How can I maximize my learning experience at clinical?

Irock · Oct 17, 2010

If your nurse isn't really happy about having a student, you may ask your instructor to pair you up with another nurse. In my clinicals, I made it a point to tell my nurse that I would be happy to help with her other patients, and not just the one that I was assigned for. You get a lot more experience that way. Your patient might not have anything interesting going on. The first Foley I did on someone was on a patient that wasn't mine, but I had asked my nurse to please tell me if there was anything interesting I could do for ANY of her patients.

Also, it sort of sucks, but if you help with the "grunt work" (i.e. bed changes, baths, etc), your nurse will be happier to let you do the "fun" stuff like IVs, Foley's, trach care, etc. At least that was my experience. Sometimes the nursees are so behind on baths and charting and stuff, they don't have time to let you do any of the cool stuff.

I used to also tell my nurses to please just let me know if I'm slowing them down or getting in their way. Sometimes it helps to acknowledge that you are aware that they are really busy and pressed for time. More flies with honey than vinegar, right? LOL!

Spikey9001, BSN, RN · Oct 17, 2010

If your nurse isn't really happy about having a student, you may ask your instructor to pair you up with another nurse. In my clinicals, I made it a point to tell my nurse that I would be happy to help with her other patients, and not just the one that I was assigned for. You get a lot more experience that way. Your patient might not have anything interesting going on. The first Foley I did on someone was on a patient that wasn't mine, but I had asked my nurse to please tell me if there was anything interesting I could do for ANY of her patients.
Also, it sort of sucks, but if you help with the "grunt work" (i.e. bed changes, baths, etc), your nurse will be happier to let you do the "fun" stuff like IVs, Foley's, trach care, etc. At least that was my experience. Sometimes the nursees are so behind on baths and charting and stuff, they don't have time to let you do any of the cool stuff.
I used to also tell my nurses to please just let me know if I'm slowing them down or getting in their way. Sometimes it helps to acknowledge that you are aware that they are really busy and pressed for time. More flies with honey than vinegar, right? LOL!

Yeah, I'll try that... Last week was more of orientation so we didn't have any patient assignments... this week we will have actual patients that we're responsible for. I just want to feel like the ground beneath me isn't made of marbles! I'll also try to smooth things over with the nurse I was with because I DID ask a LOT of questions and they were pretty stretch and starved for time...

coast2coast · Oct 17, 2010

It helps to be pretty straightforward with the nurse you are shadowing.

Introduce yourself and tell them what you can do ("I am allowed to do morning care/PO meds/physical exams/Neuro checks/Ambulation/Etc"). This will get you some good practice tasks for the day.

Then you say the following: I'd love to do whatever I can today, and please let me know if I'm in your way. If you do ___ x,y, z procedures____ could I observe?

Usually, at some point during the day while I'm breathing down the back of their neck, I'll also throw in a "If I'm in your way just let me know!" for good measure.

If your patient has been cared for and you have down time - find your nurse and ask "Do you mind if I follow you around for a bit? Is there anything I can do to help with your other patients?"

Even the busiest nurses will open up a bit when you give them some idea of who you are and what you know. They just don't have the time to question students to suss out what level they are on - present this info and you will go much farther than you are right now.

Badger4lfe262 · Oct 17, 2010

Do the best you can with what you are given. Some days you will be with what seems like a nurse that doesn't want anything to do with you. This happened to me often in school, but if you put forth the effort and dig in that is all you can do, some nurses will respond and some won't. I am on orientation at work and now am not allowed to do anything but shadow. Take advantage of clinical, if your patient goes to a procedure go with them because once you hit the floor you will never be able to just pick up and go with a patient to see something awesome exciting and new!

DizzyLizzyNurse · Oct 17, 2010

Also, she was behind the desk a lot more than she was actually in the patients room giving care... so I learned a lot of logistics, but nothing relevant to what we're learning in school (which is the hands on care).

You didn't say this did you?

