Starting nursing program...How are Clinicals?

Hi Chrissy,

I am currently in my second semester, Med/Surg. Before starting, I was anxious about clinicals due to the many horror stories floating around and I didn't know what to expect. All I can say, based on MY short experience and observations, please keep that in mind, is that your clinical experience will mainly depend on the professor you get assigned to and your mental approach. Other important factors are the hospital you are assigned to and the nurses that work there. I've been lucky to be at the same hospital for both semesters and they have the nicest, most helpful nurses who are always willing to help out the students by talking to us, showing us things, etc.

During your clinical day, you will work closely with your patient. Depending on your professor, you will also work closely with him/her. Some handcuff themselves to you and follow your every step and breath down your neck and others pretty much leave you on your own if you show them that you know your stuff. You also work with your fellow students, because you are also part of a team and you will help each other out alot. I've been extremely lucky to have professors that taught for the joy of teaching with nothing to prove to anyone. They were like my Mom (who was a nurse) and took me by the hand and said, here, this is exactly what you need to do and exactly what you need to know.

Some of my fellow students are having a horrible time right now and also in the last semester because they were assigned some seriously unbalanced professors with a chip on their shoulders and something to prove. Those are the kind of "professors" who have a piece of paper that says they can teach, but let's face it, just because that paper says they can teach doesn't mean they know how to share their wisdom in an effective and positive manner. There is one professor who constantly yells at all her students no matter what the scenario. (eg: in front of patients) She seems frazzled all the time and doesn't practice what she preaches.

As for nurses working with students, that depends on the nurses. The ones I have worked with have been wonderful. They take time to talk to us and show us things and they always encourage us and have a smile even when they are in a rush. One nurse always tells me that she remembers how it was for her, that she had horrible nurses and professors and she doesn't want to be that way with us and wants to break that cycle. Another told us last week that we are a gift for the future, to not give up no matter what and to keep up the good work. That was amazing because it was completely out of the blue and was totally appreciated. Others can't stand students and will barely interact, let alone crack a smile at you.

You will only do what you have learned and never anything beyond that. So every week you will build upon your skills. All in all, clinical days are an exhausting experience because you never stop for one minute, not mentally and not physically, until you go home. So far I have seen fellow students break down in tears; I have seen a lot poop and vomit and blood and smelled a vast array of aromas (you know the kind ) But believe me, you will love every exhausting minute of it, even if it makes you want to pull your hair out or kick someone's teeth in, because it is the most amazing experience and you are a Nursing Student! You will never forget it and you will learn!

Hope this helps you out some! :wink2:

Thanks Chrissy! Your reply really helped me. I'll be starting my 1st clinical semester within 2weeks. I'm really nervous,hopefully my nervousness will have worn off within the next 2weeks.

I just finished my first semester. Our clinicals were in the nursing home and to be totally honest, it was not at all what I expected.

We arrived in the morning, met our residents, did our assessment and for me, that was pretty much it. The rest of the day was spent having coffee with my instructor, checking on my resident and occasionally helping out my classmates. That's it. I was very disappointed.

This semester, though, is med surg. So, I'm thinking that's all going to change.

I just finished my first semester and clinical was fun - I can't wait for the next semester to start so that I can get back into the hospital.

It was cumulative for me - meaning that the first week, we learned how to interview; so during clinical, we interviewed our patient. The second week, we learned how to take all vitals but blood pressure; so during clinical, we interviewed our patient and took vitals. For the third week, we learned how to make bed; so during clinical we made beds, took vitals and interviewed out patients.

By the last day, we were doing everything that we could for out patients. So if everything we learned we did - our instructor or the nurse working with the patient would do the things that we didn't learn yet.

But it was a really good experience.

A lot of it depends on the program you're in. I'll tell you about MY clinical experience and hope that it helps you!

I was mostly in a hospital setting during my clinical experience. In my program, we're required to do TOTAL patient care. Meaning, if your assigned patient is incontinent of bowel and goes in the bed - you have to take care of the mess and clean up your patient. If you get assigned to pass meds, you pass meds along with any other patient cares. Total patient care is in place for those nursing students who haven't worked as CNAs. So during clinicals, you're basically a CNA and a nurse. Some days, you won't be busy at all and other days you'll be running around like a crazy person, sweating all over the place! It can be unpredictable and crazy at times, so try to get as much of your careplans done the night before they're due as possible.

In my program, we have clinical on Tuesday and Wednesday. We go to our site to pre-lab on Monday after class. We gather as much information on our patient as we can - identifying data, medical hx, medical diagnoses, all medications (with times and dosages), etc. Use the chart and kardex to fill out as much of the careplan as you can. Then, you go home and do your pathophys. Go as much in depth as you can. Then, go over all the medications and figure out why the pt is on the med and relate it back to a medical diagnosis. Know as much about the pathophys and medications as you possibly can - just in case your instructor asks you any questions. In my program, we also fill out drug cards Monday night. On a 4x6 index card, we write the drug name (generic and Trade), the classification, the action, the use, the safe and usual dose, common side effects, and nursing implications. If your program does drug cards as well, it REALLY helps to color code them. Meaning, on every card you do, you write the drug name in red, the classification in blue, the action in orange, etc. It takes a bit more work, but once you get it down it's worth it. That way, you can quickly glance at the card and be able to find the class or action in a flash rather than having to skin through other info to find the info you need.

Also, watch out for staff nurses and CNAs. Where I've been, most of them are really nice, but once and awhile you get a few that are not so great. Some nurses will try to get you to do their work for them - work that doesn't even pertain to nursing, such as making copies. CNAs will use you and try to get you to do their work as well. I had one CNA that yelled at me for not answering a call light that was going off. For one, the call light didn't belong to my patient. For another, my instructor asked us not to answer call lights that didn't belong to our patients, because it could be a safety issue - especially for those students that have never worked as CNAs. So don't let yourself be taken advantage of! Patients will try to take advantage too - some can be really mean and rude - but you have to understand what they're dealing with and at the same time be assertive and explain to them what needs done. Also, know your scope of practice and don't let anyone try to get you to practice outside that scope! My instructor told us a story about an LPN student a few years ago who did this. She was meek and kind of shy. She happened to be in the pt's room when the doctor arrived. The doctor bullied her into pushing a med into the IV line. She received an Unsatisfactory for the week - not a huge deal, but if it had been me I probably would have cried for the entire week and felt guilty for the longest time.

Just be confident, organized, and know your stuff and you should be okay. Don't let the small things get to you - you don't want to be that student (there's one every year!) who hides in an empty pt room and cries because she's overwhelmed. Everyone will be nervous the first day - all the girls in my rotation were popping TUMS and Gas-X like they were candy. And realize that clinicals are meant for PRACTICE - you're not expected to be a nurse already - you're practicing to be a nurse - so don't try to be perfect and don't beat yourself up over stupid little mistakes.

You'll get to do really cool procedures and see things done, too. My first week, I got to do a drsng change and go to dialysis with my patient. I've also pulled an NG tube, taken care of a pt with a paralytic illeus, watched a wound nurse debride a wound, packed a pressure ulcer, and had a pt *almost* have a MI (which was NOT cool at all).

After the first couple weeks, you'll get used to it and a lot of the time you'll find yourself having fun! Good luck!