Give me a day in the life at clinicals!

catzy5 · May 16, 2008

I'm wondering...when you go to clinicals for 8 or 10 hours one day a week at the hospital...what is it that you DO all day? There's only so much a student can do I would imagine...You can't be busy the whole time? Do the nurses use you as a sort of "slave"? If your patient has an accident, do they expect the student to clean it? Do you feel like you are in the way a lot of times? What in the world do you do for all that time? Seems like a long day to me.

Clinicals actually fly by, you will be very busy.

At first you will probably just shawdow an RN/LVN, (if your lucky) I was thrown in on my first day, no CNA's so me and my school buddy jumped in and did Bed baths, changed everyone and did all vitals for the first day, having never ever done anything like that before. It was really hard but I will remember that first day FOREVER! Now we do full patient care for 1-2 patients (ending my first semester) we do assesments, all vitals, Meds (accept IV), charting and anything else thats going on. We usually have an assignment or two on top of that or goals we are trying to reach. If I find myself with any free time at all it is to my benifit and everyone elses to find other nurses that might need a hand with something, I often do other nurses Vitals, Accu checks, or help clean up a patient etc...whatever you can find to do DO! Every experience is a learning one.

obicurn · May 16, 2008

Thanks. I figured it would different locations. Schools make it so difficult to plan in advance for child care and things like that. We aren't allowed to pick our own class schedule or anything, even though all the classes we have to take are offered at multiple days and times. They basically say...here are your classes....you have to be in class a on monday from whatever time to whenever.....every day.

I'm struggling trying to work out my schedule for my kids' needs.

NightOwl0624 · May 16, 2008

Question:
When you are assigned to a clinical location 1st semester, is that the same location you will be at throughout nursing school or do you get shuffled around all over different places?

We change locations throughout the program, and I think most schools do, too. For example, for Peds, there is pretty much only one hospital we can go to.

As for how the clinical day goes, I think a lot will depend on your instructor. I have seen two extremes, all in one rotation! My last rotation (1st semester med/surge) went like this:

First instructor:

Always at least 30 minutes late. Takes another hour to assign us a patient. We do assessments, but are not allowed to do meds (well, maybe one of us can if she can handle it). When we are done, we go back to the conference room as she does not want us answering call lights. We do a long post conference where she checks our charting, and we leave 2 hours early. This instructor was fired half way through the rotation.

Enter Second instructor, who was trying to make up for lost time of the first instructor:

We arrive and within 5 minutes we are given two patients. Patients were carefully selected to give us a wide variety of experiences - usually very high maintenance with a lot of meds to give. We are to give total care to these two patients - including everything a CNA would normally do. That includes vitals, assessment, bed pan/cleaning up, turning/walking, all meds except IVs, and anything else that may pop up (catheters, test preparations, things like that).

If anything "interesting" was happening on the floor, my instructor would always make sure a few of us were pulled in to observe. She was really good at rotating us so we all had lots of things going on.

If you had time after you did everything your patient needed, she would either reassign you or send you off answering call lights.

She kept us very, very busy, but time flew by and we learned a lot.

I hope you have a great instructor, because it can make a huge difference in what you get out of this experience!!!

catzy5 · May 16, 2008

Question:
When you are assigned to a clinical location 1st semester, is that the same location you will be at throughout nursing school or do you get shuffled around all over different places?

we get shuffled around

melsman1904 · May 16, 2008

Like others have said: You will be busy. Normally, when we get down time(like when our pt is d/c) we either get another pt., help a classmate with their pt. or we use this "free time" to study. I would advise you to always bring a something to study( even if it is just a handful of note cards). You will appreciate that extra 5-10 minutes here and there of study time when test day rolls around.

moviestarwife · May 16, 2008

I just finished my first semester clinical. I think most of the people posting on here are further along in their schooling. It was actually much easier than I thought. If you have CNA experience than your one step ahead! I don't, so I felt rather awkward with the regular stuff--moving patients, doing basic cares. The medication stuff was easy. This is how my first semester clinical went:

Wednesday: Get patient assignment (we only had one), get the charts and read through them completely, fill out a patient worksheet with all the data, make a time line, do drug cards for all of their meds. on the MAR for your patient. Further into the clinical we started doing nursing diagnosis and care plans.

