Getting more clinical experience outside of school?

[anashenwrath, ASN, RN]

Hi all,

I've only done three clinicals so far, but I'm feel like I'm not learning anything and it is becoming very frustrating. I'm an evening student, so by the time we get to the hospital (GU, GYN, and GI surg), the patients are usually eating and/or have visitors, and soon after, they're ready for bed.

Each student gets assigned to one patient, so if that patient is asleep or wants to be left alone, we basically just chart vitals and get out of there.

When I see the primary nurse or PCA for my patient anywhere near their room, I pounce like a madwoman, asking what I can do to help, but there's usually nothing to do! Our professor believes it's best that we learn by doing, but that's hard when you're alone with a patient who has been bathed and toileted and medicated already and is just ready to sleep after vitals.

I feel like it would make more sense if we actually got to work with a specific nurse, rather than a specific patient. Is that just not the way it's done?

Also, is there any way for me to get more clinical experience outside of school? As a new student, there are so many things I can't do, but I just want to shadow a nurse and get some experience! I'm starting hospice volunteering in March, but that will be a lot of bedside and home care. I want to develop some hospital experience by working with someone, not just walking into a patient's room alone, taking their vitals, chatting, and walking out so they can get their rest/family time.

Sorry for the wall of text!

[purple_nomad]

Sadly, clinicals just tend to be this way. Really, clinicals seem to mostly be about you getting comfortable with the mechanics of actually BEING in a hospital, assessing a patient, doing some meds, etc. But when it comes to actual experience...eh...it doesn't REALLY happen.

Ask your nursing adviser about possible internships, perhaps to do over the summer. I did one this past summer for ten weeks. It was paid, I got a place to live, and I got 10 weeks of for-realz nursing experience. I had a preceptor, and she just had me jump right in with patient care. By the end of it, I was passing all meds, drawing labs, planning full care, doing all charting, etc.

It was the best and most helpful nursing experience yet. I highly recommend it! Search the net for internships in nearby hospitals (most of them are in the summer), and see what happens! You usually have to be past junior year, going into your senior year to get into them.

Good luck!

[cbc1147]

Hi, I know how you feel. Trust me. I been in the same situation. But there is some light at the end of the tunnel.

You can always volunteer but as a volunteer you would not be able to do much but observe and run to get water and ice chips for rooms as applicable. You can always find a hospital that takes on nursing students after their first year in a patient care technician (PCT) role which allow you to apply your nursing skills and work with a licensed nurse.

As far as your actual clinical experience when I was in the same boat I would look at the patients medication administration report (MAR) and see are there any evening medications, if so I can use the drug guide to brush up on them, if not I would look at what they took earlier in the day and what I should be looking for on my assessment of the patient.

As for the visitors I would always go into the room introduce myself and acknowledge the visitors, but I would let them know that I still need to perform an assessment and that I would be back later to get that done. That way you give them a heads up and then they are expecting it.

If I got a difficult patient who refused I left my instructor and charge nurse know and I would get a different patient chart and start all over.

Good luck, hope this helps.

[anashenwrath, ASN, RN]

This was great advice! I have some free time coming up in summer, so I'll see if I can find anything.

Just knowing others have had similar clinical experiences calms me down.

Thank you!

[anashenwrath, ASN, RN]

@cbc: This is helpful. I should try to spend more time doing research rather than pacing outside their room uselessly. The charts aren't very helpful, but maybe looking through drug guides and the like would help me out. A coworker of mine who is also a nurse said I can research the patient's condition and learn things that might be useful for patient education.

So glad to hear there's light at the end of the tunnel!

[caliotter3]

Keep your eyes peeled on the floor. Follow the nurses around just to see what they are doing, with their permission of course. You will be able to get a "feel" for what a shift is like. It will be great if you can watch them do a procedure, even if not for your own patient. Better than nothing.

[anashenwrath, ASN, RN]

Keep your eyes peeled on the floor. Follow the nurses around just to see what they are doing, with their permission of course. You will be able to get a "feel" for what a shift is like. It will be great if you can watch them do a procedure, even if not for your own patient. Better than nothing.

thanks!! i think it's weird that we get a single patient for the night instead of a nurse to accompany on multiple patients. is that how it normally is? i mean, even if there was nothing else going on, having to get vitals on multiple patients would keep me busy. and if a patient or two said that they didn't feel like chatting about their health, it would be ok, because I'd have other patients to speak with!

[JROregon, ASN, BSN, RN]

I am surprised that you don't do some type of patient clinical prep the day or morning before. We spend several hours writing up ours and it includes the patient's pathology and clinical manifestations, medications - why the patient is taking them, side effects and patient teaching, assessment for each. Also, we look up labs and the meaning behind numbers that are high or low. Possible nursing diagnoses. Our first several nights of clinicals did not involve a ton of learning. Ask your instructor if she doesn't mind you shadowing a nurse at some point and helping with basic care for other patients. Makes the time go faster. Clinicals are all about reaching goals that you've set for yourself and the goals that your school wants you to meet. If you do shadow a nurse, pick a good one.

[anashenwrath, ASN, RN]

I am surprised that you don't do some type of patient clinical prep the day or morning before. We spend several hours writing up ours and it includes the patient's pathology and clinical manifestations, medications - why the patient is taking them, side effects and patient teaching, assessment for each. Also, we look up labs and the meaning behind numbers that are high or low. Possible nursing diagnoses. Our first several nights of clinicals did not involve a ton of learning. Ask your instructor if she doesn't mind you shadowing a nurse at some point and helping with basic care for other patients. Makes the time go faster. Clinicals are all about reaching goals that you've set for yourself and the goals that your school wants you to meet. If you do shadow a nurse, pick a good one.

Well, the day and morning before I'm at my day job. And the evening before clinicals is lab, so we're getting more skill practice than anything else. I really wish we'd get patient info before clinicals start, so we could do some research and discuss it. But literally, I get there, the instructor says, "ok, your patient is Mrs. X in room B. She's 30 years old and had an appendectomy." then I go see the patient, take vitals, and read the chart during down time. If i happen to see a nurse or PCA doing something, I'll try to get in on it. But our instructor doesn't want too many students in a pt's room at once, so if that pt was assigned to another student, I don't want to cram in there too.

It really seems like a bizzare way to run things. maybe it gets better when i have more skills? i just really thought the instructor would accompany us the first time we tried something new.

[tashacorinne]

As others have said, try following a nurse. I know when I had down time during my clinicals I always did more research about their diagnosis (even though we had prep time to do this too) or I would just ask the nurse who is caring for my patient if I could shadow her. Just try to make the most out of your time in the hospital. Also, don't worry too much, you will get more experience as school goes on. Aaaannnd, my final point, do a summer internship/preceptorship, that really helped me out!