How do clinicals work?

Nursing Students General Students

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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.

Specializes in ICU.

Wow! You had in exciting day in clinical! I'm a first semester student as well and I was all excited about getting to remove a foley... Your day was even better!

Only one caveat: Don't confuse or conflate these tasks with learning to be and think like nurses. "Ooooh, you're so lucky, you got to do ..... and I never even saw one of those when I was in school! The nurses will think I'm a total loser!" is something we see here a lot. I am glad, thrilled, that you're pleased to see what goes on in the clinical setting and have some practice in doing some of those psychomotor activities, but never confuse them with nursing skills; we teach those tasks, and more, to lay people all the time. Because a mother manages her child's ventilator and suctions his tracheostomy or runs his home hemodialysis doesn't make her a nurse.

Enjoy all you see, seek out new experiences, and stay curious. And always try hard to put it into the big picture-- why are we doing these? What do we find out about this patient? What should we observe, plan, teach, understand about them? Then you're really learning to be a nurse.

Specializes in Hospice.

What I have really learned that sticks out occurred to me while I was feeding a pt in LTC last week. He could only communicate with loud retching sounds, and opened his mouth like a baby bird when he was ready for another bite. I learned that he deserved my respect and compassion, and so I treated him with respect and compassion. I thought about his life, what type of person was he before he ended up broken here in this chair in the day room of a LTC facility? Did he fight in a war? Have kids, grandkids, a long and happy marriage? I pondered all this while quietly feeding him. He wasn't my patient that day. My patient was self sufficient and fed herself. I looked around this day room at these people there and knew there were so many back stories that I wanted to know and never would. And I briefly wondered also if I had it in me to see human suffering on a daily basis. I decided that the biggest honor I could give to this man and any other patient was their dignity. So I learned that dignity needs to be preserved at all times with all people. And I want to remember that everyone of these patients as a story, people who love them, or loved them, as the case may sometimes sadly be. Memories they joyfully held onto for as long as they could. And I have learned after only two weeks in LTC that this kind of nursing may call to me even more than the Trauma nursing I have aspired to for years.

Specializes in Emergency Department.

Learning to do new skills is always fun for me. If I had a chance to do them some more, I'd be a whole lot better at doing them... but then again, I also recognize that they're basically just psychomotor skills. I used to say that you could teach a monkey to start an IV... but the trick is knowing when it's needed! I find that I also enjoy learning why a particular intervention is needed because while I may not be able to do it myself, I try to know who can, and to find a way to bring the patient and intervention together. That can be bringing the patient to the intervention or bringing the intervention to the patient.

I must admit, though, that the first time I saw a PICC placed, I thought it was pretty neat! Although I've never had to place an IO line, learning how to do it was a bit, shall we say, hairy. We were using chicken legs... and some very sharp Jamshidi needles. There was a very real fear of popping through the bone into our hand/fingers on the other side of the bone... I have yet to try a BIG or any of the newer methods of starting an IO.

I learned to shut up and fly under the radar of my instructor.

Specializes in Forensic Psych.
I learned to shut up and fly under the radar of my instructor.

Yes! Attention is a double edged sword. You can either win big or lose big...and the risk of losing isn't worth the gamble.

Specializes in Neuroscience.
Although I've never had to place an IO line, learning how to do it was a bit, shall we say, hairy. We were using chicken legs... and some very sharp Jamshidi needles. There was a very real fear of popping through the bone into our hand/fingers on the other side of the bone... I have yet to try a BIG or any of the newer methods of starting an IO.

What an interesting way to do an IO! I bet you'd never place your hand under where you were drilling. I was just fortunate enough to be there for the in-service education they were giving the nurses. Still neat though.

I also was able to give me first shot. The nurse told me when we got out of the room to not be so aggressive about it. I took the "give the shot like how you would throw a dart" thing a little too literally, but my patient was generous. All in all, a good day. Learned from my mistakes, learned new things, I just love this whole experience.

