How to Deal With a Bad Clinical

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A clinical for one of my classes this semester has basically been a disaster. We haven't given any meds, we haven't done any assessments...we haven't even been assigned a specific patient to take care of. Most days our instructor just hands us off to the nurses and techs on a certain unit and says "see ya". I don't even think our instructor tells them what we are allowed to do or what we should be focusing on learning. I think the nurses are afraid to let us do anything because we are mostly only allowed to watch them do things. One day, during the entire clinical day, I had to sit and listen to the nurses and techs very judgementally gossip in detail about specific patients and badmouth them the entire time. How would you handle a clinical like this? Just suck it up? Or advocate for yourself since you are paying to get an education?

That sounds horrible. What semester are you in? I am in my first semester and it is boring as hell.

B O R I N G. I'm an EMT and a CNA and this is just a huge time sink with nothing useful.

I figured out very quickly if I was going to have any chance of making this useful I had to be assertive. I am always asking nurses if I can do stuff. For example, some CNAs were talking about how this one guy hadn't taken a leak in a day. I told the nurse and reminded her that I was cleared to give catheters.

We have 6 week rotations to different places so at least that way we aren't stuck with crappy staff the whole semester, but that hasn't been the case-- it's just the level of practice and chance to practice is low low low.

The 2nd semester we are doing med-surge in various hospitals. Hopefully it won't be this boring.

So I would say you need to do a combo of sucking it up but start advocating for yourself and any people you see you can help.

My clinical instructor didn't really make us do anything. She did assign us patients though. Some people choose to sit and do their entire care plan but I wanted to 'get my money's worth' and created my own learning experience. Anytime the nurses or aides needed help, I was there. I made sure I knew what I was allowed to do and communicated that to the staff. If I wasn't able to do.something, I clearly said that I wasn't but asked if I could observe anyway. I would ask questions like 'what do you all put in rooms in anticipation for a new patient' and I would do that once a patient was discharged and housekeeping was finished. I helped with all patients that I could even if they were not assigned to me. I made sure my cohort knew I was available to help. I volunteered to go to procedures with my patients.

The staff probably have students from multiple programs at various skill levels that do clinical on their floor. You should be the one to inform the staff of the things you are able to do. I don't mean give them a laundry list of things right after report. Say "room X needs their Foley out, I can do that if you like". Or "we haven't learned trach care yet but I will like to observe when you do it".

Now with the gossiping staff, I'll stay there for a moment if I think it will be a quick rant otherwise I wonder off even if it is to go look at all the supplies in clean utility.

CharlieFoxtrot

32 Posts

That sounds horrible. What semester are you in? I am in my first semester and it is boring as hell.

B O R I N G. I'm an EMT and a CNA and this is just a huge time sink with nothing useful.

Nothing useful? Wow. To be an EMT, CNA, and in first semester, know everything, and not find anything worthwhile in the clinical setting! It must be awful spending time with the ignorant peasants...

The 2nd semester we are doing med-surge in various hospitals. Hopefully it won't be this boring.

You make your own fun. If it's boring for you, you're definitely not looking hard enough.

Specializes in MICU, Burn ICU.
My clinical instructor didn't really make us do anything. She did assign us patients though. Some people choose to sit and do their entire care plan but I wanted to 'get my money's worth' and created my own learning experience. Anytime the nurses or aides needed help, I was there. I made sure I knew what I was allowed to do and communicated that to the staff. If I wasn't able to do.something, I clearly said that I wasn't but asked if I could observe anyway. I would ask questions like 'what do you all put in rooms in anticipation for a new patient' and I would do that once a patient was discharged and housekeeping was finished. I helped with all patients that I could even if they were not assigned to me. I made sure my cohort knew I was available to help. I volunteered to go to procedures with my patients.

The staff probably have students from multiple programs at various skill levels that do clinical on their floor. You should be the one to inform the staff of the things you are able to do. I don't mean give them a laundry list of things right after report. Say "room X needs their Foley out, I can do that if you like". Or "we haven't learned trach care yet but I will like to observe when you do it".

Now with the gossiping staff, I'll stay there for a moment if I think it will be a quick rant otherwise I wonder off even if it is to go look at all the supplies in clean utility.

Do exactly this and see if it is boring still.

Really, it's what you make of it. If you choose to sit around at the nurse's station all shift, then you make yourself bored. Get up and speak with the nurses, interact with the patients, assess the environment, charts, etc and help your nurses out. Ask them questions. Learn why they did x, y and z.

