So excited about end of 1st clinical rotation...what's next?

That Guy, BSN, RN, EMT-B · Apr 19, 2010

Depends on your program. We do 2 rotations in Med/Surg before we touch OB/Peds. We were given a lot more freedoms in our 2nd rotation and didnt have a hovering entity over our shoulder all the time.

nsstudent33 · May 5, 2010

We did our peads/OB after our first med-surg placement...I enjoyed both! Definietly more freedom BUT with peads they are very watchful with meds because of the patient population!

Tina1968 · May 5, 2010

Thank you for responding! We did OB/maternity rotation this semester and I know we are scheduled to do peds and psych next semester. How was peds, I'm a little nervous about that one. I have two little guys and it's hard for me to see them in any kind of pain no matter how minute! Psych, on the other hand, I can not wait; I am so looking forward to that.

Tina

turnforthenurse, MSN, NP · May 7, 2010

Let's see my very first clinical rotation was in an extended living facility for a few clinical days then the rest of the semester we went to an LTC. My second semester was on a general med-surg unit in a hospital, but I still practiced very basic nursing skills as well as assessments. Didn't get to pass meds much that rotation - only twice!

The rotations at my school are 7 1/2 weeks in length. Junior year rotations include older adults (gero med-surg), adults (med-surg), OB & mental health.

Older adults - we had skill competencies on IVs/venipuncture and trach care/suctioning. Basically this rotation was like med-surg but with older clients. For our paper we did a home visit using assessment tools - kind of like case management.

Adults - one of my favorite classes by far. The unit depends on the instructor; some students were on tele floors. I was on a women's health floor but I really liked it. Ages range from 18 - 65+. I got A LOT of medication experience in this rotation. I also learned a lot. We also had our OR experience during this rotation and I got to see a redo left fem-popliteal bypass.

OB - we rotated between postpartum and L&D. L&D was a lot of fetal monitoring (looking for decels and late decels) and observation and caring for the mom intrapartum and immediately postpartum. Once the baby was born we did apgars and an initial assessment as well as administer erythromycin ointment and aquamephyton (vitamin K) injections. We also got to see c-sections and some students got to see tubal ligations. Postpartum was a lotttt of assessments - on mom & baby. It was also a lot of teaching, but there were days where I had moms who already have kids, so there wasn't a lot to teach.

Mental health - my least favorite rotation so far. I was bored to tears in clinical and there was a lot of busy work in the class. I love talking to patients, but that is all we did during this rotation - no assessments, no medications, no skill what-so-ever (sorry if you are reading this and you are a psych nurse or thinking about going into psych! I'm just voicing my experience during my psych rotation). The nurses on the unit hid at the nurses station all day and never interacted with the patients, except during med pass. I felt bad for those patients.

Senior year clinicals at my school include critical care, community/public health, peds & precepting (where you choose an area of nursing that interests you, you're stuck on a unit with a preceptor and are required to have 120 clinical hours to gain experience). Of these rotations, I have completed critical care and I start my community/public health rotation on Monday (it never ends!!! :uhoh3: )

Critical care was my favorite rotation BY FAR. I was a deer in headlights at first and I felt uncomfortable especially during the first couple of clinical days, but I love critical care. A lot of your patients will be on ventilators and will be sedated, usually with propofol/Diprivan, but there are also a lot of patients in the ICU/ICU step-down units who are not sedated. You'll deal with a lot of vasoactive drugs (basically, drugs that either vasodilate and decrease BP or vasoconstrict and increase BP) and you have to titrate them by mcg/min or mcg/kg/min. It's a lot of observation. Practically every patient in the ICU/step-down is on a tele monitor. You will learn how to read/interpret EKGs. There are a lot of lines/tubes/drains to deal with! A-lines, PA (Swan-Ganz) catheters, central lines, other drains/tubes...A patient I had was on a ventilator, had 5 IVs running at the same time, 3 chest tubes, a hemovac, a JP drain, an A-line and was hooked up to tele. The ICU/step-down can be boring but the pace can change very quickly - anything can happen! I was having a calm day and then BAM - code blue! Not my patient, but someone else...a lot of nurses and all of us students ran down there to see what was happened. None of us are ACLS certified (yet) so they had us rotate doing chest compressions...I could feel this patients ribs and sternum cracking beneath my hands! It was so cool lol! I also had an "alternative experience" and went down to the ER for half of the day to observe and also to practice technical skills - IV starts/blood draws, foley insertion, NG insertion and medication administration. If someone coded, you would help with that as well - but no one coded when I was down there. The ER can also be boring but can also be very fast-paced. I loved it and I loved the adrenaline rush :yeah:

