1st year nusing student - what exactly is clinicals

~Mi Vida Loca~RN, ASN, RN · Nov 10, 2009

It really depends on so many things and some schools have different clinical sites per semester. We just did ours in LTC facility AKA nursing home and we shadowed the nurses sometimes but mainly did CNA tasks with a few smaller things like Accuchecks that CNA can't do here. also practiced listening to heart and lungs and assesments.

Next semester we are in the hospital where we will pick a patient and pretty much work with that patients nurse, then we move on to 2 patients, we will also do some mental rehab facilities, and respite care, and various other things.

Our last semester we take on a full patient load under a preceptor I believe it is, where they will be overseeing things but we will be practicing like a full nurse if that makes sense.

sweetiepeas · Nov 10, 2009

I am a first quarter student and we are also doing ours at a LTC. We basically apply what we are learning in class. We get one patient and we work on an assesment and interview techniques. Listen to heart and lung sounds. Once we were passed off on injections we can administer with a nurse present. So now when we get there we do CBG's (Blood Sugars) and then we draw up and adminster all of the insulins. We also were able to do flu shots.

So mostly whatever you learn in class you can do in clinical. We will be learning next week about doing catheters but only a few people at my facility have them so most likely I won;t get to insert one this quarter. Also we are learning IV bags, getting the drip count correct and hooking them up. We are not inserting or starting the IV yet.

Good Luck!

cincin1 · Nov 10, 2009

In the hospital I was always paired up with a nurse to either shadow (at first); and as time went on, to perform nursing roles more independently. We did rotations to specialty units sometimes, like ICU, ER, and OR. Also sometimes we did simulation lab experiences (animated mannequins) and that would count towards our clinical hours. Lastly, we did community nursing projects like working at flu clinics and performing wellness and prevention teaching and/or screenings. Clincal can be lots of different things I guess!

9livesRN, BSN, RN · Nov 10, 2009

Hi there, usually on the 1st semester all you do is get used to the settings, charts, and routine. Move patients, make beds, give showers, or bed baths, clean but, and learn therapeutic communication.

now if you have finished pharmacology you might pass meds aswell!

twinjeep97 · Nov 11, 2009

Im surprised at how different schools expect different things.

I guess it depends if you want to be an RN, or going for BSN RN. I am in a 4 year BSN program. I am in my 1st semester of clinicals and it is much more demanding than I thought. Before my 1st clinical I asked numerous times what clinicals were like and couldnt get a straight answer. Here's my experience so far in 1st semester of clinicals.

1st day of clinicals, shown where to document in charts (nurse progress notes), where we see all the patients active orders for meds-"MAR"- may be called somthing different in your hospital. We were also shown how we get into the "PIXIS" supply-which is med supply. Meet the floor nurses, learn different protocols for hospital.

2nd clinical, assigned our first patient, we were told our nurses (LPN's, RN's, NA assigned to our patient). However these nurses are so busy that we don't even have time to ask questions. Luckily my clinical instructor is always more than willing to help. Were also started to do head-to-toe assessments and chart our findings. We needed to document everything in the chart even if staus has not changed. We do assessments for every patient when we come in and when were about to leave for practice. Also did bed-baths, changed linens, and learned how to assess IV patency, osotomies, emptying catheters, etc.

3rd clinical- First off, there are so many different procedures and skills,and which all vary with every patient in terms of how you do the procedure. In lab they show you how to turn patients and do bed-baths, however they do not show you how to do these things with a patient who has 2 IV's, 2 JP drains, 1 Picc, and 1 Central line. It is hard at first to figure out best and safest way to manuever the pt. There's no way once you graduate nursing school you will have learned everything. My 3rd clinical consisted of cleaning and packing a wound, and doing a sterile wet-to-dry dressing change.

4th clinical- As long as we passed our Med-math exam, getting at least a 90% then we are allowed to pass meds WITH clinical instructor with us. We also started drawing up and giving SC injections, and next week we are able to give insulin.

Each clinical is a diferent experience. Your clinicals will depend on your instructor, hospital, and floor.

-My best advice is to know everything about your patient, such as history, meds, orders, activity, diet etc. Many patients will ask for somthing to eat, whether or not they know they are NPO status. Also pay close attention to the patients fall risk, and follow protocols for "MRSA," which I almost walked into room without gown, it was my 1st clinical and I was very nervous haha! Also pay attention to allergies, a common one seems to be latex, so find other gloves than latex and place next to sink so you remember each time entering the room.

Our instructor also makes us write down all our pt's meds, active and prn, which most of the time its about 25+ meds in unit I am in now -"Med-surg." Our instructor wants us to know the classification of each drug, and why the patient is taking the drug.

We also need to look up the patients lab values- Na,K,Cl,Bicarb,Creatinine. If the labs are abnormal we must document why they are abnormal (Ex: K+ level is low becuase the patient is on Lasix, so make sure the patient is taking a K+ supplement is too low, if not prescribed then tell the nurse. We also must document lab values in terms of WBC count, hemo/hemat, glucose. We then have to say why there WBC is abnormal (Ex: Bc patient recently had abdominal surgery, which also caused the patients hemoglobin to drop. )

I am in my first semester of clinicals right now, and have about 4 weeks left. My advice is to carry around a little notebook to put in pocket of scrubs to write new procedure learned, or how to empty JP drain, or somthing you learned. Also get in the habit of writing all your patients meds out, after a while more and more meds become familiar, and recognizable. Also make sure when doing your skin, hair, nail assessment, you look for any redness, swelling, and make sure the area has been documented (Size,shape, color, discharge, so that in a few hours when you look again at the spot, you will know exactly if the wound has gotten better/worse. I now see how easy it would be for a nurse to miss a reddened area and not notice until the wound becomes deep, or infected.)

I hope this helped a little bit, if you have any questions feel free to message me!

guiltysins · Nov 11, 2009

Jesus christ you guys are freaking me out now LOL.

izzycatswimRN · Nov 11, 2009

I'm in my first semester in an accelerated program. Our clinical times consist of getting patient assignments the day before clinical and getting any info we can from their chart and the computer. The day of clinical we take our patient's vitals, report to the nurse assigned to the patient, and basically spend the clinical time doing whatever needs to be done for our patient. Sometimes its helping with breakfast, or using the bathroom, changing linens, bed baths/showers. Now that we've had our med check offs we can give their medications with our instructor or the nurse present. If we have a moment to spare we can see if our clinical mates need any help. Or if our nurse has something interesting she is going to do for another patient, if she needs a little extra help with a patient, or whatever, we can go with him/her to that patient and help out.

Overall I really am enjoying my clinicals. My assigned hospital hasn't been the best with cooperating with us students but that's okay. I would advise you to make buddies with the techs. They can teach you TONS of stuff since they do tend to do a lot of the "dirty work" i guess you could say.