I went in this afternoon to prep/read the chart for my pt assignment for tomorrow and I'm just scared of all that's going on with the pt. She's got COPD, DM, recovering from a perforated bowel, she's on 02, got a foley, central line, peg tube, colostomy, has thrombocytopenia, and just this am was having runs of v-tach Not only that she's covered in wounds. Wounds from surgeries months ago that haven't healed, pressure ulers, and just all kinds of different things going on. Plus shes on 18 different meds and has about 5 different drug allergies. I feel like I don't want to so much as blow on her.... Nothing like easing my way into med surg clinicals
I'm surprised schools still do the "learn your patient the night before your clinical" method. We get the info on our patients at the beginning of the clinical, not the night before - when students should be, um, going to bed early (one would think). I wonder how many schools still do this previous-night method?
You are exactly right Marie! I just graduated in Dec. of 2007 and we had to do that same thing for all rotations except Peds. In peds, we hit the floor with the nurses and listened to report and dove in from there.
In my other rotations, we had to go up to the unit with professional looking clothing and white lab coat and research our patient. We then went home and spent the rest of the night putting together a care map. If you have never heard of a care map, you are not alone. Is a care plan on steroids. It is so complicated!
Sleep was unheard of during those rotations. Craziness is what it was!
Sometimes when I'd go in the day before and the patient would sound very complex, I'd walk in and they did not look as bad as I expected! That's a lot of meds to look up, but it sounds like it will be a great learning experience. Just jump in there and ask your instructor or the RN if you don't understand anything!
that poor woman but youll be able to juggle a caseload full of patients to that extent. We get report in morning, one side of my sheet is diagnosis, past medical/surgical history. the other is whats happened overnight. then its what i need to do for that patient during the day what i need to look out for and why. just make sure you do FOB's on her and never be afraid to ask for help
I understand where you are comming from as I just finished my med surg rotation last semester. I had a few patients that on paper looked really complicated but it was those patients I feel that I learned the most from once the clinical day was through. It may seem scary at first but come the second time it wont seem so bad.
I'm surprised schools still do the "learn your patient the night before your clinical" method. We get the info on our patients at the beginning of the clinical, not the night before - when students should be, um, going to bed early (one would think). I wonder how many schools still do this previous-night method?
All schools that I know of in my area go to the hospitals the day before clinical, so you complete the care plan (at least in the beginning clinicals).
BTW..aside from the colostomy....your patient sounds like she's my MIL! Seriously.
Its true you never know what you will find, I had a patient once subdural hematona, sub arachnoid hematoma, skull fracture, frontal sinus fracture, craniotomy, I figure at least decreased loc, maybe comatose, well lo and behold, wide awake, feisty, wanting to go home, fighting with everyone on the floor, didn't want me to touch him, yikes, I was scared but excited about learning new skills, spent the whole day just trying to get his vitals and change his gown,
I'm surprised schools still do the "learn your patient the night before your clinical" method. We get the info on our patients at the beginning of the clinical, not the night before - when students should be, um, going to bed early (one would think). I wonder how many schools still do this previous-night method?
We did for Med/Surg I. It was RIDICULOUS. We couldn't get the info until after 5:00 pm the night before clinicals, then
had to be there at 6:45 the following morning. We had to look up labs, pathophys, meds, etc. A ton of work...
I think our school is doing away with this... Honestly, I never understood the point.
Def. know your stuff when you walk through the door. But remember, the most important job you have is patient care. Connecting with your patient. The patient is not a speciman in a lab, they are real people. I believe alot of us forget that.
Not only that she's covered in wounds. Wounds from surgeries months ago that haven't healed, pressure ulers, and just all kinds of different things going on. Plus shes on 18 different meds and has about 5 different drug allergies. I feel like I don't want to so much as blow on her.... 
baxtersmomRN
8 Posts
You are exactly right Marie! I just graduated in Dec. of 2007 and we had to do that same thing for all rotations except Peds. In peds, we hit the floor with the nurses and listened to report and dove in from there.
In my other rotations, we had to go up to the unit with professional looking clothing and white lab coat and research our patient. We then went home and spent the rest of the night putting together a care map. If you have never heard of a care map, you are not alone. Is a care plan on steroids. It is so complicated!
Sleep was unheard of during those rotations. Craziness is what it was!