I was wondering if anyone could describe to me how their day goes during clinicals? What is the order (and when) do you learn certain skills? I will begin clincials either this summer or this fall and I am very excited but also extremely nervous!!! What should I expect in the begining?
Nov 23, '02
You should expect to learn baths, I&O, and basic patient care. As time goes on, you willbe given the opportunity to do skills, such as catheters. shots and giving meds.
Good Luck and have fun learning! And don't be scared! You'll be fine!
Nov 23, '02
And you will learn to do Care Plans
Nov 23, '02
i'm doing med/surg now and have all my skills checkoff long behind me. we can now do anything that a "real" nurse can do.
so my mornings usually go like this.
1. get my patient assignments/room numbers.
2. poke my head in the doors for a quick hello and to make sure they are breathing, heart beating, how many and what kinds of lines they have, etc. usually spend about 2-3 minutes.
3. get report from the nurse.
4. think about what needs to be first...... is the patient going for test? blood sugars before breakfast? early meds?
5. then i line up my morning assessments. we have flow sheets at the hospital so this makes it easier to make sure all systems are covered.
6. talk to the patient while doing assessment.... in general, how are you feeling today? do you have any pain? have you gotten to talk to your dr. today? is your family coming in? do you have any question?
7. so i cover all my patient assessments and then begin any procedures that i need to do...... dressing changes, pass meds, hang IV, change IV sites if needed, etc.
8. by this time the physicians have usually made rounds, so i check for new orders. we aren't required to "make rounds" with the docs but sometimes they want us there regardless.
9. by this time it's usually time to either start my next round of meds or a patient is ready to go off the floor for some type of test or something just "comes up" that you have to deal with like an IV infiltrating or mr. so and so is now puking in room 80000000. so i deal with that.
10. i like to do a mini noonish assessment. pain? complaints? how you feel? type of thing
11. start winding up around 12:30 oclock so i can be off the floor by 1ish. just finish up loose ends of what ever needs to be finished.
and of course, you have to work in calls to docs if a patient lab report comes back way off. for example, pt with cystocele repair went into surgery with H and H normal. 1 day post op the H and H was 8 and 25. 2 days post op it was 7 and 20. so of course the doc had to be made aware of all that was going on. i got new orders to hand 2 units of PRBC.
and then you work in time for just "talking" with your patient. letting them know you care and are there for their needs.
and then you work in time for patient teaching. and believe me there is always teaching that needs to be done.
and then you work in time for the person that felt "fine" at 8 a.m. and @ 11 a.m. is tachycardic, sweating profusely or is lethargic and confused when he/she wasn't before.
so it makes for a busy day but i love it. always something to do.
Nov 23, '02
Here's how ours goes...
Tuesday we get our patient assignment. We have to get all their meds, their history, and the information about present illness (including labwork that is outside normal limits). We also go do a brief assessment of the patient.
Wednesday morning we have a 1 hour pre-conference with our clinical group and instructor. We are expected to be able to answer questions about our patient, their condition, and their medications. Then we are released to the floor (if the instructor thinks we have prepared enough and know enough to do what we need to do). First thing is to do AM vital signs and assessment. Some of the assessment can be done during the bath. We also bathe the patient and change linens. We give meds including IM and SQ injections, we can hang IV fluids and piggybacks (not blood or chemo). We can put in NG tubes and change dressings and insert/dc catheters. Most days we do stay very busy between caring for our assigned patient and finding other "cool" things to do on the floor. I have gotten to go with my patients for procedures like EGD, bone scan, and ECG.
We go back again on Thursday for half a day that is basically Wednesday but we have less time to get things done.
Nov 24, '02
Your guys' days sound pretty similar to mine. The only thing I dislike is new orders. At our hospital, it's very hard to tell when new orders are taken off (still lost on how they do that) and when they are ready to be given. I don't know if I don't really get it becuase it's a hospital-specific thing or what.
Nov 25, '02
Thanks everyone for descriptions of your day, its helping with my anxiety! Can't wait to start the real "nursey" stuff!
Nov 25, '02
Good luck. But stay away from the word "nursey". It's so diminuitive-sounding. And we could stand to get away from that type of impression!
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