Clinical

Nursing Students General Students

Published

I need an opinion. I had my first day of clinicals today in a hospital setting. Of course nervous as I have an instructor that does not like to be asked questions, and is not willing to provide help. We were assigned a patient and had a partner. My job was to obtain vitals and complete the paperwork while the other did the assessment. I began by looking round the room and not able to find a BP cuff. I asked my instructor who was standing there observing my partner and she did not answer. I continued to look as I then took a temp. After the temp and pulse, I still did not see it. The instructor asked why I was just standing there after 6 minutes in a mean tone. I told her I could not find the cuff and she said to follow the cord from the wall. (I forgot it was on the wall and hanging on the siderail!) Duh. I then found it and took the BP. I will admit I was super nervous and not at all familiar with hospital BP cuff storage area. Later in the day the teacher also allowed the person who was to do paperwork (me) all day to get an assessment in. I failed to get everything in, by mistake! I was so preoccupied with how to enter vitals in the computer (it was assumed we would figure out where and how to enter these in) and how to find things to perfect my paperwork that I forgot to complete the assessment. Ok here I screwed up! I was also very focused on the fact I was the nurse in charge of the paperwork and it was not DONE!

The instructor asked to speak to me after class and told me I am failing and not doing well based on the days activities. I'm feeling so discouraged and find it hard to imagine how this will progress. Now I'm afraid to even be in this clinical, feeling very unsupported as a student. I'm ok with assumptions at times but I was hoping for some support and ability to ask if I'm not sure, ESPECIALLY on the first day when my nerves are in knots. I guess my lack of confidence in not knowing my way around showed today, but I felt that was kind of uncalled for from the instructor, day one observation only is not fair but this is only my opinion.

Specializes in Medsurg.

Oh dear. That situation sounds awful. It sounds like your nerves got to you. Your going to go back in there with a level head and your going to excel! My RN clinicals weren't as tough as my LPN ones. What I did for tough instructors was imagine they were naked or something. It made me smile......a lot.

If humor doesn't work, start working on your stress management skills now. A big part of clinicals is not just the knowledge aspects but also to strengthen the fortitude of that student. BREATHE! I practice mindful breathing a lot. Breathe in slowly 1-2-3-4-5, out 1-2-3-4-5 that's 1. Do that till 10. Only thing that your mind should be focused on is those numbers. BREATHE!

And here's a hug. Do come back and share with us how you doing. Get your RN girl!

giphy (2).gif
1
Up Vote Up Vote ×

I don't know what your program uses to evaluate for clinical, and I don't know how your program determines the pass/fail aspect- but it sounds like the instructor basically gave you an "unsatisfactory" rating for your first day. The good news is, YOU CAN ONLY IMPROVE FROM HERE! In my opinion, if your instructor did not properly orient you to the unit you're having clinicals on (here are vitals machines, here is the nutrition room, here is where clean linens are kept, etc), they failed in one of their duties as well.

I think the most important thing for you to do now is practice managing those nerves. I was such a nervous heap on my first day of clinicals I tried to take a radial pulse ON THE ULNAR SIDE OF THE WRIST (**facepalm**). That being said, I finished that first round of clinicals with "exceeding expectations" as my final rating. I remembered I was there to learn- if your instructor is not willing to help, there is certainly another student or a nurse or a tech on the floor willing to lend a hand (especially for something as trivial as the location of a BP cuff). Nursing will be a stressful job (I'm only in my third semester where I'm taking care of three patients, not five or six and most days I feel drained)- your instructor may simply be trying to push you in order to encourage better coping skills. When in doubt, simply remember the patient takes priority; not paperwork, not charting, the patient and the patient's safety are number one. Take a few deep breaths, count backwards and forwards in your head, roll your shoulders a few times, find something that brings you inner calm and go from there. You'll get through this.

Up Vote Up Vote ×
Specializes in NICU, PICU, Peds, Pediatraic Home Care, Infusion.

FIRST day of clinicals. So sorry you had such a miserable day. I would not go out of my way to interact with this instructor in anyway except when required. Take slow deep breaths and shake it off.

I was so stressed out during clinicals with a notoriously wicked instructor,(and she liked me!), that I had to stop in the ER before going up to the assigned unit and get a breathing treatment before I coded each day of those clinicals. The staff in that ER understood.

Hugs to you. Keep us posted. You will survive. Keep your eyes on the prize.

1
Up Vote Up Vote ×
Specializes in Dialysis.

Sorry you had such a crappy first day. Keep your chin up--we have all been there, and it does get better. I felt awkward/silly about every little thing (including vitals) with my first few clinical shifts. I remember at one of my very first rotations in the hospital, the patient I was assigned to loudly complained about me and called me stupid in front of my clinical instructor. I had to step out, and my instructor found me crying in the med room. The difference is that my instructor was incredibly supportive and kind--she lifted me up, instead of tearing me down. It made all the difference in the world.

It sucks that your instructor is not as supportive, but just remember that he/she will not be your ONLY mentor throughout nursing school. You will meet PLENTY of incredible nurses along the way, many who love to nurture/educate.