I obviously haven't had pubilc health yet, but I heard nothing but bad things I haven't had peds either but I heard it was boring. The kids are cute but a lot of times the parents are the ones who will do the bathing and things, not you. I know that I will be on an oncology floor for my peds rotation and I know we do not administer meds (unless it's something like Tylenol). We can do technical stuff like dressing changes and assessments but nothing with IVs. It's mostly just observation & interacting with the kids and their families. We also get an alternative experience in peds. Some students went to a mental health unit; others went to the PICU, NICU or ER. I plan on going to the PICU/NICU :)

CrunchyMama, ASN, RN · May 7, 2010

1st semester was medsurg, 2nd which I'm ending now was half OB and half psych. I HATED OB and glad our school doesn't do a peds rotation. :) Next semester and the following is suppose to be all medsurg. Every program is different. Good luck!!

sneakymom2011 · May 7, 2010

1st semester- fundamentals. 8 weeks on an oncology floor. It was interesting, but kind of hard dealing with end-of-life issues when you are a 1st semseter nursing student. I had really nice patients, and 2 of them, they wanted nothing to do with me :crying2: One was dealing with his own end-of-life issues, and the other one just didn't like students (though why she got put with one is beyond me). I got to do meds 2x (but so did everyone else).

2nd semester- OB/Peds. And yes- I agree (if anyone says anything) that 2nd semester was NOT the time for this. OB clinical was ok. I did get to do a lot duirng the 2 times I was on the PP floor. Passed meds- tried to teach a non-compliant diabetic that it was important for her to eat good food (and not just salad) while nursing. And that's what I did my paper on.

Peds was BO-RING. I was on the floor 5 times. We could pass pills and do injections. Every single one of the kids I had was on a G-tube- so I could do no meds, no feeding. Well- I did have a very nice 13 year old, but he was on no meds at all and was going home. Many times we did our assessments, read the charts, and were bored the rest of the time (though I tried my hardest to find SOMETHING to do while I was there)

Helped out the aides by feeding a couple of the babies. That was fun

Our school no longer offers the program I'm in. And we were told that in the new program, OB/Peds will be taught as an upper level course.

Now when we weren't on the floor- it was kind of fun. OR rotation was kind of neat, but I don't think I want to be an OR nurse. Not enough patient contact for my liking. I got to ride around with a home care nurse, now I liked that. But you have to have some floor experience first before going into home health. And I can see why. They are so much more independant than the hospital nurses (which I liked too)

This time is medsurge. They were doing something different with clinicals- and from what I read I think I'm doing my Psych rotation first- and that's 5 12 hour days. I hope I don't forget all of my medsurge skills (assessments, meds etc) because if this is how it is- I won't have clincals on the medsurge unit until August (we get a break in between for the summer)

Cheryl

~Mi Vida Loca~RN, ASN, RN · May 8, 2010

We did LTC first semester, Med/Surge part of second, Peds and Maternity and Respite care the other half. Next semester we have Psych and Med/Surge as well and 4th we have Med/Surge again, Focused and our preceptorship.

allnurses Guide · May 8, 2010

We had med/surg, day surgery and women's surgical health (post C-section, but caring for mom only, no baby interaction....hysterectomies, miscarriages, mastectomies) this semester. Next semester is more med/surg and psych rotation. Third we have more med/surg, pediatrics and OB. Not sure yet about fourth semester.

I wish we went on through the summer. I hate that I just now got to where I feel like i have an inkling of what I am doing with med passing and assessments and interacting with patients, doing patient teaching etc. and now this long lag.

Tina1968 · May 8, 2010

Thank you for responding!

I totally agree, I'm feeling so great falling into a routine with care of pts and comfortable with performing clinical skills and BOOM: 2 months off. Most people would love this schedule, but we're nursing students and we love this stuff! (secretly, though, looking forward to spending more time with my kids)!