Tips for first clinical?

RNinJune2007, RN · Oct 18, 2005

Hello! It's definitely understandable that you are nervous. I recently had my first hospital clinical and... WOW!! I've now had two, but they are awesome. Being there reminded me why I want to become a nurse (we had clinicals once prior at a LTC facility which made me rethink becoming an RN: Just not my thing!!). Use your resources!!

For example, the RN assigned to your room- take all the advice you can. During breaks of caring for your patient, if you have a couple minutes, watch a classmate or a nurse do a procedure or administer meds to a pt. if you are allowed. (The first hospital clinical, we couldn't pass meds, but after that, we had a test, so the second time we could... the first time I watched a nurse administer a lovenox injection, and I am sure glad I did!! I had to give one this last time... it really eased my nerves !)

Don't get too overwhelmed. It gets more and more easy. Integrate the health assessment (if you will be doing this; I assume you are) into the daily care (i.e. BEDBATH) When filling out the charting form for health assessments don't get overwhelmed, because it's a lot!

Last but definitely not least, ASK FOR HELP when you need it. Whether it is a classmate, nurse, instructor, or otherwise.

GOOD LUCK!!!

lccougar02 · Oct 18, 2005

for all clinicals: get as much experience as you can, it will make you a better nurse and help you know what you want to specialize in. Help your classmates and they will help you back. ASK QUESTIONS! Dont be afraid to ask questions, even if you think they are stupid.

GOOD LUCK!

Montessori Mommy · Oct 19, 2005

As nervous as you are, remember that you are caring for a person not a "patient". I am a nervous wreck each week before clinicals, but as soon as I introduce myself to my person, and we have a chance to talk, I relax. The past few weeks, the information I read on my patients the day before was enough to scare me to death! Both times, once I met the person I realized that they were scared, loney people who responded well to a smile, kind voice and some attention. :)

Don't be afraid to talk about your fears with your classmates. We all felt so much better when we started admitting how fearful we were. Our instructor overheard us and joined in, telling us about her nervousness before clinicals in school.

Before you leave for the day, be sure to tell the person you are leaving the floor, and thank them for allowing you to care for them.

Best of luck!

Beth

betsyMT2003 · Oct 19, 2005

Thanks for the tips, everyone - I'll keep them all in mind! Thanks for taking the time to respond.

kpmadonna · Oct 19, 2005

Hi everyone! I just had my first clinical orientation at the hospital today, and next Tuesday will be my first "real" day. I'm VERY excited, but I'm also nervous about making the transition from lab to hospital. Would anyone like to share any tips? I'd love to hear from others who felt the same way I do.... TIA! :)

The one thing that I learned is never hesitate to ask for help. I was very nervous my first clinical, I took a look at my first patient and said, "this lady is way to fragile, I dont want to hurt her" but by the end of the day I really found out how amazing she was. I found that on my first day they tend to understand more that you are learning and try to give you someting simple like vitals to start with, and that helped me start the introduction process with my patient, and it made me less nervous. It is pretty rare, but my clinical instructor made my whole group give injections on our first day, which was very nerve racking, but now that I have done it I am not so afraid of it. Best of luck with your first patient I am sure that it will be great, just have a smile it makes everything go so smoothly!!!

chinacatSN · Oct 16, 2010

Hey, everyone. I'm in my first semester of LPN school. We start clinicals in about a week. I already have everything I need - cute, comfy scrubs; nice, comfy shoes; a great stethoscope; everything. It's been awhile since I've been in the clinical setting (used to work as a CNA) and I've never worked in a hospital - only long term care facilities.

I'm really nervous about lots of things - the not-so-important things are covering the tattoos on my arms (can't wear long sleeves because my meds make me sweat A LOT when I'm warm) and I don't know if I'll be able to handle being on my feet that long.

I'm also really nervous about administering meds - I passed my Math and Meds course with a 97% and I understand the math pretty well, I'm just nervous. I don't want a med error and I'm a perfectionist (OCD, literally, I have OCD) so it's a big issue for me. And I'm really nervous about performing any procedure. I know that's what the instructor is there for, but still.

So if anyone has ANY tips on surviving clinical, post them please! Thanks!

Roxyann57 · Oct 16, 2010

What goes through my head when I walk into the clinical setting:

I receive my patient and read the chart, write down what I think is useful and get report from the nurse.

