Question About Clinicals

I am going to be entering into nursing school shortly and plan to go into either L&D or pediatrics. My question about clinicals is this: i am not a huge fan of LTC and was wondering what would be expected of me during clinicals for LTC? What exactly will i be doing?

Thanks for any imput,

Cheryl

mommy to 3 almost 4

[mitchsmom]

I think that really depends on your program - you'd get a better answer if you could ask someone at your school.

In our program, we did LTC for our fundamentals class (1st semester) and basically did assessments, CNA duties, and therapeutic communication practice & worksheets(didn't pass meds yet because they hadn't taken pharmacology yet).

[meownsmile, BSN, RN]

A lot of your clinical will revolve around daily care until you get farther into your program. Showers/baths, toileting, feeding, theraputic communication, vitals, bed changes.

I dont think it matters how you get there, we all have to go through the basic stuff before we get to what we think of as "the good stuff".

[cdietrich404]

A lot of your clinical will revolve around daily care until you get farther into your program. Showers/baths, toileting, feeding, theraputic communication, vitals, bed changes.

I dont think it matters how you get there, we all have to go through the basic stuff before we get to what we think of as "the good stuff".

So i will have to give old men showers and help them after they have gone to the bathroom? I dont know if i can do that. I really want to be a nurse but my gosh, the thought of having to do some of these things really makes me think that i am not cut out for this.

What do you think?

Cheryl

[christvs, DNP, RN, NP]

So i will have to give old men showers and help them after they have gone to the bathroom? I dont know if i can do that. I really want to be a nurse but my gosh, the thought of having to do some of these things really makes me think that i am not cut out for this.

What do you think?

Cheryl

Cheryl,

Hi! Helping with bathing and toileting are part of the job when you're in a LTC clinical. I think a lot of people think it feels weird or they don't look forward to it at first, but if you really want to be a nurse, I would try to tell yourself you're only in a nursing home clinical for a short time (one semester) and after that you'll be learning "more exciting" things! I did not love nursing homes either, but just got used to dealing with "unpleasant" things after a while. Now I graduated with my BSN and can work in med/surg which is what I really love! :) you can do it !

-Christine

[MIA-RN1, RN]

So i will have to give old men showers and help them after they have gone to the bathroom? I dont know if i can do that. I really want to be a nurse but my gosh, the thought of having to do some of these things really makes me think that i am not cut out for this.

What do you think?

Cheryl

I looked at it as a way to learn to really appreciate the jobs that the CNA"s have to do. I wasn't enthused about LTC either but I came out of there enriched in both knowledge and experience. I met some wonderful elders there and look at it now as a priveledge to have been there.

[RNsRWe, ASN, RN]

So i will have to give old men showers and help them after they have gone to the bathroom? I dont know if i can do that. I really want to be a nurse but my gosh, the thought of having to do some of these things really makes me think that i am not cut out for this.

What do you think?

Cheryl

Well, almost all of us got through it and went on to the next bit of coursework (remembering that you're ALWAYS going to have to deal with unpleasant bodily functions from time to time, no matter what semester you're in). I don't think any of us were looking forward to it, but some were more hesitant than others. Those who got past the "ickies" and were able to focus on helping a PERSON got through it fine. Those who couldn't look past the "ickies"....didn't.

Learn to focus on why you're there: helping the patients. And if that means toileting, well, that's what it means. My second day of clinical in my first semester I had a woman who was able to get to a bedside commode, used it, and then when transferring back to bed "let loose". So I'd clean her up (with help, we were all new!) and 10 minutes later, she'd need the commode again. Repeat procedure. Repeat messy cleanup.

Focus....focus :)

[student_girl]

So i will have to give old men showers and help them after they have gone to the bathroom? I dont know if i can do that. I really want to be a nurse but my gosh, the thought of having to do some of these things really makes me think that i am not cut out for this.

What do you think?

