Clinicals - What Not to Do?

[meganec17]

Hi all,

I am beginning my sophomore year of Nursing school, and will begin clinicals on a Med Surg unit in a few weeks. I was hoping to get some advice to what to do/what not to do in terms of being helpful, and not an annoyance to my nurse.

If you've worked with students, what did you appreciate them for? What annoyed you, or made you resent them? I'm hoping to "get on the nurses good side", so I can make my learning experience as positive as possible!

Thanks for your help!

[cocoa_puff]

Never, never, never stand around in a group at the end of the hall talking.

Never, never, never carry your cell phone while you're on the floor. Leave it home or lock it up in a locker. I mean it. Cut the cord. If you need to look something up, ask your nurse where the manual or the binder or the book is for that in the nurses' station or how to do it on the floor computer; she may even take pity on you and give you the answer. :)

Do not ever let anybody find you sitting in the nursing lounge studying or doing homework. You study at home or in the library. In the hospital, you're there to learn a lot about patient care. You ought to have come prepared, and you can make notes for yourself to look up new stuff when you get home.

When your patient goes on a field trip to xray or GI lab or PT or anywhere, go along and soak up all you can. If your instructor gives you the chance to spend a day or two in a different place, TAKE IT. Fun places where you can learn a lot you can apply anywhere: cardiopulmonary rehab, diabetes clinic, GI lab, PACU, ortho clinic, inpatient psych or geripsych, shadowing the infection control nurse specialist or the wound/ostomy specialist ...

Write a nice thank you note to your preceptor or any nurse that is particularly helpful to you, and say exactly why. Make a copy for the nurse manager so s/he knows who's doing a good job at that. It's also reinforcing so that nurse will be good (or better) for students the next time.

Bring snacks for the whole staff (don't forget night shift!) on your last day.

Smile a lot!

This should be laminated and placed in the front of every nursing student's binder. Great advice, GrnTea! :)

I would also like to add that if your patient is complaining of pain (or anything), do a very quick, focused assessment before reporting it to your clinical instructor or the pt's nurse. That way, instead of saying, "My patient says he has pain," you can tell the instructor/nurse, "My patient is complaining of dull lower back pain (6/10), that just started 5 minutes ago but is chronic, no radiation, guarding, N/V, he says that moving makes it worse, but he would like some PRN pain meds."

[ahosoda]

I find it funny that so many people on here say, "don't be afraid to do bed baths, dirty work, feeding patients, etc." when I was going to say the opposite. My first few weeks of med surg clinical I was excited to try new things... inserting catheters and IVs, wound care, colostomy care, chest tubes, you name it, I was ready. I was a CNA and med assistant for a few years before nursing school and first semester just seemed like a review of CNA classes. I was ready for the big leagues.

And then I actually got to clinical. The nurses were just using me to do the dirty work while they did all of the things we were supposed to be learning. Or they would pawn us off on the CNAs. They didn't even offer me to let me watch the major skills. But of course I wanted my preceptors to like me so I did everything I could to please them (trust me, I can CNA with the best of them). Meanwhile I wasn't learning anything.

I told my instructor my concern, and she told me I needed to be more assertive. Instead of flat-out saying "no" when a preceptor asked me to do something like a bad bath with a CNA, I just politely said "I would love to do that if we have some down-time later. But I would really prefer to help you because I think it would be more valuable to my learning." I'd also apologize because I know having a student will slow you down if you are teaching them the right way, but will make your day go faster if you make them do the dirty work. I fully acknowledge that. Now, if you haven't done a lot of bed baths or changed a lot of incontinent patients, it probably would be helpful to accept these challenges.

Luckily my instructor gave me the advice to be more assertive before my shift in the ER (each student only got 6 hours in the ER and it was my main interest). Had she not given me this advice, I would have agreed to be the sitter for an elderly woman with dementia and missed out on a TON of stuff, including a trauma patient.

You have to make your education your priority. Is it more important that you gain confidence in your knowledge and skills or is it more important to get a gold star from your preceptor? I probably pissed off a couple preceptors but I learned a heck of a lot more that way. There's a balance. You CREATE opportunities for yourself in nursing school, they don't fall in your lap. If you have even 2 minutes of down time, ask the nurses in the nurses station if they need help with anything or if they have any interesting patients. These are the times I learned the most.

[WKShadowNP, DNP, APRN]

Luckily my instructor gave me the advice to be more assertive before my shift in the ER (each student only got 6 hours in the ER and it was my main interest). Had she not given me this advice, I would have agreed to be the sitter for an elderly woman with dementia and missed out on a TON of stuff, including a trauma patient.

