so, today my clinical instructor told me to "move it along" during med admin.

kgh31386, BSN, MSN, RN · Dec 5, 2010

Are you getting quicker? Or staying at the same pace throughout the semester? And how slow are we talking?

BeenThereDoneThat74, MSN, RN · Dec 5, 2010

There are times (IMO) where lack of speed (or lack of a decent pace) implies lack of confidence. Being on the other side of it, while I am watching my student, I am also watching my patient. This very thing happened to me yesterday. A student was fumbling, and the patient could smell her fear and lack of confidence. And this is one of my strongest students. She is always very thorough, but this time was just taking too long. Ijust felt like if she picked up the pace a bit, it would have made for a better performance for her.

I completely get that you do not want to mess up. Do you feel particularly nervous during certain skills? Because if you don't, you should have the ability to 'move it along'. Some students speed things up when they are nervous, and that's not good either. What semester are you in?

2ndyearstudent, CNA · Dec 5, 2010

she's right. i'm moving slowly. however, it's not because i'm out to lunch, so much as i'm concerned that i'll make a mistake that may get me eliminated from my program.

By our third semester, we were expected to do our checks and give our meds in an appropriate amount of time. You can't move slow, you can't look rushed. Before that, I always got reprimanded for moving too fast even though by my internal clock I was moving at a snail's pace.

TerpGal02, ASN · Dec 5, 2010

I have gotten that too this semester with medication administration. At our clinical site, every med was unit-dispensed in these little plastic bags you had to tear open. I am, and have always been TERRIBLE at tearing open packages, opening plastic grocery bags at the store, etc. It's even harder for me with gloves on. I guess its just something I will have to learn.

BeenThereDoneThat74, MSN, RN · Dec 5, 2010

I am, and have always been TERRIBLE at tearing open packages, opening plastic grocery bags at the store, etc. It's even harder for me with gloves on.

Okay, I HAVE to go there (remember, I am an instructor)... whats wrong with this picture???

NYNursingStudent · Dec 5, 2010

Okay, I HAVE to go there (remember, I am an instructor)... whats wrong with this picture???

The thing that made me :huh: was the gloves. You wash your hands before you go to med cart, so your hands are clean, and you don't need gloves?

TerpGal02, ASN · Dec 6, 2010

The thing that made me :huh: was the gloves. You wash your hands before you go to med cart, so your hands are clean, and you don't need gloves?

Our instructors have always made us wash hands AND glove during med administration. I guess I am just a little clumsy with my fingers. Like at the grocery store, if you are bagging yourself and the two edges of the bag are stuck together, I have a terrible time getting them unstuck. And no, I don't wear gloves at the grocery store LOL! Sorry if this made anyone upset, I actually got a very good evaluation this semester from my CI.

healthstar, BSN, RN · Dec 6, 2010

Always wash your hands when you go to the room, glove, and wash hands when you leave the room.

murphyle, BSN, RN · Dec 6, 2010

Interesting... it was always my understanding that one did not need to wear gloves during preparation of a medication unless you could reasonably expect to come in direct contact with the med, and/or it was something that could absorb through skin (e.g. transdermal patches, split/crushed pills, liquid preparations, etc).* Otherwise, washing/sanitizing hands before and after prep is an appropriate practice. Gloves are only required at the point of patient contact, i.e. IM/SC injections, IV administrations, NG/PEG administrations, etc.

This leads to an interesting question for administration of PO meds... in a routine med pass, you pull the ordered meds from the cabinet in their sealed packaging, take the still-sealed meds into the patient room, check the meds against the MAR and patient ID band, deliver the meds out of the packaging and into a medication cup in sterile fashion, and place the cup on the patient's side table. The patient then swallows the contents of the cup. You never touched the meds or the patient. Do you need to wear gloves, or are washed hands before/after appropriate? Discuss. :)

* Chemotherapeutic and radiotherapeutic preparations are not discussed here; there is a special set of precautions for handling each of these, and a student would not be reasonably expected to handle them.

NYNursingStudent · Dec 6, 2010

Always wash your hands when you go to the room, glove, and wash hands when you leave the room.

Your hands are still clean from the med cart, no rewashing is necessary. (this is how we learned)

sandyfeet · Dec 7, 2010

for me, clinicals feels very similar to my fear of heights. i just don't want to die.

Do you feel this way the entire clinical day, or only when your instructor is observing you? Moving slowly and deliberately is one thing, but if the hospital is causing you anxiety that is something different to work on. You mention a fear of heights- do you have any other fears like a fear of public speaking?

For me, clinical has been an exercise in building confidence in myself so that I am allowed the privilege of taking care of others. I would rather take my time and make sure I am doing each step perfectly, but it comes off as looking like I don't know what I'm doing. Patients definitely pick up on that. And for me it gets worse when my instructor is observing, so I just have to take control of the situation and pretend she is not there. So to answer your question, yes, the same thing happens to me, and I am working on it too!