Communication and Critical Thinking

Faith07 · Mar 25, 2010

...hmm..we'll my first clinical experience was pretty much a scary feeling & somewhat exciting..not knowing what to expect.its a whole new world, you meet many different people with different personalities, some you'll like and some, well, not so much (but don't let em get to ya!).you can never be fully prepared, but if you want to be somewhat prepared, you must prepare yourself mentally, physically and emotionally. the night before you come to clinical, know your vitals, lab values, meds, know the floor you'll be based in & find out about possible patient diagnoses.i remember my first few clinicals, during patient reports, i didn't have a clue what they were saying.so it would help if you knew some nursing abbreviations e.g. npo means nothing by mouth, any word that ends with itis means inflammation etc.

sleep for at least 7-8 hours the night before & prepare what you're gonna need ahead of time. eat a good breakfast before clinical (really important).come to clinical with enthusiasm and know that you are there to learn, so if you don't know, ask! alot of nurses will be happy to help you.if you're unsure whether to trust what the nurses say, make sure you ask your clinical instructor first (know your school policy!) because you have a different policies as a nursing student.most patients are also willing to tell you about their condition, dx and tx so don't be afraid to ask (of course after you've introduced yourself as a nursing student). try to learn as much as you can, because as a nursing student you have the privilege! you will face many challenges, and learn alot in nursing! you'll also build your communication & critical thinking skills as you gain more experience :) so enjoy! :)

urty · Mar 25, 2010

Critical thinking definitely comes with experience. Know your basics as Faith07 suggested, and know your pathophysiology. Part of critical thinking is knowing if something is out of whack in the patient, how will it manifest to you. For example, if a patient is having a lot of ectopy on their tele perhaps electrolytes are off, so check them. If the patient is tachycardic with a temperature, is it an infection or are they dehydrated. Are they peeing? Give a fluid bolus, is there a response? I work in ICU and I know our nurses grill the capstone students on this stuff. They become pretty good at identifying a patient about to circle the toilet.

As for communication. Ask questions! If you can, look up the patients meds before your day starts so you know the adverse reactions and patient education regarding those meds. Your nurse may ask you what will happen to the patient if you push morphine or toradol too fast, what to expect with their vital signs, etc. All in all, if you don't know then ask. Who cares if you think it's a stupid question, at least you'll know the answer and be a smarter nurse.

Mell Bell · Mar 25, 2010

I am just finishing my first round of clinicals. It was at a long term care facility, and the first couple of days I was absolutely terrified, uncomfortable, nervous...I didn't know how to talk to actual patients, I felt like I didn't know ANYTHING. But now I don't want to leave, I love it so much!

The best advice I can give you is to never say no to doing something new. If a nurse or CNA asks you to do something or to help her out - do it! You will learn the most from the nurses that are working at the facility every day. Watch how they interact with the patients, and always ask questions. If there is something in particular that scares you, confront it, get in there and do it. I was terrified to feed the patients that couldn't feed themselves. The first time I was asked to feed someone I just sort of stood there frozen, so the CNA showed me how to do it. Something as simple as feeding someone was just so scary to me, but I'm a pro at it now.

Talk to your clinical instructor and the people in your group for support, they will be there to help you out. Go in prepared and ready to learn. If you hate it the first day, or feel like you have no idea what you're doing, don't beat yourself up. You will get the hang of it.

Also, don't skip meals, I chose to go straight through and didn't eat dinner, did a pretty messy dressing change and almost fainted. Eat that protein!

lisamc1RN, LPN · Mar 25, 2010

During my first clinical, I had an elderly man who I assessed to have respirations of 38 while on 2 liters of oxygen via nasal cannula. The gentleman was struggling to breathe and I was getting anxious and didn't know what to do to help him since he was already in an upright position, so I went and got my instructor who came with me and immediately noticed that the nasal cannula was on the side of his head. She pointed it out to me and I immediately moved the cannula back to his nares. His breathing improved dramatically over the next several minutes. :) Lesson... You might want to check the equipment to see if it's performing properly before you panic. A kinked, badly placed or unplugged piece of equipment can make a situation look bad, but provides an easy fix and a lot less embarrassment if you catch it before you go to your clinical instructor. LOL.