Discouraged in Clinical

Mrs.D., BSN · Oct 3, 2018

This is not normal. You need to be either assigned to a nurse, or assigned to a patient, or have some sort of assignment. That is your instructors job to do.

Everyone runs their clinical differently. You should have a conversation with your clinical instructor, in private. Ask to meet them 15 minutes before your next shift to discuss things. Don't accuse them of not running a good clinical just because they might do things differently. Just mention things like you "feel you need more structure and guidance in order to get what you need from the clinical." Something like that.

Sometimes some people s*ck at running clinicals. Not everyone is cut out for it. If your instructor brushes you off, or after discussing it with them nothing happens, talk to your teacher for that class or the dean.

While you wait, answer call lights. I've learned a lot that way. You can assess patients while you're helping them. Bring up any concerns, curiosities or questions about the patient with their nurse. That's what I would do if my instructor was laissez faire.

meanmaryjean, DNP, RN · Oct 3, 2018

Don't be generic in your offer of 'help'. You are not there to help- you are there to learn and practice.

Be direct. Say to the nurse "I really need to practice assessments- would it be ok if I assessed all of your patients now and we could compare notes when I'm done?

elkpark · Oct 3, 2018

Not normal.

AlmostThere19, BSN, RN · Oct 4, 2018

I'm honestly afraid to say anything to anyone, even talking to the instructor in a polite and respectful manner, because I'm scared I'll be targeted and fail the clinical.

Mrs.D., BSN · Oct 4, 2018

I'm honestly afraid to say anything to anyone, even talking to the instructor in a polite and respectful manner, because I'm scared I'll be targeted and fail the clinical.

I hear you, it can be very intimidating. However, you need to learn to advocate for yourself. That's step 1.

Also, your instructor will not fail you for asking questions in a non-acusitory, respectful, calm, and well thought out manner.

She may have just always had self learning students this far, or students who didn't speak up so she's never changed anything, or maybe she has too many students and you will get excellent instruction when it's your turn to go with her, or maybe she's new, or many many other things. Nothing will change if you don't change it. You absolutely will have to learn to speak up for yourself. However, if that's uncomfortable for you this early in, do as the PP suggested and make a list of things you want to learn, and then ask a nurse if you can go in with a patient of theirs to practice. Or maybe you could ask to just watch them do an assessment or two and then go off on your own.

SiADH135, ADN · Oct 4, 2018

I'm a 3rd semester ADN student, and your situation sounds very different from mine. Regardless of location, school, or hospital, you, as a STUDENT, are entitled to an education. That's literally what you are paying for. I'm glad you're acknowledging that your situation is not a good one, and I know it can be scary, but you have to speak up for yourself (of course, in a professional way.) Top 3 things I would do:

1. Look at your 3rd semester clinical expectations/skills sheet and see what you can legally do with your instructor/RN/by yourself. That way you can tell your nurse "hey, I can help you with this!"

2. Talk to your classmates and see if everyone feels this way. Strength in numbers. If everyone is on board, talk to your instructor, or even the director of your program.

3. Make the most out of your clinical experience, even if your teacher or RN ditches you. It might sound weird, but it's an absolute blessing to be in the hospital setting. Do anything except stand around...

Good luck!

Chrispy11, ASN, RN · Oct 5, 2018

Very different from my clinical rotation. We were assigned a patient from semester one, clinical one. Every semester was hands on. By the second semester we had two patients. Not everyone did meds every week. In you shoes maybe attach yourself to a CNA, help them. A nurse sees you have initiative and may ask for your help. I did this even when I had patient assignments and learned a lot more. I will say depending on the wing, you may not be assigned anyone. When I did my Psych and L&D rotations, this was the case. In L&D unless we were assigned to an OR or immediate delivery, we worked pretty much as a group to the area assigned. In every clinical with those exceptions we had patient assignments. I know some instructors are better than others, but it sure doesn't sound as if you are getting the most of your clinical experience for your money. I would contact the head of the program. Best to discuss program expectations with them.

