How do clinicals work?

twarlik · Jul 22, 2004

During my first semester, we were assigned one patient and were responsible for AM care (feeding, baths, linen changes) and meds. This was at long-term care, so we usually had a ton of oral meds to give. Starting in the second semester we would be assigned 2 to 4 patients and we were responsible for all required nursing care. That means we were doing baths, meds, IV's, blood draws, dressing changes, caths...you name it!

Don't worry about not knowing what to do. Your instructor will always be around and there will be floor nurses who you can ask questions. Some of the nurses can be more helpful than others, but that's a topic for another day...

Good luck with school.

mavnurse · Jul 22, 2004

I don't have any info for you, but I just wanted to say thanks for posting this - I'm curious, too! I'm starting clinicals next month and I have noooo idea what to expect.

From what I understand about my school, you go around with your instructor and they talk to the nurses on the floor to find out what procedures need to be done where. Then you go do whatever it is, under the prof's supervision and instruction. There are 10 people to a clinical group. I don't know how they split everyone up. I don't know anything. Ahhh help!!!:uhoh21:

PennyLane, RN · Jul 22, 2004

Each school is slightly different. Some places you start of in a LTC facility at first.

At my school our first semester we just practiced our skills in the lab. After that we sign up for clinical spots for Peds, OB, Psych, Med/Surg, and Community throughout the rest of the program.

While at clinical your instructor assigns you 1 or more patients, and you're their "nurse" for the day. You're responsible for meds and all other orders. In the state of Maryland they're not allowed to teach us to start IVs or draw blood in nursing school. We're also not allowed to do IV pushes, but we do everything else.

EarthChild1130 · Jul 22, 2004

My first semester was in LTC, and we were assigned a patient for the day...we gave baths, assisted with dressing, feeding, etc...we didn't give any meds though.

This past semester, I did my psych rotation at a state mental hospital, and I was assigned the same patient for the entire 8 weeks. With him, I did assessments, status exams, etc...no 'technical care' stuff...

The upcoming semester is my med/surg rotation, and I have NO idea how that will be! lol

bgm44 · Jul 23, 2004

I haven't done my clinicals either but what if you can't lift the patients, what do you do? I know that the school part of the program will be okay but I'm terrified of clinicals and everyone you talk to has had different experiences. I guess I will just have to wait and see.

AmyLiz · Jul 23, 2004

I haven't done my clinicals either but what if you can't lift the patients, what do you do? I know that the school part of the program will be okay but I'm terrified of clinicals and everyone you talk to has had different experiences. I guess I will just have to wait and see.

You should always have help moving a patient if it isn't something simple...both as a student and as a nurse. You have to protect your back!

maire, ASN, RN · Jul 23, 2004

I just wanted an idea of how they work. Do you stay in groups and go throughout the hospital? Do you just watch the nurses? Do they throw you in there and tell you what needs to be done and you do it? With first year students going in I'm sure you don't know much so how does it work? Do you do labs first then go? I'm just full of questions.

Each school and each semester is different, I think.

For me, in the first semester we started in LTC, did all am care as previously posted, but gave no meds. We were not allowed to give meds until the second semester. As for labs, for the first 2 semesters, we practiced skills in the lab first and had to pass skill check-offs before we were allowed to perform those skills in the clinical setting (foleys, wound care, vitals, etc). We started out assigned one patient, then 2, and eventually 4.

HTH. :)

maire, ASN, RN · Jul 23, 2004

I haven't done my clinicals either but what if you can't lift the patients, what do you do? I know that the school part of the program will be okay but I'm terrified of clinicals and everyone you talk to has had different experiences. I guess I will just have to wait and see.

If you can't lift a patient you get help. And if the two of you can't lift the patient, then ask for more help. LOL During my first semester me and one of my classmates almost dropped a stroke patient on the floor. It wasn't funny at the time but now I can chuckle about it. The lady wasn't hurt and after it was over she was very amused by the whole thing.

