Frustrated about clinicals-- how to make more of my time

Hopeful2011 · May 19, 2010

You'll always run into nurses who have their set way of doing things and don't interact with their student unless the student asks them a question... but I think you should do your assessment of your patient, and try to find out if it is okay for you to pass meds and start an IV with the nurse you are assigned to if your professor isn't with you. In my program we are all on the same floor.. so we don't really have the issue of the professor being on a different floor.. but sometimes it is hard to find the professor and so we are allowed to give meds as long as the nurse is with us.

I think you could introduce yourself to the nurse when you get on the floor and give her/him a highlight of what skills you are able to do and which ones you aren't and tell them that you want to learn as much as you can during this shift and ask if they wouldn't mind if you shadow them with other patients if your particular patient doesn't need you....

I've learned that if you let the nurses know that you want to see and learn more then most of the time they are more than willing to let you see and do more.

Good luck!

anon456, BSN, RN · May 19, 2010

Thanks- I think I just need to be more vocal and then if the nurse still doesn't give me good vibes I'll just try to do my own thing within the activities I'm allowed to do. I am not permitted to start IV's until my instructor helps with the first one and passes me off. After that I can do with another RN. I can pass meds with supervision but cannot get them out of the pixis of course. I can also chart that I have given meds and other assessments. I just feel like I'm bothering the patient-- if they have already been assessed that shift, I am then going to assess them again just for my own learning. Some patients are great and love to tell me their life story. Others are not really enjoying their time in the hospital and want to be left alone.

itsmejuli · May 19, 2010

When I was at clinicals without enough to do with the nurse I'd help the CNA/PCTs. I'd also watch for other obviously busy nurses to see if I could assist them in any way.

aussiemom · May 20, 2010

I definitely understand what you are talking about in regards to not wanting to bother patients. I'm not sure how far along in your program "Block 2" is, or how many other clinical experiences you have had, but this feeling does pass as you start to "own" the space- meaning feeling more confidence in yourself and what you are doing there. You begin to take ownership of the procedures you are doing and of the care you are providing. Something my professors told me that was very helpful was to not doubt yourself and your assessments. You are providing a valuable service and ARE caring for that patient while you are there and have every right to be there. You might require a validation from your instructor or preceptor nurse, but you are very vigilant as a student about finding the "right" things. Remember also that any extra pair of hands is helpful. You can also learn a lot by observing your nurse. Some may be too busy to talk through their process, and that's not personal. Some told me that they appreciate having students complete thorough assessments. They do, of course, complete a quick focused assessment on their own later on to verify your findings, and then verify that the full shift assessment has been done and documented...by you, the competent, confident student nurse. :smokin:

Put a bug in your instructor's ear as well- that you would like to be checked off on your IV's. They may come across an opportunity on another floor, and can let you know (depending on your policies and all). One final thought- many nurses told me that there's lots of time to learn hand skills, like IV's and Foleys. They can teach family members how to do skills. What is most important is learning how to "be a nurse"- developing good judgment and assessment skills. It is a little disconcerting, but I have to trust that what so many of them are saying is right. :up: Ok, enough procrastination from NCLEX review. Best of luck to you!

anon456, BSN, RN · May 20, 2010

Thanks again! I did have a more productive day yesterday. Still did not do any IV's (none needed to be done on that floor), but I did jump in and help when I saw the need. I reconstituted some meds, and the CNA asked me to do some accuchecks because she was behind. I spent a lot of time with my chosen patient and he told me his whole life story while I was taking his health history. LOL

My instructor is trying to find those of us who still need to do IV's the opportunity to do that.

Good luck on NCLEX!!

DolceVita, ADN, BSN, RN · May 20, 2010

Wow! We do not follow nurses. In our first clinical we followed a nurse for one shift and never again. We are given our patient assignments and off we go. Get report, do care & meds etc. then give report. Of course, there is the obligatory care plan to do.

I would like to follow nurses from time to time. I thing I would learn a lot more about how they manage time and patients.

suzers26 · May 22, 2010

Like DolceVita, we don't shadow the nurse. If we do run low on things to do I normally ask a nurse if they would mind me shadowing them. At the beginning of the shift whichever nurse has my patient(s) I ask if they are doing anything that might be helpful for me to observe please give me a heads up so I can try to be there. Normally they are thrilled you're asking to learn from them. You can also find out from your nurse what they have going on that you might be able to do in advance and perhaps set a time with yoru instructor from the beginning of the shift if it's something predictible. Also, in the hospital we go to, if we run into any down time the nurses normally really appreciate it if we just keep up with the call bells. 9 out of 10 times the call bells are on for something we can do independently (we may need to find out if there is any restirctions for ambulating, eating, fluids, etc first) and it gives the staff nurses a good break for that shift we are there, also giving us more basic communication practice.

As far as being able to do skills and pass off on them. Our instructor suggested we keep a list of what we have, haven't, and would like to do again for comfort reasons, and let her know each week if there is something(s) in particular we would really like to work on, or need, either the day before or at pre conference.

And as far as redoing assessments, it's nothing invasive so sometimes I'll even go room to room, introduce myself as a student and ask if they'd mind if I did another assessment on them. It helps a lot to get it down pat, especially if you can get the main diagnosis of why they are there and can practice focused assesments. Practice makes perfect, right? lol

turnforthenurse, MSN, NP · May 27, 2010

I would ask questions. Ask the staff if they need help with anything. And answer call lights, even if they aren't your patient!

anonymous1919, LPN · May 28, 2010

So you just follow nurses? You aren't assigned to a patient? Well if the nurse is really busy- ask if you can dig into some of her patients charts. Look at their diagnosis, their labs, and meds and try to figure it all out. What's off about their labs? How does that go alone with their diagnosis (IE: Diagnosis: Chest pain, Lab- Troponin is negative, what does that mean)? Which meds are being used to treat what? If this was your patient what kind of nursing diagnoses would you do? What would you teach them if this was your patient (IE: Anemic patient, teach patient about foods high in iron)?

Assessments are also crucial to learn how to do well. You shouldn't need the nurse you are following to do that. If you think you're reading an interesting chart- ask the nurse if you can perform a physical assessment on them and see if you can pick up on things that pertain to their diagnosis (IE Pneumonia listen to their lungs, AFIB- listen to their heart). Passing meds you shouldn't care either way if you get to do. Passing meds isn't what nursing is about. Understanding why those meds are given and what reactions your patient should have and what they shouldnt is what nursing is about.

I hope I helped