Tips for a Great Clinical Experience

Ellen Grover, MSN, RN

It's finally time to put all the skills you have learned in nursing school into practice - with real patients! Your first few clinicals can be exciting but also overwhelming. As a nursing instructor I love to see the energy that new students bring to clinical, and I have found that if students come in with a positive attitude and follow the tips below they are better able to keep up their enthusiasm throughout their rotation and have a good learning experience

How To Have a Great Clinical Experience

STEP 1: Treat the nurses you work with respectfully.

Realize that some will see you as additional work on top of their already very heavy workload. Try to find a way to reduce that workload for the nurse you are paired with. Can you go check a blood sugar? Empty a foley or drain? Help a patient to the bathroom? A recent study showed that developing a positive relationship with the nursing team helped students to feel more satisfied with their clinical experience. (See article here)

STEP 2: Volunteer to perform a new skill.

A female patient needs a foley placed and your instructor asks who wants to do it. You may be thinking, "I've only ever practiced that in the lab, I'm not ready to try it yet." Do it! You have your instructor with you and probably several other students that want to observe that can also help - it is the BEST time to do your first foley. You never know if and when you will get another opportunity.

STEP 3: Remember you are in a professional workplace.

The staff and unit manager are all observing you and the other students. Students with extra time on their hands often tend to socialize which can become loud and disruptive. Here are some ideas to do instead: ask if you can answer that call light that's on, look up the medical term/medication/disease process you did not understand, go check on your patient and see if there is anything he needs. You never know if the unit you are on will be hiring after you graduate. They may remember you, and they will remember the reputation of your school during clinicals.

STEP 4: Ask questions!

Take advantage of the experience of your nursing instructor and the nurses you are working with. This is the time to ask "dumb" questions. As a student nurse most skills are new to you and now is the time to see in practice what you have been learning in the classroom. If you don't know how to do something, ask for help. Never, ever perform a nursing task by yourself that you are uncomfortable with. Remember the safety of your patients is of utmost importance.

STEP 5: Work on your care plan.

Did I hear a communal groan when I mentioned care plans? They are a part of your clinical experience and they're not going away any time soon. The best you can do is take down all the info you need from your patient's chart while you are at clinical and use it as a learning tool. It may bring up questions you hadn't thought about before (why did my patient on diuretics have such low K and Na?) and help you make connections that you otherwise may not have noticed. It also REALLY does help you learn important details about medications which will be invaluable as you continue to build your nursing skills.

STEP 6: Care for a variety of patients.

Did you already have a patient with heart failure and diabetes the last two weeks? Maybe your patients all had foleys but none had chest tubes or wounds or drains. Let your instructor know so that she can assign you patients with a wide variety of issues.

STEP 7: Arrive on time and be ready to work.

Do everything you can to avoid missing a clinical. Sometimes circumstances are out of your control but making it up in the lab is not equivalent and you are missing out on precious time with patients.

STEP 8: Review the basics before your first clinical.

It's OK to be nervous - I would much rather have a student be nervous than overly confident. However, you MUST know normal vital signs and how to measure them accurately. Practice skills at home AND in the lab during open lab time. Studies have shown that this kind of experiential learning, where students actively observe and participate in learning, positively affects student performance. (See article here)

Follow these tips and it will help you improve your skills and develop your competence in treating real-life patients.