Hailie54

Hey there! I recently took a brutal nursing research course so I am pretty familiar with PICOT. After my spending my first few papers agonizing over finding studies relevant to my PICOT questions, I learned that the easiest thing to do is to get a general idea of a topic you want to cover (in your case would be new grads and turn over rates/stress) and then search using those key words. Once I find a few strong articles that display any hint of a trend I form the PICOT question around those articles. I don't know what your professor demands as far as levels of evidence go, but it's difficult to find reliable studies that will cater to a very specific question such as yours. Hope this helps and good luck!

Fibroblast, I'm currently finishing up my junior year in a BSN program, so I don't have tons of experience but I have learned that if you want to make things easier for yourself in school, you have to adapt to your professors, both in clinical and in lecture. Some instructors are sweet as pie, others may be more sarcastic or rude. Like it or not, we are at their mercy as they are the person that is evaluating our clinical skills. Putting effort into assessing how each individual instructor likes things done will go a long way. If they want you to do injections a certain way that is different than you were initially taught, do it their way (obviously keeping safety as a priority, and don't ever do anything if you are questioning safety). If they make jokes often, make a few jokes back (tread lightly, keep it appropriate). If they're more serious, carry yourself in a more serious manner. These tactics will help establish a relationship with your instructor when you're having difficulty in this area. Adaption skills are crucial to becoming an effective nurse, especially when it comes to interacting with others. Especially in patient care, you constantly have to reassess and readjust to different patient's needs. If you start practicing this skill with professors, other students, nurses on the units, etc., you are putting yourself in a better position to be able to deliver patient-centered care in the long run. While some things may not seem fair in nursing school, focusing on negative experiences will ultimately make the already difficult process much more challenging. The further along you get, the easier it will be to let things roll off of your shoulder. It's a steep learning curve and just managing the day-to-day grind is exhausting without harping on negative experiences. I'm sure you'll find your way with this instructor and others, just keep your eye on the prize! Good luck in your program!

Sweetheart2005, (For some reason it's not letting my reply to your post, so sorry if this ends up in the wrong spot) You hit the nail right on the head with the emphasis on paperwork during clinicals. Last semester, (which was my first semester with clinicals) there was a HEAVY emphasis on paperwork. We had to complete a 12 page long care-plan on each patient and had a multitude of other assignments to complete throughout the semester. This left us little time to shadow a willing nurse or see each other's patients to learn about the different disease processes up close and personal. Mind you we weren't on the most student friendly unit, never received report from the nurses, and pretty much had to bully our way into assuming any kind of responsibility for our patient's (nursing) care, which may have also factored in to the heavy reliance on getting spots at the few computers available to students. This semester is the opposite, I get report from the nurse and aunt spend about 20 mins fishing around in my patients chart to get acquainted with their history, meds, and labs and then I am off caring for patients the rest of the day. The paperwork load has been reduced by a good 70% and I have learned SO much more this semester and feel such a relief to be able to fully engage in the clinical experience without having mounds of written assignments looming over my shoulder. I don't think care plans are a waste of time like some others do, but it's a major waste of time to spend half of the day getting kicked in and off of computers during valuable clinical time trying to get the info needed to complete them. Thanks for your input!

Thanks for the reply! One thing I am good at doing is knowing my limitations and asking for help, so hopefully that'll keep me out of some trouble as a new nurse, lol.

Hang in there Staci! You seem like you really have your hands full but you can get through it. My advice is to take it week by week, otherwise it can get very overwhelming. As far as BP goes, is there any specific problem your encountering? If you are worried about accuracy in general, it is always good to check the patient's chart to find out what their baseline is. Most of us enter the first clinical with only having practiced on other students/ family members with relatively normal values. In the clinical setting, you will see abnormal values often. You can always take it a second time on the opposite arm to test the accuracy (barring any issues that would make one side contraindicated for BP.) You can also try the two step BP, where you palpate the radial pulse when inflating the cuff and marking the number at which you stopped feeling the pulse. That number reflects the systolic (top) number and then you would deflate the cuff and add 30 to the systolic number when reinflating the cuff to auscultate BP like you normally would. This way, you have an idea of how much you need to inflate the cuff (30 mm hg above your palpated systolic number,) which then gives you time to listen to that first beat. In all honesty, you will be using an electronic cuff most of the time. With that being said, you don't want to stop practicing until you feel confident. If a patient takes a bad turn, getting the most accurate vitals becomes much more important and your instructor will expect you to be able to turn out accurate results. Don't ever be afraid to ask your instructor/nurses/fellow students for help and good luck!

Thank you for the response! It makes me feel better knowing that it isn't just my program. I enjoy my program and have great instructors that really care and want their students to succeed. Just wanted to get opinions on how nurses would weigh the value of clinical vs. theory hours when preparing to be an RN.

Hello Everyone! I am in my second semester of my junior year in a (highly praised) BSN program. My program is known for high NCLEX pass rates. I know it's important to be prepared for the NCLEX but I wanted to get some opinions on the importance of theory vs. clinical hours. Throughout the whole program (4 semesters), we only complete 12 weeks of clinicals per semester at 10 hours per week. So, we gain 120 hours of clinical experience each semester, which amounts to 480 hours of clinical experience in total upon graduation. As I will be half way done the program at the end of this semester, I am beginning to worry that we will graduate without even attempting yet being somewhat competent in basic skills that we will need to perform as a new nurse. I hear people graduating the program without ever inserting foleys, feeding tubes, etc. Is this lack of clinical preparation a common thing? I feel like the program is so concerned with NCLEX pass rates that they ignore the clinical portion. In all honesty, I believe that this intense focus on theory and testing will be detrimental to both to us as new nurses, and the patients that have to take their chances with someone who has barely gotten their feet wet in Nursing. I would love to hear others' opinions on the matter, perhaps this is normal or I am not seeing the full picture? Thank you in advance to all who reply!