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My 3rd day of clinicals for the LPN program! Does it get better?


We have to start as an CNA in a nursing home and do everything a CNA has to do. My 3rd day was the 1st day we got our own patients. We were partner with another student and then I helped her with her patient and she helped me with mine.

First time I had to do vital signs on a patient and it was nerve wracking. I think my partner may have been getting frustrated with me but she had taking CNA courses in high school, so she was a little more skilled than I. I had the hardest time to finding brachial pulse. Is it harder on the elderly? Which made it harder to find the B/P.

Then bed baths and doing with a partner was just confusing, I wasn't getting what my partner was trying to do.....I'm thinking we should have changed his brief before the bathing process. I don't know. Plus for bed baths, wouldn't u use two basins? One with soapy water and another with clean water to rinse off?

I don't think I work well with partners but at the same time I needed help because I was so confusing and doing it with a real person, you don't want to make it more difficult on them. Plus turning them over, it's harder to do on a real person then it was in skills class...because these are elderly and some have fracture hips, or strokes one side....and trying to do all this and try to do it with some dignity for their sake....it's tough.

I know that I don't think I could be a CNA and especially for what they are paid

It's your 3rd day. Relax. It will be hectic but you will get there. When I was a student it took me weeks of practice to be able to get a blood pressure. If you don't have a BP cuff of your own I suggest getting an inexpensive one from CVS/Walmart/target and practice on family members until you get more comfortable.

Bed baths: depending on facility and cna. I usually use one large basin for soapy water and a smaller container/large cup for rinse, whatever is on hand. And I don't change brief before bathing but when I'm doing peri care (which I do at the end since it's the dirtiest) whatever you don't don't do peri care and use the same rag to wash the rest of the body, because that's just nasty (and improper infection control)

quiltynurse56, LPN, LVN

Specializes in LTC and Pediatrics. Has 3 years experience.

The more you do it, the easier it becomes. It is nerve-wracking doing cares on people those first times. Bed bathes generally go much easier with a partner too, especially if they need help with mobility. Practice with the BP's as the PP said. Also, go through the ADLs in your head before you do it. Think now what you could have done differently the next time you do a bed bath. Gather all the items before going into the room and set things out. Start with the face and work down, skip the peri area and do the legs and feet. I would use a clean cloth to wash the peri area and remember to wipe front to back on the women and use a clean area of the wash cloth each time you wipe there. Each section of the body, pat dry and cover them up so they stay warm.

Just keep reviewing the steps in your mind with the patients you are assisting. It WILL come.

Thanks, y'all! I think mostly nerves, nerves get the best of me. He had a BM is why I wonder if I should have done the brief first. I would for sure changed the water and get a new cloth after I did the peri care! Yeah, I think I'm going refresh myself on everything before Thursday and be more prepared. Try to get out of my head. It's nerve-wracking with having a pair of eyes watching you and seeing if you do something wrong! Yet, only got one warning so far (I wore my hair the wrong way) and only 4 more clinicals to go...so that's good!

Just trying to find that brachial pulse, I can find it on myself and on my mother but on the patients it's hard. It may be just my nerves.

Thanks again for the advice!

vintagemother, ADN, CNA, LVN, RN

Specializes in Med-Surg, Psych, Geri, LTC, Tele.

A tip about the brachial pulse...if u use a good stethoscope and cuff, or an automatic Dynamap, you will not have to find the brachial first. The cuff will find it!

When I was in school and they required us to find the brachial pulse, I practiced locating it on friends and family at home. This really helped!!

I too had trouble with the brachial pulse for a long time! I practiced finding it lots of times on willing friends and family :).

It will definitely get better :). You have to start somewhere, we were all there at one point. I know it's hard (and you will want to cry, or puke, or drop an anvil on your foot before you have to leave for clinical if you are anything like me) but these experiences will make you a better nurse. Hang in there :) You are probably doing better than you think you are! It's no easy thing to be a student nurse. Keep your head up and keep working hard, you will get there!

