My first clinical course and I hate it

classicdame, MSN, EdD · Oct 23, 2012

I sure remember those days. You sound like me, wanting a list of what you can and cannot do. I recommend you consider this: Only DO what is in your objectives. Otherwise, your job is to keep the patient safe. You can be prepared for questions by asking questions of the nursing staff about your patient. Has he ever fallen? If he has any deficits (hearing, vision) ask how they are considered in his care. Talk to your classmates about what they intend to report. Once you gain some confidence this will all get better.

Morganalefey · Oct 23, 2012

I remember, when I was in nursing school, feeling the exact same way you do about clinical. I also didn't feel "legitimate," didn't feel I belonged there, and most of the nurses on the floor didn't do much to help with that.

My very last semester of nursing, school, in one of our last few weeks of clinical, I had a pt, a woman in her 40's or 50's who had CA and was trached as a result of it. She could only speak in whispers. The first thing I noticed, was her terribly depressed demeanor. She wasn't receptive to me At ALL. During AM care, she asked if she could have her hair washed. I found out, all they had on the floor were these dry wash shower caps. She didn't want that. I begged my clinical instructor to run to L&D and get a bottle of baby shampoo. She came back w/it, and I asked my pt nurse if another student and I could wash the pt hair. She was extremely hesitant of letting us use water b/c of the trach. I pleaded w/her, and promised we would be extremely careful, and she relented.

We were, or course, very careful while washing her hair, and the whole time she was nothing but smiles. We found out that she hadn't had her hair washed w/soap and water in over 2 weeks. When we were done, I had a whole different pt on my hands!! She was so happy...it felt so good to her to finally have clean hair. She was literally like a different person. She told the other student and I that we made her day by taking the time to do something so simple.

My point is, you may feel like you don't matter, but as a student, with one pt for 6 hours, you have the time that the nurses and aides on the floor don't have, to make a difference to someone who really needs it. It doesn't have to be something big, it really can be a very simple thing! So instead of trying to avoid your instructor, take the time to really get to know your pt, see what you can do to make their stay a little more comfortable. Remember, as much as you don't want to be there, they don't want to be there more!

No one really enjoys toileting or giving bed baths. It's just part of the job, and is a very important part of giving holistic care to a pt. Nursing isn't all about codes and traumas and adrenaline rush. In fact (thankfully) that is a very small part of it.

Last week I left work *grateful* that I had the time to rub my 90-something pt's back for 5 minutes. I truly wish I could do those things more often.

As far as not enjoying pre and post conference....it's really an important part of your learning experience. It is going to give you practice on what it's like to give report in the future, as well as helping you to see the bigger picture with your pt. You may also learn a lot from fellow students' experiences.

On that note, no one likes to be put on the spot, but it happens in nursing all the time. I may be in a room passing meds, or toileting when my phone rings and I hear: "Nurse Morgana, Dr. Cardiologist is hear and wants to speak w/you." I go see the Dr and he bombards me with 20 questions. Sometimes on a pt I haven't even had a chance to see yet!

I don't know if I helped you at all. You are certainly entitled to your feelings! I just hope I gave you a glimpse into what kind of an impact you can have as a student. As well as, help you understand how all the tedious things your instructor is making you do is actually going to make you a better nurse.

Best of luck to you!

JessiekRN · Oct 23, 2012

I remember feeling the same way as a student; invaluable because so much was happening around me that I did not yet fully grasp, and helpless because obviously the patients I saw needed care, but I was in no way prepared to give it or to understand what could even be involved. Add to that the feelings of anxiety and pressure that come with being a student and having your actions monitored and graded. Prior to clinicals, I had hardly set foot in a hospital before. My two best friends were in another group together, and I felt alone, initially. It's a tough environment. I know for myself what helped me get through was to sort of take my ego out of it. Yes- I'm a student, say to yourself, I'm here to learn, not to save lives, not yet at least, and no one expects me too. But you can, as the above poster mentioned, do what you can do- bring patients water, if its appropriate. Bring blankets. Of course you're not there to only do those things, but they are a part of nursing, patients will appreciate it. In the meantime, soak up as much as you can, watch the nurses, read charts if you are allowed, remember this is the price you have to pay to get where you really want to be. We all started out at the bottom. Is it fun? No. But nursing isn't always pleasant. Don't expect it to be. You're there to make the most of every minute. Talk to your patient- they might know more about medicine and interventions than you do at this point, if they have a long medical history. Work on your communication. Look at their medication list and their history and try to figure out the purpose of each medicine. Don't wait for opportunities to come to you in clinical. Instead jump on every chance there is to do something new or different, even if its not your patient. I know it sucks sometimes. Just keep the end in sight, it will come before you know it.

loriangel14, RN · Oct 23, 2012

Feeling like you don't know anything is normal.You are a student and you are still learning.Give it time and you will feel more comfortable.I didn't start to feel comfortable until my third placement.

Yes your instructor will be hanging around watching you,that's part of her job.Her role is to ensure that students are working in a safe manner and to supervise the care you are giving the patients.

You will have to realize that as a nurse providing personal care is part of the job. You will have to learn to deal with that. Even if you are working somewhere with aids you still will responsible for hands on care. If someone needs to go to the toilet or needs a soiled brief changed you will not be calling someone else to do it.The jobs that involve no patient contact require lots of bedside experience first.

