Feeling Useless in Clinicals

llg, PhD, RN · Apr 21, 2007

What you're feeling is pretty common and understandable. You want to start feeling competent and "ready" -- but you will not be fully comepetent and ready for at least another year. It generally takes 6-12 months on the job as an RN before people reach that point in their development. Up until then, many (most) people experience a lot of doubt and insecurity -- and like you, a feeling that they have not "done enough" to function independently as a nurse. They are right: they have not done enough yet. That's why you still need to go to school for another 6 months and then go through a new grad orientation and then work a little on your own before you will have actually done enough.

Just take it one step at a time and continue learning along the way. Use your current clinical experiences to really get to know your patients and develop a deep understanding of what it is like to be a patient and have a health-related problem. Learn how to assess and interact with patients and learn about the types of interventions that help them. The technical skills that you may feel you should be practicing are the easy part. You will pick those up as you go along. Organizational skills, prioritization, and delegation are trickier -- so, pay attention to those things when you can. Talk with the nurses and CNA's and learn to establish good working relationships with the other members of your team. Later, when you will really need great interpersonal skills as well as clinical skills, the foundation you build now will come in handy.

Daytonite, BSN, RN · Apr 21, 2007

Ha! Ha! Ha! Forgive me for laughing, but you are going to be singing a different tune when you get your first job. Something that you can be doing to help yourself now is looking up the pathophysiology, the medical care and the nursing care of the patients that you do have when you get home from your clinicals. If you don't do it now, you are definitely going to be doing it when you start working. There's no way you can remember all this stuff. At clinicals you should be looking to see how the nurses on the staff are organizing their work and what they are doing at report time because you will be doing it soon enough. Nursing school doesn't give you much experience with these skills. Most new grads find themselves feeling like they've been thrown to the wolves. When you're getting paid you feel pressured to perform. While you're a student you can still be poking around investigating these things without the pressure. Nursing, you will find, is more than just taking care of the patients.

MomRN20082b · Apr 21, 2007

Thanks so much for the advice and information. I will definitely take it and run with it! I feel so much better now!!!

law3576 · Apr 22, 2007

I feel the same way with my clinicals. I feel like a tech who can pass meds. I do assess the patient and pass meds but that is it. I clean the room, change the sheets, bathe my patient, order their lunch and take vitals. I am on a telemetry floor and the patients I have had are not needing any IV piggy backs hung or anything like that. I just feel like I'm not learning what I need to know for when I graduate. Glad to hear I'm not alone in feeling this way.

marilynmom, LPN, NP · Apr 22, 2007

Some clinicals are better than others, some clinical instructors are better than others, some RN are better with students than others.

My best clinical experiences so far have been psych (just because I learned sooo much interacting with the patient) and OB. In OB I was able to put in Foleys, give quite a few IM shots, actually do the assessments on my own and chart them, help with breastfeeding, etc etc. I really had a chance to practice some skills. It was a very interactive clinical experience!

Right now in Peds, the RNs are so protective of their patients (can't blame them) that I literally have done nothing but assessments and vitals and tube feedings with formula. But doing something simple as vitals and assessment on heart patients has been quite a learning experience for me--I've been able to pick up murmurs, learn about the respiratory machines, etc.

I've found you have to be very proactive in clinicals or you could easily do nothing sometimes. I NEVER just stay with my one or two patients but I follow nurses around just watching. I also go home and read about the patho of diseases I am seeing and procedures, surgeries, etc. Some floors are very slow too....my last clinical the RNs just sat around and chatted for 2 hours, they didn't even have much to do so sometimes as students your not either (that is why I bring my books, etc).

queenjean · Apr 23, 2007

I do assess the patient and pass meds but that is it. I clean the room, change the sheets, bathe my patient, order their lunch and take vitals.

This is what I do 99% of my shift, and I am a nurse....what sort of experience are you looking for?!

law3576 · Apr 23, 2007

I guess i want more experience with IV's, hanging piggybacks and everything else.My last rotation was on a med surge floor where there were alot of dressing changes, tube feedings, and IVPB. I felt lost when I was doing those things but I really enjoyed them learning those skills. The floor I am on now just seems more boring. We also have one patient still so when I'm done assessing and passing meds there isn't alot else to do. I try to follow the nurses and ask questions but they brush me off so I spent alot of time reading my med-surge book and preparing for tests.

queenjean · Apr 24, 2007

Maybe you can latch on to a helpful-appearing nurse and ask if you can do all her IV meds.

Sometimes I think it is the most helpful when a student tells their preceptor exactly what they want or need; not that you aren't doing that to a degree already, but saying something like "I really feel like I need to work on my EKG interpretation skills, so if anyone needs one, I'd like to be there when it is read, to get some practice and pointers."

Some floors are more "boring" I agree, because they are more about time management or maybe hands on, long term care (like an acute rehab) and there aren't as many "skills" to learn.

I just thought the original quote was funny, because I was like, hey, that's what I do all the time! We're not saving babies from burning buildings most days, mostly it's just pretty routine.

Gennaver, MSN · May 1, 2007

I am currently in month 12 of an 18 month ASN program. I have been doing clinicals since the first week of nursing school and I don't feel like I've really done all that much. Other than passing meds, I feel more like a CNA (which I already am in my job) than a nurse. Is this common or am I just not getting the clinical experience I need?
I recently started a new job as a Nurse Tech. The description stated that only current nursing students could apply and that it was designed to give more experience to the students. I have been there for 2 months and I don't do anything different than the CNAs. I guess I'm just wondering if the experience you gain comes after you graduate and start as a nurse... that scares me a little bit. Any opinions?

Hi,

As a current student who is, like you, a current CNA and PCT I think that it might be likely that you and I do not have the "exact" same learning curve of clinicals than non pre-health care students.

There are so many things that you and I may take for granted...as I have reflected repeatedly on because my hindsight bias makes me feel like my "clinicals" have not taught me any hands on skills other than starting an IV. I am five weeks away from graduation.

Our prior patient care does enhance our current clinicals however, I feel, because we are currently learning our lecture material and are better able to digest and synthesize information.

Something that my current clinicals ARE doing is giving me a LOT of insight into the pathophys and nursing care rationales that I do not think I would have had if my previous hands on care wasn't already done. I am having "aha!" moments to myself in clinicals which do not involve the hands on basics but, the thoughts.

Hang in there, because we are soon going to be at the begining of a brand new learning curve SOON:balloons:

Gen-in IL