First day of clinical

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I had my first clinical today. I'm on the medsurg unit at our small community hospital. I had no idea what to expect when I showed up for chart study last night.....

I ended up with a severely obese pt with pyodermic gangenosum, abdominal yeast infections and a boatload of other complications and diseases. But the above two were the main things that we were focusing on today.

So I was worrying last night about bedbath, because I've never given one before and here I am with my first pt ever and these are the things I'm going to have to work with. Well when I came in for pre-conference this morning, I was told the pt probably also had MRSA and is in isolation and that I would have to gown up everytime I had to enter the room.

I had a really difficult time with all of this. The yeast infections and gangrene, while not as bad as I was expecting, were things I've just never had to deal with. And can I say that there are places on individuals I have never been until this morning....

I think what bothered me the most was the fact that this was my FIRST PT EVER. It was a lot to grasp- a lot to smell- a lot to see and clean-- and I don't think I've ever felt so vulnerable and "on my own" before. And it's different when you're actually dealing with someone's life. It's a scary thing. And the fact that now I'm dealing with an infectious disease really scared the crap out of me. I felt so unprepared and I didn't know what the precautions were that I needed to take or what I would see when I went into the room. It was hard.

Anyways, I managed and got through it all, and I did do a great job- I was able to put aside the "ewww" factor and just do what needed to be done, but dang....why was this my first pt ever??? :confused:

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

This is a great first patient even tho there were probably times all the different diseases scared the bejeesus out of you, when school is all said and done, it's alot easier to transition to floor nursing if you hav been exposed to as many different diseases as possible, I made it through school never seeing gangrene (not that I didn't try for the occasional case on the floor out of sheer educational curiousity lol), never actually administering an enema (which is quite frequent on my floor with the current disease of the month - small bowel obstructions) which also come with NG tbe insertion, another skill I'd have liked to try at least once before graduation. I also learned last week why the patient taking lacutlose for increased ammonia levels is like a clinical unicorn in school, we learned all about it, heard all about it and talked all about it but not one of use ever actually saw it, well I have to say I think it because that one right there would have made me rethink my career choice just for a second (the lactulose is intended to cause the big D to draw the ammonia out of the body, but it's like nothing I'd ever seen/smelled before, it even beat out my C-diff patient and that one too a smell/sight all it's own lol). Keep after the challenging cases to learn as much as possible and after a few weeks this first one will be a distant memory and when you encounter them again (small community hospital with these issues, you'll meet again) it won't seem as intimidating.

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that is one major concern I have

example like you gave an NG tube, what do you do when you graduate and are asked to do this procedure and you have never done it before? sorry this might sound like a stupid question but it has been on my mind for a while!

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

If you're ina supportive environment like me, your coworkers are more than happy to help, I spent 8 weeks with a preceptor, and I've been on my own for almost a month now, and I still have the occasional "OMG I am THE nurse!" moments, if I find something during an assessment I want to double check or just have a general what in the world is this order/lab question, I have never had a problem getting the answer, funny thing is tho because I did my practicum in school in the ICU there have actually been time's I've been the one with the answers and I've become the night shift go to person on PCA machine set up lol

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Specializes in MSN, FNP-BC.
that is one major concern I have

example like you gave an NG tube, what do you do when you graduate and are asked to do this procedure and you have never done it before? sorry this might sound like a stupid question but it has been on my mind for a while!

Just ask for help. I remember doing my first NG and was nervous as hell so I asked someone to just be there to make sure I did it right. I wasn't afraid to say that I wasn't 100% confident in this skill and I had no problems at all in getting someone to help me.

I think that's the key. If you act like you know everything (call it a big ego) and then screw it up, you aren't going to make any friends like that but if you are confident enough to say "I dont know can you help me?" you'd be amazed at the help you can get.

Note: I haven't started clinicals yet but I'm a tech and we had to take a short tech class where they showed us once on a dummy how to do an NG and then we practiced on each other without actually inserting the tube, just went through the motions. It was about 8 months after that, that I had my first opportunity to drop and NG.

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Yea...I know I learned a lot today, and I know that technically it was a "good" pt- and I suppose you could even say I'm thankful (?!) for the experience. I think it was all so much, for my first day- I don't know what was more overwhelming...the sights and smells, my first toileting (pt was high risk for falls so I got to stay and clean!), or the realization that I will be exposed to so many different scary things for the rest of my life...or if it was just all of it combined.

A part of me felt so badly for the pt because of all of their pain and a part of me wonders...how does one get to be in such rough shape? It's sad and scary and so many many things all in one. And it's scary to think that it could happen to any one of us at any time, depending on the circumstances. But I guess that's why I chose this field- it's almost a karma thing...I know that if I were in the pt's position, I would want the best care possible. And I know that a lot of times, the best care possible sucks, and that's not fair.

But yes, it was a great learning experience and thank you for your encouragement...I think it just put me in one of those places today where you really take a second look at life. And I didn't run for the hills, so I must be on the right path!

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Specializes in Post Anesthesia.

Welcome to nursing!

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I remember my first clinical day...my professor had to literally push me to get me to step inside the door, wake up my patient and do my assessment.

I am now in my last semester and I walk in the patient's room without a problem (make sure I knock first). No matter how early it is, I tell myself that I have to walk in there and check my patient. It is part of being a good nurse. Assessment!

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