Terrified for clinicals because...

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I'm a 2nd year AD student, and for our clinicals, our instructor requires us to have our patients (2 or sometimes 3) MARs memorized, in addition to memorization of the patients' pertinent medical history and lab values. For each drug the patient is on (doesn't matter if we'll be giving it or not) we need to be able to recite to her the morning of clinical: Drug name, class, what it does, why is the patient receiving the drug, and all major side effects. This could potentially mean dozens of drugs to memorize. We also have to know all our patient's lab values (esp. pertinent ones), if the value is high/low/normal, and what that means for that patient and their disease process. All of this information must be recited to the instructor without looking at any of our papers, and after obtaining the patient information the previous evening. Granted, the patient will hopefully be on at least a few drugs I am familiar with, and explaining their history shouldn't be too bad. Labs are another story, but I'm going to start memorizing normal values for the major tests.

This is in additional to care plans with 2 nursing diagnoses for each patient, which we have to also verbally summarize to our instructor.

I am going crazy about this, not only because of the work required the night before clinical, but because the instructor I have has a reputation for being incredibly tough and making students cry by severely reprimanding them in front of their patients.

Is anyone else here required to do similar things to prepare for clinical? Am I thinking this is harder than it sounds? This is so much more extreme than my clinical demands were last year, I'm having a hard time keeping a positive attitude while thinking about the demands and behavior of my instructor.

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We have to look all that up and do all the work, but we are not required to be able to recite things verbatim from memory. We will be required to be able to tell her what is going on with our patient something like " Mr. X is a 70 yr old with peripheral neuropathy admitted due to injury to his left foot. He is scheduled for Below the knee amputation on such and such a day etc" (totally made up)

If your instructor is reprimanding students in front of patients, someone needs to be reporting that as it is highly improper among other things.

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My instructor has been teaching for quite awhile, and I think this is the way she has always done things. I am sure students have complained, however it must not have been enough. I am hoping that the stories I have heard are more or less exceptions and not the rule when it comes to this person! I know this teacher wants her students to recognize the seriousness of giving medication and providing other care, which is definitely important. I am well aware of the crucial details of the job, which is a big part of why I get nervous regardless of the instructor. I am extremely conscientious when working with patients, and I am hoping this teacher realizes how seriously I take clinicals and we can at least have a decent relationship.

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Specializes in Geriatrics, Cardiac, ICU.

Wow. Why do you have to memorize it? Not even RN's know things by heart and there is nothing wrong with having it written down; in fact most nurses refer to their notes as their "brains".

I'm sorry you have such a hard instructor, I think you'd be better served to spend your time the night before understanding what is going on with your patients rather than memorizing things you could easily look up.

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I agree! While it's important to know about medications and labs, it is more important to concentrate on the patients' diseases and the interventions I will be doing. There is only so much a person can do in such a short period of time. I wouldn't be so worried if there was more time to prepare than just one evening, or if there were just one patient instead of 2 or 3.

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I'm wondering what school you go to because it sounds just like mine!! I am having a hard time with the meds and I will be "med nurse" this semester. I am totally freaked out!! Maybe we could help each other. I don't know how this works, are you able to email me privately?

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Specializes in Med-Surg, Cardiac.
I'm wondering what school you go to because it sounds just like mine!! I am having a hard time with the meds and I will be "med nurse" this semester. I am totally freaked out!! Maybe we could help each other. I don't know how this works, are you able to email me privately?

What's "med nurse"?

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MN NursingStudent,

You have got to be kidding...your clinical instructor wants you to MEMORIZE almost everything about your patient? She is being unrealistic. PERIOD! If she expected that from me, my stress level would be too high I wouldn't remember at all, and I would learn absolutely nothing from this clinical rotation.

I did have an instructor once who expected us to know a lot about each of our patient (diagnosis, history, likely cause of illness, labs/procedures scheduled, results, nursing care for the day, home/current medication, etc), made us share all of this with our classmates the first thing in the morning after giving us 30 minutes to look up information. If we didn't mention what we should be looking or investigating throughout the day, she would ask. If we didn't have an answer, she would make us think about it then get back to us.

But expecting you to MEMORIZE everything is just IMPOSSIBLE! For goodness sake, you are a student! Not even RNs practicing for a long time can do that!!!

Try talking to former students of hers. They can give you good advice.

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i am going crazy about this, not only because of the work required the night before clinical, but because the instructor i have has a reputation for being incredibly tough and making students cry by severely reprimanding them in front of their patients.

just do your best. whoever said speaking to a former student, that's a great idea. don't let them see you cry. i think they are seeing how you react under stress. keep cool and start with the little and end with the big (beginning with history and ending with lab values). know your medications and the action they have on the cellular level. know norms of labs.

just do your best and be honest with her. if you can't remember, tell her and ask if you could have a moment to look it up. just look as competent as you can.

i think sometimes these mean clinical instructors forget that we pay their salary for an education, not to be belittled.

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Specializes in ICU, CVICU.

That is pretty ridiculous. We have to know everything about our patients but memorizing labs and meds is just crazy. Our floor is constantly changing - new meds and labs are always being ordered and sometimes when we walk in, our patients from the day before are gone. Is there no one you can appeal to at your school? This just seems a bit crazy if you ask me.

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Specializes in DOU.

My clinical instructor has a reputation for being absurdly difficult, too. It was rumored than her students hid in their patient's closets last semester when they saw her coming.

I don't know how you can possibly memorize everything, so I suggest you write down the medication info on an index card, including relevant labs, side effects, etc. and tell her you think it is vitally important to be as prepared as possible, but you simply can't memorize everything in such a short amount of time. Tell her you were worried that attempting to do so may jeopardize your patient's safety if you inadvertantly forgot some vital information. Then you can (and should) focus on understanding the patient's pathology.

So far, although my instructor expects a LOT out of us (even the staff nurses think so), I have to say that she is extremely bright, and I expect to learn a lot from her. The rumor mill was a tad bit exaggerated.

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What's "med nurse"?

Med Nurse is a day in clinical where you are assigned 5 pts that you will do nothing but pass meds to. Sounds easy? Well, you need to know every single med that you are passing to these pts. Side effects, action, labs, etc. You also need to know how to prioritize which pt should get their meds first, second, and so on. I've heard horror stories from previous students. It is a pass or fail assignment, and if you fail, you FAIL!! I'm really freaked out because I really need help with my med actions. My teacher told me that a lot of the knowledge is there, but that it isn't quite up to par for med nurse. If it was only po's it wouldn't be too bad, but it's everything. I don't even want to think about it! HELP!!!!!!

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