Trouble in clinical. Prioritizing. Help

Nursing Students Student Assist

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I am told by my professor that I could fail because I am unorganized, unprepared (I don't know anything about my drugs or any other material I have went over in the previous semesters), and I look like a "deer in headlights". I often ask the same question over and I will need more assistance through a skills procedure. Other days, she says, I am on point. She says she's going to fail me if I am not consistently on point, and because she doesn't know what level I'm at (one day I know what I'm doing, time management is good-other days, not so much) she thinks I will be unsafe.

This is my last semester, and I don't know what happened between 3rd semester and now, but I seem to have a brain fog. Please don't respond with ways as to how I can fix this or that I need to identify the underlying problem. Thank you, but for this post, I just want to ask about how to become better as a last semester nursing student in clinical. I don't know what happened between now and last semester, but everything is sort of a blur.

For all nursing students and RN's out there:

-After you receive report on your patient from your professor, what are some general questions you would ask the RN taking care of that patient? I know this is a broad question, since questions are usually specific to your client, but I feel like lately I haven't been asking my nurse any questions. I just go into the room, do my physical assessment, talk, check IV site look at pump and see what's infusing, see if the bag is almost empty, go back to the nurses station, document, briefly look at medical history (if there's time), then move onto the next patient and repeat.

-I think my problem is I'm afraid to ask questions because I feel they're stupid.

Thank you.

Well, it sounds like you go to a great nursing program. I can't really say the same for my school.

Specializes in Hospice + Palliative.

I know so much varies from program to program, but something struck me in your description. are you only getting report from your instructor? We are required to be at change of shift report for our pts, and I have to say that I have learned so much from getting to listen in. Besides getting a much fuller picture of your pt (and getting a jump on filling in one of the Brain Sheets like Esme posted), it gives you the opportunity to see what the real nurses think is important; what they ask for clarification on, what they want to know about how the night went for the pt, etc. It gives you a better picture of what's NEED to know. (Plus, it also gives you a heads up on anything that might be happening during your shift with your pt; like dialysis, radiology diagnostics, PT, etc)

Yeah that would be so great if I could do that. I even asked my professor if it was possible to come earlier, but she said most likely not because another clinical group comes in the mornings (i come in the afternoons), and that CI wouldn't be happy if I was there (because that's how she is).

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
bella14k said:
Yeah that would be so great if I could do that. I even asked my professor if it was possible to come earlier, but she said most likely not because another clinical group comes in the mornings (I come in the afternoons), and that CI wouldn't be happy if I was there (because that's how she is).

This is a RN program? ADN or BSN? Why don't you spend a regular shift with your patients?

Specializes in Critical Care; Cardiac; Professional Development.

I have to say, this program sounds terrible. By senior year/semester you should be doing 12 hour shifts and learning to manage patients more independently. Probably not helpful to you but with a program like this it is no wonder new grads struggle so much when they hit the floor in a real job.

After being an RN for 40 years I can tell you that NO question is stupid if you do not know the answer and not knowing the answer will potentially cause harm to your patient! As a Diploma grad, we were required to be on the floor at 7am in order to listen to report given to the day shift from the night shift on ALL patients, not just the patient we were assigned to care for. Just listening to shift report provided me an insight into the type of information the next nurse would require for continuity of care. Oncoming shift nurses asked questions of the prior shift nurses. None were deemed stupid. Is it possible for nursing students to listen to shift report? If not, nursing students are being deprived of one of the best learning tools that exist.

Specializes in LTC, Corrections, newbie to OB/GYN.

Sadly I think there are many programs that are pushing graduates thru their school without care or concern if they are properly training each one. I attended my local (very small town) technical college for the LPN program and then LPN to RN transition program for my ADN. I am very thankful I had 2 very wise nurses as my instructors (they did our lectures and clinicals) for the LPN program. Although we only did 6 hours of clinical 1 day each week, we actually did work. However, the RN program is nothing but a complete joke. It is mostly self taught and although the syllabus states 12 hour clinicals, we were lucky if we got 6 hours once a week. We asked about having a preceptor and were told it would not be allowed because of how the school's program was set up. Most facilities were not thrilled to see our students arrive, so we were treated (most of the time) like we were a nuisance (this is all thanks to our instructors--some were very lazy, very unprofessional, would cancel clinical and not notify the facility) I am very thankful for the LPN teaching/training I received before attempting to become an RN. I feel very incompetent in my abilities as an RN.

Have you checked in your area for nurse extern jobs. Had I known this was an option in the city about 45 min from my home/school, I would have taken advantage of it. I feel it would have helped me where my school didn't.

Specializes in Hospice.

We listen in on report in the morning and in post conference we have to "give report" to our clinical instructor and classmates. It's very helpful because we learn not to prattle on about our patient but what we are supposed to focus on if we were actually giving report.

Just an update: I have gotten much better in prioritizing and was passed by my clinical instructor and she had many good things to say about my turn-around...

I just wanted to mention this for those of you nursing students who have this same issue...yes, you can turn it around :)

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Good for you! Hard work pays off. Sometimes we all need that kick in the behind!

It might be helpful to others if you would tell us what you learned to do differently.

bella14k said:
Just an update: I have gotten much better in prioritizing and was passed by my clinical instructor and she had many good things to say about my turn-around...

I just wanted to mention this for those of you nursing students who have this same issue...yes, you can turn it around ?

Congratulations! I'm so happy for you.

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