starting ADN clinicals soon...COLD FEET?

TazziRN, RN · Apr 13, 2007

That's what your med checks are for, the five Rights. Check them every time and your chances of making errors decrease. If you do make one, fess up as soon as you realize it. Most med errors are inconsequential but you still need to fess up. The reason the error was made will be checked out and methods of prevention instituted.

You'll do fine!

mrsalby · Apr 13, 2007

Ok first take a deep breath. Were you ever worried about the first mouth you dug into?

I started when I was 38 with family, dogs, birds and worked full time etc. It was hard and I eventually went part time to when I can make it at work. But IT CAN BE DONE! You will be fine and your instructors will help you thru the med part and when you get finished you will understand a check and triple check with the meds. You will be surprised with how many meds you will have an idea and understanding about by the time you graduate. Of course there are hudreds more out there. You will be fine.

Good luck

nj1grlcrus · Apr 13, 2007

you will do just fine, and no one will tell you to do something stat in a hospital, because you are just a student, any emergency will be handled by the hospital personnel. But you will really excell in clinical, BECAUSE you have

years of experience in dealing with patients, the real reason you do clinical in first year nursing. so relax and enjoy it, spend your energy studying- not worrying;)

Mommy TeleRN, RN · Apr 14, 2007

Hey girl - I'm 31, mom of 2, and just about to graduate. I still get scared about messing up esp as I'm about to enter the ICU setting...but I'll tell ya the same thing my first clinical teacher told me -

IF YOU ALREADY KNEW IT ALL YOU WOULDN'T BE A STUDENT

They will start you out pretty slowly. Probably only PO meds at first. If it's like my school you will have to research your meds before giving too. At my school usually the teachers will verify the PO meds and let you go by yourself to give them. But they still go with us for ANY IV meds we give. The only thing we are allowed to do on our own is flush a peripheral line like if a med is done running.

You will have many clinicals and your confidence will build. We have 2 patients now and when I have one it seems so simple - yet that use to seem so complicated! lol When I am team leader I do meds for 4 patients. I know I will be overwhelmed again when I am a graduate nurse but again I will be in training mode and will progress up to handling my own load. It all comes with time and experience - you've already done this once as a DH. I bet the first time you cleaned a pt teeth you were probably pretty worried but now it's easy as pie.

As others have said - there are safeguards in place and the most important thing is knowing your 5 rights and using your resources to check things like interactions and side effects.

I am really just now starting to feel a "little" comfortable with meds as I'm starting to give things pretty regularly. There are still a LOT of meds I don't know a lot about but I will continue to research. The more you use a med the more you remember about it (ie how fast to push a med) You begin to remember which meds are for BP and will automatically know to check a BP or a HR if it causes bradycardia. It comes with practice, practice, practice.

If you can eventually find an intern type position I think that greatly helps with comfort levels! I can't give meds as an intern, but I do learn an awful lot of other things like pt positioning and picking up on s/s of pt condition worsening etc.

You will find yourself progressing each week ... you have your teacher and fellow students as great resources too (also in my program LPNs join us the last 2 semesters and they are WONDERFUL in clinical!)

buddiage · Apr 14, 2007

Don't worry- I know you want to do really well. I was scared, too.

They teach you how to avoid errors, and it is up to you to enforce them (the five rights). You will not be giving meds unless your instructor is there. You will likely be in your drug book and telling your instructor what the action of the med is, and the side effect is (and maybe any implications).

My school is very safe, and I feel okay about giving meds (and totally respect the responsability).

You will grow to be more and more comfortable as your semester goes on. You will be writing about it, talking about it (probably in a post conference type of setting) and hearing others share their experiences ad nauseum. You will ask lots of questions, read a lot, study those notes a lot...and then you find your rhythm as a student, and things do start to come together a bit. I am nearing the first year of my ADN program, and I can tell you, it's been the most wonderful, at times most stressful, time of my life.

