Clinical Experience????

My clinical experience so far consists of giving baths and changing sheets. I actually forgot I was going to be an RN. I found myself thinking only what the CNA's work consists of. We don't have time to look at charts before we meet our Pt's. I had 2 pt's my first day of med-surg. I am questioning my ability of being an RN because I have no idea what I am supposed to be learning. By the time I find an actual wash cloth and clean gown, time's up, off to post conference. My instructor will ask what did you assess? Well, I finally found the ****ing wash cloth. NOT HAPPY!!!!! AAAAHHHH!!!!!!! I mean really, first day, no one tell's us where anything is, just those two pt's are yours. Ummm, I guess clean them, vital signs, then what, Why can't we look at their charts first?? AAAHHH!!!!

[angel Ann]

student nurses shouldnt be always left alone doing the bed baths,changing sheets etc.Your first exposure to clinical placement would be introduction to the staff,finding who your preceptor is and making yourself familiar with the area you are on.Doing vital signs is a part of your job when you start on the first week but your learning should progress as you go along.I wonder if you have a planner and start making your objectives for a certain period of time and evaluate yourself and write a reflection.When you do bedbaths and vital signs,you are actually doing an assessment-you can interact with your patients,asking questions and gather your objective and subjective signs:wink2:

[hippienurse]

I think of it like this "you have to walk before you can run". You have to learn the basics of care (the CNA stuff) and from there you form a basis to keep building on.

In our clinical we have to go the day before to gather info on our pt. Then, first thing you should do the assessment, before the client is getting up or cleaned up. Then as you clean them up you can continue to assess them and talk with them like someone suggested above...

[stressgal, RN]

This very topic came up today in our Pharmacology clinicals. As our preceptor said, the very best way to assess a patient is while you are bathing them. Think about it, this is a time you have access to every part of their body. You can talk with them while bathing, giving you time to ask questions for a data base. I have had 3 med/surg clinicals, 3 hours each, and was able to complete physical assessments and a data bases. It is a matter of practice and comfort. Keep at it, you can do it!

[crb613, BSN, RN]

My clinicals are great!I have met some wonderful clients,given alot baths,changed beds, read charts, done assessments, comforted some lonely people, got to go to surgery on my 3rd day & see a atka (my client). I love it and cannot wait to be a REAL nurse instead of a student. The clients make my day and I love to be able to do something to make theirs eaiser!

[HappyNurse2005, RN]

are you in your first semester? we didnt do much more than that our first week, but we did read the charts the day before clinicals. we did baths and vital signs. we slowly built up more and more assessments, with supervision, etc. and now, as I am in my 3rd semester we do so much more. i do baths, meds, assessments, charting, any dressing changes, inserting/removing of any tubes, etc.

it gets better the farther along you get

love, rose

[Fiona59]

Patient care is vital to your client. They usually don't like being dependant on another to perform such personal chores. Be glad that they trust you.

As somebody else said, you can assess the patient while doing personal care. Talking with them sometimes tells you a great deal about state of mind, functional ability in order that you can gear your teaching to an appropriate level, heck, are they even orientated to reality??

CNA's are often your only source of some of this information because once you are an RN on many units you don't get this kind of time with your patients.

It's hard being a student, but the grunt work has to be done. Nursing isn't all about IVAC, chest tubes, catheters, monitors, etc. It's about anothers wellbeing and trying to assist them back to health.

[jaimealmostRN]

Everyone else's posts were great and I totally agree but some other things you can assess (if not just for practice) are:

Pulses, radial and Dorsal pedis/Posterior tibialis (top of foot and inner ankle)

Apical pulse with stethoscope

Bowel sounds in all 4 quadrents

Lung sounds

Capillary refill

Homan's sign (have them dorsiflex their foot if they have pain it COULD-not always indicate a thrombus formation)

Temp and color of extremities

Ask them to tell you about their past medical and surgical history and dates

Ask them about their diet at home, how they cook (frying, boiling), who in the family

cooks.

Ask about any recent weight loss or gains in the past 6mos

Ask them to squeeze you hands and let go to determine if they have any weakness on one or both sides

Since you are in your first semester you may not know what a normal heart sounds like, but you can just listen to listen (ahh so thats where I hear a heart/lungs!). And I would not do any teaching if you do not fully understand the concepts. But this practice will really help you later on when you can put 2 and 2 together! Good luck!

[NewEnglandRN, RN]

On a typical clinical day, we are assigned one patient. The night before we go to the clinical site to review the chart ansd start our paperwork.

7:30-8:15 a.m. We do our pre-conference utilizing the data we collected the night before. Our wonderful Clinical Instructor will answer any questions we could not find out the night before

8:15-10:45 a.m. We do are history & assessments while performing ADLs. We need to assess:

• all VS inc AP
  
• skin condition: presence of skin turgor, edema, skin break down
  
• All peripheral pulses
  
• ROM of extremities
  
• I&O for the morning
  
• Evaluate respirations
  
• Listen for Bowel sounds
  
• Listen to lungs
  

10:45 -11:30 We report-off to the Nurse, finish our paperwork and have a post-conference.

As tired as I am of bedbaths, they are very useful in gathering client information. This week we will be starting PO meds and I am the first student :uhoh21:

Don't worry, you won't have to do bedbaths forever!

[wonderbee, BSN, RN]

What a difference one semester makes. During first semester, I remember the rush to the clean linen room to get what was left of the clean towels, gowns, etc. There were never enough for all of us and some of us had to wait. Also, everything we did took a painfully long time. Unless you've had prior clinical experience, this is to be expected. I'm in the last third of second semester. Beds and baths are only a PRN thing for us now. It's all coming together and I'm starting to feel more like a nurse now.

I think that the first semester is about learning your way around the hospital environment and getting comfortable with patient interaction. It also makes you employable as an aide, which is also a valuable learning experience. I know it seems tedious and you might even feel a little ridiculous but it's a necessary foundation. Hang in there.

[kimhaw]

I know what you mean about the clinical experience thing. We have been in the hospital 3 weeks and I have not gotten to do none of the things I checked off on. Mostly just baths. The nurses on the floor really act like we are in the way. On r.n. who was the treatment nurse told us she was not wasting her time letting students help her. So alot of my time in clinical has been doing the basic assessment. One girl who is foriegn. told our instructor last week she was not paying good money to wipe a## all day. She said this b/c a r.n on the floor told her that she should not be following the cna's around since she won't be a cna when she graduates. but what else are we going to do, stand at the nurse's desk and look stupid. Sorry for the vent but its my first sem. maybe next sem. it will get better.

[SC RN, RN]

8:15-10:45 a.m. We do are history & assessments while performing ADLs. We need to assess:

• all VS inc AP
  
• skin condition: presence of skin turgor, edema, skin break down
  
• All peripheral pulses
  
• ROM of extremities
  
• I&O for the morning
  
• Evaluate respirations
  
• Listen for Bowel sounds
  
• Listen to lungs
  

Are you really just in clinicals for 2 1/2 hours per day (meaning, only 2 1/2 hours on the floor)? How many days do you go? I'm just curious because we are on the floor for at least six if not eight hours per day and we do this two days per week. Anyone else have more or less hours? It's interesting to see how different programs work!