i have no idea what im supposed to be doing

ImThatGuy, BSN, RN · Apr 12, 2011

You will stand around a lot. In fact, it's stupid how much standing around in the way you'll do. It seems like nurse clinicals are so unstructured.

You'll get there, probably have a meeting, listen in to the shift change patient reports during which time no staff member will recognize your presence, then the meeting will break, and you'll have to go be student nurse.

I generally go wake the patient up, do a head to toe (takes like 6 minutes), and then I go document. Breakfast comes about 30 minutes later so in the mean time I stand around the counter waiting for 2:30. When breakfast does come the LPN students quickly swarm and deliver all the trays in about 20 seconds. It's an impressive feat really, and it happens all over again at lunch. They also pick them up when they're through. (You may have to take a blood sugar and give pre-meal medicines.) I wait about 30 more minutes, go see what they ate, move the tray to the sink, and then go wait my turn to give medicine which has to be supervised. I give it. I document that and how much they ate and then I fill out the other sundry forms in the chart. I then stand around and wait some more until I can find someone to help me wash the patient. We assemble the gear, and then I stand by the bed scrubbing, doing my best to coerce the patient to do it his/herself. Usually they don't want to even when they're capable. I never get the other end of the spectrum. (No one does this the way you see in the video when they teach you this in school.) Dry them off. Get a new gown on them. Change the sheets. Do whatever else. Document. Hurry up and wait. Maybe there's later medicines. Maybe there's not. Fill out everything else in the chart. Done for the day. It's 9:30 and we leave at 2:30. There is a noon vital taking session to break up the monotony with lunch but the vitals take like two minutes, and you can read above how the lunch rush goes. Sigh. Thankfully I'm now completely finished with all medical-surgical unit rotations.

Becca2011 · Apr 12, 2011

My first semester of clinicals I stood around practically holding the walls up because I felt so useless.

This semester, I search for things to do after I do assessments and vitals on my 2 patients. (And whatever else that is commanding attention at the moment) I answer call lights, I help other students out if they need it, I ask the RNs if there are any medications I can give or things that need to be done, I go through the hard chart to complete my weekly clinical paperwork, I find patients to chat with--And if there's REALLY nothing to do whatsoever, I go empty out all of the soiled linen carts in the dirty utility room and stay out of the way. My clinicals are once a week from 9:30am-6:30pm. Certainly makes the time fly faster!

Good luck with your clinicals! :)

cogath · Apr 12, 2011

First semester I spent a lot of time talking with my patient and providing encouragement, support, etc. A lot of interviewing went on but not a whole lot else.

Second semester, I hit the ground running, meds, foley's, peripheral IVs, PICC, PCA's, NG, gastrostomy tubes, continuous pulse ox, oxygen, pneumo boots, (all on the same person) -- get them up, walk them q3 times (which is harder then you think with all those tubings), shower, change their gown, bed change, dressing change, cough/deep breath, pain assessments, oral care, vital signs q2 shift and full head to toe q2 shift. Sometimes turn/repositioning, toileting if they are able, insulin infusions, or wound vac's. In between physicians rounding and other people coming it to talk to your patient. And documenting and recording report. If there's free time I try to help others

ashleyisawesome, BSN, RN · Apr 12, 2011

First semester I spent a lot of time talking with my patient and providing encouragement, support, etc. A lot of interviewing went on but not a whole lot else.
Second semester, I hit the ground running, meds, foley's, peripheral IVs, PICC, PCA's, NG, gastrostomy tubes, continuous pulse ox, oxygen, pneumo boots, (all on the same person) -- get them up, walk them q3 times (which is harder then you think with all those tubings), shower, change their gown, bed change, dressing change, cough/deep breath, pain assessments, oral care, vital signs q2 shift and full head to toe q2 shift. Sometimes turn/repositioning, toileting if they are able, insulin infusions, or wound vac's. In between physicians rounding and other people coming it to talk to your patient. And documenting and recording report. If there's free time I try to help others

we were ALLOWED to do all of these skills first semester, but it was rare that there was a patient on my floor that needed any of these things. during the semester i got to change two sterile PICC dressings, give two IV pushes, d/c like 2 or 3 IVs, hang one IVPB and watch another student insert a foley cath (the only foley our clinical group had the whole semester)

it may sound like a lot but I was lucky if I got to do one new skill every two weeks. so far clinical is boring, i hope it picks up next semester.. we start up again may 3rd.

other than that i did the usual, am care, head to toe assessment, vitals and PO meds and documentation. all of this took a total of about an hour maybe... we were there from 0630 to 1515. ughhhh

momtojosh · Apr 12, 2011

HAHAHA....imthatguy....we LPNs are impressive arent we......you just brought back a vivid picture in my head...us lpn students hoovering waiting for the food cart to be brought up and passing them out...and i remember RN students just standing there...did you guys not have to do that?....in fact while we were doing AM care to doing head to toe assessments(which didnt count,but we still had to do them)to passing meds thats all i ever saw RN students doing...and to say a friendly "hey" to us, never happened either....I never quite understood that....i remember the staff not wanting RN students there(at least this group)as they had the holier than tho attitude...i DONT do bedbaths they would say....let alone pass trays....hehe....bet they werent offered a job there either...i was,while i was a student....

i am now pursing and RN career and I learned alot from clinicals from LPN school,especially how to keep busy....

thanks for the mems!!!.... :lol2:

so to the orginal OP...keep busy,there is always something to do.....

