LPN Clinical Experiences

TheCommuter, BSN, RN · Feb 22, 2007

Hi, there! I'm sorry you're not getting much out of your clinical rotations.

Unfortunately, my clinical rotations were quite similar. The vast majority of your skills will be learned on the job when you already possess a license and are employed. Many new grads are not prepared for the workforce, but good coworkers will bestow their experiences upon you and teach you the skills as the need for them arises.

The first quarter of my LVN program emphasized CNA skills such as bed baths, transfers, toileting, and feedings. The second quarter involved med passes, ostomy care, blood sugars, injections, tracheostomy care, a rotation in the ER, and other assorted skills. The third quarter included suture removal, med pass, wound care, wound drains, and other med-surg skills. The fourth quarter involved observing childbirth in the L&D department, postpartum, newborn nursery, the teen clinics, and the NICU.

Overall, I really learned nothing in clinicals. 95 percent of my learning has taken place on the job with the help of coworkers who can show me the ropes. Good luck!

Rainscape · Feb 22, 2007

Thank you...that is really encouraging

pagandeva2000, LPN · Feb 22, 2007

Would some of the LPN nursing students mind sharing their clinical experiences?
The school I attend seems to focus so much on the nurses aide portion. I have nothing against nursing assistants or the work required (and no, I don't think I am too good). However, I am not going to school to become a nursing assistant. It is just that even if an opportunity came up for me to learn something I am too wrapped up in caring for my patient to leave him/her. I have been in clinicals for several months and I have only passed meds (with supervision), a couple of finger sticks, one shot and suctioned a tracheostomy. Is this usual? Am I expecting too much?
I am just worried that once I am finished with school that I won't be prepared.
Thanks

Sorry to say it, but most of us are not really prepared for the real world when we graduate. What semester are you in? Because the first one is usually the nursing assistant portion. What is unfortunate is that the student is working under the license of the clinical instructor. In other words, if you screw up, SHE is held liable. This is one of the reasons why many instructors give strict orders not to do anything without their permission or their knowledge (there are lazy instructors, also, though). Most of my clinical instructors did not make a big deal about us doing much more than nursing assistant work, however, they expected us to provide nursing answers to the questions they asked, such as the medication side effects, disease process and nursing intervention. IN FACT, some of my clinical instructors were so lazy that we used to leave to go home three hours after we got there, or sometimes, they would designate a student to call everyone to cancel!! I came to work as an LPN dumber than dumb...believe me...and I just got my license last June. I am still learning and I still feel a bit unprepared. But, what I do is draw on what I have retained, use a bit of common sense, and if I am not sure, I MAKE SURE that I tell the RN. I'd rather look dumb than harm someone.

What I am learning is that it really takes time. Let me make you laugh a minute. My head nurse told us that if a person has difficulty breathing and you hear wheezing, to give them 2 liters of oxygen with a nasal cannula and inform the physician ( I work in a clinic). Three days later, a woman came in and had difficulty breathing. She spoke Spanish, so, I had to get an interpeter while I was checking her chart. No history of asthma. But, I listen to her chest sounds, and I hear what appeared to be wheezing, so, I get the O-2 administer it, then I got another RN, who got the preceptor. Her pulse oximeter was 99%. The preceptor told me that she was not wheezing, that it wheezing happens when it is an whistling sound when the person is exhaling (I think....I STILL forget). I had to take away the oxygen and the patient got upset, because I think it was comforting to her to have it. All I can do is laugh at myself, and, now, I am looking for my CD ROMS to re-listen to chest sounds. My head nurse told me that she was proud of me because I didn't ignore the patient and I tried my best. This will happen to you, too. Best wishes... :nurse:

