Terrrible first day of clincal

  1. Hey there! I had a pretty bad first day of clinical. I am a junior BSN student on an ortho/neruo floor. My pt. was quite difficult (advanced Alzheimer's) but it really came down to I just didn't know what to do. I know how to do the skills, but I was just walking around clueless! I'm formulating my game plan for next week and I know that I need to check the care plan for these items (& times)

    Head to toe assessment
    AM Care (Mouth, bath, and linen)
    Any IV care
    Any cath care

    What else is on a typical RN task list? I know that they do it all but I am really new at this so any guidance is appreciated. I know that with each pt it will change, and that I need to be flexible with times/scheduling. I'm trying to compile a little check list of things to do and look for.

    What would you suggest?

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    About Zelda21

    Joined: May '12; Posts: 64; Likes: 78
    from US


  3. by   krisiepoo
    I found that I wasn't so much not knowing what to do as just outright being bored sometimes in clinicals, is that what you're referring to? you did your work and then had nothing else to do? When that happened to me, I brought my paperowrk with me and would start in on finishing that and I would also start answering the call lights in other rooms. I'd help them with what they needed or get their nurse if it was something I couldn't do. I let the CNA's know that I was there to help if they needed it, I asked the nurses if they would be bothered if I trailed after them. I learned so much more doing those things than I would have otherwise.

    Sorry if that didn't answer your question. Trust me, it will get better when you have more patients.
  4. by   i♥words
    So your instructor hasn't provided a game plan for you? That seems odd.

    I think you need to locate Esme's brain sheets.
  5. by   Zelda21
    I was a little bit bored, but what I'm saying is the first day I didn't know that I had to give my pt a bath, or change his/her linen. I don't know what a typically task list for an RN is? The floor I am assigned to for this semester has no CNAs, they seem to have a pretty low census, but the RN who was over my pt was super busy. I did ask her is she needed any help, and did all that was asked of me.

    There was a lot of paper work, but I had most of mine started to where I really want to learn the hands on stuff.

    My instructor was super helpful.... "Just take care of your patient." Haha I was like what does that even mean?! I tried though, and my instructor didn't call me out on anything so I guess I did okay. I get feedback but until then I am trying to formulate my own game plan. We are expected to already be very comfortable with CNA tasks, which like I said I know how to do the things, I just don't know really what to do when I'm there. Wah I don't want to be spoon fed but I'm lost and my instructor, though very sweet, wasn't with me a whole lot.
  6. by   Stephalump
    Hey! I had a similar experience during my first year. My clinical instructor popped by briefly a couple times a day and asked me if I had any questions. Other than skills check-offs, that's really the only interaction I got. So while I did get some skills down, I was left completely unsure what the heck I should have been doing all day! Very frustrating. Now that we've covered a ton of information, I feel like I'm being taught to assess and educate on SO many things SO often, I can't even keep anything straight any more.

    I've started doing what you're doing...making a list of stuff to do. I bought the Med-Surg Clinical companion and I'm using that to compile my list. So if the pt has a chest tube, I know to assess for Xyz every hour or four hours. If he has an IV, I'll also go in and check for Xyz. If they have pneumonia, it lists interventions to do, so I can add that to my list. Hopefully I'll get into a routine once I'm working and it'll be much more streamlined

    I use a brain sheet as well, but I haven't found it helpful as far as time management goes - moreso for keeping pt info handy.
  7. by   SaoirseRN
    If the nurses on the floor are doing all the care, then you would do everything, including the bathing and linens, toileting, feeding, as well as the more nursing specific tasks (meds, assessments, dressing changes). Basically whatever care the patient needs, even if it generally falls under the scope of a CNA, would be a nursing responsibility on that unit.