Help With Clinicals

blackribbon · Jul 14, 2015

You are getting to place IVs? Lucky you...we weren't allowed to do them in nursing school at all. I learned on the job. As for shortage of nursing skills because it is a weekend?...don't make that assumption...you may not get the opportunity to watch procedures but if the patient is sick enough to be in a bed for the weekend, they still need skilled nursing care.

My best advice is to be humble and always ready to learn. I always made sure that even the techs knew I considered them the "experts" and would love to be included if something needed an extra pair of hands. I was always quietly respectful and standing there with clean gloves so I could assist at a moment's notice. Because of this I was often asked to assist ... doctors, nurses, PAs, and even got to count the bloody sponges during a c-section observation. I was grabbed to observe many "cool" cases. Save your questions for when you are away from the patient unless it affects your patient care...and never be afraid to volunteer to do the messy jobs so the RN (or whoever) can free their hands up for the more critical things.

bryony · Jul 14, 2015

You are getting to place IVs? Lucky you...we weren't allowed to do them in nursing school at all. I learned on the job. As for shortage of nursing skills because it is a weekend?...don't make that assumption...you may not get the opportunity to watch procedures but if the patient is sick enough to be in a bed for the weekend, they still need skilled nursing care.
My best advice is to be humble and always ready to learn. I always made sure that even the techs knew I considered them the "experts" and would love to be included if something needed an extra pair of hands. I was always quietly respectful and standing there with clean gloves so I could assist at a moment's notice. Because of this I was often asked to assist ... doctors, nurses, PAs, and even got to count the bloody sponges during a c-section observation. I was grabbed to observe many "cool" cases. Save your questions for when you are away from the patient unless it affects your patient care...and never be afraid to volunteer to do the messy jobs so the RN (or whoever) can free their hands up for the more critical things.

I do consider myself lucky to be able to do them. I'm not so much concerned with the lack of "cool cases" that we are exposed to because it was made very clear to us that we are there to learn patient care in limited forms and that includes assisting with ADL's, vital signs, and anything else the PCAs may need help with. The opportunities to perform the skills that we checked off on do come few and far between, but there is plenty of time to get better at them later. I just wanted advice on how to improve my clinical experience from anyone who has had dealings with students. Thank you for your comment.

blackribbon · Jul 14, 2015

I felt lucky to check off even 5 new things each rotation...I only did one straight cath (male) while in school but ended up giving 4 newborns their first baths (most students don't do any). I can now do female foleys without batting an eye in most cases. There is no way to determine what "skills" you will learn on a rotation (my first feeding tube was on a cardiac step down unit)...but remember, the skills are easily taught on the job. One of my best clinical instructors told us that any trained monkey could learn the nursing skills, we were getting licensed to be able to recognize when NOT to do something (like not giving a scheduled BP med to someone's whose BP is 99/59) and to recognize that "something" had changed and our patient needed immediate reassessing and possible intervention. You are only in your first rotation...many of those checked boxes will be blank when you graduate...and it won't matter. Never turn down an opportunity to observe and if you have downtime, talk to the patients....they can tell you what is "scary" and what "hurt" and how to be a better nurse. You can also use this time to practice a very important nursing role and that is "teaching" and "patient advocate". With one patient, you often actually have the time to figure out the "whys" of why a patient is or is not compliant with their treatment...is it that they are afraid, don't understand, or maybe just don't consider their disease process a priority because they are a single mom trying to keep the electricity on and food on the table for her 4 little kids.

bryony · Jul 14, 2015

I hadn't quite thought of how "we're getting licensed to be able to recognize when NOT to do something." Thinking of it that way makes me feel a lot better about not being able to place that IV the other day lol. Thank you very much.

LobotRN, BSN, RN · Jul 14, 2015

Also remember to keep your eyes open for how a unit feels to you! If you happen to get on a good one, with supportive nursing staff, and you feel like it would be a possible place to start your career, don't be shy! Let your nurse know that you like it there and how much you have learned with him/her. If you think you've made a good impression, would he or she be willing to introduce you to the hiring manager? After you leave a rotation, the hiring manager hearing your face and name might help your application find it's way into the "possible job offer" pile! Ask if it is ok to keep in touch as you continue through nursing school. :up:

kbwilliams95 · Jul 15, 2015

Even though I'm a student nurse, I was on a med-surge floor this past semester and what set other students apart from the others was their willingness to learn and take on challenges.

Jenngirl34RN · Jul 15, 2015

I just graduated, so am not an RN yet (taking the NCLEX in two weeks :nailbiting: ), but in my program some of the things that separated those of us who did well in clinicals from those who did not are:

1. As others have said, be willing and eager to learn any and everything the hospital staff and your instructor can teach you

2. Make sure you are proactive about asking to do things...no one will ask if you want to do something, you have to take the initiative. I always asked the nurse I was working with if s/he was expecting any interesting or new procedures with any patients that I could watch or participate in. If another had something interesting coming up and I was all caught up with my own patient I would ask if I could observe.

3. Don't ever, under any circumstances, do things that you are not allowed to do, even if a nurse at the hospital offers to let you and not tell your instructor. You could get in serious trouble, even get kicked out of your nursing program, if you don't follow the rules.

4. If you are at all unsure of what you are doing, ask.

5. If you are all caught up and having nothing to do for your patient right that minute ask the nurse or CNA or whoever if there is anything you can help with. There is always a lot to do if you are willing to do things like changing bedding, or helping to ambulate someone to the bathroom, and the nurses and CNAs I have worked with have all appreciated the offer of extra help.

6. Do not ever feel you are too good to do something. There was one student in my program in particular who thought that cleaning up patients and emptying foleys were beneath her. The nurses and CNAs on the floor did not like her much (shocker) and she was always upset that the rest of us got to do a lot of things she never got to do.

Best of luck!