RPN_2012 · Apr 12, 2011

Well instead of just standing around ask if you're allowed to look up drugs for the different conditions patients on your floor have, bring your drug book to clinical and MAKE DRUG CARDS!!! Familiarize yourself with all kinds of forms... ask if you're allowed to look at the charts so that you can familiarize yourself with how everything is writen/done, as well as get used to shorthand and "decoding" some people's handwriting. Talk to patients, volunteer to do vitals on like every patient you see, help out making beds, and what ever else might be useful on your floor like giving out food trays and helping patients set their food up, opening containers etc... volunteer to sit in on therapy sessions like OT, PT etc... Do ROM on pt (ask the nurse first), restock the supplies like glowes in and hand santizer in all the rooms, ask the nurses if you canhelp with ADL, and if ou can observe when they do thing you're not yet allowed to do...there's like a million things you can do at clinical even whe you're done what you had to do, go the extra mile! Don't just stand around!

JBMmom, MSN, NP · Apr 12, 2011

Whenever my patients didn't need something, I attached myself to a PCT or nurse and helped them out with anything I could. I ended up with quite a few experiences that no one else got that semester because I put myself out there to meet the nurses and show my interest. I saw ostomies, wound vacs, dressing changes, and from helping the PCTs I really increased my comfort with basic patient care- bed pans, ambulating with patients, etc.

You get out what you put in. Use it as best as you can.

CuriousMe · Apr 12, 2011

I was always busy during clinicals. Once my patient's needs were met, I'd either help another student out, or work with another nurse to do skills or pass meds on another patient.

I agree with the above post...you get out what you put in.

ImThatGuy, BSN, RN · Apr 12, 2011

HAHAHA....imthatguy....we LPNs are impressive arent we......you just brought back a vivid picture in my head...us lpn students hoovering waiting for the food cart to be brought up and passing them out...and i remember RN students just standing there...did you guys not have to do that?....in fact while we were doing AM care to doing head to toe assessments(which didnt count,but we still had to do them)to passing meds thats all i ever saw RN students doing...and to say a friendly "hey" to us, never happened either....I never quite understood that....i remember the staff not wanting RN students there(at least this group)as they had the holier than tho attitude...i DONT do bedbaths they would say....let alone pass trays....hehe....bet they werent offered a job there either...i was,while i was a student....
i am now pursing and RN career and I learned alot from clinicals from LPN school,especially how to keep busy....
thanks for the mems!!!....
so to the orginal OP...keep busy,there is always something to do.....

I did what needed to be done with my patient, but I didn't want to **** in the cheerios of the LPN kids so I just stood out of the way. I could seriously be so veged out standing at the counter that the food cart could roll up beside me and I wouldn't notice until it was half empty anyway, lol. I seriously hate med-surg. I also have selective hearing (and vision), lol. If I'd hear a nurse talking to a surgeon or something on the phone I'd be right there and hear it and say "Well, I'm gonna watch that when that happens, ok? Thanks" leaving of course no room for a negative answer. Sadly, I can never go anywhere as a student or trainee and get into anything I perceive as interesting. It happens in nursing school, it happened ten years ago in paramedic school, and it happened in field training when I first started out as a police officer. Then I get out on my own though and everything goes to hell in a hand basket. Typical day in the neighborhood, lol. Wouldn't have it any other way though. Best way to learn. Get everyone else out of the way and go get in neck deep.

~Mi Vida Loca~RN, ASN, RN · Apr 12, 2011

Sometimes the unit we were on was so slow we did stand around and there was NOTHING to do. My last day was this way. The pod I was in everyone was taken care of and good for a few hrs. If a call light went off me, the nurse and the aide would do paper, rocks scissors for who got to answer it because we wanted something to do. We cavi wiped everything, cleaned everything and sat around, with nothing to do. It was the most brutal half day ever. I love busy days, they go by fast. Especially for a 12 hr shift.

ImThatGuy, BSN, RN · Apr 12, 2011

I'm told now in ICU everyone just sits around and looks at each other. They say medicare quit funding CHF patients in critical care settings so now they have like zero census. They'll occasionally get someone with pneumonia or pulmonary edema or the moronic drug overdose and that's about it.