Wow my clinicals kind of stink

SNKerri · Sep 1, 2006

For Med-Surg 1 I think maybe if you are bored or having nothing to do after you finish up with you pts(who are not likley to be boring everytime, think traction or first ambulations or high pain or high anxiety or removing foleys and first time toileting) you can ask your clinical instructor if it is okay to follow your nurse around to all of thier patients and observe. Ask your nurse to verbalize assessments(your pts shouldnt be sleeping yet) and show you the steps taken to IV PUSH and hang bags. Be with her when she is drawing up meds and do the calculations along side of her. Its true you can not do a lot of things yet but observing really is great. My favorite thing about observing is picking up all the little tricks that the nurses use in practice. They know so many things that will make your life easier that come with experience. Before you go to clinical make a list of 5 questions that you will get the answers for before the end of the night from your co-assign nurse.(we had to do this for our clinical and it really got us thinking). Also make sure that the nurses KNOW that you will do ANY procedure or injection, if they know this then they will often find your instructor and let her know about thier procedures for the night. The Med-Surg 1 experience was boring for me, until I made it known that I would be willing to do anything and that I wanted to learn. I also dont know if your instructor will let you do this but we were allowed to go around the unit and sit and talk with different patients that werent our own, often times people just need someone to talk to and its the perfect time to practice theraputic communication! :rolleyes: GOOD LUCK!!

BoonersmomRN · Sep 1, 2006

I wish I could do procedures w/ the other nurses- but we aren't allowed to do anything w/out our instructor....argh....AND she said we wouldnt have anyone who was in traction..I dont know why.

willdgate · Sep 1, 2006

I am on an Ortho floor from 3-10. This is the first time our school has been on this floor and the 1rst time we have been there at night. There are just SO many schools around here that they all fight to get clinical time slots.
Today I went in at 3- got my patient info- went in - did my assessment- came out- saw this woman was basically in perfect health except her ankle fx.
My client only had 2 standing meds (prednisone + avelox)- and they were scheduled for 10 so I wouldn't be giving them. She had prn Morphine which I was able to give ONCE.
By 4:30 I was finished with my paperwork ( literally) and was just running small errands for my client ( more water, extra pillow, etc). She was sweet but basically wanted to be left alone with her friends playing cards until she needed something. Plus, there was nothing to DO. No bedbaths, no linen changes, no dressing change ( my pt had surgery that AM and the surgeon hadn't been around to do the 1rst one yet) no NOTHING.
I went around to help my classmates and guess what- they were all in the SAME boat. A FEW had dressing changes but they were simple sterile dry changes. I then sought out the nurses- who were busy- but basically with stuff I can't DO- I helped move a few clients and ambulated one to the bathroom. I also was battling 5 other classmates looking for stuff to do. The nurses were all " Wow! You all REALLY want something to help do!".
My instructor is PEEVED. She didn't want PM clinicals and when she got them she was PEEVED that they stuck us on Ortho- because she knew that this is what the situation would be. She said she would move us up to 2-3 patients each ( this is Med/Surg 1) but even THEN - we won't be busy for 7 hours.
Basically she is going to see if she can turf us out on a rotating basis to see more action on other floors. I will be following RT around next Wed. The following week I will be in the PCU. The next week I will be at a diabetic clinic for a day BUT- when there we ARENT TO TAKE A CLIENT b/c the Instructor won't be with us.
Some of my classmates are on cloud 9 ( " ooh this is SO easy"). I am BORED OUT OF MY SKULL. I'm not using ANY of my skills. I DID accomplished something today when I found a dorsalis pedis pulse by doppler that the nurse couldn't find. That's the highlight of my day. Assessment. One PRN med. 1 doppler pulse. Paperwork.
We have to do a paper on our clients- and mine is going to be pretty bland- no hx of anything, no abnormal labs, 2 meds, 1 prn, she didn't have much of a teaching need b/c PT had already been there and she was young.
Now 10 bucks says that since I typed this out...my next shift will go haywire LOL.

You will see your fair share of nursing stuff, all in due time, believe it

MMARN, BSN, RN · Sep 1, 2006

I am on an Ortho floor from 3-10. This is the first time our school has been on this floor and the 1rst time we have been there at night. There are just SO many schools around here that they all fight to get clinical time slots.
Today I went in at 3- got my patient info- went in - did my assessment- came out- saw this woman was basically in perfect health except her ankle fx.
My client only had 2 standing meds (prednisone + avelox)- and they were scheduled for 10 so I wouldn't be giving them. She had prn Morphine which I was able to give ONCE.
By 4:30 I was finished with my paperwork ( literally) and was just running small errands for my client ( more water, extra pillow, etc). She was sweet but basically wanted to be left alone with her friends playing cards until she needed something. Plus, there was nothing to DO. No bedbaths, no linen changes, no dressing change ( my pt had surgery that AM and the surgeon hadn't been around to do the 1rst one yet) no NOTHING.
I went around to help my classmates and guess what- they were all in the SAME boat. A FEW had dressing changes but they were simple sterile dry changes. I then sought out the nurses- who were busy- but basically with stuff I can't DO- I helped move a few clients and ambulated one to the bathroom. I also was battling 5 other classmates looking for stuff to do. The nurses were all " Wow! You all REALLY want something to help do!".
My instructor is PEEVED. She didn't want PM clinicals and when she got them she was PEEVED that they stuck us on Ortho- because she knew that this is what the situation would be. She said she would move us up to 2-3 patients each ( this is Med/Surg 1) but even THEN - we won't be busy for 7 hours.
Basically she is going to see if she can turf us out on a rotating basis to see more action on other floors. I will be following RT around next Wed. The following week I will be in the PCU. The next week I will be at a diabetic clinic for a day BUT- when there we ARENT TO TAKE A CLIENT b/c the Instructor won't be with us.
Some of my classmates are on cloud 9 ( " ooh this is SO easy"). I am BORED OUT OF MY SKULL. I'm not using ANY of my skills. I DID accomplished something today when I found a dorsalis pedis pulse by doppler that the nurse couldn't find. That's the highlight of my day. Assessment. One PRN med. 1 doppler pulse. Paperwork.
We have to do a paper on our clients- and mine is going to be pretty bland- no hx of anything, no abnormal labs, 2 meds, 1 prn, she didn't have much of a teaching need b/c PT had already been there and she was young.
Now 10 bucks says that since I typed this out...my next shift will go haywire LOL.

