Disorganized clinical

HouTx, BSN, MSN, EdD · Apr 17, 2015

Patient care has to be fast-paced in order to keep up with the workload. Staff nurses are not going to tolerate anything that slows them down. So what's driving the disorganization? Do you have to meet elsewhere & go the the unit as a group? Can you just go by yourself & meet everyone there? I can understand your frustration - I'm one of those odd ducks that is pathologically early (for everything). I can't deal with those chronically tardy or "just under the wire at the last minute" people -- arrrggghhh.

studentnursemon86 · Apr 17, 2015

We have to meet at another part of the hospital and then go in as a group.

If someone is late then it holds everyone up.

We get there at 7am, nurses are already doing report by then.

It was my first day on this unit and I received no orientation on where things were. I got to my patient room and the nurse was already passing meds.

I agree that she shouldn't wait around. She is responsible for the patient at the end of the day.

I'm just frustrated because I was reprimanded for not knowing my patient had 7am meds when we had just gotten to the unit, this was the first time I had this patient, and I didn't yet have access to the EMR to look up orders.

How is that my fault to be yelled at?

pixiestudent2 · Apr 17, 2015

It's honestly shocking that your instructor would wait for a late comer. Maybe because it was your first day on that unit so she gave some leeway.

But I don't think a clinical instructor will make you late everyday... I hope not at least.

studentnursemon86 · Apr 18, 2015

I hope not

I just felt it was unprofessional to yell at me in front of the patient.

I hadn't gotten report and was on the floor less than 10 minutes.

He seemed to expect me to know everything the patient needed in that amount of time.

mrsboots87 · Apr 18, 2015

Sound slime your instructor may have been trying to save face in front if the staff RN for getting you guys to the floor late as if it was your fault. My instructors never wait for a late student. We meet at 630 for a quick meeting and get our assignements and then are on the floor by 645 so we don't miss report. If a student misses report, they get send home and miss clinical that day. Don't feel bad. It's not your fault you missed the meds and didn't know much about your patient. It's likely the instructor knows as well and is just a jerk.

windsurfer8, BSN, RN · Apr 18, 2015

Then ask for report. Get involved. Do not stand around waiting for things to become "organized". It is nursing and it is FAST paced. Get in there..adjust. It is a little shocking to students sometimes because it is pretty intense. I will say it is UP TO YOU to solve problems. If you are confused ask people there. Ask your clinical intstructor. Ask the nurse. And be appreciative of the unit for allowing you to be there..they do not have to do it. If I have a student and he or she just stands there waiting for me to hand her info they are not getting anything from me. The ones who get busy and moving are the ones that get the help. You want to be a nurse? Go do it.

Taggart · Apr 19, 2015

We must be going to the same school. I honestly do not like the place where I'm going, but I'm going to stick it out because it was very easy getting in..

studentnursemon86 · Apr 19, 2015

The school and curriculum are good. I like the unit. It is just me instructor that I am not a fan of at the moment. Every other instructor was great so far.

As for being a go-getter.

I was looking for my patient's chart which was MIA. Asked 3 people where it may have been and they told me outside the room. It wasn't there, at the nurse's station or in the patient's room.

The nurse was too busy to give report since she was in the middle of a med pass, and I hadn't had access to their computer.

So yeah, I'm. Not sure how I could know what meds the patient was on given the circumstances.

All I knew about this patient was that they came in for wheezing on admission.

Turned out, they had a long history and had come up from ICU the night before.

Oh yeah, and we don't go to the clinical night before. We aren't allowed to:

So there is no possible way I could know what their 7am meds were at that given moment.

Later that day I got the SBAR sheet and report from the nurse, got vitals, assessed my patient, washed her hair for her, passed afternoon meds, talked to her about her extensive history, and checked her sugar q2h and maintained her insulin drip with the RN.

If I'm allowed to be there on time I can get things done.

NurseGirl525, ASN, RN · Apr 20, 2015

We meet in the lobby no later than 6:45. Our instructor tells us who our nurse and what room number our patient is. We do not wait for late people. As soon as we get off the elevator, I drop my things off and go and find my nurse for the day and get report. Once I get report, I print off and see what meds are due. Usually our first med pass is at 7:30. I go down and introduce myself to the patient, get vital signs and do a quick assessment. Then I pass 7:30 and 9am meds. I go back and do a full assessment and other things for the patient, then get ready if they have an 11am med pass. It is face paced but I get a mental plan in place before going up to the floor. My first week, I was super clumsy. My second week, things went fairly smoothly except for a small hiccup here and there. Redoing a cath was not on the agenda but had to be done. Those things happen. Just get an idea of what needs to be done. Our nurses know that we do the med passes on our patients so they don't do them. Maybe your nurse for the day didn't know she had a student? On our unit, the nurses work well with the students and have an understanding up front of what is going on. Also when I meet with my nurse we discuss what I am and am not responsible for as far as everything goes that day. I let them know exactly what I will chart. My med passes, vital signs, I&O, glucometer readings. I will meet with them about my assessment findings but they need to chart that as I know they won't want to go off of me for an assessment. I just chart simple things. Most nurses do not want you messing with their charting so I do not. It's all about communication.

studentnursemon86 · Apr 20, 2015

That's how ours is supposed to go.

It is nice to see other schools doing away with going in the night before.

So much can change in one night.