MN_NursingStudent

I enjoyed my psych rotation, and I actually would consider working on a psych floor. Several of my classmates really liked it as well. Very few truly disliked it. I'm sure it varies depending on the hospital and group of clients, but I liked it because it's a bit more laid-back than med-surg, and you generally have time to talk with lots of the clients there, which is fun (at least, for me). If you like the more "human" side of nursing, as opposed to the technical side, you'll like psych. It's important to remember that mental illness does not discriminate, and affects people of all walks of life, socioeconomic class, education level, age, etc. Treat the clients with respect and remember they're more like you than you may think. Don't be afraid. Use common sense. Hopefully your instructors have taught you appropriate communication techniques for mental health clients. Some nursing diagnoses I used were self-care deficit, anxiety, impaired social interaction, social isolation, and disturbed thought processes. The appropriateness of the diagnoses of course depends on the patient and their main diagnosis. Good luck!

Thanks Emily USFRN! That cleared up all my questions. I will definitely get that book too.

Good point... I assume I would clamp the primary tubing and unclamp the secondary tubing. I just want to make sure I do everything exactly right - my clinical instructor has gotten very upset at students in front of their patients if they do not know exactly how to do something, so I want to avoid anything like that if at all possible.

Thanks! It doesn't sound too bad, I think I'll just need practice. Just for further clarification - So if I was removing an empty secondary bag, would I flush the line with that empty bag, still attached remove that, and spike the new secondary bag, and I'm all set? Oh and would both the primary tubing and secondary tubing clamps be open?

Help! I start clinicals very soon and am trying to remember the procedure for backflushing secondary IV tubing! Do I lower the old/empty IVPB bag, and let the primary fluid run into it, then remove the old bag and attach the new IVPB med, prime, and set the pump (and lower the primary IV bag)? Are both primary and secondary clamps open or closed during the flushing? As long as the old and new IVPB meds are compatible, is backflushing always safe? Thanks so much for any help! :uhoh21:

Technically, the information doesn't need to be memorized for the entire day, however we need to know it if we are asked a question. We will be quizzed on the bulk of things before we even get on the floor, so we have to get there early anyways. We do get to take the MAR bedside (we have to, to do our 3rd check), and we are supposed to make drug cards with all the details on the drug and bring them along. We need to have copies of our care plans as well. The instructor may or may not check our cards and documents, but we need to have them. However, we can't refer to them while we are verbally quizzed. I am thinking it's going to be impossible time-wise for the instructor to quiz every person in the clinical group (there will be 8 there at a time) about every single drug our client is on (even those we will not be administering), in addition to the information about our 2 patients (medical dx, relevant history, labs), and our care plans for each of them, BEFORE we even get on the floor. So, I think I will focus much more on the drugs I will be administering, plus any other significant drugs I may see effects from during my time there, or that are important or unique to the patients' condition. The patients' other general information isn't too difficult for me to remember, thank goodness. I am really curious to see how the first clinical goes (next week). Next Monday, I am going to talk with some of my classmates that have clinicals with the same person this week and find out how things went. Hopefully I get assigned to some great, fun patients as I did last year, and will at least enjoy my time spent with them! That's the best part about nursing, for me.

Thanks everyone for your advice and comments! It feels good to know that what I am up against is as crazy as it seems to me. Someone mentioned that my instructor may just want to see how we react under stress. I've heard that is part of the reason she reacts so harshly if a student doesn't know something. All the information I've been told is from students who have had this person as recently as last year. Supposedly, if there is an issue in the patient's room, we are supposed to keep our cool and ask to take the conversation outside of the room because it's unprofessional to carry on in front of the patient. At that point, she backs down. I know this person has a wealth of knowledge and experience, and hope to learn a lot from her, if possible. As long as my care plans are good, that's what really matters as far as grades go. We get a clinical evaluation at the end, but all our points come from the care plans.

I agree! While it's important to know about medications and labs, it is more important to concentrate on the patients' diseases and the interventions I will be doing. There is only so much a person can do in such a short period of time. I wouldn't be so worried if there was more time to prepare than just one evening, or if there were just one patient instead of 2 or 3.

My instructor has been teaching for quite awhile, and I think this is the way she has always done things. I am sure students have complained, however it must not have been enough. I am hoping that the stories I have heard are more or less exceptions and not the rule when it comes to this person! I know this teacher wants her students to recognize the seriousness of giving medication and providing other care, which is definitely important. I am well aware of the crucial details of the job, which is a big part of why I get nervous regardless of the instructor. I am extremely conscientious when working with patients, and I am hoping this teacher realizes how seriously I take clinicals and we can at least have a decent relationship.

I'm a 2nd year AD student, and for our clinicals, our instructor requires us to have our patients (2 or sometimes 3) MARs memorized, in addition to memorization of the patients' pertinent medical history and lab values. For each drug the patient is on (doesn't matter if we'll be giving it or not) we need to be able to recite to her the morning of clinical: Drug name, class, what it does, why is the patient receiving the drug, and all major side effects. This could potentially mean dozens of drugs to memorize. We also have to know all our patient's lab values (esp. pertinent ones), if the value is high/low/normal, and what that means for that patient and their disease process. All of this information must be recited to the instructor without looking at any of our papers, and after obtaining the patient information the previous evening. Granted, the patient will hopefully be on at least a few drugs I am familiar with, and explaining their history shouldn't be too bad. Labs are another story, but I'm going to start memorizing normal values for the major tests. This is in additional to care plans with 2 nursing diagnoses for each patient, which we have to also verbally summarize to our instructor. I am going crazy about this, not only because of the work required the night before clinical, but because the instructor I have has a reputation for being incredibly tough and making students cry by severely reprimanding them in front of their patients. Is anyone else here required to do similar things to prepare for clinical? Am I thinking this is harder than it sounds? This is so much more extreme than my clinical demands were last year, I'm having a hard time keeping a positive attitude while thinking about the demands and behavior of my instructor.