:chuckle Sorry. I just had to laugh. I experienced the exact same thing on my first semester. It was a nursing floor, no med/surg, no ortho, no nothing, just nursing. My clinical group and I were literally stalking the nurses to see if they needed help with anything. WHATSOEVER!! It was so boring! :yawn: However, I'm learning to appreciate that down time because now I'm in a med/surg floor and it is soooo busy!! It's fun, but I have to learn how to manage my time, because I usually fall behind. And I'm only a nursing student! So, hang in there. It'll get busy. Believe me. :nurse:

Tweety, BSN, RN · Sep 1, 2006

There's a PM class that comes to our floor, and there's about 10 of them. They run into the same problems because the basic care is usually done by the time they come in and they wind up being bored.

Good luck.

Imafloat, BSN, RN · Sep 1, 2006

Sorry that you are bored! I loved being on an Ortho unit when I had Med Surg 2. Your patient just happened to be a medically healthy person with an ankle fracture, that won't always be the case. You also won't always have a patient with a roomful of guests, I think that you just had a super easy patient.

How about some good things about being in Ortho. Being in ortho will serve you well, you will be a pro at pain meds and all the ortho lectures and test questions in the semesters to come. Since it is your first clinical it is hard to see the big picture, but I enjoy ortho patients, they are mostly healthy people who got hurt, they can still talk to you and take care of many of their ADLs. This is what I liked about ortho and maternity, most people were able to communicate well. You and the other students can use your down time as learning time. When we had down time we would quiz each other on stuff that was wrong with our patients (general stuff, no HIPPA violations). We put our powerpoints from lecture on our clipboards and would go over a slide at a time. We would find a place out of the fray but still visible. We would only do this a minute or two at a time so it wasn't like we weren't doing our clinical jobs.

You have a ton more clinical time, you will look back at this and wish it was this slow paced again!

Daytonite, BSN, RN · Sep 1, 2006

BoonersMom. . .I understand your frustration, but had to laugh at the last part of your post. Murphy is always lurking around the corner to foul a good thing up! What you can do next time is try finding some really interesting charts to look through. Another thing is to find the manuals on the unit and go through them. It would have been nice to find something on traction and how it is put together. Nothing makes the staff disappear faster than hearing that they are getting a patient and they have to be set up in traction! I would have also looked for an orthopedic textbook. You don't usually run across those on the regular nursing units.

In today's world, most of the docs visit during the morning or daytime and want to be home at night. There used to be a time when the the 3-11 shift was hot with docs coming in to do all kinds of procedures. Not anymore. Have faith that Murphy's Law is going to bite you in the bum for your next clinical! :chuckle

llg, PhD, RN · Sep 1, 2006

I see this a lot at my hospital with the students in PM clinicals and in clinicals on the weekend. Sometimes, it even happens on the day shift because I work in a children's hospital where the parents are often there doing the hygiene, feedings, etc.

I suggest you sit down with your clinical group together with your instructor and plan some learning activities that you can do on your unit during the slow times. Your instructor should be able to help you come up with some good ideas. Here are some suggestions:

1. Get some equipment and/or supplies that you don't usually use and review its use, practice with it, etc.

2. Review all the meds on all the patients -- their indications, side effects, etc. You should be able to do this without having a HIPAA problem.

3. Similarly review all the diagnoses -- or some other aspect of care

4. Arrange to perform some routine chores for the unit. Even cleaning and/or stocking supplies can be a big help and will earn your group the affection and respect of the staff. As unglamorous as the work my be, it needs to be done by somebody.

5. Stage a mock emergency drill ... or some such mock procedure. How would you evacuate all those patients in a fire? What would happen if there were a power outage and the backup generator did not kick in right away? etc.

Good luck,

llg

KrisRNwannabe · Sep 1, 2006

I work on an Ortho/Neuro floor. yes you will get some patients like this but you will also get little old people with broken hips that take a zillion meds. i work the 3-11 shift and it is by far the busiest shift. you will get action just be patient.

Kris

fleur-de-lis, BSN, RN · Sep 1, 2006

If this trend continues, are you allowed to learn to answer call lights and phones on the unit? If so and you prove to the nurses that you are willing to jump in, they will come find you for interesting things. I know you said you can't do anything without the instructor, but are you not able to even go into rooms with the nurse and observe? That seems harsh. Ask your instructor for suggestions too and see what she comes up with. Good luck!

BoonersmomRN · Sep 1, 2006

Thanks everyone!

It is such a difference from last semester. I was on a Med/Surg floor ( for fundamentals) and was always running around like a chicken with my head cut off.....wet-to-dry dressings, NG tube feedings, Peg tube feedings, o2 masks, oral care, am care, bedpans,piggybacks, all sorts of meds, finger sticks, urine collections, etc etc etc! It was a BUSY floor!

I know I will see some action...I hope it's next Thurs:)