clinicals???

NurseNature · May 23, 2007

We have always had clinicals two days per week for 8 hours each day. I am always terrified the first day of clinicals but I always end up loving them. It is so much fun and you really have a lot more time to spend with patients and, to look out for them as well, than the actual nurses do. You usually are assigned one or two patients in your first year, depending on which class you are in, and when you are done doing what you need to do for your assigned patients you can help or spend time with others. Good luck and don't be too worried because it really is lots of fun and it will make you that much more excited about your career choice. TIP: I have always carried a folder with me with examples of assessments or wordbanks or whatever it is that you are worried about forgetting or messing up on. It just makes me feel better knowing that I have the info there whether I end up using it or not. Definitely bring your med sheets or drug handbook.

anonymurse · May 23, 2007

Remember that whereas you can successfully appeal test and paper grades (objective; you can point to information in the book or information in handouts or lectures), you can't do squat about clinical grades (subjective, based on instructors' impressions). So if you aren't OCD, at least act like it. If you have an opportunity to read a pt's chart, take it. If it's OK for you to show up on the floor an hour early to do that, do it, and maybe you'll find a doctor working on the chart and maybe you can hear what he has to say about the pt's new orders. Maybe you'll have chances to ask nurses how things work on their unit. Bring all your references to every clinical. Buy an IV drug book and a lab book. If you got to review the charts the day before going up to the floor, read up on the pathophys online and get your care plans in order. Research the patient's meds. As much as possible, write down your projected schedule of events (meds, treatments, fingersticks) for the clinical. You might want to work labor pool as a nursing assistant as soon as you're qualified by dint of being a student with so many clinical hours, just to get to know how the hospital works and to get to know people. The end result will be that you will ask your instructor fewer stupid questions. There ARE such things as stupid questions and if you ask them you will scare your instructor and she will have a BAD subjective impression of how safe you are. If you can wait on a question and get the answer from a book, online, or from a trusted non-instructor nurse, then wait. Also remember that first impressions are lasting ones. If your first tasks to get signed off on, like hand-washing, seem trivial, you need to get your attitude fixed. Do you know how many seconds to scrub? When you have to use soap and water and not alcohol-based gel (circumstances as well as diseases)? Be ready with the answers to all snap questions so they can't catch you unaware. A little effort spent at the beginning will pay off because the "halo effect" will work for you. Project an image of being serious, sober and dedicated--don't be the class clown. Don't argue. Don't ever show that anything upset you, even if inside you freak over everything. Take your time and be safe. Practice things on your spouse and kids and friends before you do them in front of an instructor in clinicals. Remember the object is to survive. Prioritize. Making 100% on a test is far less important than passing everything. The temptation is to put more time into studying for tests than studying for clinicals because you are rewarded with a hard numeric grade with tests. If you did all the reading and made all the lectures, trust that you have the knowledge back in your head somewhere. Don't worry about NCLEX until just before you graduate. You can't take the NCLEX unless you graduate. Survival is your goal. Our first lecture included the famous words "Look to your left. Look to your right. One of the three of you will not make it." It was true. With school under your belt, you will hopefully take the Kaplan Complete and pass the NCLEX. Will the test care if you were an honor grad? Then you will have your license. Will the state care if you passed with a 99 or a 86? Then you will have your first job as a RN. Will anyone in the world care if you were inducted into the school honor society at that point? No. And if you flunk clinicals, you'll never see these milestones. So study for clinicals. And if you had spare time, if you spent it helping your fellow students study both for exams and clinicals, if you bought them lunch when they were broke or helped them move or watched their kids, they will never ever forget you. The instructors? You'll never see most of 'em again. Prioritize accordingly.

margaretptz · May 23, 2007

Great advice, I'm going to print it and put in the front of my clinical notebook. Thanks

WDWpixieRN, RN · May 24, 2007

The most grueling part about clinicals for me are the hours....I am NOT a morning person, so 0600 mornings do not = a happy student nurse -- and sometimes not a very awake one. I really have to struggle sometimes, particularly if I couldn't sleep the night before. I can't wait to get out of school and work nights!!

