First Clinical Jitters

msygrnbw · Jun 13, 2014

You will do it!

While in clinical

1) Be early! If assignments are made, look up your patient early as possible!

2) Develop rapport with your nurses. I know it's important to develop with your pt as well, but imo it's as much if not MORE important to develop it with the nurses on the floor! Let them know you will help with ANYTHING and EVERYTHING you can. This will make them soooo much more likely to bring you around when they see something neat.

3) Don't be overly weird/cheery/annoying. If you are trying to chat while your nurse is pulling meds for pts, just shut up. I don't see this advice much on the forum, but there is a time for questions - use it and observe that your nurse is still human! Do not rapid fire them with questions while they are obviously busy (Yes, I actually have seen this quite a bit with students on our floor)

4) Answer call lights - but do NOT get the patient up unless you are 100% sure that you know how they get up (1 assist, 2 assist, etc) I would 5000x rather you let my pt know you will let me know they're in pain than having that call light ringing and ringing since I am busy passing meds/changing a dressing, etc.

5) Look through ORDERS. This is one thing I REALLY didn't get/overlooked while I was in school. I looked up my meds, I looked up the pt history, labs, etc. But I don't know how, I totally blanked a lot on orders. I don't think I quite understood the hospital computer system I had and I didn't realize how much information the orders have in them. They tell you parameters, blood transfusion orders, whether you should elevate an extremity, lab orders, etc. I so wish I had gotten more experience with orders both as a student and as an orienting nurse. It tells you a lot about your pts treatment that is so easy to miss as a student.

6) Don't be afraid. I was so SCARED of making mistakes, of not knowing answers, that I lacked participation. I could have seen/done so much more. I got decently easy patients. I aced classes. But I could have learned SO much more had I asked for a challenge.

Good luck! You can do it!

LoriRNCM, ADN, ASN, RN · Jun 13, 2014

If it's your first clinical you won't have to worry about stabbing anyone with needles...... yet! You'll be expected to do assessments and perform CNA duties.

adnstudent44 · Jun 13, 2014

I did mostly CNA duties but I also did give my first shot and pass meds for my first clinical.

As for tips? I agree with the first responder who said don't ask questions while the RN is pulling meds for your patient. Our instructor actually told us that directly as a rule.

Bring everything they tell you to bring, but at the same time bring as little as possible. We had girls in our group who had their pockets full to brim and it made them bulky and hard to move patients when they needed to. After 1-2 weeks their pockets lightened up quick.

Definitely develop a rapport with the nurses, but also develop one with the CNAs too. Depending on your facility or the department you are in, sometimes the nurses won't have time that moment to help you or answer right away, but the CNA might be able to (as long as its not something that only an RN can answer)

which brings me to the last tip I have, one thing you should really try to memorize if you haven't already is know what RNs, LPNs, and CNAs, can and can't do. It might sound like common sense, and maybe it is, but sometimes you are in a situation where someone asks you to do something you think you can't do, or you see someone doing something you think they can't do but they ask for your help. Make sure you know all of those protocols for the facility and for your school, because sometimes your facility might allow something your school doesn't because its stricter. If you know it well, then when something like that comes up you won't have to second guess yourself.

Everline · Jun 13, 2014

I gave injections, did assessments, passed meds, inserted a foley catheter and did blood glucose checks along with all the usual patient care stuff during my first clinical rotation. I suppose it just depends on your particular school and your clinical instructor.

First of all, having jitters is entirely normal. I have them every clinical day, and I'm my fifth clinical rotation. Take a deep breath and remind yourself that there are people there to help you. You are not expected to go out there and own the floor like a charge nurse. :-) See it as a time to learn. If you don't know something or don't feel comfortable, simply ask for assistance. More than likely you will not be able to do anything without your clinical instructor by your side. Be gentle on yourself, take in all you can, offer to help whenever you can and don't hide in the bathroom. :-) You will do great!

ellaballet · Jun 13, 2014

Thank you so much for all of the positive words!

Yeah we do meds, foleys, wounds, assessment, the whole shebang in our first rotation! I took fundamentals, skills, health assessment, pharmacology, etc my first semester and I gave injections and did assessments at a free clinic but haven't done it since. Now that I'm starting med surg we are expected to do everything...eep! I have to keep reminding myself that they're not going to give me like a trainwreck patient on day 1 and expect me to swoop in all on my own, someones going to be watching over me, etc. I think I just keep picturing myself walking in, given my assignment and then being thrown off on my own for the rest of the shift.

Hahaha and if I know one thing as an ex CNA its how important it is to get others on your side!

LoriRNCM, ADN, ASN, RN · Jun 14, 2014

Yes in your first rotation but not your first day, or even your first few weeks. You won't have to do anything you haven't been checked off on in your skills lab.

ellaballet · Jun 14, 2014

Maybe not! But I've already been checked off on pretty much..everything? at least I can think of in skills lab. All schools are different! My first rotation is only three times a week for a little less than 2 months, and then I start pedi/maternity. I've just given injections on a real human 2-3 times, the rest on a mannequin so hopefully they let me do it in clinical.

adnstudent44 · Jun 18, 2014

We had all of our skills checked off before we started our first clinical, otherwise we were not allowed to start clinical. I think it depends on the program, because I definitely had to be prepared to do anything starting my first week, which my instructor explained and stressed with us.

@ellaballet its okay to be nervous, its impossible not to be, just try and not show it to the patient and if you have any questions about a skill you are about to do for the first time on a patient make sure to ask your instructor first and not in front of your patient. Don't feel embarrassed, just ask something like, "This is my first time and I just want to run through all the steps with you..." Don't straight up ask/say you don't know what to do (because well you should know it if you were checked off), but just talk through it with your instructor.

Also, I don't know what you have had in your program, but we had a CD for our computer that played videos of the skills we learned in fundamentals. I made sure to rewatch everything before clinical, just as a refresher. It helped a little bit with my nerves and gave me some confidence. Hope I've helped a little bit! Good Luck!

kmcjon · Jun 20, 2014

Try to relax, it's a learning experience. It's ok to be nervous, I sure was. But it gets easier. Clinicals are my favorite part of school you get to use all those things that you have been learning. Every time you have the opportunity to use a skill, take it. Better to do it now, than to have no experience as an rn.

Ziggy2 · Jun 20, 2014

Be on time. Plan for traffic, parking issues, getting lost. Eat breakfast...and a lot of it. Look professional. I don't know how many times I have seen students with too much perfume or makeup on, or long/loose hair. If you do not know the answer, admit it. Remember, everyone was most likely nervous on their first day too. You are there to learn so be a sponge.

ellaballet · Jun 22, 2014

Thank you every one for the advice!