I would add - make sure you thank her for her time and help. Nursing students slow down RNs....I say this as an LPN in RN school. Tell her you felt in the way and don't want to annoy her with questions so maybe it would be better to write your questions down and ask everything at the end of the shift? She will most likely appreciate you trying to make it easier for her. Remember she has a lot of work to do on top of mentoring you. Maybe you can talk to other nurses there, too and they can show you "stuff". I second the idea of helping with bed baths, passing trays, etc. Good luck! You will catch more flies with honey!

ChristineN, BSN, RN · Oct 17, 2010

Ask if there are any bedside procedures you can watch (ie bone marrow biopsy? Paracentesis? or even just an IV placement?) Most doctors and nurses don't mind if students watch

When you have down time, always ask the nurses if there is anything you can do for them. Even if it's just changing bed linen or getting a blood sugar, they will be more receptive of you and your classmates since you offer to help out.

If you are assigned to a patient, read their progress notes, H&P, study their labs, etc.

nrice28 · Oct 17, 2010

Thanks for this post. I am so nervous. I start clinical this coming friday and I was wondering what to do/not to do? I have several friends in clinical and they all tell me to not talk too much with the patients. Don't ask too many questions and don't talk about personal stuff with the patients. Thats really all I know. But I am also nervous about bed baths, and just everything. lol..its so scary to just start. I hope my first day is a good one and I feel comfortable. Have any of you guys been on an Orthopedic floor? thats were I will be. What should I expect. I think I will be doing lots of bed baths/ bed changes and bed pan changes. Hopefully theres more than that. But it is my first semester in clinical. Thanks! :)

nrice28 · Oct 17, 2010

Ask if there are any bedside procedures you can watch (ie bone marrow biopsy? Paracentesis? or even just an IV placement?) Most doctors and nurses don't mind if students watch
Hi, ChristineN, I was wondering how often student nurses pass out. I am so worried about this b/c my instructor said it happens alot. What should I do so I don't. I would be so humiliated and freaked out!! TIA

ChristineN, BSN, RN · Oct 17, 2010

Ask if there are any bedside procedures you can watch (ie bone marrow biopsy? Paracentesis? or even just an IV placement?) Most doctors and nurses don't mind if students watch
Hi, ChristineN, I was wondering how often student nurses pass out. I am so worried about this b/c my instructor said it happens alot. What should I do so I don't. I would be so humiliated and freaked out!! TIA
I've never seen it happen, but I don't work in OR or OB, which is wear I would imagine it happening more. I have had students assist with distraction on pediatric pts during IV placements and the students were awesome, no fainting there.
You said you will be on an ortho floor. You will probably see alot of surgical incisions and wounds, and, depending on what you're allowed to do, there may be dressing changes. Some of these wounds won't be pretty, so you will need to be prepared for this possibility. The ortho floor at my hospital that I have worked on some gets alot of diabetic foot and wound pts, some of which will end up with amputations.

nrice28 · Oct 17, 2010

OMG!! Thanks so much for this invaluable info!! Jeez, if I were to pull back the covers and not see a leg would feel probably kinda shocked. I mean, its just not what you would expect. But now I will make sure to have my shock guard up. lol..but I should have mentioned that my professor said it happens alot b/c of wound changes. Oh no! I don't know how I will do. I am so scared. I really don't want a bad experience make/break me. I really do want to be a nurse. I guess if I really do hate it then i could just remind myself its just temporary and next semester I will be on a different floor. Thanks so much for the heads up. oh man, im am in for a lot. LOL!

flyingchange · Oct 17, 2010

I have several friends in clinical and they all tell me to not talk too much with the patients.

Why on earth not? As students we are in a position to actually have the time to talk to our patients. I talk up all of my patients. Irrelevant personal stuff, no, but things that are relevant to your assessment of them - including determinants of health - are all fair game. I've never had a patient say to myself, my instructor, or the primary nurse that the time I spend chatting with them was offensive. On the contrary - every patient seemed to appreciate that I learned about them as a whole functioning person.

Interviewing your patients and interacting with them beyond simple procedures will give you a knowledge and insight into their health status that you probably won't get from reading their charts.... so I guess that answer's the OP question of maximizing clinical time a little bit too.

If you need something to 'do' while you talk to patients, pull up a chair and give them a warm blanket and a foot massage. They. Will. LOVE. You.