I'm curious how it came about to ask a student nurse to be a sitter. I'm uncomfortable with this policy because of the risk to the student, the liability of the facility, and the safety of all involved.

Is your clinical site perhaps you place of employment as well? If that is the case, it compounds their request because you were off the clock.

I'm glad you got the exciting side of the ED instead. I am quite fond of it. But not just for the adrenaline stuff, we're not a trauma center, but the every day juggle that tests my prioritizing skills, challenges my time management, and satisfies my need to fix problems.

[HelloWish, ADN, BSN]

I like the advice in this post!!! I am a student and fortunately have instinctively done much of what you all have advised already. However, I do have to say that in today's day in age, we have to carry our phones! Maybe the nurses aren't aware that is how we are asked to communicate with our instructor and how he/she communicates with us. The instructor will text us to go observe somewhere or we have to text them to come and help us with a procedure, pass meds or whatever the case may be! In fact my clinical instructor would probably ask us to go home if we didn't have our phone. We are expected to text our instructor for many reasons. Please be aware that we are required to carry our phone and use it for clinical purposes. I know that doesn't mean all students are using their phone as they should, but when I am on my phone that is why!

[WKShadowNP, DNP, APRN]

I like the advice in this post!!! I am a student and fortunately have instinctively done much of what you all have advised already. However, I do have to say that in today's day in age, we have to carry our phones! Maybe the nurses aren't aware that is how we are asked to communicate with our instructor and how he/she communicates with us. The instructor will text us to go observe somewhere or we have to text them to come and help us with a procedure, pass meds or whatever the case may be! In fact my clinical instructor would probably ask us to go home if we didn't have our phone. We are expected to text our instructor for many reasons. Please be aware that we are required to carry our phone and use it for clinical purposes. I know that doesn't mean all students are using their phone as they should, but when I am on my phone that is why!

That is interesting. I can only hope that all are being prudent with it.

[RNsRWe, ASN, RN]

But Jules! My hot-lips Hoolihan brand scrubs run small! I can't help it if my Ds get in the eyeline of my patient while I'm auscultating his lungs! And oops! My thong is showing. So sorry.

Ok, I have MET you, lol....and you didn't last long on my unit

[WKShadowNP, DNP, APRN]

Ok, I have MET you, lol....and you didn't last long on my unit

I can't understand why some think that's ok.

I do have Ds but most people don't believe it because I am modestly dressed.

Compare (not me in the cape, the picture by which I'm standing is my typical scrub attire):

And me in a little black dress:

Va-va voom?

[RNsRWe, ASN, RN]

Some REALLY GREAT advice here; any student who doesn't take full advantage of this is missing out big time.

What can I add that hasn't been said....well.... BRING A PEN. Seriously. Do NOT show up to get report, sit down, and when I begin talking ask "do you have a pen I can borrow?" It will not go well for you. Same goes with other mundane, routine fundamental supplies you ought to have in your possession. Asking to borrow my stethoscope because you are having trouble with yours and would like to see if a really good one (like mine) helps you hear better... SURE! Asking to borrow my stethoscope because yours is in your car.... AGAIN.....not so much.

And about that cell phone.....I don't care if your instructor wants you to carry one. I don't think she intended you to keep it in your hands the majority of the time, texting. I DO think that keeping it in your pocket, on VIBRATE, should be sufficient to give you notice that you are wanted by the instructor for something, but NOT become a nuisance. Answer it when appropriate....NOT at bedside, thank you!

And snacks. Yes...bring snacks :)

[HelloWish, ADN, BSN]

When I say "carry one" (the phone), I don't mean in my hands. I mean on my person, such as in a pocket on vibrate!

[Crissy1]

This is very true! My clinical instructor yelled at me the other day because I didn't have my phone. We were in orientation no pt care given that day.

[RNsRWe, ASN, RN]

This is very true! My clinical instructor yelled at me the other day because I didn't have my phone. We were in orientation no pt care given that day.

We aren't talking about you not having one on your body somewhere (except GrnTea, lol, she's a real hard-ass!). We're talking about you having it on vibrate, not an annoying ringtone. And that students should not be whipping it out bedside, should not be answering their phones in a patient room or --wait for it---WHILE your preceptor is explaining something to you. Your clinical instructor will understand you took three minutes to call her back because one of the above events was occurring. If she doesn't, please refer her to AllNurses

[Crissy1]

I am printing this out and putting it in my clinical binder. Thanks for your insight. Much appreciated!