lost in clinical.. confused about nursing school...:(

lunden · Nov 6, 2008

wow, i really hope u find out what is going on. def. try talking to the instructor, another student or somebody. it was a long road to get to where you're at, so open all your options. hope everything works out.

shrimpchips, LPN · Nov 6, 2008

What do the other students in your clinical group think? Are they experiencing similar problems?

I'm still in my first clinical rotation at a LTC. I don't particularly like the LTC but everyone has their likes and dislikes. For awhile I was in the "later" group so I really didn't do much...the girl who had my patient in the morning would pass meds and give my pt a bath/change her, so for awhile my experience was pretty boring and I wasn't learning anything. We finally switched to the earlier time so now I'm the one passing the meds and doing her AM care, which takes me awhile because my patient is comatose and I need like 4 people to help me roll her around and things like that. Maybe you can ask other students in your group to assist with things they might need help with? That's what has helped me (and other students in my group) - and it helps to get all of the experience you can get.

Good luck! :nurse:

whiteoleander5 · Nov 6, 2008

I'm in my first semester, still got 6 more weeks left with 4 clinical.
We already had 4 clinical.. and so far, I am still feeling very lost. I don't know what to do at all when I'm at clinical, I usually just went in, take vital morning vital sign, do physical assessment, give PO med., or just help the PCAs around if needed. I honestly have to say I didn't learn anything much at clinical, I don't know what am I doing there. I don't really know how to talk to my primary nurse, and my clinical instructor is very intimidating (most of us try to avoid talking to her if we could, cause she just make you feel so bad and that you are doing everything wrong). I feel like i'm only there on monday, to fill out the paper work, which is patient's vital sign, physical assessment, etc. so I could have something to turn in by the end of the day. I don't feel a connection with my patient, its really bad (and I feel guilty sometimes ), but sometimes i really feel I'm only there to finish "my work" instead of helping the patient to feel better.
How can I make my clinical experience better?? What do people do during clinical? do you constantly keep in touch with the primary nurse? like ask how is the patient doing? (does that make them feel annoyed, cuz sometimes I am really afraid talking to them I dont know why >
this whole clinical experience has been pretty negative for me so far, I don't even remember how many times I thought about quitting nursing school already. I spent almost 17 hrs doing careplan on 2 patient last week. and i dont even know if I learned anything from it . The instructor is not helpful. I really don't know what to do, I dont think i'm ready to move on to next semester at all!!! (which is at med. surge, my current floor is "oncology/respiratory") is what im feeling normal?
because I really feel worse each time going to clinical, because it seems like everyone's learning something new, and i'm stucked here and dont know how to move on! I feel so selfish too because I dont have much connection with my patient. =(
is nursing school just not for me.. is it normal what i'm feeling right now?
I really want to learn and to improve.....

Hey, I am in my first semester also, and I wanted you to know that you are not alone. I am completely intimidated by the nurses (...sometimes, they just dont seem like they want to help & like I am a bother, so I dont want to annoy them!) and like you, I am also a quiet person and shy around people I dont know. I still dont have that assertive quality but thats what I am hoping nursing school will help me with..

The only thing I have surprised myself with this semester is how much I truly do get attached to the patients I have... At first, I am probably shy when I introduce myself, but Im certainly improving, at least with the patients. And yeah, sometimes it can be awkward and I dont know what to say either... but you kinda learn as you go along. Ive only had 3 patients so far, but after the first day I feel a "bond" with them. I am actually quite surprised that my shyness hasnt prevented me from opening up to patients. There isnt one patient that you can say you've had any type of bond with? Not one patient that impacted you in someway? Maybe its because you're just nervous & afraid (of the other nurses & instructor) that you cant open up.... I think I would be the same way if my instructor was like yours. Having an intimidating clinical instructor certainly doesnt help your situation and is contributing to why you feel this way.

Every week I dread (and yet am excited) clinicals, but then after I get home from them, I realize "wow, that was pretty cool!" and that it wasnt as bad as I was thinking it would be.... I cant say its been a negative experience for me. Even when Im thinking "OH CRAP what do i do?", it all seems to work out... Sometimes I do feel lost. But its natural, i think. You just have to think of the progress you have made (I am sure you've made progress even if you disagree...)

Dont think that nursing school isn't for you just because of this. There are so many days when I say "*** am i doing?". But then something happens (usually at clinical...like when one of my patients says "Thank you" and is so elated that I helped them!) that reminds me why this is for me, even when I am lost, and confused, and discouraged...

I would recommend trying to form some bond with your patients, you'd be surprised how much it makes me feel less nervous at clinical...and I know you can do it, because I am one of the shyest people on the planet:p. Its not as hard as you think... Also, make a goal every week for something you want to try!.... (For example: Last week I focused on interviewing skills (we had a whole bunch of questions to ask them), and this week my main goal is to do a complete heart assessment.. It gives me something to focus on, so I can feel like I am learning something!)