Thurs. & Fri.: 7:30 pre-conference

8:00 on the floor. Accuchecks, patient cares, assessments (two focused and one basic head to toe), meds with the instructor (yes you are quizzed, but you can have your drug cards--actually HAVE to have your drug cards), feed patient (if needed), help classmates with their patients, ROM, repositioning etc.

11:00 Chart everything and report off

11:30 Post conference with classmates and instructor

Wednesday's were the worst because of the amount of preparation. However, the better the preparation the smoother things went. I started out making a very generalized timeline and found out that if I broke things down into 15-30 minutes increments it went much better. That doesn't mean things will always go as planned, but it really helps!

Remember that it is a learning experience, and really enjoy your patients.

Good luck! :nurse:

jackson145 · May 16, 2008

I was never really busy at clinicals and most of my classmates felt the same way. I spent most of my time answering every call bell that went off so I'd have something to do. At one point, we asked for extra patients to be assigned to us so we could keep busy. The day just drags on when there's nothing to do. OB/Peds was the worst for the guys because there wasn't a single patient who would allow them in their room. They spent the entire 5 wks emptying trash cans and running errands.

Also, we weren't allowed to study during clinicals. We were told that studying was for our own time.

lemonlimeEMT · May 16, 2008

I'm wondering...when you go to clinicals for 8 or 10 hours one day a week at the hospital...what is it that you DO all day? There's only so much a student can do I would imagine...You can't be busy the whole time? Do the nurses use you as a sort of "slave"? If your patient has an accident, do they expect the student to clean it? Do you feel like you are in the way a lot of times? What in the world do you do for all that time? Seems like a long day to me.

For the record, this is all just my opinions and my experience: no two clinicals were alike. Some days, I sat around at the nurses' station a lot, bored out of my mind, watching the clock slowly turn. Other days, I never even had a chance to go to dinner.

One clinical day:

My clinicals this past semester were from 1230-2030 (8:30pm). At 1230, my clinical group (of 14 students) would meet in a conference room for "pre-clinical". Here we'd talk about any house-keeping issues, some days my instructor would bring a case study for us to do or an article to discuss; other days we'd talk about the program and any issues/problems we were having. Mostly my instructor was just trying to keep us busy (doing something at least semi-educational or productive) until after 1330 when the other nursing school students left the floor. We tried not to overlap our times too much, so that our poor patients and nurses only had to put up with one student at a time. Then around 1330, we'd go to the floor. The hospital I was at was set up into "pods". There were 6 pods to a floor, and 6 patients to a pod, with a nurses' station at each pod. Usually there was one RN per pod and one PCA per 2 pods. I'd arrive at the pod, introduce myself to the RN, tell her what my "goals" for the day were and what I could do with her, what I had to have my instructor there for, and what I could do by myself. My "goals" were like taking care of 1 patient, taking care of 2 patients, etc. My instructor liked to add on patients for us as the semester wore on. We also had to complete parts of our paper work, by the end of clinical to turn in. Around 1730 (5:30), I had to meet my clinical group for a 30 minute dinner in the cafeteria. So between 1330-1730 and 1800-2000 I did patient care. During this time, I had to do a physical assessment and review of systems on my patient. I also had to do any patient care for that patient. But like I said, there are 6 patients to a pod, and one nurse to those 6, so I spent a lot of my time helping to care for the other patients. I did a lot things like helping the patients get out of bed to go to the bathroom, changing bedpans and diapers, passing out dinner trays, those "basic" type things. On my patient(s), I gave meds. With the RN there, I could do oral, sublingual, topical, NG/peg tube meds. Anything "invasive" (IM, IV, subQ), my instructor had to be present. If my patient went off the floor for a procedure, I'd go with him/her. I also spent quite a lot of time observing the nurse as she worked. At 2000, we'd meet back in the conference room for post-clinical. In post-conference, we'd talk about our day, and share any insights, experiences, or learning opportunities we had.

