Can someone please explain clinicals?

[RNIAM, BSN, RN]

I posted this on the student nurse board as well.

What exactly happens? How does it work in your school? Do you

discuss what you are doing ahead of time? How are you judged?

Do you have to show your instructor everything you do or just

certain things? What is the scariest clinical experience you have

had? What the worst/best etc? I basically want a good idea of

what a typical clinical situation is. Thanks a bunch.

[whipping girl in 07, RN]

It depends on the instructor, the rules of the state board, and the level of clinicals.

In our first clinicals, pretty much all we did was bedbaths, vital signs, shaky head to toe physical assessments and TALKED to patients (the hardest part...OMG, I can't ask her when her last menstrual period was, or if he had a bowel movement!)

Later, we had to have an instructor check meds before giving, and a nurse or instructor present with invasive procedures (inserting a foley, starting an IV).

Typically a clinical week went something like this: Monday afternoon, pick up assignment, go home, look up all meds, significance of lab work, all procedures, patient's dx, write pathophysiology and tie together primary dx with secondary dx's, meds, labs, etc. Do care plan, come up with nursing dx's, interventions, expected outcomes, goals, etc. Tuesday morning, go to clinical with all this paperwork done and patient was discharged or died so you get a new patient and do all the paperwork while trying to take care of him (not every week, but it will happen). Figure out what works, what doesn't, show meds to instructor, give meds, check AM labs, do AM care, etc. Go to lunch. Come back and try to finish up. Go to post conference and talk about your patients and your day. Try not to fall asleep when Miss Smarty Pants gets into the psychosocial aspects of her patient's illness and drones on about the patient's childhood and how she will use massage and guided imagery instead of narcotics to relieve her patient's pain. Go home and redo crappy clinical paperwork because the instructor looked at it and now it's illegible from all the red marks. Wednesday morning, show up and do it all again, hoping that your patient (the second one, remember the first one died or was discharged) is still there so you don't have to do the stinkin' paperwork AGAIN after you redid it last night. Make it through the day and sit through even longer post conference and talk about everything you learned. Daydream about going to MIT, it's got to be easier and less boring. Go home and wash the poop, blood, vomit, and tube feeding out of white uniform before all the stains set and redo paperwork one more time before turning it in on Thursday. Get papers back on Monday when picking up new clinical assignment and try to hold back tears until you get out of the hospital and to your car because there's so much red and a big "U" at the top.

Fortunately for me, my clinical experience was not that bad every week. Eventually I learned how to write a goal statement and what an expected outcome was. Eventually I got back papers that only had a little red on them (usually had to do with psychosocial stuff).

Just hope the nurse you work with (you'll be taking at least one of his/her patients) is decent, patient, and willing to work with you. Since it wasn't too long ago that I was a student, I am very nice to the students we get (on my rare day shifts). Get on your instructor's good side (assuming she has one... ) and try to see everything, even the mundane, as a learning experience.

Scariest clinical? That would be my second med-surg. We had 6 students taking 5-6 patients each, so we had practically the whole floor. There was a wing that had ten rooms and it's own nurses station, but was still considered part of this particular unit. I was charge nurse (for nursing students) and I had two students taking 5 patients each. The REAL nurses handed me the narcotics keys and said, "You seem to have it under control. See you later," and left the floor. Until lunchtime! My nursing instructor, the other nurses, the other students were on the other wing and did not know we were by ourselves. Fortunately nothing bad happened (like someone coding) and at the time I didn't think anything about it. Now it scares the $h!t out of me!!

[RNIAM, BSN, RN]

konnihall

All I can say is:eek: Ok but really that second med surg rotaion would have scared me as well. It sounds so exciting though. Thanks again for the insight!

[jschut, BSN, RN]

We went to the hospital, found the clipboard with our patients name and room number on it and were responsible for getting report and history on that patient before our instructor got there.

Then, we did AM care on our patients, and did an assessment on them at the same time. If anything interesting was going on with them, we were allowed to go with them (any procedures or X-rays or the like). We couldn't do too much, and whatever we were not checked off on, we had to have an instructor with us to do. We had plenty of time to write out our assessments and to write up our careplans.

I think one of the best parts of my Med-Surg rotation was when I was almost in tears for flubbing up so badly in front of an instructor, that I was crying. She patted me and told me that I would be a fine nurse, and to be assured....she would let me know before I flubbed up so bad it would effect her! :)

My scariest part was my first IM injection. Oh Lord, I was shaking so bad! But thank God above, I got through it and was told I did a good job! WHEW!

The very best was at graduation. Seeing the instructor that everyone had said was the very worst (she was always good to me). She looked like a big proud peacock showing off her chicks. I've never seen her smile so big and stand so tall! Although I'll bet she does for every class, I prefer to think we were special! :)

My instructors were all great people and I have the highest respect for all of them. I am proud to have been taught by them, and I can only wish you have the same luck and enjoyment with your experience! (And I'm sure you will!)

Then, after our day was done, we had a conference in another part of the building and we all discussed our day. How it went, what we did and how we did it.

That's what we did....

Don't fret so....I'm sure you'll be fine too!

Good Luck!

Julie

[SmilingBluEyes]

Depends on the school. One year, our clinicals were 6 hour days two days a week...and classes were three days a week...for about 5 hours, I think.

The next year, we did 12 hour clinical days...from 6 a.m. til 6 p.m. one day a week and classes were much more intense and longer....like 8 hours the other days.

Keep in mind: This did not include Pre-clinical visits to review charts, look up meds, and write care-plans for our assigned patients. That was done the night before.....and care-plan writing was a time-intensive process. I can remember staying up late hours doing them. But I got smarter.... I got so I built care plan shells in my computer on Word for Windows and used what applied for each case, personalizing them as I went. It worked well for me. GOOD LUCK!!!!!

[nell]

konnihall, LOVED your post! Brought back what little I remember of the experience...

SmilingBluEyes,

But I got smarter.... I got so I built care plan shells in my computer on Word for Windows and used what applied for each case, personalizing them as I went.

Jeeze, you young'uns have it easy! I'd never even heard of a computer in 1975.

I do remember my first and worst experience: the very first time I walked into a patient's room.......I fainted!!!!