It would really be helpful if you told us what class you are in. In Funds, I wasn't allowed to pass meds but did the usual care, participated in activities and spoke with my patients. I asked the LVNs about the meds they were giving and helped with vitals - surely you guys should be able to do that. If you are on a med-surg floor, I'd ask your instructor what is expected of you guys/what you can do/can't do etc. If your instructor seems clueless, take it up with the Dean on what is expected of you guys for that clinical.

But please don't just sit around! That looks terrible like you don't want to be there. I know a nursing student who did that and had an unsatisfactory because of it.

Jstimmm

26 Posts

I agree with you! A two year nursing degree should not take two years. The first semester in clinicals is super boring and made me question if I could even live that way forever. Other nurses on this board seem to think they are superior to those that do not find Nursing as stimulating as they do.. all I can say is that you should advocate for yourself. Find out who the charge nurse is , or the RN covering your wing, and follow her around when she allows it, to see what she is actually doing. That is how I combat mist f clinicals.. because they are SO boring.

Nothing useful? Wow. To be an EMT, CNA, and in first semester, know everything, and not find anything worthwhile in the clinical setting! It must be awful spending time with the ignorant peasants...

You make your own fun. If it's boring for you, you're definitely not looking hard enough.

I'm not bragging. It's a simple fact that clinical this semester is changing diapers and giving showers. You know, CNA work.

Hopefully things will get more challenging.

CharlieFoxtrot

32 Posts

I'm not bragging. It's a simple fact that clinical this semester is changing diapers and giving showers. You know, CNA work.

One of the qualities that good leaders need to experience is being a follower and doing the literal sh!t jobs that your subordinates have to do.

As an RN, you are looked to as a leader and will have to eventually delegate tasks to the UAP's, CNA's, and LPN's on your care team. If you are unwilling to do menial client care tasks like bathing clients, wiping bottoms, emptying bedpans, and cleaning up messes - or believe that such tasks are beneath you - maybe it's time to rethink your choice of profession.

Yes, RN's generally may not do these tasks, but there may be situations where you, as a leader, have to pitch in and help those beneath you. I have more respect for leaders who are not afraid to lend a hand caring for clients - even if it's beneath their duties - because, at the end of the day, we are there for the clients.

Jstimmm

26 Posts

I don't agree. If someone in nursing school feels that wiping butts, and cleaning clients is below them, they should not question their career choice. If that were true, everyone I am in school with should. That is CNA work and it doesn't take much training (2 weeks for me) or skill. STNA pay is substantially lower than RN pay. For someone taking all of the steps and time to go to school and dedicating them self's, aggravation is to be expected when you are stuck doing CNA/STNA work. BUT, it does get better- when you graduate I hear. Lol. I get to do the flu shots and stuff, but not actually practicing much of the skills besides assessment , and hand washing.. I get to do that a lot ! Lol

CharlieFoxtrot

32 Posts

That is CNA work and it doesn't take much training (2 weeks for me) or skill. STNA pay is substantially lower than RN pay. For someone taking all of the steps and time to go to school and dedicating them self's, aggravation is to be expected when you are stuck doing CNA/STNA work.

It's fine that you believe that pericares, hygiene, and feeding are all CNA tasks... But what does the N in CNA stand for?

I, too, am paying the big bucks for nursing school and that includes basic nursing skills which some of my classmates have not had to learn prior to school through CNA certification or through employment as a UAP. Sure, I'd rather be doing something else, but client care is client care, and doing these menial tasks often helps me to build a better rapport with the clients themselves, and also earns me respect from the nursing staff. I'd rather lend a hand and have the nurses who I am shadowing tell my clinical supervisor and the charge nurse that I was helpful and showing initiative rather than sitting on my butt. Don't believe me? We've had students who were asked not to return because they felt menial CNA tasks were beneath them.

Another point to consider is that students who enter nursing school as program transfers or from different areas of direct patient care (such as mental health), doing these menial tasks may be their first introduction to basic nursing skills, and these menial tasks are designed to build confidence and get people over their hangups on dealing with bodies of all shapes and sizes. You may be experienced with menial client care tasks and totally cool with naked bodies, but it doesn't mean that all of your classmates are.

Finally, I still stand by my statement that, as a leader, I would not ask my subordinates to do something that I haven't done or wouldn't do myself.

Jstimmm

26 Posts

You do have a point there! I guess I didn't spend much time thinking that other students may have not been trained prior to nursing school . Good point!

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