Clinal Advise

Elvish, BSN, DNP, RN, NP · Dec 11, 2008

Moved into General Nursing Student Discussion

studentnurse4964 · Dec 11, 2008

Know your cliets medications inside and out; classification,uses, action, routes and recommended doses, side effects, and nursing interventions. Also know at least 10 of your clients diagnosis and how their medication relates to their diagnosis. Know your skills; cath, IM and SubQ inections, wound care, pretty much everything you learn in your skill class. Last but not least, volunteer for anything and everything and help out your other classmates. I just got done with my first semester clinicals and these are things that really wowed the instructor. Good Luck!!

Also after the first day once you have your diagnosis and meds, do a concept map on that client. Client in the center, then branch off the meds to the diagnosis, then the labs r/t the medications. Once you have that done fill in the clients lab values. If you have any questions just ask!

fethahed · Dec 11, 2008

yep, know your meds!! SE's, safe dosage ranges, s/s toxicity, incompatabilities, why they taking it, action of the drug. Practice sterile field till it becomes natural

coolpeach · Dec 11, 2008

We had our clinicals on Mondays, and on Sundays we had to go to the hospital, and pick out 1 to 2 patients for Monday. Sunday afternoon I would write a patho report on each medical diagnosis the patient had, write a care plan based on each nursing diagnosis I had chosen. I would also do a mini report on each med the patient would be taking the next day, and a little report on all the patients background info, including abnormal labs. This way on Monday I was totally ready to take care of that patient. In addition, to taking care of that patient I would shadow an RN, and help take care of her patients. We were responsible for finding an RN on the floor our instructor choose who would allow us to shadow them. The week after I shadowed an RN I would bake some cookies, and take her about 4 wrapped in pretty cellaphane with a Thank you note. I would also tell the RN I want to be helpful to you in anyway I can. Tell me what to do, and I will do it. If I get in the way tell me to back off, and I won't be offended. After a couple of weeks RN's were asking me if I would like to shadow them. They love the extra help, and enjoy teaching if they feel you have a passion, and you will be helpful, and not get in their way all the time. I think it wowed my clinic instructor that I was able to mesh into the environment, and make my own way without her holding my hand all the time. I made an A in clinical, and I am now on break, and I miss it terribly. It was my favorite part of school. Hope this advice helps.

Daytonite, BSN, RN · Dec 11, 2008

You are not there to wow the clinical nurse other than to achieve course objectives, but you are there to learn. Many of your experiences will be highly individualized and impromptu. These clinical nurses have specific job responsibilities they have to fulfill.

This is advice that is given to medical students (http://meded.ucsd.edu/clinicalmed/thoughts.htm):

Never be afraid to ask questions. If those that you are currently working with are unreceptive, make use of other resources (e.g. house staff, students, nurses, health care technicians, staff physicians). You can learn something from anyone.

There is no substitute for being thorough in your efforts to care for patients. Performing a good examination and obtaining an accurate history takes a certain amount of time, regardless of your level of experience or ability. In addition, get in the habit of checking the primary data yourself, obtaining hard copies of outside studies, mining the old records for information, re-questioning patients when the story is unclear, and in general being tenacious in your pursuit of clinically relevant material. While this dogged search for answers is not too sexy, it is the cornerstone of good care.

Learn from your patients. In particular, those with chronic or unusual diseases will likely know more about their illnesses then you. Find out how their diagnosis was made, therapies that have worked or failed, disease progression, reasons for frustration or gratitude with the health care system, etc. Realize also that patients and their stories are frequently more interesting then the diseases that inhabit their bodies.

Become involved (within reason) in all aspects of patient care. Look at the x-ray, examine the sputum, talk with the radiologist, watch the echo being performed. This will allow you to learn more and gain insight into a particular illness/disease state that would not be well conveyed by simply reading the formal report. It will also give you an appreciation for tests and their limitations. Caring for patients is not a spectator sport. As an active participant in the health care process (rather then simply a scribe who documents events as they occur) you will not only help deliver better medical care but will also find the process to be more rewarding and enjoyable.

And, follow rules.