We dont have to go and review our pts chart the night before clinical...normal???

Preemienurse23 · Aug 3, 2007

We did something like that our first semester. We didn't have to go read the chart, but we went and "picked" up our pt. We would get our dx and start on some of the paperwork we had to do. The last 3 semesters, we had preceptors and we met them on the unit and got our pts then. It wasnt required or even suggested to do it the night before.

nightmare, RN · Aug 3, 2007

Your school trains you this way and if you think about it,as a nurse ,you will have to walk onto a ward and be expected to read charts and digest the info there and then.The only reason for students getting a heads up the night before is so that they can look up things.When we were students you where expected to take the senior sister on a ward round ,with no notes,and tell her each persons name ,age ,diagnosis and treatment.....very nerve wracking but it did teach you to hold info in your head.

emtb2rn, BSN, RN, EMT-B · Aug 3, 2007

At my school, in our 1st 2 semesters, we did research the day before our 2 days of clinicals. This allowed us to:

- read the charts at our leisure, we got there around 1pm. Charts were easy to find (assuming the pt wasn't off the floor).

- research the pt hx. What's wrong with the pt? What is the standard tx? What tests have they had? How did they respond? What's the doc doing? What have the RNs documented?

- research the pt meds. Why were the meds being given, drug class, contraindications, SE/AEs, how to evaluate, implentation concerns, is the dosage OK?, etc. Understanding meds is a big deal in my school and the CI's made sure everybody could explain exactly why they were giving each drug.

- talk to the RN(s) giving care that day. What's up with pt? Anything I need to know as a student?

- build the care plan that afternoon/evening. I can create a care plan off the top of my head now and that's due to all the ones I created the day before clinicals started.

Danish, MSN, APRN, NP · Aug 3, 2007

Hi!
Im going into my third yr of nursing school and was wondering one thing...i keep reading that alot of nursing students have to go to the hospital the night before clinical and get all their pt information and their drug info, etc then read up on it and be informed the night before going to clinical.
We have never had to do this at my School...basically we get our pt at the start of clinical and have to read their chart / MAR medication sheet and then note all their pertinent info in a very short period of time and read up on anything we dont know during clinical or ask our instructor if we dont understand something.
I was just wondering if anyone else's NS does the same thing or is it just mine?
The advantage of doing it the night before i guess is you are more acquainted with your pt and their medical conditions...can look up drugs, etc. Isn't it a pain in the behind lol though to commute all the way their to find this out. Doesnt it take up a huge part of your day to travel then find all this info then go home and review it? Its probably better though than what my school does...
Thanks! :)

We never go to the hospital before the day of clinical to get info. We get report on our patient the morning of...just like any nurse would. We look over the chart and MAR that morning too. I think this is the best way to learn because you cant go the night before in the "real world"

Just my $.02

student456 · Aug 3, 2007

ok cool - i thought my school was wierd after reading about everyone having to go the night before to review charts...i guess it makes more sense to do it the morning of clinical as its the real world way

Lorie P. · Aug 3, 2007

we never got to go the night before. we only got to know who our pt's where when we arrived at the hospital.

i usually kept the same pt for the 3 days of clinical, but most of the time by the third day , you were starting over again.

our clinicals were thur, fri and monday. it never failed, on monday morning a whole new pt with all new stuff to look up.

i agree with other post, nurses do not go the night before a shift and pick and chose their pts. also each night is different and you may or may not have the same pts. that is real worl nursing.

nurse hobbit:uhoh3:

Montessori Mommy · Aug 3, 2007

Consider yourself lucky! It took me hours to do research on my patients, their dxs and meds for each clinical. Many times we'd get in the next morning to find out the patient was discharged or moved to another floor.

By our last semester, we just went in a little early in the AM to look up our patients. I'd agree with the above posters - it's more "real life" than researching the night before. By the last semester we were up to six patients, so it would have taken all night to research!

