Published Mar 19, 2004
I need some suggestions. We do not get the luxury of having time to review are patient charts prior to being assigned to our patients. Essentially we show up 1/2 hour early with our instructor and he assigns the patients to us. My last clinical instructor gave us patient history/dx/meds the night before so we were able to really put a lot of research into our daily planning for the patient. This other way really has me frustrated because literally we are off running the minute we get there. We are not allowed to go in early as the instructor won't, therefore, it kinda leaves us (the group)feeling ill prepared alot of times, and frankly, causes anxiety the night before clinical. The instructor said that this is what happens in real life, that in real situations you might not get time to look up patient information, especially when you have 4 or 5 patients that you have never seen. I feel that in some ways this is a real disadvantage for the students. Many time I have looked up info the night I get home from the hospital on my patient only to find out the next morning the patient has been switched. I've bought a pocket size Med/Surg book which is ok, but I still don't have my drug books (the ones on the ward are old and falling apart), or my other nursing books that I usually refer to. Does anyone have any advice how I get more prepared in this type of situation?
We must go to the hospital the evening before and start our careplans, otherwise we cannot care for the patient if we do not have it mapped out. In your case I would probably go to the primary nurse that is in charge of that patient and get report first. I can see where that would be tough Good luck.
We take our own drug books with us to clinical. I have a clip board that has an area that is underneath to store this book along with my papers. As far as being organized, or preparing you cant in the real world, so basically when you get there, after report, go to each pt's chart after vitals or if a cna does them let her/him, and go look up the h&p and dr's orders, then go about your assessment, or if you have no time look after your assessment. You usually have a couple hours before the majority of the meds need to be given, and baths are not until after breakfast. Also if your pt can help themselves it is ok to set them up to bathe themselves and tell them if they need help you can come back and assist in areas they cant get to. From what I have learned, each patient and bath or other duties will not be on time all the time. If your running behind on patient care then ask for assistance or tell your nurse, or aid so. Prioritize your patients needs, and get the meds on time. Get help from the aids or other students if you can, or the nurse. If you have down time help other students, aids, or nurses, they usually will return the favor.
Good luck !!
I know at times it seems the day will never end. But it does.
I think this is a pretty common scenario. We don't get to really read the charts either until we have some free time later on in the shift. We get our assignment from the instructor, look at the cardex for our pt. at the nurse's station which pretty much hits the hot spots on what we need to know to get started (age, diagnosis, diet, how they ambulate, tests/ labs, one touches, etc.). Then we can meander over to the medication book on the med cart in the hallway and glance over what meds they're on and note if any IV's are in the future, etc. And of course, if you listen to report from the change in shift, you can get quite a bit of info from that too. So just gather up what you can to get things rolling and you'll do fine.
VivaLasViejas, ASN, RN
This is actually great preparation for real-life nursing, where you have about 15 minutes to gather all your info on your six patients for the shift. :)
When I was in school, however, we didn't get thrown to the wolves like this until our last term, by which time we were all so sick of writing care plans for pts who inevitably had been discharged the night before clinical, that we relished jumping in there without 3 hours of prep work. Now sometimes I wish I had the luxury of reading over an entire chart and making notes before trying to care for someone with multiple medical/psychosocial issues...........
Cardex is a great suggestion! I totally forgot about it, usually the unit clerk has it in her hot little possession and in front of her. One primary did point it out to me a couple of weeks ago, but it totally slipped my mind. Thanks for the suggestion!
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