Any advice for starting clinicals?

BellaBoo12 · Feb 25, 2014

Hi Stephanie!

I will be graduating from the LPN program this June, so I've been in clinical a whole lot. This is coming from my experience, so just know that yours may be a bit different. When we started, we were in long term (a nursing home) and basically started with CNA care on our clients. For our first day we were paired up. We had one girl in our group who had never done any kinds of hands on care, so she was very anxious. However, she has come a long way and after only a short while... was she able to enter a patients room and help them out on her own. Today, she is able to do catheters and everything! Never let fear stop you... ever. I think the hardest part is being able to walk into a patients room and help them use the bathroom or to give them a bed bath - especially if you've never done it before - it is scary! Don't worry though! You will get so used to it! I've learned that if you go in there with a smile and introduce yourself and have a legit interest in learning about them and how to help them... you wont have any problems. Some patients are more difficult than others of course. If your patients are able to speak, don't be afraid to ask them about their routine and how they like to do things. Let them know you are a student! It not only sparks conversation, but it lets them know that you may need a little help until you get comfortable with caring for them :)

After long term we hit subacute which was mostly like a rehab type setting. The pace is a lot faster so be prepared as you move forward. Most patients in this setting are there to get better so that they can get home. That being said, don't think they all do. I've had very ill patients who ended up passing away on that unit. Many of them are able to walk and do things on their own - others not so much. I'd say they are more independent than those on the long term unit. When I moved on to this level I started passing meds. I'm not sure how strict your professors are, but mine were brutal - straight up. I'm not going to lie to you and say it will be easy because it's not. To save yourself from getting yelled at, and also to benefit yourself, I highly suggest you start looking at medications now so you have an idea of the information you may need when you start passing them. Know the medications brand and generic name, the safe dose range, the class, the actions, the major side effects, and patient teaching. Here is an example: You have a patient who suffers from severe anxiety at night time. The doctor prescribes them an anti-anxiety medication Xanax (alprazolam) 1mg po at bedtime. This is all fine and well... but you aren't a doctor you are a nurse. So think, what can I do as a nurse for this patient in combination with that Xanax? What are their triggers? Would sleeping with the TV on help to calm their anxiety? Maybe having a night light on, or the telephone near by would help?Do they have a stuffed animal? Think out of the box :) nursing professors love this. KNOW YOUR 5 RIGHTS OF MEDS! Right patient, dose, route, medication, and time. I also like to follow the patient right to refuse one as well after teaching has been done. I honestly think the scariest part of clinical is med pass but thats just my opinion. Not so much in long term, but in subacute and in the hospital when they start getting more strict. Check out MaxiLearn cards on amazon if you don't already use them. They are a pain, but they've helped me a great deal.

Last but not least, stay positive but not overly confident! I'm almost a nurse and I'll tell you, every day I walk into clinical I'm scared to death... I feel like I know so much but sometimes I feel I don't know enough. I talked to a nurse at the hospital I'm currently at about this and she said "honey, I've been a nurse for 10 years, I pray everyday on my way here that I don't make a mistake. I'm still scared - It's good though it means you are cautious. Plus, I still don't know everything." Just keep that in mind.. it's helped me a great deal. Introduce yourself to the nurses!!! I can't stress that enough. CNA's are your angels.. they will help you if you ask! Excuse me, today is my first day and I don't know how to use a hoyer... could you please help me? Guarantee someone will help you... don't be surprised if you sometimes get an attitude though. Sometimes they don't like students and it's just in your best interest to be on their good side from day one. Get a report from your patients nurse! Even if you don't understand half of what they're talking about, take notes and ask your professor to explain. Your nurse needs to know if you're caring for their client and especially if you are passing meds so don't be shy :) The absolute hardest part about nursing school is getting knocked on your butt and having the strength to get back up. Every single day is a challenge... but if your heart is set on it it's all worth it. Every single patient you have will teach you something and all of them will touch your heart in some way. They are and always have been my motivation. Clinical scares me but it's literally what keeps me on my toes and motivated. You'll be wonderful! Do the best you can do and keep your head high. You got this!

male nurse USA™ · Feb 25, 2014

ask questions. its not a CNA job. you're on training so take advantage

BellaBoo12 · Feb 26, 2014

ask questions. its not a CNA job. you're on training so take advantage

Yes!! Ask as many questions as possible. Anything that comes to mind - this is how you learn :)

Deidre1017, LPN · Feb 27, 2014

I start my clinical rotation at a nursing home next week and I'm kinda nervous too!!! I had my head 2 toe assessment final yesterday....

LearningByTheDay · Feb 28, 2014

I am also in my clinicals for my LPN program! (This is my third week) Remember everything is good! You need GOOD SHOES, Attitude, and Mindset! (Singing "If your happy and you know it" always helps me get happy in the morning) Ask questions! And do not forget YOU CAN DO IT!

LPN709 · Feb 28, 2014

I graduated last year so hopefully I can help :) everyone else has great advice, but I will tell you about me and my class. The first thing is be on time!!! It sounds like a logical thing but if you are late, someone else has to pick up the slack for your patient. And as a student, that's definitely not fun. And if you know your going to be late (car trouble etc.) Please take the time to call beforehand. Make sure you have all your equipment/books. But the most important thing (for me) was meds! Know your meds, what they are for, adverse effects, 5 rights etc. And if you don't know something, be honest about it to your instructor and look it up. Knowing your skills is also important. However, our instructor gave us notice so we had time to look in our skills book and refresh our knowledge before we performed a skill. Know your head to toe assessment and if something sounds wrong get your instructor. Go with your gut! But still, know those meds!! :) good luck!