We had two 1/2 days every other week for 1st semester; we have one full day every week for 2nd semester. 3rd semester consists of 2 almost full days. I haven't even thought ahead to 4th semester yet, lol.

The other "hard" part of clinicals for me was the fear of the unknown -- not knowing for sure what I would be doing that next day. How really ill my pt was or what skills I might be required to do. There was a lot of feeling overwhelmed between drugs, skills, and learning to care for a human being on a very personal level.

The paperwork is also nasty. That sometimes contributes to that lack-of -sleep the night before clinicals -- ugh!!

SoulShine75 · May 24, 2007

My clinical sites were usually geared toward what we were studying at the time. For instance...1st semester (fundamentals) we went to a LTC facility an were able to ONLY do those skills that we had already passed such as injections etc... and basic care ofcourse. We usually had to be at the facility by 6 or 7 am and were assigned a single pt to care for all day (until 5). This clinical lasted 4 weeks (once a week), so we went 4 times. As our semesters went on we were given a little more responsability and autonomy.

Ex: 2nd semester we had 2 pt's and were able to do all the skills that we already knew. Once the instructor is more comfortable with your abilities they will give you a little independance and you can do a lot of things on your own such as pass meds, injections, etc... This clinical lasted 7 weeks, so we had 7 clinical days.

3rd semester we were given 3 pt's by the end of clinical and we had A LOT more independance. We had to get our assignments the night before, on our own. We were on the med-surg unit for 7 weeks (10 hours a day) and the second part of 3rd semester we were at the psych facility for 4 weeks.

4th semester (my upcoming semester :w00t: ) We have the first half of our semester clinical in OB and Peds and the second half with a preceptor on a unit provided instead of with our instructor.

During all of our clinicals we were responsible for charting, keeping the nurse informed, working with others, helping others and LEARNING, LEARNING, LEARNING. Every semester we also got to go to one "specialty unit" to observe only. 1st semester we went to The wound care clinical or rotated with a wound care nurse. 2nd semester we got to go into surgery...super cool. 3rd semester we got to go to ICU and CCU.

So there ya go...I hope this helps some.

2bNurseNik · May 24, 2007

Question???

For an ASN degree, is 450 clinical hours average, or even sufficient?

SoundofMusic · May 25, 2007

I think clinicals are just one MAJOR learning experience. You learn all about the sights, sounds, smells of a unit. You learn about the staff, the layout, the pace. You learn about charts, equipment, the flow of everything, etc. If you have a good instructor, he/she will really lead you everyday, make assignments in the a.m., and will be there on the floor to assist you throughout the day. Sometimes they assign students as "team" leaders, or whatever.

Ours always started with a report of some kind, then patient assignements, then you get your vital signs by a certain time, then baths, a.m. care, and anything else the patient needed AS WELL AS your assessment of the patient. This is all a lot of stuff, and the assessment is your most important thing. It takes time to learn to do it right, and you may or may not chart it right off.

Once you were done there, you got into the chart and started learning about the disease or condition -- everything you could so you could go back to the instructor and explain all of those assessment findings. Then it's back to round on your patient, help the nurse, do more care, etc.

Ours was very thorough and trained me to look for things and to be able to understand the patho behind it. If you haven't had patho first, I think it's harder. I was lucky to have had it before I started clinicals.

I actually loved clinicals in the long run. We got to go to specialty experiences, different units. Got to see a lot and learn a lot. I can now say after 2 years I'm ready to start work ... and I sort of know now what to do when I walk on a floor, but I"m always learning more all the time!

Oh, and don't forget post-clinicals, where you get to present all sort of lovely papers and assignments, concept maps, etc. FUN, FUN, FUN!!

Sometimes you get luck and get with a good group of colleagues as well . .. we all ended up having a lot of fun with it ...