Disappointing First Clinical Experience

Nursing Students General Students

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Hello Everyone!

I am a first year nursing student and had my very first day of clinicals this past Sunday (I am doing a weekend/evening program). I was very disappointed with my experience as we were there from 6:45AM until 1PM and spent 80% of the time standing around not really doing anything. I thought we were going to get 1 patient a piece. Instead, I had to share a patient with three other classmates. Out of the 6 hours we were at the clinical site, we only spent about 1 hour with our patient. The other 5 hours were spent meandering around, trying to figure out what to do with ourselves. The nurse we were working under was busy with her other duties and said she would "grab us" if she was doing anything interesting or needed our help. She didn't end up coming to us for anything. The most interesting things I got to do were to fetch supplies out of clean utility and take a classmate's blood pressure. Our clinical instructor is very nice, but she is vague in her instructions and isn't very forthcoming with what she expects from us. Obviously they cannot assign us too much, because we are first year students, but I thought they would have assigned a lower ratio of students per patient, had all of us complete vitals on an actual patient, taught us how to use acu-chek, given us the hospital policy to read over, etc...

What I am wondering is this: was my experience pretty typical? Should I be worried? What can I do to make the best of my clinical rotation? Any information or advice will be greatly appreciated.

Thank you!

Specializes in being a Credible Source.
Hi Mi Vida Loca! I was in a hospital.

I was wondering though - would anyone suggest maybe trying to get a nursing assistant or nurse extern job in a hospital? Maybe that will help me in the long run?

The extern gig, sure. The CNA thing... not so much.

I definitely agree with the advice you've been told about putting yourself out there. No job is to menial, I've found that the nursing staff really does appreciate it and seek you out to see and do cool things.

If there really is nothing to do (hard to imagine though) at the very least ask if you can shadow your RN. Anything is better then standing around and talking with your classmates.

Additionally, don't stress so much. This was your first clinical day! As you learn both more clinical skills and more theory, you'll have more opportunity to be be hands on.

Specializes in being a Credible Source.

There's always something to do.

Ask the ward clerk if there are copies to be made or admit packets to collate...

Or disinfect the equipment...

Or make sure every patient has a tidy bedside table, with an empty trash bag, fresh water, and ample tissues...

How 'bout asking the aide if there are bed baths to be done?

Empty the trash in every room...

Crash cart inventory...

Linens put away?

You get the picture... recognize that your presence on the unit is actually a hindrance to us... unless you're actually helping out... in which case we're delighted to have you around and we'll seek you out for experiences.

Specializes in Gerontology, nursing education.

Nikkole,

That sounds like a very frustrating and disappointing experience. Especially for beginning students, I try to keep the first day rather light so that they can get used to the facility. I give a tour of the facility and the floor on which the students will be assigned, go over policies and procedures, and split the students into pairs and send them on a scavenger hunt so they can locate the code cart, fire extinguishers, linen closet, etc. I introduce them to the staff and, if there is any time left over, I will ask them to shadow and observe staff members for the rest of the time we're there for that day. In acute care, I assign one or two to follow a licensed nurse and in long-term care I assign the students to follow a nursing assistant. The second day of clinical for beginning students I tend to assign them to follow a nurse (or again, a CNA in long-term care) but I assign patient care for more senior students.

Having said that, there were several times when the census was way down and I literally had students falling over each other. There weren't enough patients on the floor for senior students to have more than one patient each and I could tell that they were frustrated. Because the census was so low, I tried to find alternative experiences for them (e.g., observing surgery, going to other departments for observations, etc.) That was rather challenging, because, being a new instructor I wasn't sure exactly how far I could go in finding alternative experiences.

If your instructor is new, that could also explain why your first clinical experience seemed a bit disappointing. I felt that there was a very steep learning curve when I started and many times I wondered if I was doing right by my students. I know that I made plenty of mistakes...we all do.

To answer your other question, I worked as a nursing assistant in a hospital when I was in my AD program many years ago. I felt that it was quite beneficial because it was a foot in the door for getting hired there as an RN and it helped me gain comfort with patient care and become better organized.

Hi Moogie-

Thanks for the insight! It is much appreciated. Our first day was on Saturday and that was when we toured the hospital, got to see the other floors, learned the codes, and found out where to locate supplies. The second day we were there was Sunday, when clinicals "officially" started.

As far as our instructor finding alternative experiences, I don't think she has the freedom to do so. I got the impression, while I was there, that we were pretty much confined to one wing, which consists of about 20 beds. I don't think our instructor feels comfortable asking the staff to allow us to observe, which explains why I was in a group of 4 students for 1 patient. Don't get me wrong, our instructor is great. She genuinely wants to help us and wants us to be successful.

It seems like a huge concern among nursing students, not only in my class, but among other posters here, is not getting the opportunity during clinicals to learn the skills we need to be a competent nurse. Any words of advice on this?

Also, I am currently a CNA at a nursing home. It seems as though things are done a LOT differently in the hospital setting and I am hoping that obtaining a position in a hospital will give me an advantage.

