A.M. Care question--About to start 1st clincials.

hikernurse · Feb 23, 2008

Of course it's normal to be nervous before your first clinical :).

The best way to do am care is to think about what you do to get ready in the morning--teeth, face, hair, shower--that kind of stuff. Tidy up the room, make or change the bed (depending on if you are in a hospital or LTC), open the curtains.

If you only have one patient--believe me, a real advantage of NS--take some time to talk, touch the patient if appropriate--a hand on their shoulder if you are washing their face, that kind of thing. Elders, especially, often don't get touched enough.

Whether or not the aide sticks around, you'll do fine--you can always track him/her down to ask questions, your clinical instructor will be reachable and your fellow students are also good resources for stuff like this.

BrayaRN · Feb 23, 2008

I recently went through an RN program. I remember the nervousness that came with every clinical day, and especially the first ones. After 2 1/2 years in school I worked at an aide in a hospital for 8 months.

First of all, it is okay to be nervous. But like the previous poster said you will probably only have one patient. My favorite part of being an aide was getting to talk to the patient and make them feel cared for.

Second, the way the CNA will perform AM care will probably be different that what you were taught. Be sure to perform the care as you were instructed.

Third, enjoy yourself. My fundamentals clinical was held in a nursing home. The patients just love the attention. Remember that most patients love the care they get from student nurses.

Good luck, you'll do fine.

annaedRN, RN · Feb 23, 2008

One thing to think about - giving a bath is a great time to do an initial assessment -mobility, skin integrity, activity intolerance, basic range of motion. And as the PP stated, the patients truly enjoy the extra attention and look forward to you coming! Just take your time, remember to provide them privacy, and safety is of utmost importance. Before you know it, you'll be a pro!

NoviceRN10 · Feb 23, 2008

I just had my first clinical "experience" this past week. We went to the hospital and shadowed 2nd year students for a few hours. I was so anxious about it that I had myself in tears the night before :cry: . I really needed to calm down! I was so scared because all the skills I thought I might need to "test" hadn't even been practiced for weeks (vitals). I didn't know what would be expected of me. It turned out to not be a big deal after all. I ended up doing a bed bath for the first time (well, my friend and I shared the duty), assisting in wound care (if handing over supplies and holding a foot out of the way counts), and helping reposition a patient. I didn't want to step on the toes of the students I was shadowing, so I didn't do much else. You can make yourself a list of am care and stick it in your pocket, if that will help! My biggest hurdle was approaching the patient for the first time. I was scared. She was on a vent and had a trach. It took me a while to get up the nerve. My best advice would be to act more confident/comfortable than you feel, and whatever you do, put a smile on your face :)! I really wish I could go back in time and re-do my "initiation."

mgalloLPN · Feb 24, 2008

Thanks everyone. I will be in a nursing home at first. I will only have one patient at first. We just haven't "learned" any of the stuff yet. The only thing we have done is vitals and bed baths. We start in 2 weeks and haven't reall been taught anything. Just stuff needed to know for the tests. I feel clueless. Like LaineDecr2007 said "Second, the way the CNA will perform AM care will probably be different that what you were taught. Be sure to perform the care as you were instructed." We haven't been taught to do anything other than those I mentioned. We were supposed to do sterile gloving but didn't get to it and in that same day that we were doing bed baths on the manequins, we were supposed to do mouth care, hair care, foot care, etc. but we didn't get to anything but the bed bath and using the mechanical lift. We were all doing something different. What happens if we don't get shown how to do something and then they still want us to do it anyway. I was told that the CNA's we will be following at first aren't that willing to help you because they are very busy and don't have time for you and that we should rely on fellow classmates. I really don't want to do something that I am not supposed to do or do something incorrectly and risk being kicked out.

annaedRN, RN · Feb 24, 2008

If you are not sure of "the right way to do it". Maybe refer to your textbook (usually a fundamentals of nursing) - it usually has skills listed and broken down so you can mentally see what the steps are. Hopefully the CNAs and other students with CNA experience will be able to show you. Make sure you provide privacy by pulling the curtain and keeping covered body parts that aren't being actively washed, be sure you know whether their side rails are to be up or down, if you raise the bed to give the bath be sure to lower it when you walk away or are finished, make sure to gather all the supplies you need BEFORE you start the bath. As far as teeth/hair/nails -if you do it to yourself you know how to perform the care...it just takes a while to get used to doing it for someone else.

You should have had time to have these skills demonstrated and time to practice...sometimes it is up to the students to make time to practice. But, if something comes up that you TRULY are concerned/worried about or do not have any idea what to do about...be sure you find out the answer. If no staff is close, approach your instructor and explain your problem, be honest and concise. Make sure you have looked at all the issues surrounding whatever your problem is - think it through because the instructors like for you to try to solve problems when possible

Just remember it is your 1st clinical day - the instructors do not expect you to be perfect. Just be as prepared as you can be. Focus on giving safe and complete care. Take each clinical day as a learning experience. Before you know it, you'll be working as a nurse and giving students advice!!!