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First clinical in hospital

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Specializes in Medical/Surgical/Telemetry RN. Has 2 years experience.

Had my first clinical today in the hospital. I could barely talk with the patient because he was extremely lethargic. I felt bad for waking him up to do my assessments and i couldn't complete all of them due to his condition. I was a bit shy but I am hoping this goes away with practice. Any advice for understanding how to communicate better with a patient even if they cannot answer you because they are in severe condition? Felt bad for the patients condition. Really just looked like he was just trying to hold on. Any help on how to talk with patient's who can't speak back to you? Thanks so much.

Sometimes you just can't communicate with patientsbecause of their current or past condition. You can use non-verbal cues to assess for pain such as facial grimace, moaning, restlessness abnormal vital signs. Sometimes it is hard to complete an admission assessment if they are non-verbal and no family. You have to rely on the physician H&P and do your best. You can always talk to them even if they can't respond. Let them know what you are going to do before you do it. Don't talk over them as if they aren't there.

al3x117, RN, EMT-B

Specializes in Medical/Surgical/Telemetry RN. Has 2 years experience.

Sometimes you just can't communicate with patientsbecause of their current or past condition. You can use non-verbal cues to assess for pain such as facial grimace, moaning, restlessness abnormal vital signs. Sometimes it is hard to complete an admission assessment if they are non-verbal and no family. You have to rely on the physician H&P and do your best. You can always talk to them even if they can't respond. Let them know what you are going to do before you do it. Don't talk over them as if they aren't there.
Thanks so much for this. Thank you for the advice.

I agree with everything that RNKPCE said. It's also important to introduce yourself to the patient and to address them by their name.

roser13, ASN, RN

Specializes in Med/Surg, Ortho, ASC. Has 17 years experience.

You can also let your CI know that your patient is not likely a good prospect for your learning experience. If you are having difficulty even holding a conversation with the patient, it is likely that they are either in pain, under the influence of prescribed medications, or significantly unwell. Regardless, not a patient who would benefit from nor welcome a student nurse.

Your instructor may choose to change your assignment.

You can also let your CI know that your patient is not likely a good prospect for your learning experience. If you are having difficulty even holding a conversation with the patient, it is likely that they are either in pain, under the influence of prescribed medications, or significantly unwell. Regardless, not a patient who would benefit from nor welcome a student nurse.

Your instructor may choose to change your assignment.

We might never really know it, but such a pt might benefit a lot from the human touch and presence. Perhaps our reward from such a patient is in Heaven.

sallyrnrrt, ADN, RN

Specializes in critical care, ER,ICU, CVSURG, CCU.

Lordy it's been 47 years since my first clinical....

but it I promise you will eventually be able to completely asses a patient, regardless of communication ability, by your visual, somatic, and actual hands on assessment of the whole patient....

im grateful for your question, as a seasoned 4+ decades RN, I have , or had forgot how it was in 1970.....

yea, I been at it that long, I promise your accurate assessment will eventually begin, as you enter the patients door...

best wishes

Edited by sallyrnrrt
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al3x117, RN, EMT-B

Specializes in Medical/Surgical/Telemetry RN. Has 2 years experience.

Thanks so much! Great advice! Wow that is incredible 47 years. Congrats!

Lordy it's been 47 years since my first clinical....

but it I promise you will eventually be able to completely asses a patient, regardless of communication ability, by your visual, somatic, and actual hands on assessment of the whole patient....

im grateful for your question, as a seasoned 4+ decades RN, I have , or had forgot how it was in 1970.....

yea, I been at it that long, I promise your accurate assessment will eventually begin, as you enter the patients door...

best wishes

I agree with all of the above posters. Watch for nonverbal cues from the patient such as the patients body language and take note of that while you're talking. Also sometimes when the patient is nonverbal it's easy to forget that we still need to communicate with them and talk them through everything that we're doing.

Don't worry practice makes perfect!

al3x117, RN, EMT-B

Specializes in Medical/Surgical/Telemetry RN. Has 2 years experience.

Thanks so much for the advice! Yea it was my first clinical and I definitely felt inadequate. It was more of a shocking moment for me. I was doing my best that I could to talk to the patient. At the same time though I wish i used like a piece of paper or something to write down words that I could communicate with him. I was trying to think outside the box but i unfortunately didn't get around to it. I really enjoyed have this patient though because it taught me a lot of how to approach a patient who is severely ill and is alone. When I went home from clinical that day I literally couldn't stop thinking about my patient. I then wish I could have comforted him more. It is a tad disappointed when you know you could have done a little more and I know I am learning, but my personality says do better next time.

I agree with all of the above posters. Watch for nonverbal cues from the patient such as the patients body language and take note of that while you're talking. Also sometimes when the patient is nonverbal it's easy to forget that we still need to communicate with them and talk them through everything that we're doing.

Don't worry practice makes perfect!