If there wasn't a lot to do on my pod that day, I'd try to just sit with my patient and talk to him/her. Of course, there were always the days where the patient wanted to sleep or had a bunch of family visiting and didn't want you bothering them beyond what was necessary. So sometimes I got a little bored. Although, I must say this stopped happening towards the end of the semester. I think in the beginning of the semester, I didn't feel all the comfortable in my role as a student nurse. I did what I had to for my paperwork with my patient, but I didn't spend a great deal of time trying to talk to him/her. And I didn't spend a lot of time trying to get to know the nurse I was working with or helping her out with the other patients. As I grew in my role and gained confidence in myself, I found it much easier to find plenty of things to do. I'd often find it being 7:45 and wishing I didn't have to leave in 15 minutes. I got very comfortable helping out the nurse or the PCA, talking to the other patients (beyond just sticking with my patient), and making myself useful or finding things to observe so I could learn. I wish it didn't take me to the end of the semester to figure that out.

lemonlimeEMT · May 16, 2008

I guess the thing you have to remember is: you aren't limited to patient care only for your patient. Just because the lady next door isn't the patient you are doing all your paperwork for, doesn't mean you can't go into her room and change her diaper or watch someone start a PICC line or even just go in and talk with her.

Alternator81 · May 17, 2008

Ok.. This is mine

0645-0700:

Look for new orders in chart, MAR for new medications, SEARCH for the nurse. Get report.

0700-0800:

Introduce myself to my pt (make sure they are breathing :uhoh21:), check PAIN, Take vitals.Do full assessment

0800-0830:

get 0900 meds ready

0830-0845:

Get glared at by nurses cause I am taking too long on the pyxis!

0830-0900:

Find instructor so I can give 0900 meds

0900-1000:

Give Meds, Give bed bath, change bed:uhoh21:

1000-1100:

Usually help my friends give baths

--visa versa

1100-1200:

Give more meds, Blood glucose/insulin, vitals, do charting :typing.

1200-1300:

Still doing charting, give nurse report

, say goodbye to patient.

vashtee, RN · May 17, 2008

I have never been bored at clinicals, and for the record, I am at the hospital from 6:30 am - 7:30 pm. In addition to everything that was mentioned here, I do a lot of wound care and deal with a lot of tube medications (I tend to choose these patients intentionally). sometimes the wound care can be quite time-consuming and gruesome.

Oh, and I had total care for 3 patients this semester. We weren't allowed to delegate anything, and I never got to shadow a nurse. We schedule our clinical instructor for IV push medications and certain IV meds; otherwise we were pretty much on our own.

lemonaidangel · May 17, 2008

My usual schedule:

0600: Get assigned patient, get report from nurse, go through client's chart for important information (diagnosis, meds, new orders, etc.), pull out drug cards, review labs.

0730: wake up sleepy client, introduce self, do vitals and full assessment

Chart

0830: go with instructor to med room to pull out 0900 meds, give to client

chart

0900: help with bath, change of gown, change sheets

1000: ask fellow students if they need help with anything

1030: start interrogating client. (We have 13 page assessment profile sheets we need to fill out on each client before we can start a care plan. Most of it is subjective information. Very detailed! It usually takes at least an hour to ask all the necessary questions, sometimes longer.)

1200 or 1230: second set of vitals and head-to-toe assessment

chart/ review to see if new orders came in

eat lunch

1330: ask nurses/classmates if they needs help with anything, check back with client to see if he/she needs anything.

chart as needed, report to nurse

1430: post floor conference with instructor and clinical group

1500: go home!

The rest of the day is spent finishing filling out the assessment profiles, looking up lab results and reasoning why they are important to the client, creating a care plan related to client's assessment

Schedule repeats itself the next day!

We're allowed to do pretty much everything except IV's (that comes in the fall). Catheters, injections (including insulin and heparin), dressing changes, you name it, we do it.