First Day At Clinical Falls Flat

[norm758]

So we are five weeks into our RN program and our first day at the hospital was yesterday. I was extremely anxious about being there, especially since we had to take vital signs on a real live patient.

So we got a tour of the hospital, and talked to the OR/PACU nurses, and met a few of the nurses on the medical units. Everyone we talked to seemed friendly and genuinely happy to see us there. So the moment arrived for us to meet our first patient.

Our instructor handed me a slip of paper with a room and bed number, and a last name. She said choose a buddy and go! So I partnered up with the student who happened to be standing right next to me. We gelled in and walked over to the patients bed. He was in the process of being helped out of bed by a family member who says, "Oh, just in time! He has to go to the bathroom."

My brain proceeded to switch itself off. This wasn't in the script! My co-student said, "We're here to take vital signs." And then she went on to say that we could come back later, and I may or may not have jumped in at that point. But the patient said it was okay, we could go ahead, he could wait, and lay back down.

My brain finally woke up and I thanked him, and introduced us as students. He introduced his family member as a nursing instructor at another area college. Pressure! So I asked my fellow student if she would take VS while I entered data on the computer. So I managed to log on, but could not remember how to get into the patient records.

While I'm wrestling with the computer, my fellow student starts calling out numbers. Sweating now, I had to pause to write them down. She finished up and joined me at the computer, and we both struggled to figure out what was happening. As it turned out there was a glitch in the way we were set up in the system, so it was just a glitch. But it served to throw me off even further.

Again, the staff was super helpful. One nurse saw us huddled around the computer next to the nurses station and stopped to say hello, and we asked him for some help. He figured out how to get us into the patient's chart so we could document. And that was that. I've been analyzing my performance, and though I should probably cut myself some slack, I feel fairly disappointed that I wasn't able to think a little faster on my feet. But this is a process, just like everything else, and with some (a lot) of practice, it will become routine. Presumably I will look back on this day with some humor.

I am interested in other first day experiences! Any similarities? Any encouraging words would be greatly appreciated. Thank you!

[PCU_RN9, MSN]

HAHA. Very similar story. It was my first day in the hospital and I had my clinical day before we even had our first class! Anyway we had our clinical instructor tell us a room number for a pt for each of us and we were to go in and basically just introduce ourselves and ask how theyre doing and feeling. Well I'm trying to play out in my head what I'm going to say and I'm so nervous at this point. I walk in and say I'm PCU_RN, I'm a nursing student at so- and so college. The patient cuts me off mid sentence and says to me "I need to go to the bathroom" (and like you, I was thinking "this was not in the script, this wasnt supposed to happen") This pt was up to the chair with multiple IV's, oxygen, and was obese. In my head I was like UHHHHH????? I did not even no where to begin. The patients nurse and another nurse ended up assisting the pt to the bathroom and I watched their technique and helped out standing the pt. Its crazy how far you come in such a short period of time. You definitely will look back on your first day and laugh at how such a simple task caused so much anxiety. I know I do! Good luck with NS.

[Hygiene Queen]

I remember a classmate and I were struggling to remember how to print out the MARS for our individual patients.

Well, we thought we had it when we heard the printer take off... yay!

But then, the printer kept going... and going... and going!

We could not get it to stop!

The unit secretary was fit to be tied.

Apparently, we had managed to print out all the MARs for all the patients on the entire floor... twice.

We got reamed by the US for wasting paper, ink and holding up the printer.

That was... embarrassing.

Also, I have found that when patients realize you are a student, they tend to be very forgiving.

If they mentioned that I seemed nervous, I'd tell them, "That's a good thing because I am trying to do things right! Be worried if I don't seem to care!"

Believe it or not, that would get a chuckle.

If you come to clinical prepared, show honest-to-god effort, keep your patients safe, behave responsibly, show common sense and ask good questions, then you are doing just fine.

[LCinTraining]

We were clumsy and slow at bathing our patient and my little old patient just stared at us. I finally chuckled and said "we look rather clumsy this morning don't we?" She laughed and said "yes". Ice was broken and we got on with our day, only to realize later we forgot to assess lung sounds in back before we got her up and to breakfast.

[threelilies]

If you come to clinical prepared, show honest-to-god effort, keep your patients safe, behave responsibly, show common sense and ask good questions, then you are doing just fine.

I'm in my Med-Surg semester (which is the second clinical semester in my program) and that seems to be about the best way to sum up how this works. Relax and don't beat yourself up. Nothing ever goes according to the script. My first day of clinical I could not get the stupid vitals cart to turn on. Then we couldn't find a manual bp cuff on the whole floor. Then my partner ran over our patient's gouty foot with his bedside table. The dear man was very, very kind to us but breathed an audible sigh of relief when we left his room.

The best advice I can give you is if the patient needs something that is beyond your scope, go get help to meet their need before you start doing anything that isn't critical or time-sensitive. Think about it: are you getting valid vitals if the patient is sitting there needing to void? How comfortable would you be if you were the patient in that situation? It's thinking that sort of thing through that clinicals teaches us. Slowly and painfully and with all due embarrassment included. Good luck!

[nurseprnRN, BSN, RN]

My first clinical day we passed out breakfast trays and one of my classmates found a patient stone cold dead in the bed. She left the floor and never came back to school. Hehehe.

[norm758]

Thank you for your advice. Your story made me laugh, and laughter is precious.