Cheryl

The firsts are the worst: First naked man, first adult diaper, etc...it gets easier after. Not being cut out for LTC doesn't mean not being cut out for nursing or L&D/Peds. Don't worry and have faith in yourself.

Good Luck!

[Fiona59]

Labouring women often have bowel movements while pushing and the nurse cleans it up without comment. Would you feel that disturbing? What about the postpartum patient passing large clots

Peds out of my area of experience but there are 12 yo bedwetters out there who will be hospitalized.

There's no way around it, nursing involves bodily fluids and contents in all areas. A big part of a patients self image comes from their nurses reactions to their problems. They can and will respond to your attitude towards them and their "accidents".

[meownsmile, BSN, RN]

You have to remember if we werent there to help with these daily normalties who would.

I guess a good way to get around it is thinking of yourself as being the one who needed help or to have these daily things done and how you would appreciate someone there to help. No its not pleasant, the patient has gone through their period of embarressment and depression for not having the ability to do these things for themselves. Your best reaction is to reinforce to the patient that you are there to help them and it IS PART OF YOUR JOB. And remember EVERYONE has times in their lives that they cant do their own activities of dailly living, even before they are elderly.

Some instances to add to the above posters list: for all us normal adults

1. The knee or hip replacement patient learning how to walk again and has to concentrate more on standing than cleaning their own bottom after bathroom.

2. People who have epidurals, last part to wake is the "saddle" area, they may urinate in their bed and not even realize it.

3. A new colostomy patient who has had the appliance pop off the stoma and is laying in a mess.

Nursing homes are not the only place you will be doing these tasks.

[Califlower]

Taking care of a patient's elimination needs is a big part of taking care of the patient. I know there is all sorts of pain -- you can break your arm or have surgery or give birth -- whatever. But think of the times you had severe diarrhea or constipation! Or a UTI! Good elimination is very very very important to a person's well-being, and as a nurse, you should be there to make sure it gets taken care of.

I always think of it like this -- to whom is this more embarrassing/uncomfortable? Obviously, the person who cannot take of this most basic need is going to be very embarrassed and uncomfortable. When it comes down to it, poop is poop. Everybody poops. Nothing to it!

[Ayvah, RN]

Assisting with toileting, bathing, and cleaning up after patients have accidents is something that you will have to deal with during nursing school, as a CNA and as a nurse.

For example, say you are going in to give your patient meds, and they tell you they've had a bowel movement in bed, and you know that the CNA for this patient is in the middle of giving a bath. You can't just let that person stay like that until the CNA is available. Also, think of how the patient will feel if they have an accident in bed and you are there to help them and you have a disgusted look on your face from the sight/smell. You need to be OK with all of the above things, or at least be able to be completely calm and cool about it in front of the patient, for the patient's sake.

Today I answered a call light for an elderly woman to reposition her leg in the surgical floor of the hospital. As I was helping her with that, her nurse came in to start an IV on her. He talked with her that he was going to stick another tube in her, and she then proceeded to ask if a bowel movement collects in the same tube that the urine did. We told her that no, her foley was different, and that the BM didn't go through that too. She then asked where it went, and he told her "the bed". Well anyways we discovered she had gone #2 in bed, and together me(CNA) and the nurse cleaned her up. She was very embarrased and apologized repeatedly, but we both reassured her and were nonchalant about the situation. She told me that she sometimes went twice in one day, to which I reassured her that patients vary considerably, some going twice a day, while others didn't go for a few days, and some simply not going without help. Afterwards she felt better and was smiling! Later on she was talking to her husband that she had a bowel movement and told him that at least she was having one, instead of not being able to go for several days and needing help. It was nice to turn her perspective around on that. Something as little as a bowel movement can really affect a person in good or bad ways.

As other posters have said, the first time is always weird, but after that it is much better! No one hops out of their chair excitedly to clean up a code brown, but its just something that needs to be done by nurses and CNA's alike. Its just another part of patient care and always will be a team effort.