Clinical in Nursing Home--experiences?

elephantlover, BSN, RN · Jan 16, 2019

For my fundamentals clinical we were in an LTC facility as well. Yes, the main focus was on basic nursing skills and ADLs. Minor soap-box moment: these skills are so important! Yes, RNs do delegate to assistive personnel in certain settings, but they are still involved in patient care! I currently work on a medical floor at a teaching hospital and guess what? Nursing home residents make up a large part of the population that we work with.

During this clinical practicum, I also practiced assessment skills, care planning, passed oral meds, and did wound care. Check out the course outcomes in your syllabus.

Keep an open mind! I had been a CNA for 5 years prior to my fundamentals clinical and I had a lot to learn. Some days I had to seek out opportunities to learn. For example, if there was a patient on a different wing who had a PEG tube or trach I asked to be assigned to that patient or shadow the nurse. Overall it was a good experience. You have a great opportunity to teach your classmates who are less familiar with patient care. I know a lot of my classmates had not touched a patient prior to our first clinical. I enjoyed going into patient rooms with them to support them. I hope you have a really great experience!

**NICU Guy, BSN, RN** · Jan 16, 2019

It is basic Nursing skills. A majority is "CNA" work, but it is the foundation of nursing. Many of your classmates have never touched a patient before and need these basic skills to get them introduced to the heath care field.

Luchador, CNA, EMT-B · Jan 16, 2019

14 hours ago, galactose said:
Hi everyone!
I am about to attend my first clinical--and it is at a nursing home! We will be working the LTC side. As a former CNA, I am curious as to what nursing students do during nursing home clinicals? So far my instructors have said we will be turning, transferring, toileting, showering, (ADL related activities)---but wouldn't this be equivalent to CNA work? Let me know your experience in your clinical! I feel a little disappointed if it is similar CNA work, as I really wanted to start learning new skills ?
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I'm also a CNA and the first semester of clinical was pretty boring. The most important stuff you will learn is assessments and writing care plans.

We were cleared to start Foley's, give shots (IM, subq, etc) and pass meds but I was only able to give one shot the whole semester and that was because I pestered the RNs at the facility. If you want to use any of your training you will have to show initiative and bug the RNs to let you do stuff. When you get cleared to give Foley's check and see which patients with Foley's are due to be changed and so on. I'm sure it's going to be the same each semester during clinical rotations.

BiscuitStripes, BSN, RN · Jan 16, 2019

I did my fundamentals rotation in a SNF as well, this is fairly common with nursing programs. I've been an EMT for years and I currently am an ER and Trauma Tech in a busy Level 2 Trauma Center, so this semester it was a pretty boring for me because I do more in the ER than I was allowed to do in the clinical site.

Typical day at the SNF clinical for us included taking vital signs, helping with med passes (almost all oral meds with very few blood sugar checks and insulin SubQ injections, no IVs, no IMs, etc.), turning patients, changing patients, bathing patients, feeding patients, participating in Bingo and other activities in the day room with them. On the days the wound care nurse came we were allowed to assist with dressing changes for pressure ulcers and surgical wounds. If we weren’t doing any of the above, we were practicing head-to-toe bedside assessments on patients.

There wasn't much to do, very little skills, and there was 10 students in a small facility, so people were usually fighting over who got to do what. I think throughout the entire semester I gave 2-3 SubQ insulin injections, did 3-4 POC blood glucose checks, passed oral meds to 3-4 patients, did one nebulizer treatment, maybe 3-4 dressing changes, and that's it. There were more than that but I had to share with the other students. No one in my clinical group did any catheters.

At the SNF I was at, there were many CNA’s, LVN’s performed the majority of patient care, and RN’s were the charge nurses. Even though I’m in an accelerated BSN program, we learned from the LVN’s. Majority of it was CNA type work with the exception of assisting with med passes, wound dressing changes, and head-to-toe assessments.

As someone else said, this may be the first time some of your classmates have stepped foot into a healthcare environment, let alone been tasked with patient care. That is a big deal for some people. Take it for what it is, try to learn as much as you can, and move on.