You will never give meds without having your instructor there. You will get the "feel of it." I am not an expert, but feel like I have come into my own as a student nurse. We all want to be "perfect." Be sure to allow yourself to enjoy the learning process of it too. The more you learn, the more you realize you have to learn.

You are going to be fine. They will never ask you to do something you have not tested out on, and even if you passed, the instructors are there for you to assist you in learning. DON'T BE HARD ON YOURSELF.

megananne7 · Apr 14, 2007

That's what your med checks are for, the five Rights. Check them every time and your chances of making errors decrease. If you do make one, fess up as soon as you realize it. Most med errors are inconsequential but you still need to fess up. The reason the error was made will be checked out and methods of prevention instituted.
You'll do fine!

There are 7 now... More stuff to remember!

Mommy TeleRN, RN · Apr 14, 2007

what are the additional 2?

PickyRN · Apr 14, 2007

So, for those of you out there, second careers and families, does the idea of making a career change make your head feel as if its going to explode? :selfbonk:
One of my biggest concerns is making a dosing error. What happens if you screw up the medication? I'm getting a 98 in pharm which I am happy with, but my nursing patients tell me to quit worrying over this. What happens if you are told to do something stat and you have no idea what to do?
I guess I am scared of screwing up and causing harm to a patient.
Is this normal apprehension? Any thoughts would be appreciated.
Jen

Nursing is my second career. I was a pastor first, but found that it didn't pay enough to support my family AND pay off my 7 years of student loans. So my mom (30yr RN) suggested I become a nurse. I bit the bullet and went back to school (aargh!). Did my head feel like it would explode? Not really.

Yeah, you worry about stuff like med errors, but you soon realize that they happen to everybody, and you try your hardest to not make one. Also, with anything that might kill somebody (insulin, heparin, etc), you double check if you're not sure. If you are told to do something stat, do it. If it's really stat, they will expect you to do it right away, and if you stand there and look like you don't know your first name, they will get somebody else to do it.

Just remember, inaction can be just as harmful as the wrong action. If you learn your book smarts, clinical skills, and common sense, you will do just fine.

PickyRN · Apr 14, 2007

Right Medication.
Right Dose.
Right Time.
Right Route.
Right Patient.

Those are the original five. I found a website that said the next two are "right reason" and "right documentation", but I also found "right to refuse" as well as "right to be educated." I think that we could continue to add "rights" ad nauseum.

Natkat, BSN, MSN, RN · Apr 14, 2007

As a student you will never give a medication STAT. As everyone has said you won't give a med unless your instructor is right there with you. As you learn more and get more comfortable you'll be able to give meds on your own, but that's a long way off.

I HATED giving meds in clinical because there was so much "hurry up and wait". We had to break our necks doing things for the patient and looking up our meds, then wait around for the instructor to get there. If I tried to go off and do patient care, the instructor would show up when I was in the middle of a bed bath or something and she didn't have time to wait for me to finish, so I ended up missing my chance to give meds that day.

Then the nurses we're with that day get frustrated waiting as well. Once in a while they would go ahead and give meds just as the instructor popped around the corner. It was very frustrating.

This past week I gave meds by myself for the first time and it was such a relief! I could just do my thing, get organized and prioritize my day. It was so much better than standing around helplessly waiting for the instructor arrive.

Mommy TeleRN, RN · Apr 14, 2007

natkat - that is why drives me crazy about clinicals too - takes soooo long to get anything done. this semester has been a little better since we have a "little" bit more autonomy. One thing we have done with meds is divide up into 3 teams. Team 1 gives meds from 8-8:45, team 2 8:45-9:15 and team 3 9:15 to 10:00.

This system isn't perfect because inevitably there is a PRN, something not on the floor (the student is responsible for contacting the pharmacy) or a drip that needs to be rehung. But it does give "some" structure to your day. If you are on team 2 you can go ahead and get your AM care done and know to show up at the PYXIS at 8:45. This was the students' idea and the instructors were very open to the idea and implemented it.