Clinicals with no sleep

[BSNstudent09]

I am about to start my pediatric rotation. We are to go to the floor and choose a patient the night before clinicals. We can not arrrive befor five pm. We then have a 30 page paper due on that patient and family. It is do the next morning before 630 am. Needless to say we are up all night doing the paper then pull a 12 hour rotation passing meds etc... Seems unsafe. Am I just a whinning student or does this not seem right? Is this how all schools do it?

Thanks:eek:

[ADPIE10]

I am about to start my pediatric rotation. We are to go to the floor and choose a patient the night before clinicals. We can not arrrive befor five pm. We then have a 30 page paper due on that patient and family. It is do the next morning before 630 am. Needless to say we are up all night doing the paper then pull a 12 hour rotation passing meds etc... Seems unsafe. Am I just a whinning student or does this not seem right? Is this how all schools do it?

Thanks:eek:

1) It's always a good idea to give your professor the benefit of the doubt and state so.

2) Based upon your statements, I respect that you are concerned about patient safety. (You should also communicate this to your instructor.)

Be open minded and allow your instructor to practice therapeutic communication.

3) Ask your instructor to clarify the expectations with regard to the paper.

4) Request recommendations to succed in fulfilling the requirement.

You both should share the mutual objectives of maximizing patient care and successful learning. Remeber to review your notes on therapeutic communication before speaking with your instructor.

[MassED, BSN, RN]

We have a similar scenario at my school and it sucks. You find out info about the patient late (6-7 pm) on Wednesday afternoon; fill out a 15 page FRONT and BACK packet of info about them; then show up at clinical @ 6:45 a.m. You are expected to know all your meds, sometimes as many as 15 front and back, have completed prior nursing assessments, etc. . . If you show up for clinical with out the completed assignment you are sent home for the day. THEN after pre conference we are expected to do FULL a.m. care of 3 patients ( bed baths, linen changes, assessments, breakfast etc.c.c.) Before med pass @ 0900. I really do hat my school- qwe have lost sooo many and I'm afraid I may be next lol!!!

what you are explaining was the norm for my ADN program, but that is different than what OP was writing about with a 30 page paper. Maybe she didn't mean a 30 page PAPER, but like what you wrote, more of a packet that includes the normal meds, s/e, history, etc. Your ADN program sounds very typical. It does end, eventually!

[justme1972]

No, doesn't seem right.

Yes, it is unsafe.

This is NOT the norm at nursing schools and I know one instructor that is putting her license on the line, and I guarantee it would be her last day in the hospital if they knew here students were showing up on no sleep.

[aphi~gn]

I don't know where these schools are. . .but I would like to know. . . .How can this be considered normal:no:. . .that amount of work to be done in less then ONE DAY is absolutly CRAZY. . .If they tried to send my home if I didn't have a 30 page packet done when given less then one day I would freak out. . and then go to the dean . . .forget talking to the CI. This is not a safe practice. .and on top of that. . it is not necessary. Reading the info off the chart and getting report the day of has worked wonderfully for my program. . .and then when we are ready to give meds we look them up before we get them out. .if we are unsure of what the med is. . .you shouldn't have to do ALL of that work before you even have your clinical rotation. PS I also can't believe they make you do cares for 3 pts and deliever trays before they will let you pass meds. . . .These people sound like slave-drivers:angryfire My programs is nothing like this. THANK GOD. I feel sooo bad for any student nurses that are in these types of programs.

[AOx1]

That is not realistic, nor does it in any way prepare the student for realities of nursing. This is where nursing education is becoming off track, IMO. In no circumstances as a practicing nurse will you arrive the night before, learn about and assess your patient, and write a 30-pg paper about them. This is not teaching you critical thinking, it is merely a gauntlet to pass through. My students arrive at the clinical floor, listen to report, perform an initial assessment, and come back to the conference room. Once there, they look up any unfamiliar medications, fine tune their assessment and look up needed info about the patient's diagnosis, and then we discuss needed and priority care for the day. I then check on them hourly to see how they are progressing, help with procedures, etc.