Best of luck!

onyx77 · Aug 3, 2007

We are required to go to the facility the day prior to clinical to get our pt information. This is helpful not only in the fact that you get a little bit of a heads up, but if the disease process is one you're not familar with how are you going to assess and know what is or is not normal for that pt. There are a lot of times that your pt isn't there in the morning and it is more "real world", but then again, we are learning. How can we be expected to know everything when we are just learning the disease processes and all? Yes, it is a pain in the butt to have to go to the facility on a day that there is no clinical, but I do prefer to know WHY things are being done to my pt before hand. And to be quite frank with you, we don't have time to look things up during clinical. We are required to know it before clinical. We actually have to write out a detailed description of the pt's dx and hx, have med sheets done, and have a game plan for the clinical day or we are sent home!

Devil_Duckie, LVN · Aug 3, 2007

Wow.... I graduated from an ADN program this past May and before every single clinical, we were required to go the day before and get our assignment for the next day.

We would usually beat our instructor to the site (she was required to make our assignments, not us!) and end up waiting an hour or so until she waltzed in and threw together assignments. Then we would track down the chart on our patient(s) and spend about another hour (if we were lucky and not interrupted every 10 seconds by the nurse, attending, physical therapy, etc) to write down every detail we could: meds, primary/secondary dx, lab reports, allergies, everything.

Then we'd go home and spend most of the night doing a write up on each patient we had, usually 5-10 pages of research pertaining to the diagnosis, medications, and labs. Most nights, I was up til 12 or 1 writing, then back up at 5 to be at the clinical site by 6. No kidding. And, if our paperwork was not complete, was incorrect, or even just 'too short,' we would be sent home from clinical, one absence counted against our record.

We'd have a pile of make-up work to do and would be faced with being kicked out of the program if we missed another clinical, even for being ill, emergencies, etc.

Count your blessings, y'all. Not having to do any prep work before clinical sounds like a dream.

Altra, BSN, RN · Aug 3, 2007

And to be quite frank with you, we don't have time to look things up during clinical. We are required to know it before clinical. We actually have to write out a detailed description of the pt's dx and hx, have med sheets done, and have a game plan for the clinical day or we are sent home!

Then we would track down the chart on our patient(s) and spend about another hour (if we were lucky and not interrupted every 10 seconds by the nurse, attending, physical therapy, etc) to write down every detail we could: meds, primary/secondary dx, lab reports, allergies, everything.
Then we'd go home and spend most of the night doing a write up on each patient we had, usually 5-10 pages of research pertaining to the diagnosis, medications, and labs. Most nights, I was up til 12 or 1 writing, then back up at 5 to be at the clinical site by 6. No kidding.

These posts sounds pretty much like my school experience. For one thing, I think this is dependent on what your clinical hours are -- I can't imagine a student being able to get your hands on the chart during the early part of day shift long enough to glean the needed info. Secondly, as a student you are seeing disease processes for the first time, not the 100th time. Now ... give me a dx and brief pt. hx and I can probably tell you what 80-90% of the orders & meds are without even looking at the chart. But I could not have done that as a student -- I lacked the knowledge and experience. In addition, our clinical time (except for a couple of specialty rotations) coincided with day shift, from arriving early enough to print MARs and listen to report with all other nurses on the unit, to following the "flow" of the day's activity. If a patient was scheduled for the OR or other test or procedure, we already knew that and were expected to do our best to work that transport in with other nursing care required of our patient(s). Clinical was not the time for reading -- we were to learn by doing and learn from nurses, MDs and others present and jot down things that we wanted/needed to read up on later.

To the OP: despite some philosophical differences between your school and some others in regards to clinical time, I truly would not stress over this. This is the way it's done, others before you have been successful learning this way, and there's no reason that you can't be successful too.

Good luck to you. :)

vashtee, RN · Aug 3, 2007

I *like* being able to pick a patient in advance. This allows us to look for different sorts of patients to work with and seek skills not yet mastered. (If I need to do IM injections, I look for patients who have them ordered.) I am not in the hospital merely to work; I am there to learn.