What does everyone do to prepare for clinical days the night before?
Its hard becuase we are having our patients chosen for us the first few weeks so we dont know what we'll get, but I feel so flustered in the morning scrambling to find all my little gadgets and deciding what info I should write down and take to be ahead of the game.
Last week we went in and our instructor gave us a patient and said go...
We went into the rooms and just started doing vitals and assessing.
But while having to gather all this objective data, "life" happens and trays come or the patient needs help to the bathroom or you go in search of linens or to request pain meds.
I felt so unorganized! There's so many things happening all at once and I still need to learn my stuff. Anyway any tips would be appreciated.
For my program we get our patient assignment the day before (instructor picks 6 patients who, among other things, are likely to stay for the next 2 days so we can see continuum of care... if you get there before the instructor you can have your pick of the 6, otherwise you get what's left) and are responsible for an 8 page clinical prep exercise.
We need to interview our patient to get their statement, their concerns/problems, assess their understanding of their condition and their discharge plans. We have to know the class, action, rationale and nursing implications (side effects, what to check before admin, when to hold) for each drug, implications of any abnormal lab values, pathophysiology of admitting diagnosis. Then we do a concept map, come up with our top nursing diagnosis with goals and interventions.
Before we pass meds we have to check off with our instructor and tell her the class, action, rationale and implications of each medicine before we give it (I type my clinical prep and make myself an extra copy so I can look over it before I get quizzed). We are required to have PDAs in my program with ePocrates essentials, which has drugs, labs, dx, etc.
I bought a clipboard that opens up and has room to store papers. In there I keep my patient care summary, med list, prep sheet info, and handouts given by my instructor. My clinical group liked it so much they all bought one. I also keep my PDA with me for reference, and for the calculator if I need to do dosage calcs.
Now that I've had clinical a few times, I write myself notes to prompt myself on things I forget a lot. I hate going in and doing my assessment, then coming out to chart and reailzing a missed a whole body system (I'm in an assessment class this quarter, so there are a lot of things I haven't "learned" to assess yet). So I write down what I tend to space on so I don't have to bug my patient 50 times more than is necessary.
Every clinical day is full of challenges. You need to face each one as it comes, and as you overcome it, give yourself a pat on the back. It's one more victory!
Last semester, we would get our patient assignment the day before and we'd have to look up about all their disease diagnoses, treatments, labs, meds, nursing diagnoses etc. Took forever. This semester (2nd semester), the form isn't quite as in depth. We were assigned our patient for the 1st week of clinical, but starting next week we can pick either 1 or 2, and later in the semester the instructor said 3 is ok if we feel confident. She said we can come in cold one week if we want to too. In regards to the medicine, she really just seems to want us to know why the patient is taking it and any specific precautions we should take.
We don't bring books....each of us in our group brings a notebook with hospital papers in it, plus a hard-copy of the assessments as a guide in addition to the paperwork we will ultimately need to turn in post-clinicals that week.
And I'm like the OCD person above!! I bought a special watch for clinicals, an extra lip gloss, lotion, pen, notepad w/cheat sheets, etc., etc., that all go into a ziploc that is in a bag with my notebook and stethoscope and that all goes in with me to the hospital and ends up in my pockets. I am NOT a morning person and couldn't cope if I had to hunt all of this down in the a.m. (like the watch I couldn't find the morning of my first clinical 2 weeks ago -- NEVER again!!). The only other thing I took today was my drug book, but yeah, who the heck has time to reference that!! UGH!!
Don't sweat about the watch thing... in fact I never even wear one, I just use the one on the wall in the pts room. Saves my watch from getting wet and being a pain in the butt all the ten thousand times I have to wash my hands
This semester our clinical instructor doesn't assign us patients until the day of clinical. She does this because in the past she would assign patients the night before and the students would get all the info on the patient only to come back the next day to find the patient had been discharged. We come in a couple hours early and complete a 3 page paper on our patient. However, it is a big pain because there aren't enough computers to go around and I usually end up not getting a computer!!! My pockets are filled to the brim each clinical day. I carry a small notpad with lab values, etc., at least 2 pens, a sharpie, pen light, stethoscope, assessment guide, alcohol pads, and my patient information that I looked up prior to clinical. I still feel so disorganized and I am in my second semester!
Don't sweat about the watch thing... in fact I never even wear one, I just use the one on the wall in the pts room. Saves my watch from getting wet and being a pain in the butt all the ten thousand times I have to wash my hands
LOL.....I'm nearsighted and can't wear contacts due to now also being farsighted and having dry eyes (old age has its drawbacks), so not only is any clock on a wall with tiny second-hands impossible, but when I saw the BP gauge up on that wall WAY above my pt's head I figured I was doomed...I usually only wear glasses for driving...I'm managing the gauge okay, but no way am I going to depend on a clock on a wall for assessments!! :) Besides, I rather like my watch!!
