Did you feel prepared for clinicals?

[Le-Lee_FNP, MSN, RN, NP]

So I am starting to get nervous because I am starting clinicals in the fall. Since my program is online, I have not had any hands on experience performing health histories, physicals, or advanced assessments. My first rotation is women's health. It's not like in nursing school when you get to go the the simulation lab and practice putting an IV on a dummie so that you at least know what to look for. I am terrified about performing pelvic exams and pap smears because I have no clue where to even begin. Will my preceptors think I'm an idiot for having to be walked through everything step by step or will they expect me to know the basics already?

I guess I am just wondering what level of expectation my preceptors will have of me. I have to find my own preceptors so should I tell them straight up that I need to be taught from square one? i mean sure I will know about signs and symptoms and common complaints, etc. but I won't know the first thing about how to use a speculum or palpate a uterus. I am going to feel the same way about my other rotations as well.

For those of you that went to online programs how did you prepare for clinicals?

For those of you that went to B&M, did you have some sort of simulation lab or were you able to practice certain things with your classmates? (Not pelvic exams I'm sure, but other things?)

Personally my health assessment course is a joke and I don't feel prepared for anything.

[traumaRUs, MSN, APRN]

I went to a hybrid program but did clinicals in a busy ER so got lots of experience quickly. Just explain up front that you need to see one first then walked thru a second.

[Dr. Tammy, FNP/GNP-C]

As a distance education FNP student, I was feeling pretty much the same way when I did my OB/GYN rotation. When I arrived, my preceptor said to just start seeing patients. Thankfully, she was kind and when I explained to her that my skill base in this area was limited to videos and whatnot, she let me follow her around for the first day or so before I started seeing patients on my own. Then, after that I presented to her the rest of the rotation which really worked out well. Ask your preceptor about the style and format for reporting and presenting they expect and this will be a very helpful guide. Also, as far as doing pelvics, its pretty much a snap and if you are working in a busy place, you'll get dialed in pretty quickly. Also, if your preceptor is doing colpos' try and get in on every one they do. Also, if your program will let you, ask to be put on the call list when your preceptor is on labor and delivery schedule at the hospital. That way, you get experience with that too.

[Corey Narry, MSN, RN, NP]

I went to a classroom-based program. We did pelvic exams on female human models to learn the skill before doing the exam out in the field during clinicals. We did prostate exams on male human models. There is a company that provides male and female models for students to learn reproductive system exams and charge a fee for the service. It is a very controlled environment where the models pretty much guide and tell you what you should be palpating or examining. They also gave pointers on how to make actual patients feel at ease. It was very uncomfortable for many students, that experience being a first for most of us, but after getting past the initial shock, it was fine. I'm glad we had it 'cause it made doing the exam during clinicals easier.

[BCgradnurse, MSN, RN, NP]

I also went to a classroom based program and we did the same thing that Juan did. The models were amazing-they knew more about anatomy than we did! It was uncomfortable at first, but did make a difference going into that first clinical.

[Le-Lee_FNP, MSN, RN, NP]

thats why i feel like i am at a disadvantage doing an online program. No models to practice on. bummer.

[MERCEDES674, MSN, RN]

I am in an online program and we had live models to train on for a weekend. I have been watching the videos on learnerstv. Com. They are very good videos for med students but i have found them to be useful. If possible invest in some review cds to help with practice.

[Le-Lee_FNP, MSN, RN, NP]

I was thinking about either asking my own personal OBGYN if I could shadow him for a day, or calling around to other women's health places to see of an OBGYN or Women's Health NP would let me shadow just so I can see what it is like before I dive into clinicals. I wish my program offered some type of hands on practice, even if it was just for one or two days for the health assessment labs.

Videos just aren't the same as real life practice. I want to actually be able to hold the utensils in my hand and know what structures I am palpating for, or see the techniques the providers are using. I guess I'll just have to hope it all works out.

[Dr. Tammy, FNP/GNP-C]

thats why i feel like i am at a disadvantage doing an online program. No models to practice on. bummer.

I agree, distance education is not for everyone. I'm curious, did you know this going into the program or did the program mislead you in someway that you would have access to lab practice?

[zenman]

I went to an online program and we had videos from our textbook as well as videos offered online by different medical schools...yes, medical schools, then we had to videotape a couple physicals on friends or family, then we met for 2 days to do physicals with faculty supervision. Pelvics were done with paid models who guided us through them. Thankfully, as a PMHNP, I only have to put my hands in my pockets.

[Le-Lee_FNP, MSN, RN, NP]

I agree, distance education is not for everyone. I'm curious, did you know this going into the program or did the program mislead you in someway that you would have access to lab practice?

I don't think the program mislead me. I think it was my own lack of knowledge. I researched many programs before decided on one. The one i chose was the one I could start the quickest. It appeared to me that many of the distance programs had a few visits to the school for lab practices so i guess i just assumed they would all be that way. I am not knocking distance ed for the didactic portion of the program. I have done fine that way. But my health assessment course has just consisted of learning the skills by watching videos and reading. I am a hands on person when it comes to physical exams and I feel like I am going to have to have my preceptor teach me everything, and I'm just not sure how they will feel about that.

[ghillbert, MSN, NP]

I am just completing my first IM 5-wk clinical - I did not FEEL prepared before I started it, but I quickly realized I know a lot more than I think I do! A key is getting a good preceptor. Mine let me set the pace, and was willing to support more when needed (I felt I was awkward getting the history and knowing what order to do the physical exam in, so watched her do a few), and willing to let me run with it when I was confident with something.

I can't believe how much I have LOVED this semester and clinicals. I am glad - after studying part time for 3 yrs while I work fulltime, I was getting bloody sick of it and wondered what I had gotten myself into. Luckily I think I'm gonna like it.

PS: I realized this semester that at the start of each term I have read the syllabus and thought "Crap, how will I do that!?" but then you're ready by the time it comes around. eg. this term we had to go into simulation lab and see a patient, ask for test results etc, examine them and get a history, then go write up admission orders and note... all while observed by 4 faculty members. I thought I'd crap myself when they told us at the start of the semester, but we had it this week and it was great!