My one suggestion would be to mirror what WhaleTails said--focus on the patient first. During clinical, your instructor is evaluating your patient care--and it sounds like you spent more time trying to figure out the EMR than assessing your patient. I don't really get how you are completing paperwork without having done an assessment in the first place..? Anyway, I'm not trying to make you feel worse, just something to consider. My instructors warned us going in that there is nothing they hate worse than seeing students huddled around the nurses station on the computer all day. You should consider clinical as your opportunity to really hone your nursing skills-- at the patient bedside, not at the computer.

2
Up Vote Up Vote ×
On 9/7/2019 at 6:51 AM, GubbyScrub said:

I think the real problem here is that her instructor let her fail instead of pushing her to succeed. Did you skip over the part of the OP where they said it was their FIRST day in the hospital setting? I'm sure you remember your first day at clinical. If you were calm and completed all your tasks efficiently then props to you, but most people do not share that experience.

To the poster: don't let this first day syke you out! Breathe, practice, study. I'm sorry that your first day did not turn out very well, but it will get better as you orient yourself to the unit and hospital setting. Good luck to you!

Nope. I did not miss that it was her first day. In all honestly I agree her instructor was being unnecessarily harsh. But honestly that doesn’t matter as I am not her instructor.

Telling her that her instructor was being hard on her is of no real use to the OP as it reinforces the idea that the fault is with the instructor not with her performance. The bottom line is if she doesn’t improve she will fail and the only way to improve is to acknowledge that she needs to do better. Telling her anything else is undermining her potential for success.

Up Vote Up Vote ×

I'm checking in and letting everyone know how things are going. After my first day nerves things have gotten better HOWEVER. I have noticed some things. I feel that I am the subject of bullying by this instructor. I am an older student returning to school, and not sure if the instructor is partial to me for some reason. She has not been realistically assessing me or what I have been doing correctly. She is going off a minute or two observation and making huge asssumptions about my abilities. If I have to try to log in a second time on the computer she makes the assumption I have weak computer skills. etc. Her reaction to something I do, and then what another student does, even if the same thing is harder on me than on them. A student forgot to document parts of an assessment and so did I. I missed one thing, she missed 6 things, but pulled me aside and verbally reprimanded me like a child, and simply told her she is missing some things. This is the secod time I have run into this kind of behavior with a clinical instructor. Does anyone have advice on this matter? She pulled me aside and had me stay after class the last time regarding my first day, this time she pulled me into a private sitting corner, and verbalized how she thinks I can't do some things, that I know I CAN do. (she said my computer skills are not great and it takes me long to get things logged--I know it doesn't take me longer than others) I am feeling very threatened at this point and not sure if I need to just keep quiet or say something.

Up Vote Up Vote ×
Specializes in Clinical Leadership, Staff Development, Education.

This is a suggestion, take what helps and feel free to leave rest.

If you have same instructor again (or can use with any future instructor). Ask to speak to her during "downtime", tell her you wanted to follow up on her feedback because you want to meet her expectations. Ask if she has any suggestions for you moving forward and that improvement is important to you. I agree... too tough for first day, but unfortunately, nursing instructors sometimes eat their own too. But, she may also have some identified legitimate areas you could improve and give her a chance to provide coaching.

2
Up Vote Up Vote ×
Specializes in Medsurg.

Well regards to that I'm not the one to ask for advice. Last clinical instructor I had I told her I don't like her, we don't vibe, she ain't doing her job, and that she's rude??. My clinical performance was exemplary so I didn't have any doubt she had to pass me..... don't follow my lead .

Up Vote Up Vote ×

OP, I stand by my original advice. You need to do your best with the tasks you are given, and you also need to work on this rapport and bring it around to your advantage. You really can't afford to notice how she is treating other students right now. You have to solely focus on what you are doing, and on your rapport with the instructor.

I suspect that you being bothered by things like a huge discrepancy in how she treats one student vs. how she treats you (with missed items, for example) is contributing to this. If the discrepancy is as obvious as you say, then she knows you have noticed it too. This is all such a bunch of bull. Go do your thing and refuse to let your emotions be manipulated. I'm telling you, these are the kind of people to whom you do/should (figuratively) say "oh please may I have more" - - not because what they are doing is good but because it will take the wind out of their sails.

1
Up Vote Up Vote ×
Specializes in Stepdown . Telemetry.

The ONLY person who can “fail” the first day is the instructor.

So when she says you failed, she should more accurately say, “I failed”.

I hope its gotten better for you, and i realize my words can’t change what an utter waste of space your teacher is. But maybe it can be something to help you remind yourself that you are at the most basic learning stages.

Just focus on one thing at a time and try ignore the anxiety that is flooding you when you have some unhelpful person just staring at you watching you fumble. (Easier said than done). Good luck and hang in there!

Up Vote Up Vote ×

I was in your shoes once, your instructor HORRIBLE, be focus and look out for your time management. Show up to clinical 15 minutes early and speak to your instructor, explain to her that you are new and you need some help. If you have 2nd day like this speack to your class instructor and ask to be assigned to different clinical group

Up Vote Up Vote ×
+ Add a Comment