Bruucebuff · Jul 23, 2004

I haven't done my clinicals either but what if you can't lift the patients, what do you do? I know that the school part of the program will be okay but I'm terrified of clinicals and everyone you talk to has had different experiences. I guess I will just have to wait and see.

Aah....this is where my LNA trning will come in handy. It will help out just in the being comfortable part of this process. You will just ask someone to help you. Im guessing another nurse, your instructor or an LNA (or CNA ..same thing).

justjenny · Jul 23, 2004

At my school, we learned basic skills in the Lab first (proper lifting, etc.)

Then our first clinical was at a LTC facility and finally two weeks at a "step down" unit (not really sure what to call it) to get exposure working with Trachs.....

We were assigned a patient, and that morning we got *some* info from our instructor (pt condition, reason for hospitalization, etc..) we then got report from the charge nurse as to the pts condition currently. We were required to check all charts (meds, treatments, and pt. chart) for current status and various other things (bath day? Any treatments/wounds that needed to be addressed?) and we were then responsible for AM care (dressing, bathing, feeding - whatever was necessary for specific pt) IN ADDITION, we also had an assignment to complete on our pt. (one week it was assessing skin, one week was cardio/resp, etc.)

We were given the pts. meds ahead of time, and were required to create med cards and BRING THEM to clinical and tell instructor what the med was, the action of the med, and why was pt. on this med....

At first, we were paired up (two people per pt) but only for a week or two.. then we were on our own! (boy was I scared!! LOL!)

I found the CNAs and nursing assistants to be VERY valuable! The RN was almost always to busy to even bother with us so I relied on CNAs and the occasional LPN to help me out (lifting sometimes, etc.)

What was the most frustrating for ME?

(1) My instructor couldn't seem to handle 1 students.....I could NEVER find her when I needed her!

(2) Only being a facility a short time, I never really got to know any of the staffs names, but more importantly WHERE THEY KEPT STUFF!!

It never failed that they were out of gloves (!?!?!) and I had to go hunting all over creation to find either a storage room WITH gloves (what do they hide them??) or a box somewhere to grab a couple pair until I could get help.

One thing I learned the HARD WAY:

GET HELP when lifting! Even a "one person assist" can get tired....or is a one person assist for Hercules!!

I hurt my back - and I learned my lesson!!

Jenny (sorry this was so long!!)

ADN Dec 2005

zambezi, BSN, RN · Jul 23, 2004

When I was in school, the first semester of our program we learned cna type duties. Some of us started out in LTC and some started in a hospital--med surg type area. the first week we learned the unit-had a scavenger hunt to learn where stuff was, etc. Then we helped with basic care thoughout the day and shadowed the RN. When we learned a new skill we had to be checked off in skills lab and then had to have either the RN or our teacher supervise us for the 'real thing". We didn't start heavy in clinical unitl second semester. The first week we learned using the blood sugar machine, then starting IVs (yes this was one of the first skills we learned), then foleys, then hanging blood, etc--you get the picture. We learned about one skill a week. Our class was broken into two halves. One was in me-surg while the other was in mental health or something...I felt that it was a pretty good progression. I was glad we were able to learn IVs etc in school, as I have read that many programs do not teach this basic nursing skill..

You will be fine--just enjoy learning and make sure you let the nurses you are working with know that you want to to XYZ skills after you have learned them. Don't be afraid to jump in and try the skill--it is the best way to learn. And as others have mentioned, have help with turning and transfers if possible--save your back early--and remember to offer to help others too (that way they will be more likely to help you when you need it) It is ok to be afraid but try to remain calm in from the patient--act like you have done it a million times. Each time you do something new you pick up a new trick and gets a little easier. One thing that I did (esp. with IVs and caths) was to do a few, then watch an experienced person do one or two and refined my technique based on what I did or didn't like about the way that they do things. Remember you can learn things (even if it's how not to do something) from everyone you meet.