I would love to have the pt chosen for me! We have to go to the hospital the day before clinicals and pick 2 patients, then fill out a load of paperwork on them that night, including complete care plans, med sheets, history, lab analysis, etc. It usually takes me 2-3 hours at the hospital to pick the patients and gather all the data I need, then anywhere from 3-6 hours of paperwork that night. Then up at 5am to be there on time! Count your blessings!
Yep, same here. Although clinical prep work is a pain no matter how you cut it! I do think the learning experience from the clinical prep work would be so much more effective if you had more than one night to prepare. If I could pick a pt on Tues for Fri I would have so much time to really delve into what was going on with them, how their labs relate, what to do for them medically. Oftentimes, the hardest part is making sense out of the charts and especially when there is conflicting info in the chart (which happens 90% of the time). If one doc says one thing and the other says one thing, well, what do you write on your careplan. And if something in the chart is false...well, all your nursing diagnosis could possibly not even apply!! To me, it is all a bunch of hooey. They want you to do the careplans to really get you thinking but unfortunately, these days when you have to pick your pt the day before, the "learning experience" just goes out the window. I am strugling just to get the bare minimum done. I don't have time to research CHF all over again. Really sucks.
I think careplans do have value. But I think they would have so much more value if you had more days since in the real hospital you have 0 minutes so what you learn in school (and retain) matters most. Doesn't help when the learning experience is cut short. I feel your pain!
I start clinicals in 3 weeks. Does your instructor go in with you in the beginning? I am unsure what to expect myself, but love the tips that are given on this site. Do they tell you to bring a notepad, because I will keep that in mind! Good luck to all who are starting out and thanks to those who have been there and can offer advice!-Aileen S.P.N.(student practical nurse)
I always prepare everything the night before. I make sure I have my little clinical bag full of my diagnosis books (for the dreaded care plans), my drug guide, an assessment book and my RN notes book. Yes I know...I always prepare ...just incase. :rotfl: I also make sure I have my pen light, name badge, steth and a couple of pens. I lay my uniform out too and make sure it's nice and neat.
I have a little notebook to write down assessment data and vitals. I always write down all the things I'll be checking on my pt (temp, resp, BP, pulse, assessment) the next day so I make sure I don't forget anything. I also leave a whole page for report. The night before I get my patient status emailed to me, so it seems I'm always up late looking up drugs and researching my pt's problems.
I always have good intentions of being nice and neat and organized at clinical, but I have yet to master that and my notes always look like chicken scratch. It gets a little better after every clinical though.
One day I'll be organized and everything will go more smoothly....one day.
I start clinicals in 3 weeks. Does your instructor go in with you in the beginning? I am unsure what to expect myself, but love the tips that are given on this site. Do they tell you to bring a notepad, because I will keep that in mind! Good luck to all who are starting out and thanks to those who have been there and can offer advice!-Aileen S.P.N.(student practical nurse)
Yes, you'll usually go into clinicals as a group of 4-9 students with one clinical instructor. When you get your patient, you'll be 'sharing' that patient with the nurse who has that patient. You'll likely be responsible for getting everything done, but the nurse on the floor or more likely the instructor is there to help you when you need it (hopefully).
I have assessment Thursday night and Clinical on Saturday. The instructor picks the patient for us on Thursday, so we have all day Friday to do a careplan. I love it!
I usually prepare myself the night before, ironing my clothes, careplans and my PDA. I have to be at Clinical at 7am, so I dont want to wake up too early. Once I am organized, I perform at my best.
Megsd, BSN, RN
723 Posts
For my program we get our patient assignment the day before (instructor picks 6 patients who, among other things, are likely to stay for the next 2 days so we can see continuum of care... if you get there before the instructor you can have your pick of the 6, otherwise you get what's left) and are responsible for an 8 page clinical prep exercise.
We need to interview our patient to get their statement, their concerns/problems, assess their understanding of their condition and their discharge plans. We have to know the class, action, rationale and nursing implications (side effects, what to check before admin, when to hold) for each drug, implications of any abnormal lab values, pathophysiology of admitting diagnosis. Then we do a concept map, come up with our top nursing diagnosis with goals and interventions.
Before we pass meds we have to check off with our instructor and tell her the class, action, rationale and implications of each medicine before we give it (I type my clinical prep and make myself an extra copy so I can look over it before I get quizzed). We are required to have PDAs in my program with ePocrates essentials, which has drugs, labs, dx, etc.
I bought a clipboard that opens up and has room to store papers. In there I keep my patient care summary, med list, prep sheet info, and handouts given by my instructor. My clinical group liked it so much they all bought one. I also keep my PDA with me for reference, and for the calculator if I need to do dosage calcs.
Now that I've had clinical a few times, I write myself notes to prompt myself on things I forget a lot. I hate going in and doing my assessment, then coming out to chart and reailzing a missed a whole body system (I'm in an assessment class this quarter, so there are a lot of things I haven't "learned" to assess yet). So I write down what I tend to space on so I don't have to bug my patient 50 times more than is necessary.
Every clinical day is full of challenges. You need to face each one as it comes, and as you overcome it, give yourself a pat on the back. It's one more victory!