Please dont feel discouraged. Let me know how it goes. :redpinkhe

HouTx, BSN, MSN, EdD · Nov 6, 2008

Miniangel,

IMHO, You are working with the WRONG primary nurse! It's her/his job to not only help you understand the clinical environment, but also to begin to socialize you into nursing profession. Sounds like it just isn't working. Can you request another nurse to work with? Maybe a newer nurse who still remembers what it was like to be a student.

One of the weirdest things about nursing is the fact that we are one of only 2 professions that are expected to establish fairly intimate relations with total strangers - including frequently seeing them without clothes on in the middle of the night. I'll let your imagination determine what the other profession is :rolleyes:

I remember how much of a shock it was to me to realize that patients did not mind telling me all this 'stuff' - in fact, they gladly went into detail with more than I wanted to know. And they trusted me implicitly to do whatever I needed to do .... because I was THE NURSE.

Nurses stand alone among all the 'white coats' because we are the most in touch with the patient's experience. Our scope of practice focuses on understanding the person's reaction to illness and engaging in interventions that help them to heal, physically, mentally, and spiritually. Learn how to 'center' yourself in each patient encounter by taking the time to see them as a human being rather than a patient.

Try this - with each patient, talk to them or their family members to find out how they feel about being sick. How does it compare to any previous illnesses? What do they know about their current illness? What is bothering them the most? Do they understand the meds they are being given? What do they understand about follow-up care? Mobility restrictions? dressing changes? This will not overstep any bounds - and your patients will be sooooo glad that someone is interested in them as a person.

eyeball · Nov 6, 2008

Hey! Ist of all, don't give up on Nursing School. It's hard to tell from your post just why clinicals aren't clicking for you. My first piece of advice is to figure out why. Ist: Sounds like you have the misfortune of a poor clinical instructor and boy would that stink for a first time clinical experience. Figure out what is in your control about this situation. Is the chemistry of your clinical group supportive to each of you or could it be better? Are you having a tough time being around sick people? You mentioned not bonding with your patients because you're shy and you don't know how to cheer them up.

Several thoughts:

Your job isn't to "cheer up" your cancer patients or any patients for that matter. Your job is to use whatever interventions you can to support your patients and offer therapeutic care as they confront life-threatening illness. This can be as simple as being a therapeutic listener/communicator. My sense is that there's plenty for you to do for your patients beyond the baths,bed change, feed, meds. Shy people can be great listeners and my guess is that your patients would be grateful to have you to listen and help them process their experience.

I totally get your trepidation about the floor nurses. The floor nurses at my clinicals seem pretty unenthused about having us there. Some are just not gonna deal with me any more than they have to but I try to size up one who's just a little more willing and I follow her as she performs skills I don't perform yet. I just say :"Is it ok if I watch you give insulin?" or whatever. I do the same thing with PT people, vascular nurses, MDs etc. I just go in and ask "Can I watch" or "Can I listen while you talk to my patient?" They are always fine with it and some realize I'm eager to learn and they do a lot of teaching.Another option is to go to clinical mates and ask if they need help with anything. My group does that a lot!

Hopefully your instructor is making sure you get to see interesting procedures/stuff. My instructor regularly calls us to come see new things we haven't done/seen yet. This is an area out of your control, I realize but perhaps you could let your instructor know you want to see whatever you can see that's interesting.

Sounds like you might have to stretch beyond your comfort zone to break out of this cycle. You are shy but even shy people can be assertive. Remember, this is your education. You've worked for it, your paying for it. You really are entitled to a decent educational experience! If you really want to be a nurse, remind yourself of that every time you hit an obstacle. It will help you push through. Good luck to you!

KateyAyn · Nov 7, 2008

I am in my first semester too. I have a pretty intimidating instructor, I think anyway, but no matter how intimidating you have to TALK to them. ASK questions. Because if you don't ask you won't get answers. I'm a CNA and we've been doing basic care that's it!! And I am asking questions, she's probably wondering why I am a CNA. But she may be annoyed at the simple fact that you are not asking questions. Let them know that things aren't clicking, depending on how long they've been teaching they probably know how to fix it. Hope that helps.

Nurse 2009 · Nov 7, 2008

i'm in my first semester, still got 6 more weeks left with 4 clinical.

we already had 4 clinical.. and so far, i am still feeling very lost. i don't know what to do at all when i'm at clinical, i usually just went in, take vital morning vital sign, do physical assessment, give po med., or just help the pcas around if needed. i honestly have to say i didn't learn anything much at clinical, i don't know what am i doing there. i don't really know how to talk to my primary nurse, and my clinical instructor is very intimidating (most of us try to avoid talking to her if we could, cause she just make you feel so bad and that you are doing everything wrong). i feel like i'm only there on monday, to fill out the paper work, which is patient's vital sign, physical assessment, etc. so i could have something to turn in by the end of the day. i don't feel a connection with my patient, its really bad (and i feel guilty sometimes ), but sometimes i really feel i'm only there to finish "my work" instead of helping the patient to feel better.