When I walk into the room I think...

-Does my patient have oxygen? How many liters? Is the oxygen on properly? Is it irritating the patients ears, nose, face? Does it have humidity?

-Foley? Is the bag full? Make a note of how much is in the bag when I enter the room and make sure the 30 cc output per hour is being met.

-Patient...what are they doing? Bed in the lowest level? 2x side rails up?

....Get my drift? You have to start applying your nursing knowledge to the real life. Don't forget anything. My instructor is tough and if we miss a beat she freaks. Always be aware of your surroundings. We have clinicals 7:30-11:30. It is tiring because I work after school too, but its a great way to learn how to do things and get advice from other nurses.

As for medications, we always get ours the night before we give them. We have to research the s/e and everything. When giving them just make sure you take your time and CHECK the medication. Our teacher tricked a few students and gave them the wrong meds purposely to see if they were actually paying attention.

Take a deep breath and you'll do fine!

chinacatSN · Oct 18, 2010

Thanks! Sounds like your program is a LOT different.

Every Monday (either after class or in the evening) we have to visit our patient/client and do a patient history on them. We also have to look over their chart and write down all the meds they're on and what diagnosis they have. Then we have clinicals on Tues and Wed (from 6:30 to 12:30) and we have to have all the meds researched and we have to write up "drug cards" and each and every med. We also have to research the medical diagnosis and know what disease processes are going on in the body. We need to come up with a nursing diagnosis and write up a care plan. Since this is the first semester, the nursing diagnosis and the care plan only have to be basic - at least for the first 3 weeks.

I'm a little freaked because I have been told that other nurses like to quiz the students on things while doing rounds. I'm also freaked that I'll totally mess up on something.

ziggysgal,RN · Oct 19, 2010

My program is structured a little differently, but here's some general tips from someone who had massive anxiety issues going in to clinicals (getting better day by day)... most of them gleaned from instructor advice or reading this message board.

- Relax. Yes, I know it sounds ridiculous, but find a center of calm... breathe... and force yourself to calm down.

- Take your time. No one expects you to go in and be super-efficient. In the beginning, focus on accuracy and quality of care... speed will come with time.

- Try to learn something about/from every patient you come in contact with. Take every available opportunity to observe procedures no matter how squeamish you might feel. Exposure to the visual aspect will serve to desensitize you when you have to DO it.

- Have fun! Yes, again it sound ridiculous... but if you focus on being optimistic and enjoying what you do... you wont have time to feed your own anxiety.

Good luck! They wouldn't turn you loose if you weren't ready to try!

PS on the tats... is it an option to wear big band-aids or ace wraps?

ziggysgal,RN · Oct 19, 2010

Thanks! Sounds like your program is a LOT different.
I'm a little freaked because I have been told that other nurses like to quiz the students on things while doing rounds. I'm also freaked that I'll totally mess up on something.

Don't know how specific your instructors want you to be... or how often they expect you to be correct, but when they ask you questions... commit to not saying "I don't know"... say "I will have to look that up and get back to you" (and do it) or guess using your knowledge base (better than I don't know in most cases)...

Savor the questions in clinical... they are good training for critical thinking for the NCLEX!

chinacatSN · Oct 21, 2010

PS on the tats... is it an option to wear big band-aids or ace wraps?

I've pretty much decided just to wear the long sleeved shirt and suck it up lol. But if patients complain about the "sweaty, sick looking girl" it's not my fault!

Thanks, Ziggy. That's probably what I'll have to do. We've only gone over the basics and I feel like there's a lot I don't know. My instructor has said that we'll have to learn to stand up for ourselves - not just over questions we don't know, but there are pushy nurses and doctors out there who may ask us to do something we're not supposed to do. Last fall, apparently one of the students was pressured into giving an IV med by a Dr! The student got an "unsatisfactory" for the week. I think the Dr should have at least gotten a slap on the wrist - he basically forced unlicensed personnel to give IV meds!

I have severe anxiety issues as well. I still have PTSD from an incident that occurred in 2003. It's very easy for me to get flustered and agitated when I feel like I'm being watched and critiqued. I'm just going to have to learn how to keep calm and say "no" when someone asks me to do something I don't think I should do.