However, there is one patient that weighs on my mind. I was fortunate enough to have the same patient for two weeks. Recovering from a collapsed lung. I did everything I could for him given my extremely limited knowledge. The next week in lecture we covered oxygenation, and I thought how helpful some of the techniques and knowledge would have been, and I wonder about that patient. I could have done so much better, and it bothers me that there was more I could have done. Does that feeling ever go away?

Specializes in Emergency Department.
What an interesting way to do an IO! I bet you'd never place your hand under where you were drilling. I was just fortunate enough to be there for the in-service education they were giving the nurses. Still neat though.

I also was able to give me first shot. The nurse told me when we got out of the room to not be so aggressive about it. I took the "give the shot like how you would throw a dart" thing a little too literally, but my patient was generous. All in all, a good day. Learned from my mistakes, learned new things, I just love this whole experience.

However, there is one patient that weighs on my mind. I was fortunate enough to have the same patient for two weeks. Recovering from a collapsed lung. I did everything I could for him given my extremely limited knowledge. The next week in lecture we covered oxygenation, and I thought how helpful some of the techniques and knowledge would have been, and I wonder about that patient. I could have done so much better, and it bothers me that there was more I could have done. Does that feeling ever go away?

Fortunately, none of us ended up perforating our hands with that needle. We were, however, quite paranoid of that possibility and kept our limbs/digits away from where we were inserting the needle. It ended up being that once we felt the "pop" of the needle into the bone, we would subconsciously stop forcing the needle in, and it took us quite a bit of force to actually pop the needle through both sides in one go. The table we were using wasn't quite as lucky. ;)

As to the feeling that you could do better and that there may have been more you could have done, that feeling should never go away. Don't be so worried about it that you are paralyzed by fear, instead use that as your drive to keep learning and improving. You might be at the top of your game, but even then, ask yourself if there's anything you could have done better. The answer may be "no" but that doesn't mean you shouldn't think about it... if the answer is "yes" then you make the changes you need to so you can do better for your next patients.

While I'm but a nursing student, I'm also a Paramedic. It took a while for me to settle into that role. I constantly reevaluated my own practice after every patient I had, so that I could become better and better as a Paramedic. That's something I take with me today. I know where I should be and where I'm at now... and I know there's a bunch of learning that I have yet to do before I'm going to be ready to do more learning as a new grad.

That's another thing I know about... Finishing school and getting licensed only gives you a license to keep learning! I haven't been working as a Paramedic in several years, but that doesn't mean that I gave up learning about that field. I do my best to keep up with advancements so that I can return to being a Paramedic when I finally have the time to. I don't expect to be perfect when I return to that work, but I do expect to be able to return to my previous level of ability very quickly.

Never, ever stop having that drive to learn, because what you end up learning today could very well be applied tomorrow. If you ever get to that point where that feeling does go away, take a vacation. Think about the whole situation, and consider quitting because that's when you could start to become truly dangerous.

Specializes in Neuroscience.

Another Wednesday, another clinical. Nothing super exciting today. Did another assessment on a patient, which it had been awhile. Learned I still have things I need to remember when doing an assessment. Passed meds. I actually knew quite a few of them, and pharmacology doesn't start until next semester!

Even on days where I've seen everything before such as doing just an assessment, measuring I&O's, and passing meds, it's still a great day. I can sit back and watch nurses in action, I can help to move a client to their bed, I can keep a light conversation going for someone in a lot of pain, and get him to grin.

Sometimes nursing isn't about doing all the cool things. Sometimes it's just about doing the basics of nursing. More skill check offs this upcoming week, one test with an insane amount of material, and adding things onto our repertoire of abilities we have. Today though, today was a great day. Clinical day always is.

Specializes in Behavioral Health.

First semester, I learned how to be a CNA, basically. :(

First semester I learned how to be a CNA, basically. :([/quote']

What'sw Ron with that?

What'sw Ron with that?

That should say, What's wrong with that? Typing on an iPad is hard:)

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