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.
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!!!!!!
Wow. Can any students in the classes ahead of you give you any tips on how to prepare? Good luck.
Thanks everyone for your advice and comments! It feels good to know that what I am up against is as crazy as it seems to me. Someone mentioned that my instructor may just want to see how we react under stress. I've heard that is part of the reason she reacts so harshly if a student doesn't know something. All the information I've been told is from students who have had this person as recently as last year. Supposedly, if there is an issue in the patient's room, we are supposed to keep our cool and ask to take the conversation outside of the room because it's unprofessional to carry on in front of the patient. At that point, she backs down. I know this person has a wealth of knowledge and experience, and hope to learn a lot from her, if possible. As long as my care plans are good, that's what really matters as far as grades go. We get a clinical evaluation at the end, but all our points come from the care plans.
Wow!! It looks like you have some good support and suggestions. I do think you do have it figured out. She is seeing how you react to direct confrontation and how you handle not knowing something right off the top of your head (happens frequently with MD's on the floor). I really like the idea of having the info at your fingertips on an index card, so although it may not be memorized (how idiotic is that, and a waste of limited memory capacity, at least it would be for me!) it would be quickly retrieved. Don't forget to also look at the trends, especially with WBC's and HGB and PLTs if they are abnormal-- undoubtedly she will want to know if they are improving or getting worse!
I don't think memorizing the MAR is very safe, either. It would give you a false sense of security when getting drugs ready to admin! I always take the MAR bedside when giving meds. But I do have to know how the drugs work on the booy, their side effects, etc. Some of my instructors allow us to keep drug cards with us to refer back to.
The whole being reprimanded at the pts bedside is just plain wrong:nono:--but I know how it is about not complaining. You dont want to get targeted, but you should say something about it, if only on your clinical evaluation!
Technically, the information doesn't need to be memorized for the entire day, however we need to know it if we are asked a question. We will be quizzed on the bulk of things before we even get on the floor, so we have to get there early anyways. We do get to take the MAR bedside (we have to, to do our 3rd check), and we are supposed to make drug cards with all the details on the drug and bring them along. We need to have copies of our care plans as well. The instructor may or may not check our cards and documents, but we need to have them. However, we can't refer to them while we are verbally quizzed. I am thinking it's going to be impossible time-wise for the instructor to quiz every person in the clinical group (there will be 8 there at a time) about every single drug our client is on (even those we will not be administering), in addition to the information about our 2 patients (medical dx, relevant history, labs), and our care plans for each of them, BEFORE we even get on the floor. So, I think I will focus much more on the drugs I will be administering, plus any other significant drugs I may see effects from during my time there, or that are important or unique to the patients' condition. The patients' other general information isn't too difficult for me to remember, thank goodness. I am really curious to see how the first clinical goes (next week). Next Monday, I am going to talk with some of my classmates that have clinicals with the same person this week and find out how things went. Hopefully I get assigned to some great, fun patients as I did last year, and will at least enjoy my time spent with them! That's the best part about nursing, for me.
thats to much memorizing.. that instructor must be crazy... wow.. whay does she want it all memorized? i'm glad my RN program didn't require that .. i would of flunked..lol..... well do what she says and get through it.. keep us updated on how you are doing.. my prayers are with you
I am in the exact same boat. I get so freaked drawing up a med while she watches I mess up my MAR, initials, you name it...everytime...yesterday I had an itty bitty hep, she made me so nervous I put on one glove and couldnt even click down the self sealing...I zoned in a panic attack, then comes the shame from not being able to complete a simple task and you ask yourself what if I had much more to do? I have been crying for the past 2 days and have been unable to sleep...been on here since 2:00 am looking for solace. My only advice to you is...look how many of us are on here...we got this far, WE WILL DO THIS...best of luck
Specializes in MCH,NICU,NNsy,Educ,Village Nursing.
As a former instructor this is what I recommend: Ask the students that have the same instructor if they have the same concerns. Approach the instructor with logical, unemotional (and I know, that can be really hard--it can be an emotionally charged issue!) as a group--there can be strength in numbers. Ask if you can have drug cards to refer to--that or nursing drug books are what "real world nurses" use (just be sure that you have looked up the drugs & can quickly refer to your source). As far as labs--know the norms & how your patient varies from them. Again, ask for the use of a reference card. The main point should be to help the patient and secondary to that, to help you learn. Stress can either help or hinder--that's why communication is so important. If things are bad, you can't get satisfaction from the instructor, etc., follow your chain of command. Just be sure that you are doing everything you are supposed to--care plans, knowing history of patient, etc.--so that if you have to "go above her" you don't sound like a whiner. From personal experience--logical approaches can bring good results. Remember--your instructor is responsible for the 2-3 patients you have in addition to the ones your fellow students have, so she wants to be sure you know your stuff. Hang in there & you can do it!
:yeah:
danh3190
510 Posts
Wow. Can any students in the classes ahead of you give you any tips on how to prepare? Good luck.