Anyone feel lost at clinicals?

[tothepointeLVN, LVN]

Last week was my first week at clinicals The site was ok and the staff icy with a few exceptions. I'm the top of my class but when it comes to clinicals I feel a little lost. It doesn't seem like theres alot for use to do.

We can't change bedpans because al the patients are in diapers. Vitals are done before we hit the floor and all our patients are up and wheeling about. Sure we can practice assessment on them but the thermometers and bp cuffs are put away after change of shift. Gloves are hard to find. All patients get showers so no practicing bedbaths. Oh and the cna's refuse to talk to us/let us help with anything and facility won't let us help feed the patients and a bunch of other things.

Apart from getting used to practice charting and careplanning. Any suggestions for other goals I can achieve while there? We are signed off on NG tubes and foleys but there are very few patients on them and they don't get changed often.

I choose a challenging patient so far as nurse to client relationship goes though so there's always my bedside manner to work on.

[Jules A, MSN]

Wow that was nothing like my LTC experiences where the CNAs disappeared as soon as they heard nursing students were on the floor. Can they really feed everyone that needs it without help? That is very time consuming. I'd ask around and make some friends with staff in hopes that someone will let you assist them. It sounds like a nice facility but there has got to be things to do even if only helping with showers and changing Depends.

[CT Pixie, BSN, RN]

Like Jules, when we were at clinicals, the CNA;s headed for the hills when they found out that their assigned patient would have a student nurse. Everything and anything was left for us to do. Even things that the CNA should be doing that they knew we were not allowed to do.

Things you can do other than AM/PM care, toileting, feeding...humm...

You can practice your interviewing skills

Listen to lung sounds

Listen to bowel sounds

Do neuro assessments

Practice communication skills (therapeutic communication etc)

Assess skin (or at least the skin you can see w/out disrobing the resident)

Ambulating patients than can walk w/assist x 1

Can you watch the nurse do her med pass? (standing quietly and not interrupting her/him of course)

Are there any wounds you can do the treatments on or observe the wound treatment nurse or the floor nurse as they do the treatments?

Hunt out any treatment/skill and observe if you aren't allowed to do them yourself.

In one of the facilities we were not allowed to pass breakfast or lunch trays to the residents nor could we feed anyone other than our own patient. Reason was, I was told, is that a student was passing trays from one group a year before and ended up passing the wrong tray to a patient. The patient had some condition and ended up very ill from getting the wrong food.

Another reason was a student was trying to help by feeding some residents, and fed a resident who needed all liquids thickened (student didn't know this a proceeded to give the pt normal consistency liquids). The person apirated and ended up in the hospital.

[tothepointeLVN, LVN]

The facility won't let us feed anyone. Not sure why. Maybe a problem with previous students as said above. We can set up the trays but thats it. Actually I don't think we can even pass them just rearrange the tray.

The nurse on our unit is wonderful and was talking me through how she passes meds and the procedure. The treatment nurse came through and one of my classmates got to watch something but we were told not to bombard the staff at once so I have to be patient. Hopefully the RNA will let us tag along one day.

[amjowens]

It sounds like your instructor needs to get involved. Each facility does tend to have their own "rules" re students. At my LTC clinical, we weren't allowed to pass meds until we passed our class med competency. Reasonable, but other clinical groups were allowed to pass meds. Word was, it depended on the administrator and/or nursing management at each facility. But, your facility doesn't sound at all like they should have offered to allow students if you aren't able to do anything. Why bother? Also, above all else, you've got to respect the rules of the facility. So, do all you are allowed to do, and gather some facts about what's going on so you can be clear when you do go to your instructor/program coordinator at school. I hope things get better.

On a different note, if you feel "lost" re skills, etc., just remember we ARE students, and if we already felt competent we really wouldn't need the learning experience of clinicals. Just do your best, and seek out as many learning experiences as possible. I've experienced some really grouchy and mean nurses during my clinical experiences. It's their problem, not yours. Don't let them bring you down along with them.

[tothepointeLVN, LVN]

Our school doesn't allow us to pass meds until term 2 which is reasonable. I get the feeling that the administration wants us there at the facility but the staff don't. Most of the other clinical sites are better so far as student involvement.

Paying my dues....

I don't feel lost re: skills which is good.

Our instructor is new to clinical (not teaching as she is awesome at that) and this site. I think the school likes to keep this site since it is so close to the school. Other clinical have graduates from our school so that makes things warmer I think.

[Jules A, MSN]

Our school doesn't allow us to pass meds until term 2 which is reasonable. I get the feeling that the administration wants us there at the facility but the staff don't. Most of the other clinical sites are better so far as student involvement.

Paying my dues....

I don't feel lost re: skills which is good.

Our instructor is new to clinical (not teaching as she is awesome at that) and this site. I think the school likes to keep this site since it is so close to the school. Other clinical have graduates from our school so that makes things warmer I think.

This is a great way to look at things. Bottom line, imo, any experience you can get in school is all well and good but the majority of your skills will be learned on the job. Hang in there!

[Bobylon]

Whenn we've exhausted our options in clinicals (passed trays, beds, baths, vital signs) we're encouraged to check patient charts for things we're unfamiliar with and ask or research on our own ... listen to heart/lung/bowel sounds, observe whatever procedure might be happening, if allowable (dressing changes, etc). I've been very impressed by my first 2 weeks of clinicals .... staff is great, patients are really great - I was apprehensive before, but feel really good about it, now that we're actually doing it. Good luck, hopefully you're situation will improve !!!!

[tothepointeLVN, LVN]

Thanks for your support. I tried to express my fustrations to another classmate I'm close to at another site and she just kept on talking about all the things the charge nurse has her do and all the wonderful things she is doing. Made me feel like the worse nurse ever. She fails tests and I never make her feel bad because I'm at the top of the class.

I listened to all the lungs on my unit with a classmate ( they keep them healthy no wheezes or crackles)

I get a new patient next week one that has more medical problems than mental/cognition problems. Hopefully I'll get to trail the treatment nurse who loves teaching. Our nurse taught us the med pass process and had us teach it to another student. We don't pass meds yet but she has I go through the motions.

I was so proud of my bed making though it was textbook but when I left it appeared that the CNA had remade it!!! or at the very least tucked in the blankets