Can someone please explain clinicals?

Sleepyeyes · Jun 13, 2002

Well, we used to all troop into the hospital, meet and get an assignment. Some instructors would have us go to the hospital and get our assignments the night before. (We designated someone who lived nearby and they'd call us--we took her out to dinner after the whole ordeal was over. )

Then you look over the charts and you write what you would do for that person, and keep refining it based on individual needs. Then of course, you give care. You might meet after a few hours on the floor and describe how well your plan of care is going, what changes you had to make and why, etc. I learned about some fascinating cases through others this way, and it ultimately helped me too.

Tips: Remember your 2-hour window-- one hour before as well as one hour after. Remember patient rights, and medication rights--and ask about anything you're not sure of. If you have a drug to give, get in the habit of looking it up before you give it. Especially insulin, digoxin, dilantin, KCl, heparin, lovenox, vancomycin, gentamycin.

Know the drugs you need to get a pulse or a heart rate or a BP on in your sleep. And chart what you get. Confirm any "held" meds with your instructor. Know the drugs that you cannot give as a student (such as cardiac drips or IV pushes).

Then make sure you ask about facility policy. You'll probably be given some kind of facility orientation. For instance, our new facility policy is that we mix phenergan in 9 cc's of NS to give IV, but the drug book I looked in only said "at least 5 cc's."

You also need to know about your scope of practice as a student. For instance, docs were always trying to get us students to do IV pushes--and if we did, we could get immediately kicked outta school. Big :nono: nono and we were drilled on it incessantly.

You'll do fine, I'm sure.... soon we'll see :nurse: after your name....

(Gosh I'm chatty today :chuckle: --but I hope it helps. I guess I feel I have a more personal stake in this student thing, since my daughter will be returning to nursing school soon. )

allthingsbright · Jun 13, 2002

OH, awesome thread! Maybe someone could tell me what it means in a course if it says "8 clinical hours." (Or "6 clincal hours" or whatever.) Is that 8 hours per week or day or what? I have tried to call the nursing department to ask, but they are always SWAMPED! Thank you, Amy :)

dianacs · Jun 13, 2002

LOL, I'm glad you asked this. I wanted to know also but was afraid of looking like an ignoramus. (You did not come across that way at all, so obviously there was nothing to worry about!) Thanks for bringing this up.

peaceful2100, BSN, RN · Jun 13, 2002

At my school we are expected to go in the day before and get our patient assignments then we go home and prepare for clinicals. We are required to look up and know all the meds the patient is on, why they are on it, adverse effects that can occur and anything else special that we would need to do before giving pt the med like checking BP or pulse. We were also expected to look up patients diagnosis, know what the pathophysiology is that accompanies the disease, and formulate a care plan and be able to implement the care for the patient. For my school we don't have to show the instructor EVERYTHING. Like vital signs the instructor does not look over our shoulder or for making beds or doing baths. However, for giving Medications or any procedures we can do like catheters, NG tubes, IV's, or anything else that is a procedure like that we are REQUIRED to have the instructor or a RN present with the instructor permission if we have already been checked off by the instructor once.

The scariest/bad clinical experience that I had was when I was in the OR of a childrens hospital they were doing heart surgery on a 12 month old they were not sure if she was going to live or not and fear she would die during the operation I was nervous the whole time I was watching it The little girl had the best known pediatric heart surgeon in the city The second scariest experience was the orthopedics floor. Those patients were in certain kind of casts and tracks and I always worried that I might accidently do something wrong or cause them greater pain.Of course I was being paranoid. I have also had clinicals were patients were just outright rude to everyone no matter how nice you were. I have been cussed at for no reason expect for the patient just being grumpy and out right rude. It is hard being in the hospital and some patients don't do well with being in the hospital.

The best clinical experiences I had was during my pediatric rotation and my labor/delivery rotation. During my pediatric rotation. I had a baby whose parents kept thinking I was the nurse even though I repeatly told them I am a nursing student. The told me that I am such a great, caring and compassionate nurse and they said it is amazing to see someone take great pride in their work. That truly made my day especially since I am thinking of going into Peds, NICU or OB. During my OB rotation is was great when I was in Labor/delivery and I saw a patient give birth to her first child. She came in to the hospital at 1115am and gave birth at 1152am that same morning. It happened so fast and she was nervous, she is only 17 at first she was reluctant to have anyone help her or touch her but when I was by her side trying to comfort her she then grabbed my hand. (She squeezed the heck out of it) but it was good knowing that she found comfort through that and it was ok by me. She then realized she was squeezing a little too hard and eased up. I saw the birth of a baby and it was amazing. I did not get to see the birth of my own daughter I had a C-section and I was put to sleep with that. I had to refrain myself from crying when I seen my patient's baby took his first breath but it was so hard to do the tears started rolling down my face. The nurse told me that it is ok to do that.

There are good times and bad times. So far I have had more good then bad though.

To those who wanted to know wheter 6 or 8 clinical hours is in a day or week. IT depends on how you are reading. Like at my school for every clinical credit hour it is equaivalent to about 3 clock hours meaning at my school I have 5 credit hour clinical courses so that means we spend about 15 clinical hours Per week in clinicals. So 6-8 may mean 18-24 clinical hours per week for a certain amount of weeks.