Best of luck to you.

missnursingstudent19 · Oct 5, 2018

Very different from my clinical rotation. We were assigned a patient from semester one, clinical one. Every semester was hands on. By the second semester we had two patients. Not everyone did meds every week. In you shoes maybe attach yourself to a CNA, help them. A nurse sees you have initiative and may ask for your help. I did this even when I had patient assignments and learned a lot more. I will say depending on the wing, you may not be assigned anyone. When I did my Psych and L&D rotations, this was the case. In L&D unless we were assigned to an OR or immediate delivery, we worked pretty much as a group to the area assigned. In every clinical with those exceptions we had patient assignments. I know some instructors are better than others, but it sure doesn't sound as if you are getting the most of your clinical experience for your money. I would contact the head of the program. Best to discuss program expectations with them.
Best of luck to you.

Well this is a L&D/Postpartum/Nursery clinical rotation, so that might be why this clinical is different from the others. Hopefully that's what it is!

Have Nurse, ADN, RN · Oct 5, 2018

In my current clinical, we have honestly not done a single thing but stand at the nurse's station. Our instructor separates us into groups. One goes with the instructor and the others go to nurses on the floor. We aren't even assigned a patient. We don't get to help do assessments or help pass meds. When we ask if we can help with anything, 99% of the time it's "no, we're good". I worry because I'm in my 3rd semester and I'll be a nurse soon. I need to be learning as much hands on as I can. Any suggestions from people who have experienced a clinical like this? And is this normal?

Good heavens, what school are you attending?!

Have Nurse, ADN, RN · Oct 5, 2018

I hear you, it can be very intimidating. However, you need to learn to advocate for yourself. That's step 1.
Also, your instructor will not fail you for asking questions in a non-acusitory, respectful, calm, and well thought out manner.
She may have just always had self learning students this far, or students who didn't speak up so she's never changed anything, or maybe she has too many students and you will get excellent instruction when it's your turn to go with her, or maybe she's new, or many many other things. Nothing will change if you don't change it. You absolutely will have to learn to speak up for yourself. However, if that's uncomfortable for you this early in, do as the PP suggested and make a list of things you want to learn, and then ask a nurse if you can go in with a patient of theirs to practice. Or maybe you could ask to just watch them do an assessment or two and then go off on your own.

If that instructor has that much trouble discerning the needs and requirements of her students she shouldn't be teaching Clinical.

But of course, you aren't in a position to tell her that. You might see if she can resolve this with you or have a sit down with the Dean and explain your concerns. I know of no clinical where patients were not assigned and no hands on was done! L&D or no.

FolksBtrippin, BSN, RN · Oct 6, 2018

Well don't just stand at the nurses station.

It sounds like you are assigned a nurse. Do not ask her if you can help. Ask her for permission to get vitals on her patients. Bring your own BP cuff, stethoscope and thermometer if supplies are limited.

Now think about why we get vitals. What are you looking for?

Let's say you get a temp of 101 F on a laboring woman. What could it mean? Why is that important?

Let's say you get a BP of 80/50 on a mom who delivered yesterday. What do you need to watch out for? What should you do?

Do assessments.

If you have a laboring mom, look at the monitors. Locate contractions and baby heartrate. What is supposed to happen and what would be a bad sign? Look it up in your textbook if you don't know. Consider bringing your textbook to clinical.

Do assessments. What is a normal for baby heartrate? Work on counting it, its super fast. Use your stethoscope. Now listen for respirations? Whats normal? Are respirations supposed to be regular?

What vaccinations should baby get? Did she get them yet? Does mom need education? How about siblings? Do they have questions?

When should mom ambulate? When should she not ambulate? Figure it out, and when you find a mom that needs to walk, ask your nurse for permission to walk her down the hall.

Do pain assessments. How do you assess pain for babies?

The NICU is more difficult, because you may not be allowed to disturb the babies. Watch their monitors. What are they being monitored for? Listen in on any meetings about when babies get to go home. Glean what you can.