Jules A, MSN · Feb 22, 2007

It wasn't until about 1/2 way through my second semester that I felt like I really got to the meat and potatoes. All throughout we still were responsible for the personal care stuff which was a drag but when I spent a day in ICU the nurses there did everything for their two patients, no CNAs etc. so I had more of a respect for the whole thing. Hang in there and it will get more interesting and also more stressful as it goes along. Jules

postmortem_cowboy · Feb 23, 2007

Would some of the LPN nursing students mind sharing their clinical experiences?
The school I attend seems to focus so much on the nurses aide portion. I have nothing against nursing assistants or the work required (and no, I don't think I am too good). However, I am not going to school to become a nursing assistant. It is just that even if an opportunity came up for me to learn something I am too wrapped up in caring for my patient to leave him/her. I have been in clinicals for several months and I have only passed meds (with supervision), a couple of finger sticks, one shot and suctioned a tracheostomy. Is this usual? Am I expecting too much?
I am just worried that once I am finished with school that I won't be prepared.
Thanks

Be thankful that you aren't doing CNA work all the way through. In my vocational school, we had patient care up till the last half of the last quarter, we still had bed baths, we still had feedings, we still had toileting etc etc. It was my opinion that they wanted you to know a subordinates job and know it well, so that you can tell if they aren't doing their job properly and also, some units such as ICU do not have nursing assistants, you have full care of 2 patients by yourself as a nurse. So in that case you'd better know your basic skills and know them well.

I agree with the other posters, alot of what you learn in nursing school is helpful, but not how things are done in the real world. However, to pass boards, they teach what you need to know to pass them. You have to maintain confidence in what you know as a basis of learning, and go from there once your licensed and working. I learned way more on the job from other nurses that'd had alot more working knowledge than myself than I ever did in school. When I graduated nursing school i'd never given an IM injection, not one. The clinical sites I was at just didn't have them available to have students give. The first night on a M/S unit as a license I must have given at least 20. Seemed like everyone that night was post-op with demerol ordered for pain.

Keep your chin up, I know that it seems like your a glorified nursing assistant, and all of us have been there and done that. But it'll back down to a managable amount. Our instructors pushed us to the breaking point, by fourth term we had med pass on 2 patients with full care on 3-4 dependent on the students abilities, plus charting every single day on at least 2 patients, with head to toes for all 4. So it CAN be worse.

Wayne.

Butterflybee · Mar 11, 2007

Our experiences sound similar, i did do wound care though. This my last semester is maternal/pediatrics ..dont know what to expect there.To be honest, i became bored silly during medsurg clinicals. i appreciate what cowboy has said though....learning once you get on the job. Hey im starting to get excited all over again..yippee

tookewlandy · Mar 12, 2007

Im curious ,what part is the nurse aide portion??

vonsay · Mar 13, 2007

Well, I am in funds 1 and I have done only 1 clinical so far. And on that clinical we did trachs, woundcare, glucometers, gtubes, feedings, baths, and toileting. So I think it really depends on your instructor. My instructor was a fresh RN and I think that she still understood what it takes and what you need to know.

I totally understand knowing the CNA's job to the letter. A lot of LPN's direct CNA's and how can you direct someone if you dont know the job well? Besides, you can empathize with them if you understand the work load. I've never been a CNA and I'm beginning to understand what they go through.

raebabelvn, LVN · Mar 13, 2007

I'm 7 school days away from finishing my second term. My first clinical site was all about the CNA duties. Thats ALL we did. Now I'm in Med-Surg and we're expected to do all CNA duties and whatever else is asked of us... whether we're passing meds with supervision, wound care, remove staples, ect. I think that all throughout this program we're going to be expected to do CNA duties, which is fine I guess. The only thing I hate is that the CNA portion seems to be the main focus and not learning procedures and other LVN duties.

rannah12 · Mar 14, 2007

I am in my last semester of my LPN and we have finally gotten past the CNA work. I was thinking the same thing you are "am I training for a CNA or a LPN?" But it does get better and definitly more exciting I have done most of everything in our scope of practice at least once. Something I learned is that YOU have to jump in to get the oppurtunities otherwise the nurses assume you just want to watch so make sure you are vocal and say "can I do that" most nurses say of course others say why dont you watch and you can do it next time. But I learned the more vocal I am the more I get to do. I also realized that since we will be directing CNA's it would be good for us to know what were doing so we can teach them because they dont always know how to do everything correctly.Good luck things will get better.

tookewlandy · Mar 14, 2007

Those cna duties are LPn duies as well, they teach you those because you will be doing them and responsible for them just as much as CNA is