Okay, update. Good news, I past the first semester! Started 2nd semester this week and have our first Med Surge Clinical tomorrow! I'm still nervous as heck and still having problems with B/P. I practice at home and I can do it, but when I get to a clinicals and have to do it on patients, I can't seem to get it correctly. I know one reason is I am probably not getting the cuff tight enough and nerves. I think I'm scare to be too rough with the elderly.

So, tomorrow it will be at a different site at a hospital with a different instructor. So, there are three sites that our class is split up and go to with 3 different instructors and 2 are also our instructors for lecture. Let's say their names are Ms. A and Ms. B. I had Ms. A last semester and the only thing was she gave out warnings left and right. I got two written warnings. One was because my hair was pull back in a ponytail on my neck, which Ms.B who taught Orientation and had been teaching and doing Clinicals for 20 years said that was appropriate for Clinicals, apparently it wasn't appropriate for Ms. A. The 2nd time was my fault, I didn't get all my vital signs recorded because I didn't manage my time, well. I still ended the semester with a 100% in Clinicals...so that's good.

In lecture Ms. A is usually the laid back and Ms. B is very much for perfection, spell everything right on the test and do everything perfectly in skills test. Ms. B failed me and most of her group on bed making (Ms. A and Ms. B usually split us into two groups for skills test)! I had to first fold the sheets before making the bed and it was hard to fold them correctly and then it messed me up when trying to make the bed. I passed it the 2nd time....barely. Luckily Ms. A didn't really monitor me much with the bed making last semester and most of the ones I made were occupied, which we didn't learn that in skills.

Anywho, that clinical was for CNA or geriatrics as it's called, now we are doing actual nursing clinicals and I still had trouble with B/P by the end of last semester. I've practiced at home and would get it but when I get to the site, I just get nervous and I can't seem to get the cuff on tight enough, so I can't hear it. Gah, I was hoping it would become 2nd nature for me! Of course, Ms. B who has been there for 20 years, is going to the strict one, though the people who had her last year for clinicals, said she was really not hard on them, they were surprise. I just have this feeling that she will be a little harder for this clinical, since it's Med Surge....and she should be....no one wants to let incompetent people out into the medical field. I just don't want her to think I'm incompetent :(. I think it's nerves and not knowing what to expect. Ms. A said that through out clinicals we will still do, bed baths, brief changing, vitals, ect plus the other stuff for med surge, but in a hospital, we'll do bed baths? It's not long term, but I guess if they are bed bound but then they have all these wires attached...I just don't know.

I guess I'm just nervous. Anxiety gets the best of me and I hate it. During skills test, I get shaky...how am I going to be able to give my first shot, insert a catheter, and ect.? Should I invest in some anxiety meds? Sometimes our own mind is our worst enemy.

Sorry if this post is a bit random, lol. Wish me luck and pray for me if you pray. I need it!

Oh, and thanks for tips. Y'all!

Edited by SouthernBelle85

A tip about the brachial pulse...if u use a good stethoscope and cuff, or an automatic Dynamap, you will not have to find the brachial first. The cuff will find it!

When I was in school and they required us to find the brachial pulse, I practiced locating it on friends and family at home. This really helped!!

We use the stethoscope and cuff for B/P and someone told me that if u listen with the stethoscope while pumping the cuff, you'll hear it but I can't seem do it that way.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

Oh, and thanks for tips. Y'all!
Thanks for returning a couple of months later to provide us with an update of your progress. :)

PennyMT, LPN

Specializes in LPN. Has 6 years experience.

Southernbell, I am in the same boat as you. I am in the second semester of the LPN program and start clinical a few weeks ago. We are doing assessments. My problem is I feel useless up against the CNA's because they are running circles around me and are familiar with everything, as everything is new to me. Hang in there, this is all learning. Keep in mind that the teachers know this.

Question I receive the math package for the upcoming class LPN April 2016 class to study and convert medication . Does anyone find it hard to do help