How To Do Cool Stuff In Clinical

[Guest 360983]

Here's some tips from the other side:

- There are about 20 bazillion schools in my area. If you aren't from the school I attended, telling me what semester or rotation you're on tells me nothing (unless you tell me you're on your first or last one). Tell me what you're allowed to do or what your goals are. "I can give any medication except blood or chemo." "I want to work on my IV skills." "I need my instructor to supervise any Foley insertions."

- I work in the ER, where there is NO privacy. If I'm really encouraging you to do something boring with me, there's probably a reason behind it that I don't want to say in front of the patient. Yesterday I had a patient with really cool wounds that were in various stages of healing from newly formed to eschar covered. I asked one nursing student if she wanted to learn how to do wound cultures because I didn't want to say "Hey, check out this dude's funky arms! Aren't they awesome?" She was smart and caught on to what I was saying.

- Don't be afraid to say "Can I watch?" In the ER, there are overhead announcements whenever a critical patient comes in. We teach students what they mean so they can say "Hey, since we aren't doing anything right this second, I'm going to go check out that Code 3 GSW to the head." Be the awesome friend and if someone is pulling you in to watch a procedure, grab your classmate on the other side of the floor if time permits.

- Get my attention so I know you're there and looking to learn. If you're with the nurse next to me but really interested in one of my patients, don't be afraid to talk to me. Some of the EMT students spend the whole day taking histories from patients and when they ask me about my patients, I'll tell them who has an interesting story, who is cranky, and who doesn't speak English.

- Doing "scut work" for me gives you good karma, and makes me more likely to find you when something interesting is going on. Also, don't discount the skills you're learning when you're cleaning a patient who is taking lactulose, from log rolling to breathing through your mouth.

- Let me cheer you on. I had two patients who needed IVs yesterday. An EMT student missed twice on the first patient and he really didn't want to try on the second patient. After a little cheerleading from me and his instructor, he got the next patient on the first try and I hopefully will have some awesome IVs from the patients he brings me in the future.

- A lot of RNs have cool stuff on their unit that you don't think is cool. That just means you are probably not an ortho/dialysis/oncology nurse. I think the OR is deadly boring (sorry OR nurses!). Some students come to the ER and turn green at the really cool stuff we have. That's ok. Be nice and learn what you can.

[annietart]

When I was in nursing school (I go back in April! Woo hoo!) sometimes it was just too short for all of us to do cool stuff. That's why I got a job as a PCT. I've have got to see so much stuff and have learned so much. Working hard, doing the scut, and asking lots and lots of questions. Even the most harried nurse can teach a newb something.

[clucito01]

I love this post! I wish all nurses I encounter in my clinical site carried this type of attitude! I have been doing my med-surg clinical's for 8 weeks now and have yet to practice any other "skills" besides the assessment (I haven't even done a finger stick or pass meds :-/). Don't get me wrong I have no issues with doing the grunt work! Especially because I have been a CNA for 10 years. I tell my nurse(s) every week what I can and can't do, what I will need my instructor there to do, and that if they have any type of procedures - whether it be a finger stick or a foley change - to please come find me so that I can either watch, assist, or finally get to do something myself. I am starting to get very frustrated because I am very afraid that I will go into my advanced med-surg clinical's in the fall not remembering how to do anything!

[SENSUALBLISSINFL, BSN, RN]

Clucito, do not feel bad, I am in Leadership and I have yet to put an IV line in or a Foley. In Advance Med-Surge I had two opportunities to start an IV and our professor did not let us do it, even though I made it a point to let her know and my nurse that I wanted to do it. My nurse was happy to see how eager I was, but my professor was adamant that we did not. I am in the ICU for Leadership right now and I have not had the opportunity to do it yet, even though the professor for this rotation is letting us do it... go figure. I wonder if taking a phlobotomy class is something I should look into as I would not want to start working as a nurse and not have the experience to even do that.

As for the dirty work, I am all for it, but in Advance Med-Surge I wanted to do more nursing care because I was afraid to come unprepared to Leadership, our last semester. I am all for making beds and bathing and cleaning patients, but on some rotations our group felt that this was the WHOLE purpose of us being there, to change bed lines and to bathe and we did not get to learn nursing care (though I consider this part of nursing care), we did not get to do much wound care and such...one thing... the CNAs loved us, but I wished I was more prepared in what an RN does besides the cleaning and the bathing. Right now in Leadership I feel awful to tell my nurse I do not know how to do this and that and have her look at me like "You are in Leadership and you do not know how to do this". I feel I am not up to my most potential, but I let her know, I am available and willing, let us see how this rotation ends. So far I love ICU.

[elle21]

I think your clinical day depends mostly on your nurse. Some of them hate having students and will tell you that to your face. Many of them don't want you to do anything to "their patient." But, you can still have a good day despite Nurse Mean. The first thing I do after studying up on my patient is find out where the supplies are, nutrition room, etc. So many times the nurse will ask you to run and get her something, but you either have no idea where it is or where to find it among the millions of supplies stocked in there. Tell the nurse everything you can do and want to do. Sometimes you have to remind them to let you give the meds because they will forget. One time I told a nurse what I hadn't done and she went and found a patient for me to get my skill done. You just never know! If it gets slow, study for your patient. Look up their disease and see if you can find s/s in your assessment and their labwork. That's always a cool feeling. I always help out with other patients too if I can. Don't forget to ask if you can accompany them to a test they're having done. There's a good chance you won't see a colonoscopy or the cath lab if you don't see it in nursing school.

[PaulaSullivan]

When I shadow a nurse on a special unit I always start off by saying "show me anything and everything" and "Don't be afraid to utilize me. I have two empty hands and I'm willing to help".