In my ADN program we were on a tiered system for our clinical. By the fourth semester I had five patients with my co-assigned nurse and I could complete tasks independently of my instructor (except med pass) as long as I had already been signed off. For example, I had been signed off on Foley insertion so if my patient needed a Foley I could find another student to do the two person safe insertion checklist without my coassigned nurse or instructor. Usually, though, the nurses were happy to be in there because we were still saving them time by doing the intervention, they were there for the safe checklist and moral/technical support. We functioned more as PCTs, taking care of vitals and patient needs like assisting with toileting, washing, etc. But we were responsible for knowing the pathophysiology of what's going on and the medications and treatment plan. By the time we finished our community college program, we were mostly prepared to hit the ground running in a new grad residency or nursing orientation. Our community college program is known for putting out nurses that can quickly transition to the floor because we have some experience with time management of multiple patient assignments. Granted, in the semester we probably only passed meds on five patients 2-3 times because there was only one instructor with eight students.
In my current NP program I'm working with a hospitalist. After one day of a shadow-type experience, the routine has become that I see a patient first and then write up my full HPI, assessment and plan. My preceptor does the same and we compare at the end. The only part I don't do is enter the orders and note into the computer, but I'm pretty well versed in that particular computer system so I'm not too worried about that part. There are not many interventions being performed by the hospitalists in my hospital, so I'm not doing much skill stuff, but I'm focusing on assessment, documentation and coming up with a treatment. It's been a great experience so far.