... (But that is usually when your instructor knows your getting good )

My advice- make sure your instructor knows your capabilities! If there's a skills check off your supposed to have make sure she sees it. Make sure that she knows that you know your meds, interventions etc.... That's when you will probably have a lot more liberties!

While most classmates were still taking one pt and struggling with meds and time management I was rotating to OR, PACU, ICU. It was an amazing experience.

Also make nice with the nurses! Duhhh right! Smile! Ask if they need help! Ask questions! Ehh but try to make sure your asking questions that they can actually answer. I had a classmate who I swear the man wanted to be a doctor!! He would ask the most ridiculous questions about diagnosing patients and such and he would always talk in med jargon... Boy he didn't last long in their eyes. Nurses were literally dodging him and none of them wanted him on their pts, he just came off as pompous and "above nursing Holier than Thou'ish". So like I said ask questions that pertain to nursing!

Because of these tips, I spent the last 8 weeks of clinical with the nurses specifically and barely saw my instructor except for the courtesy of checking in. By then the nurses on the floor had "their favorites" and would do Rock Paper Scissors every morning!!!

Don't be afraid of the doctors!!!! Trust me their not bad at all, well at least some of them, you'll be able to spot the approachable ones.

And we'll remember you were a PCT at one point right!?!? No need to be nervous dear you have a leg up on everyone. I had 5 years of MA experience. I'm sure you have technical skills and also you know how to talk to pts so you won't feel awkward like everyone else will. Jump right in!! And if your lucky like I was your instructor and the nurses will take your PCT experience into consideration after of course all your nursing tasks are perfected. I was starting IV's before the end of my Med/Surg semester! And took with me 5 recommendation letters, one from my instructor, one from the nurse manager and 3 from the nurses that I worked with the most. Thank goodness for Rock Paper Scissors!!!

bsartor · Jul 1, 2013

Awesome info CecixLI! You just really got me pumped about clinicals. Now I can't wait to get started! I will def use my experience and try to do all that you advised.