Is anyone else completely overwhelmed with clinicals?

SarasotaRN2b · Oct 18, 2007

I think that it is a normal feeling...and you are definitely not alone! If this is your first experience working on a hospital floor, it is even more normal. I think that we get overwhelmed because instead of concentrating on the task at hand, we project and try to go fast forward, thus forgetting things that we definitely know.

This feeling will eventually go away.

Kris

Lovely_RN, MSN · Oct 18, 2007

I feel that way sometimes and I think it's a perfectly normal feeling. What helps me are my little reference books that I can look at while I am on the floor to jog my memory. Do you have a PDA? How about a book like RN/LPN notes? or something like Fast Facts for Nurses? If you have access to the hospital's computers then you should be able to access some sort of reference program like a Micromedix for RX help or an online medical library.

Write things down because it's impossible to remember everything. If you get your patients the night before and have to do a care plan then jot your interventions down on a small piece of paper so that you can reference it on the floor the next day. When your CI lets you loose on the floor make sure to check the orders in the AM and compare them with your interventions....do they make sense? If they don't then that would be the time to ask questions.

Right now I only have to take two patients so I fold a piece of paper in half. I write down what needs to be done for that patient and by each item I place a box. When whatever needs to be done gets done I check it off. Its nice during post-conference because I look organized and my CI knows exactly what I have done for my patients.

The CI is there to ask you questions to make sure that you aren't being dangerous on the floor. It's not a crime to not know something the first time you are asked but it is your job to find out that information for the next time. What I do when my CI ask me a question I don't know is write it down in my little notebook and when I go home I look it up. If it was something major then I will go to my CI at some point in the future and say: I know that you asked me about ___________ during the last clinical and I went home and looked it up.

Kevin RN08 · Oct 18, 2007

I have had a bit of a problem identifying "my role", having been a manager, I get a bit frustrated in that I don't always have the answers. These insecure feelings are passed on to the patient and that isn't good for anyone. I have adopted the practice of studying up on my patient(s) before I meet them, then go introduce myself as a student working with my instructor and their assigned nurse. This pays off by breaking the ice for both of you. It works for me, some of my classmates just "hit the ground running" and suffer as you do.

The problem I have is in the classroom, I am a first year student in an ADN program. I've never been one to get too wrapped up in grades and have always done well (3.7 GPA)but, since we started our short rotations (5 week classes in Psych, Mat/NB, Med-surg), I have really stunk it up in the classroom. It's as if I don't know how or what to study, it's not for lack of effort as I spend 20+ hours a week reading and doing practice questions:banghead:. I just don't know what I am doing wrong. Any guidance is appreciated, thanks in advance.:cheers:

ilivet0surfxx · Oct 18, 2007

I feel like an idiot when I'm on the floor. Everything makes sense when I'm reading about it and learning about it in lecture... but applying it during clinical, I get so absent-minded. I feel like my professor thinks I don't put time into studying - she hasn't said it - but a lot of questions she asks me, I don't know the answers to. I work my butt off day and night trying to learn everything. I'm always so nervous to to go clinicals and screw up. Anyone else?

I can almost guarantee you that everyone in your clinical group feels the same way you do or has at one point or another. As a first year nursing student in a two-year ASN (or is it ADN? I'll have an associate's when I'm finished and be able to take the NCLEX :uhoh21:) approaching my sixth week of clinical I have definitely felt this way from time to time. In fact one of the other students in my clinical group came up to me and asked me the same thing you did so rest assured that you're not the only one. It's hard to remember everything when you're put on the spot, and even though your instructors are there to help it's easy to even get nervous in front of them. The first time I had to take a blood pressure on a patient with my instructor listening as well I definitely broke a sweat!

But the best answer my clinical instructor gave me, as well as several friends that have completed nursing school is that everything comes with time and practice. I was super nervous when I first started clinical but now that I've gotten more familiar with what to expect I actually look forward to it most weeks.

Hang in there!

locolorenzo22, BSN, RN · Oct 19, 2007

It comes with time....the first time I was on a med surg floor, I had NOOOO idea what to expect! I'd never really done patient care, I didn't know all the diseases and tx options, I didn't understand how to relate to patients....

Now, after 2.5 semesters, I feel more confident in what I do, I can assess someone in around 3-5 mins, give meds without problems, deal with family members, talk to doctors...do much more than I even thought possible.

I take my NS attitude to work.....I can ask patients if they've had a pain med, nausea, b/p med, etc..they say a drug name in the ballpark, and I usually can figure it out with them...I can answer almost 90% of the questions I get, and have no problems interacting....

On the clinical floor, I approach it as just another day of work(albiet an upaid one) and usually get through without a problem. My CI told me that I have a great attitude, spot-on nursing judgement for our level(If not beyond), and am a role model for my fellow students...if that's not positive feedback, I don't know what is!

Take a deep breath, and relax....patients are people too....many do enjoy having students as we care more than staff RNs sometimes....

Lucyinthesky · Oct 19, 2007

08grad - I know exactly how you feel. I've been able to hold a 3.9 GPA (I'll be done in May '08) but when it comes to clinicals I feel like a complete idiot sometimes. I am normally a very organized (to the point of being anal) person but have a difficult time 'pulling it all together' during clinicals. I have to remind myself constantly to be therapeutic to the patient and not just think about the tasks I have to complete. I seem to always forget something during my assessment and then have to go back in the room to finish it later. And when I go home it doesn't end either... I dwell on the day thinking "why didn't I do this or say that"... replaying everything I did. I feel very insecure about my skills and have been told this is normal and that I am progressing at a normal rate but it is just overwhelming at times. This semester we are actually only doing patient care two times (we have a lot of other rotations that are very helpful though) and this makes it quite difficult to be on the floor. In addition to the stress of having your instructor watch every move and already feeling insecure you only have two times to learn everything you need to at a hospital you have never been in and then you are moving on to another hospital. Sorry about the vent here... it has been a rough semester to say the least. I just keep telling myself (because this is what I'm told) that it will all come together some day.