AgentBeast, MSN, RN · Oct 23, 2012

Sort of normal for the begining. It get's better the more you learn and are able to encorporate into what you are doing in clinical.

gatoraims RN · Oct 23, 2012

It is totally normal. I however love post. conf. I am not sure how big your clinical group is, our is 12. I know most of those in my group from the prior semester. At first I turned bright red just because my name was called. Now I only turn bright red if I am caught off gaurd. Or I do not know the answer. The best thing you can do is take an educated guess or say I really have no idea. My first semester was full of I am not sure but think.... If I was wrong the instructor was very nice and would say good guess but I was looking for ..... Or if I was close but not totally correct or just not there yet they would say and... or lead me into what they were looking for.

It does get easier.

charli_appleRN · Oct 25, 2012

I was hating going to clinicals for a minute there too but for slightly different reasons. I used to be a nursing assistant so it wasnt the basic care that bothered me. It was the basic care for 1 (maybe 2) pts for 8 whole hours that was killing me......talk about a long boring night. Now had I had 15 pts to myself, I would have been busy and happy about it. There are 8 of us in my group and it took almost half the semester for me to get to do any skills. When my instructor finally got to me, I ended up doing skills the entire shift and it was AMAZING. I cant wait to go back next week...lol

rubato, ASN, RN · Oct 25, 2012

I think it's pretty normal. I am a complete extrovert, so the pre and post conference parts of the day are great for me, but I still feel kind of incompetent. Not like I did the first day, but yeah, I'm not nurse material yet. We have one very shy girl in our clinicals and I always feel so bad for her in conference. You can see that she's just dreading being called on. But, she's always super prepared and has all the right answers about her patient. It'll get better. And, just remember, everyone in your group is kind of like a little family. You're all going through the same thing. Ask for guidance and advice from your instructor as well as your peers.

Wrench Party · Oct 25, 2012

Don't worry....this seems pretty universal for a first clinical. You are in a new, unfamiliar environment, and probably will feel awkward and out of place until you get the hang of it. We must be cut from the same mold; I am also an introvert and being called on made me so nervous.

One thing that helped me was having a 'cheat sheet' (there are some floating around AN) that could be applied to our care plans.

Like...what are the meds, dosage, side effects, time given? Admitting dx (post op from appendectomy etc.), things you need to pay attention to (VS, I and O, IV sites, drainage sites, dressings, etc., trachs, etc.) the labs? patho? History? Orders? Nursing diagnoses? Interventions? Psychosocial issues? Being able to organize these the night before really helped me feel more confident, and answer questions directed at me, and plan my care.

For example, if I've got a post-op ortho patient with 0900 meds, VS q4h, turn q2h, I and O, IV fluids, and is due for PT at 1000, I know I can expect to get my VS, assessment and AM care done in one fell swoop so I can give meds at 0900 and he can make that appointment. I also need to think about charting ADLs, turns, status of IV site, those Is and Os, pain level, vitals, etc. in a timely manner.

Another very useful organizational aid is an hourly chart to write what I hope to accomplish:

0700 bedside report, breakfast

0800 bath, VS, assessment

0900 meds

etc.

lillymom · Oct 26, 2012

You are just beginning so they don't expect you to know much. The reason they ask questions and do the reports are to help you to think critically and be able to understand complex concepts. It is much easier for most people to understand things when they are directly working the issue.

I hate clinical. I have since I started and that will not change. I feel the same as you about not doing enough or doing too much. I work as a CNA in LTC so when they give me a pt and all I do is CNA work it irritates me but that is what I always expect clinical will be. I feel like a nuisance to the nurse and the patient. If I were sick in a hospital I would not want a student nurse to come and wake me up at 7:30 for assessment/bath,etc. just to turn around and have the nurse do the same but I still wouldn't refuse or say anything because it is important for them to learn.

I wouldn't mind any of this if I was a nurse because it is my job and it is expected of me by the patient as it is pertinent to their care. I don't mind it at my work for the same reasons. I just feel like I don't belong there and I doubt that will ever change. I also like to have a schedule so I don't feel so crazy.

I don't know anything about my pt. until my day begins so I usually listen to report with the nurse then I will look up their information in the chart. After I feel like I have all the information I need to properly assess and plan my day I go in and assess, only if the they are finished with breakfast though. I usually do a pretty through assessment just because it is good practice but I don't usually look at their backside until I do their bath. After my assessment I usually just write down the vitals and abnormal findings and then get ready for the med pass. I write down all their meds in my paper and what they are for or any special considerations about the meds so I can be properly educated when I give them. After that I leave them alone for a while to chart or do some paper work. I usually go back in around 10:30 and help them with a bath and such so they are clean and ready for lunch and then I go to lunch. The rest of the day really just depends on the pt. but most of the work is done by this time.

turnforthenurse, MSN, NP · Oct 26, 2012

It is normal but you will get used to it! I felt VERY awkward in the beginning and I never looked forward to those pre and post conferences because I hated talking in front of everyone lol...it was weird, I could talk in front of everyone just to talk but when I was put on the spot by my instructor, I would always get so nervous. It definitely gets better with time once you become more familiar with things.