Nursing Home Clinical

Daytonite, BSN, RN · Feb 11, 2006

You will never learn anything unless you dig in and do it. It was good you asked your instructor first, but she assessed your situation and I would say that she delegated the task to another student. Both of you students together should have been able to handle this situation. Your instructor has taken hundreds of patients to the bathroom. Now, you have taken one. :yelclap: How else do you think you are going to get experience? Just how hard was it to walk this lady to the bathroom? What did you learn from the experience (besides being miffed at your instructor)? Would you do it differently the next time? What will you do the same the next time? Or, did you two do a perfect job of it? This is the way you need to be thinking about all your clinical experiences because you are there to learn. I think you are just really nervous and overdramatizing a little. There are going to be lots of times in your future nursing career when, as a licensed RN, you will be doing something for the first time. Then, who's gonna hold your hand? Take a chill pill. Pat yourself on the back for doing some actual hands on nursing care today! A year from now you will look back at this and see this whole thing a lot differently than you are seeing it today. :nurse:

CoffeeRTC, BSN, RN · Feb 11, 2006

You do have to learn how to do these things, but did you know how this lady went to the Bathroom...like how she transfered? Was that the issue? Or was is just that you weren't feeling confident?

MIA-RN1, RN · Feb 11, 2006

The instructors also want to encourage teamwork with the students too. And I always had the feeling that we really needed to learn the CNA aspects of the job--basics like toileting, bathing etc--in order to be a better nurse and have good delegation skills down the line. ITs important to understand all the aspects of nursing and your instructor probably wanted to be sure that you get all the experiences you can get. Use it as a learning experience.

I vivdly remember sweating and panicking when I had to do my first few transfers and assists etc. Myself and another student would have to spend time just thinking out the logistics of moving the pt from point A to B but it was well worth it since now it comes as (almost) second nature. This experience will help you down the line and like the other poster said, you will look at it differently later on.

sydylo · Feb 12, 2006

We just started clinicals and after being shown how to do bedbaths for one time on a dummy, just were told to do it by ourselves. I am not asking for someone to hold my hand, but a little assistance and guidance the first time would have been great to make sure I was doing it right.

Daytonite, BSN, RN · Feb 12, 2006

Part of your nursing education is self-analysis. You have to do procedures on patients and then self-analyze how you did. What did you do right? What did you forget to do? What will you do differently the next time? You should be asking yourself these kinds of self analysis questions all the time all through your clinical experiences. This is how you grow and improve. You will never learn anything if you stand back and watch someone else. Yes, it would be nice to have someone kind of "hold your hand" to support you emotionally while you do your first "anything" in clinical. And, for some procedures that will happen. But, not necessarily for all of them. Even as a nurse of 30 years I am sometimes faced with having to do a new procedure on a patient that I've never done before. I review the procedure. Reach into my nursing mind and connect with the principles of nursing that I know and I do it. This kind of autonomy comes with time and experience. The way you get that experience is by getting your hands in there and "doing it". There were many times as a student that I wish I could have shrunk away or wanted my instructor right by my side. As I look back, I know that had I been allowed to have my way, my learning would have taken much longer. No one expects you to be an expert or perfect your first time out of the starting block. You are just expected to do it, analyze what you did, and make improvements as you continue onward. Think back to what it took to learn how to ride a bike or roller skate. It's the same thing. A few falls or close calls here and there, but without them you never would have learned these skills. The same thing applies to nursing.

michellebsn · Feb 12, 2006

I am in my 2nd level clinical for BSN. This semester we have med-surg and gerontology.i know there will be things i haven't done except in dry lab. Other i haven't since general med-surg in concepts and practices a year ago i need to remember or get used to again.You will too! i think the instrucutors know we are not going to be perfect the first few times out as it is a learning experience.This is also where they expect critical thinking and reasoning,. even in the bathroom situation.. i am scared and nervous about my rotations but mainly cause while blood etc doesnt bother me( EMT and ER tech experience) feces do. we all get over it thoough and we all get a comfort level as procedures become familiar. good luck! :nurse: :coollook:

RNSuzq1, RN · Feb 12, 2006

Hi lilmrsnurse, During our 1st semester we also had clinicals at a longterm care facility and as soon as the NA's heard there would be Nursing Students on the floor that day - they all vanished. We only asked our Instructors for help with new procedures, but things like getting patients to the bathroom, turning, etc. - it's best to ask your classmates for help or an NA if you can find one. You'll find that at a regular hospital, the CNA's are much more available.

The first couple of semesters, it's really important to get lots of practice with those basic skills - I should have my Masters Degree in bed baths and bed making I've done so many of both... :chuckle When we only had 1 or 2 patients to care for, our Instructors told the NA's that we'd be doing "total care". Now that we're in the last semester and have several patients - we're assigned an NA to give baths, change linens, vitals, etc., so we can focus on our RN responsibilities (not that any Nurse is ever above wiping someones bottom - you do what you have to do for the patient)...

My best suggestion to you is - if possible, get a part-time job as a CNA in the hospital you do your clinicals. More than half my class have been CNA's for the last year and it's the best thing we could have done. Clinicals can be very intimidating, but if you already work there, know the staff, know where everything is - it's much nicer. Plus, as an NA - you will get tons of experience taking patients to the bathroom, starting and emptying foleys, emptying drains, turning patients, changing beds with immobile people in them, documentation, on and on (all without an Instructor hovering over watching your every move and grading your performance). Our Instructors even mentioned how much experience and confidence we'd gain doing this job without them on top of us - they've been there and know all about it.

All of the Nurses I work with know I'm a student and everytime they're doing a procedure, they let me watch and help. I've been able to help with procedures that I've never seen in clinicals and have gained so much experience in this job, can't tell you how much it's helped out with clinicals. Just think, you might learn some things on the job that your classmates don't know how to do and be able to help them in clinicals - won't you feel "Smart"!!!! I also work with a few of my classmates, so when we get a break at work, we do a bit of studying together. Doing this job, you will also have some respect for the NA's that you'll be in charge of once you become an RN... Hope this helps.

lilmrsnurse · Feb 12, 2006

You do have to learn how to do these things, but did you know how this lady went to the Bathroom...like how she transfered? Was that the issue? Or was is just that you weren't feeling confident?

I knew that whe was supposed to be moved with a gait belt and wheeled walker 30 ft., but that day she told me that she couldn't walk and could barely hold a conversation as she is terminal