how can i make my clinical experience better?? what do people do during clinical? do you constantly keep in touch with the primary nurse? like ask how is the patient doing? (does that make them feel annoyed, cuz sometimes i am really afraid talking to them i dont know why >

this whole clinical experience has been pretty negative for me so far, i don't even remember how many times i thought about quitting nursing school already. i spent almost 17 hrs doing careplan on 2 patient last week. and i dont even know if i learned anything from it . the instructor is not helpful. i really don't know what to do, i dont think i'm ready to move on to next semester at all!!! (which is at med. surge, my current floor is "oncology/respiratory") is what im feeling normal?

because i really feel worse each time going to clinical, because it seems like everyone's learning something new, and i'm stucked here and dont know how to move on! i feel so selfish too because i dont have much connection with my patient. =(

is nursing school just not for me.. is it normal what i'm feeling right now?

i really want to learn and to improve.....

i am currently in my last semester of nursing school with only 4 weeks left. i remember my first semester, kinda feeling the same way. my clinical instructor was so smart and i was so scared but you really have to be confident and ask questions. they are there to help. our instructor would get patient assignments the previous day and list their meds, any procedures we would need to do and what not. we would do a pre clinical paper on our patients and i really thought that helped for me to understand. the first thing i do when i go into clinical is get report from the nurse or look at shift report. i also try to make sure i print out all the labs or look in the chart for labs, h&p, and know the meds that i will be giving, any implications to giving the med any labs i need to know for the med (lasix, you need to know potassium). i also find it easier to remain in full communication with the nurse throughout the day that way giving a report off is easier. i also try to chart as my day goes so i don't have to play catch up by the end of clinical. it will get easier as you go. you will formulate ways of doing things your own way. you also have to remember every clinical instructor is different. be confident hang in there.

avahnel, ASN, RN · Nov 7, 2008

I am in my first semester also and I understand the "lost" feeling. I have had some patients that are so easy to care for, and others that it is hard to get a conection with. I like to stay busy, and our clinical instructor helps us with that, by making us do all hygiene, and feeding of our pts even though we are passing meds. In our program, we have to have lots of specific pt info though and it is good to have the time to get to know our pts. I find it is easy to chat away and learn tons about my patient durring thier bath/linen change. I often do my charting in the pts room also. I can talk to them while I am charting thier assessment/daily care sheet ect while still spending time with them. (That also keeps me out of the hallways and away from the nurses station where my CI can think I do not have anything to do) We get assigned a different head nurse every week, so it is the luck of the draw if you get someone who likes students or not, but I have found that even the gruff nurses will still answer my questions if I have confidence, and dont seem like I am nervous. All that said, I have clinicals in the morning, and will wake up at 5:30, and my first thought will be "I dont want to go to work today" lol !!!!!! Clinicals is hard, it is a lot of work I come home exhausted, mentally and physically. I keep telling myself "This is temporary" I think next semester wil be easier.

locolorenzo22, BSN, RN · Nov 7, 2008

Let me be honest. Students for a primary nurse are a lot of extra work unless you know exactly what's going on. We are having issues with current students who are telling staff nurses what's going on, but things are not being done. They stand around, they don't communicate, etc....BUT I do remember my 1st semester...and I remember standing around a lot. We usually had 1 patient a piece, but after doing meds and VS....if your patient didn't want to talk....why should I force them? I would spend a lot of time just seeing if others needed help.

Honestly, I felt like I didn't spend a lot of time talking to my patients...mainly because I was just a "student"...

Now that I am the nurse, there are questions, concerns, discussions, etc.....that patients want to ask me about. They trust that I know what I'm saying or I'll find a answer. I make a better connection now, honestly....It takes time to find your niche. Just be there and meet their needs...not everyone needs a chipper nurse.

neongirl · Nov 7, 2008

Nurse 2009 is right .. HANG IN THERE!!

Clinical can be confusing and overwhelming at first. I think i spent the first few weeks trying remember where things were kept. As you progress you will build on ALL the things that take up your whole morning now.

Writing care plans and using NANDA is right up there with learning a new language.. you will get faster at it.. becasue you will start to know what to look for. Things will start to come together, a bigger picture will be there eventually. Sit with your patients ( now is the time to do it- you actually have the time) ask them how they got to this point. The H&P can tell you alot, but Ex: denies alcohol use, denies tobacco use. HMM?? then why does patient x have we'll say.. hepatic CA.. oh well he quit both four years ago when he had a lobe of his lung removed...

Most patients LOVE students and most people LOVE to talk about them selves.

get your nose in there, if you hear in report that the guy in 18 has a peg tube even if he's not yours ask the LPN if you can watch his feeding or his med pass....or if someone had a wound vac dressing change.. ask if you can watch and have then find you before they do it..opprotunities woun't come beat your door down.. speak up.. tell your instructor what interests you.. if you don't other students will.

kcochrane · Nov 9, 2008

I hated clinicals in LPN school, but I love being a LPN. I don't care much for clinicals for RN school, but they are a bit better since I am a LPN. So don't judge your love or hate of clinicals on how you will like being a nurse. It is much different when you get to orientation and get on your own. I find some instructors are better than others in letting you know what you are expected to do or learn. So just do your best, learn what you can from each clinical and get through it. I think as time goes by you will build more confidence and find ways to keep yourself busy. Good luck!