What you are doing will not teach you to be an independent thinking nurse in a practice setting. It only teaches you to write a paper. NCLEX is a minimum standards exam, in other words, it ensures that you meet the minimum standards of safety to be a nurse. In no part of the NCLEX are you expected to write an essay, a 30-page paper, or anything of the sort. If I am in the hospital having a heart attack, bring me the nurse that recognizes I am in trouble and can quickly act on it with rational choices, not the one who can write the prettiest paper, in APA style.

I do not mean this as any sort of attack on you, I am just appalled that your school is doing you such a disservice. As educators, our calling is to provide you with the foundation you will need to succeed as a nurse. This program sounds as if it is falling short.

[futurecnm]

in my ADN program we did collect info the night before and could not be there before 4pm. We had to have our entire careplan and med cards done (and meds known) by 0630 the next AM. I would say our careplans were about 10-15 pages. Does the OP mean a paper or a care plan packet?? Totally different things. I have no clue what a paper would be about on 1 pt. But some people did stay up all night. I refused to do that and my body would not handle No sleep. I think the latest I stayed up was about 1AM. Our instructors required that you had done the work, but obviously it wasn't totally complete and perfect. The basis of your careplan had to fit your pt and make sense. And meds were important so many of us did those first.

[MB37]

My school eliminated the practice of going to the hospital the night before years ago, out of concern for patient safety with students showing up without sleeping. Other schools in my area still do this, but they aren't required to write a 30 page paper. We write our care plans after the fact based on our assessments and interventions while providing care that day - they're long and annoying, but we have more than one night to do them in.

[wellhereiam]

Hi, I'm in a BSN program-- one of the best in the state. In our program, we're supposed to go the evening or night before clinical to collect patient data. Then we spend almost all night writing the care plan/prep info with patient data, medical diagnoses, pathophysiologies, s/s, medical surgical nursing dietary interventions, medications (5 rights plus side effects, what to assess for ie BP, class, etc) , patient labs normal labs and what they mean, diagnostic tests (explain the procedure, write what to expect, write patient's outcome), and the care plan assessment. This is due the following morning at 0600 am. It can be as little as 8 pages or as long as 20, depending on how many tests, labs, diagnoses, etc the patient has. These take me around 6-8 hours, pretty much all night. Many of my classmates don't sleep. Some do sleep by 10pm, but I don't know the quality of their paper. We have clinicals twice a week, so this is twice a week. Then after each clinical day, we turn in a packet filled with patient assessment data which consists of information for all 12 systems. Then we write about the nursing diagnoses and interventions we used, the expected outcomes, etc. This takes me about 3-4 hours and it is due the next clinical day. Yep, I pretty much slept about 2-5 hours nights before clinicals; i woudn't feel sleepy in the morning, but I knwo I wouldn't be able to think clearly. If the patient was discharged, we pick someone with a similar diagnosis. I hated these nights; dreaded them. I often fell asleep in class! But I got by. Nobody died. It sucks major though. What are you supposed to fill out within those 30 pages?

[mb1949]

Wow that sounds ridiculous, we get our patients the night before, they are assigned to us by our CI, we gather dx, drugs, etc , preconference we discuss there dx and possible nursing dx then the next week we turn in our case study approx 10 pages, including 4 nurs dx (3 medical, 1 pyschosocial)

You need to speak to someone about this

[chevyv, BSN, RN]

WE are never assigned clients the night before. Sounds absurd because pts are now seen sicker than ever so transfers happen within a few hours. I've had too many days with one client only to come in the next day and they've been d/c'd (transferred or ?). We come in 30 minutes beforehand and gather what we need and try to get it all together. Our instructors tell us this is what it's like in the 'real world'.

I can't believe a 30 pg paper! That's crazy and I'd be shedding a few tears. I'm so sorry you have to go through that. I can't help but wonder what exactly you'll be learning from that? I doubt I'd catch errors the day of clinical

[RNMom2010]

We get our assignments from our CI the day before clinicals, which start on thursdays, but we can go as soon as she has the assignments ready, which lately has been on a tuesday. We fill out a nursing process tool and write out pathos and 2 careplans with 1 LTG and 2 STG each and make drug cards all for thursday. Then for friday all that needs to be completed is any revisions to the careplans. I refuse to stay up all night, I am in bed no later then 10 before my clinicals, which start at 6am.

[Acosmo27]

huh? 30 pages overnight? Its hard to imagine any school of nursing being that evil...