Preparing for clinicals

allycat77, BSN, RN · Oct 13, 2013

We do the same only we only have to come up with one nursing diagnosis (the priority dx) and also have to do med sheets for all regular meds administered while we are the and all of the PRN meds. It truly does get easier...I spent over 2 1/2 hours at the hospital the first night I pulled information. Now I am down to an hour, and I'll probably get it down even more by the end of the semester. We aren't allowed to use the pre-made drug cards, we have to write or type it all out. So I started typing mine, which is in turn creating a database for me. Some meds every patient has at least PRN (Colace, Reglan, MOM, etc) so these I can cut/paste, check the dosing, and it's cut down considerably the amount of time I spend doing my drug sheets. Hallelujia!! LOL On one hand, I hate doing the prep stuff but on the other hand I have learned SO MUCH from doing it. Good luck to you!

If your school library has access to the "Up To Date" database, it is a great drug resource for copying and pasting!

NICUmiiki, DNP, NP · Oct 13, 2013

We do all of that except revising after clinical. Our instructor picks up our folders (with all of our work in them) at the end of clinical and we don't see them again until pre-clinical the next week.

seanynjboy, BSN · Oct 13, 2013

Hi all. I was wondering what everyone is required to do to prepare for clinicals. At my school we are required to do research the night before clinical. We have to research the pt. diagnosis, the A&P which the diagnosis is related to, signs and symptoms, treatments and labs. Then we have to come up with 2 nursing diagnosis, expected outcomes and nursing interventions. Then the day of clinical we have to present our research and come up with 2 more interventions. Then that night we have to revise everything we did to be more specific to our actual pt. Does anyone else have to do this? Just curious what you guys are required to do.

Hello!

I just graduated in April and passed my NCLEX in Sept. Here is what we did at some clinicals. (It differed with each instructor)

- Went the day/night before (or EARLY MORNING before), gathered H&P, Code Status, Psychsocial info in the chart, meds, current care plan if listed.

- After all that we went home and did a clinical paperwork sheet with included

- H&P (including surgical, medical and mental history)

- Main Diagnosis (Pathophysiology including S/S and possible treatments)

- Meds (dosage range, action, pharmacokinetics, side effects, nursing implications and teaching) - so if the patient was 80 years old and on 15 meds...get ready for a few hours of just typing med related stuff

- Labs (ranges and if abnormal we had to put what could possibly cause it and how to correct it)

- 2 nursing diagnoses r/t the patient, 4 interventions, 4 outcomes

All of that info was pretty much standard on each clinical I had. Some instructors made you go the night before, some were like whatever and said we could get the info the morning of clinicals because since in most semesters we were only assigned 1 patient in the beginning, we would have so much extra time if the RN we were assigned to wasn't busy.

Hope this helps....

Also helped that at my school we did not do the traditional CARE PLANS that most schools do. We did different things called Concept Care Maps. Same info, less work, more concise. :)

NICUmiiki, DNP, NP · Oct 13, 2013

I just bought a laser printer. I've always said I didn't need a printer, and I could print at school.

But since there is no printing available at 6am, I've finally decided to buy one because 1) I type faster than I write, 2) this allows me to do some copy and pasting from my ebooks, and 3) I hope that my neatly typed work can distract from some of the late night, delusional errors I make.

Stephalump · Oct 13, 2013

I just bought a laser printer. I've always said I didn't need a printer and I could print at school. But since there is no printing available at 6am, I've finally decided to buy one because 1) I type faster than I write, 2) this allows me to do some copy and pasting from my ebooks, and 3) I hope that my neatly typed work can distract from some of the late night, delusional errors I make.[/quote']
I went the whole 1st year without a printer, but this summer I broke down and bought a wireless laser printer, and I love having it!!! Why did I wait so long?

Wrench Party · Oct 13, 2013

Hmm..let me think...we had to get medications, history, patho, labs, nursing diagnoses, and nursing interventions. If the patient was on the floor and awake, we went and introduced ourselves and establish a rapport. I also outlined the plan of care and any other critical information, so the patient wouldn't be stunned at 0700 the next morning with a student.

One day I discovered the nursing plan of care in the back of the paper chart and realized my written care plans had gotten about

10x easier. No more trying to come up with NANDA-compliant diagnoses to fit what you knew was obviously wrong with the patient.

NICUmiiki, DNP, NP · Oct 13, 2013

Hmm..let me think...we had to get medications history, patho, labs, nursing diagnoses, and nursing interventions. If the patient was on the floor and awake, we went and introduced ourselves and establish a rapport. I also outlined the plan of care and any other critical information, so the patient wouldn't be stunned at 0700 the next morning with a student. One day I discovered the nursing plan of care in the back of the paper chart and realized my written care plans had gotten about 10x easier. No more trying to come up with NANDA-compliant diagnoses to fit what you knew was obviously wrong with the patient.[/quote'] I never look at the paper chart, but my hospital has a section for nursing plan of care in the EMR too. I'll make sure I pay attention to that section when I go back for preclinical.

fazzelo · Oct 13, 2013

not at our hospital........ a student can jic to something with a nurse observing and instructing

NICUmiiki, DNP, NP · Oct 13, 2013

not at our hospital........ a student can jic to something with a nurse observing and instructing

I'm sorry. I don't understand what you are saying. Can you rephrase?

krisiepoo · Oct 14, 2013

At the beginning we had pre-clinicals where we had to do all that plus a full med sheet. It was really time consuming but it does help in the long run. 1/2 way through our 3rd semester, we showed up 45 mins before shift start and did a quick learn of our pt and then had to have all that ppwk done by the next day (to simulate a real nursing experience).

LoriRNCM, ADN, ASN, RN · Oct 14, 2013

We don't go in the day before. Our clinical paperwork is due a few days after clinical, but our assessment flow sheets are due that same morning. Our clinical analysis is very time consuming as we have to research the patho of current dx, past medical hx, etc. But my instructor told me last week I should not be spending hours on these clinical analysis assignments. We aren't graded on them, but in my opinion, to do them right is very time consuming. But wow, am I learning a lot!