Another thing - what is the difference between a Nursing Assistant and a Nurse Extern? Does anyone know?

Thank you so much!

Specializes in Emergency Dept. Trauma. Pediatrics.
Hi Moogie-

Thanks for the insight! It is much appreciated. Our first day was on Saturday and that was when we toured the hospital, got to see the other floors, learned the codes, and found out where to locate supplies. The second day we were there was Sunday, when clinicals "officially" started.

As far as our instructor finding alternative experiences, I don't think she has the freedom to do so. I got the impression, while I was there, that we were pretty much confined to one wing, which consists of about 20 beds. I don't think our instructor feels comfortable asking the staff to allow us to observe, which explains why I was in a group of 4 students for 1 patient. Don't get me wrong, our instructor is great. She genuinely wants to help us and wants us to be successful.

It seems like a huge concern among nursing students, not only in my class, but among other posters here, is not getting the opportunity during clinicals to learn the skills we need to be a competent nurse. Any words of advice on this?

Also, I am currently a CNA at a nursing home. It seems as though things are done a LOT differently in the hospital setting and I am hoping that obtaining a position in a hospital will give me an advantage.

Another thing - what is the difference between a Nursing Assistant and a Nurse Extern? Does anyone know?

Thank you so much!

My first day on my Peds rotation there were 6 or 7 of us and 3 patients. Our instructor sent a few of us to other departments. We couldn't do any skills there, (like meds or injections even though we could do them on Peds, but since it wasn't "her" unit, we couldn't do it) anyway, I was sent to ER for the night. I LOVED it! I found my home. The nurse said it was a bummer I couldn't do the skills because there was a lot of opportunities. But I could help out with other things. It's to bad you guys can't do that.

My school always keeps it at 1 patient per student. Besides Peds we haven't had a problem with not enough patients so far. But our individual groups for our Med/Surge class was split between 3 units. So there were 7-8 students in my specific group, but than those 8 students were split between Neuro, Medical and Tele for 3 weeks and than the second 3 weeks we were split between Ortho, Surgical, and Med/Surge. I did my first injection on my orientation night when we were supposed to just be observing that night. I was all nervous and the nurse asked me if I had given one, and I said no, she was like well do you want to and instinctively I said no LOL she was like all the more reason for you to do it. After that initial one I was volunteering to do anything. If I got an opportunity to do something I had already got a chance to do though, I would let one of my classmates do it if there was anyone that hadn't had a chance to, so they could get their first time too.

There's always something to do.

Ask the ward clerk if there are copies to be made or admit packets to collate...

Or disinfect the equipment...

Or make sure every patient has a tidy bedside table, with an empty trash bag, fresh water, and ample tissues...

How 'bout asking the aide if there are bed baths to be done?

Empty the trash in every room...

Crash cart inventory...

Linens put away?

You get the picture... recognize that your presence on the unit is actually a hindrance to us... unless you're actually helping out... in which case we're delighted to have you around and we'll seek you out for experiences.

I do NOT think that I am above these types of tasks, and I completely understand that the hospital and staff where we have our clinicals are doing us a favor by allowing us to be there and therefore I am definitely willing to help. I have helped with simple tasks and do ask to help with anything I can. HOWEVER, that being said, I dont feel like making copies and things like that are a good use of my time there. Especially if thats the only types of tasks we're doing all day. We dont get that much time in each rotation really, and I want to utilize that time to learn skills. I already know how to make copies.

I felt like a chicken with its head cut off on my first day on my own with a patient too. The actual first day 2 of us were following around a PCA so we really didn't have direct patient contact. I was scared to do an assessment for some reason and finding the vital signs machine was a chore. Actually, that still is a chore. Those things are like looking for the golden ticket.

My first day of Med-Surg I clinical was last Tuesday. I had a patient on isolation contact precautions and boy that was doozy. At least he was nice and was good to practice an assessment on and suit up. I had a friend help me wash him and change the bed. Just yesterday I gave my first meds for the semester. My teacher said I did fine, even though I forgot some things. I felt like I did horribly. It has been such a long summer I forgot to do two of the most important things when you walk into the room: scan the patients armband and the medication. :smackingf I took all the time to look up the medications and compare their Y-site compatibility and forgot the basic stuff! Don't ever forget the basic stuff. I squirted NS all over the wall and ceiling trying to get the right amount for my IVP. It was a mess. I feel ashamed. Long summers actually aren't good as you think they are unless you are going around sticking people all the time.

Well, now to finish the clinical paperwork from yesterday. Yikes!!!!

Specializes in being a Credible Source.
I had a patient on isolation contact precautions and boy that was doozy.
Believe it or not, I graduated from nursing school without ever having had an isolation patient. When I started working on the floor, it took some time to get quick at gowning.
Specializes in Emergency Dept. Trauma. Pediatrics.

The precautions really suck if you wear glasses. I need to just get contacts. The mask always makes the glasses fog up. I hated getting precaution patients for that reason.

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