What are clinicals really like?

verene, MSN · Mar 5, 2017

1. How many hours per week will I spend in clinicals, and for how long each time?

This will depend on your program, and where you are in the program. My ABSN program has 4 hour, 8 hour, and 12 hour clinical slots depending on placement and day. Hours in clinical per week start at around 12 hours in the first quarter and by last quarter are 24-36 hours per week. This current rotation I spend about 20 hours per week on the floor and another 2-6 hours per week in clinical related activities (patient prep, clinical based assignments, post-conference etc.).

2. Will I have a choice as to what setting I work in for my clinicals, and what services I will perform? For example, will I have to perform enemas or clean people up after elimination, etc.? I am entering the field to become a NP and do not want to ever work as a bedside nurse. . You may have some limited choice in where you go. In my program we are given a handful of options for placement and told to rank them based on preference. You will be expected to preform all skills you have been cleared to do by your faculty. This does include hygiene care and applications of enemas and suppositories. You may not ever want to work as a bedside nurse, but be prepared to have nursing fundamentals under your belt. Also, if you come in with the attitude that you are "too good" for certain aspects of nursing care, be prepared to have a hard time in clinicals, a lot of floor nurses do NOT like working with direct-entry NP students specifically because of that attitude. Your CNAs will also not appreciate your unwillingness to help out either. These are people you want to build good relationships with and learn from, don't alienate them from the get-go.

You can know in your head that floor nursing is not for you and you don't like certain aspects of care (and no one likes everything), but you are setting yourself up for unnecessary challenges if you vocalize those thoughts and aren't willing to pitch in on the more unpleasant aspects of care. Accept that while you are in the ABSN portion of the program you are learning to become a NURSE, and you should make it your goal to learn to be a good one.

3. Will I have to be on my feet the entire time during clinicals? I have some issues with foot pain when standing for longer than 3 hours at a time.. Much of the day, yes, probably. All of the day, no. While you will be on the move much of the day it is pretty normal to be able to sit down for a few minutes at a time several times through out the day. How much time you get to sit down depends on the unit and the day.

AceOfHearts<3 · Mar 5, 2017

I find cleaning my patient up is the best time to do a very thorough head-to-toe skin assessment.

I also expect any student that is with one of my patients will perform any tasks that I myself would be doing (that they are allowed). That def. includes helping to toilet and clean up the patient. This doesn't mean I'm going tho throw the student to the wolves, but I def. expect some help in exchange for the extra time it takes me to complete tasks since I have a student with me.

GrumpyOldBastard, MSN, RN · Mar 6, 2017

Thank you! This is the most entertaining thing that I have read all day! I wish I could be there watching you as you attempt to "steer" your clinical experiences to suit your delicate preferences. If you retain this attitude, I suspect that you are going to find your path quite a bit bumpier than you expect.

JJL618, RN · Mar 6, 2017

I see the OP hasn't returned to reply to any of the comments. I assume they don't like the responses?

Joanie49 · Mar 6, 2017

During clinical you will be on your feet the entire time providing patient care. You will be expected to participate in personal care of patients so yes cleaning them up and morning care and any other care they may need. You will get no special considerations just because you want to be FNP and never want to work bedside. You will still go though all the same clinicals as other students do and expect to demonstrate respectful patient care though out the clinical experience. Normal clinical hours are 16hs per week (in area at least.) In my nursing school we all went to hospitals which did not provide much of a choice per say..... we kind of took what we got for experience and built off from that...... As another poster said it is going to be difficult to secure a FNP job without any nursing experience unless they are in desperate need......Best luck to you..........

akulahawkRN, ADN, RN, EMT-P · Mar 6, 2017

I'm going to reply in-line to your stuff below to make my responses easier to follow.

Hi! I'm entering a second-degree accelerated BSN program next fall for the sole purpose of becoming an FNP afterwards. My only experience in the medical field includes working as a certified coder, so I am just wondering what nursing school is actually like. For example, I am wondering the following things:
1. How many hours per week will I spend in clinicals, and for how long each time?
This varies by the program. My particular program had us in clinicals about 16 hours every week. One day per week was 4 hours of prep time on the floor and you'd be doing information gathering on your patient(s) you will likely have that week. We would not be doing any patient care during that prep time. The following 2 days we'd do hands-on clinical care for 6 hours each day. We'd get a 30 minute lunch and then it's back to the floor.
2. Will I have a choice as to what setting I work in for my clinicals, and what services I will perform? For example, will I have to perform enemas or clean people up after elimination, etc.? I am entering the field to become a NP and do not want to ever work as a bedside nurse. Your program will require you to be able to (and actually perform) basic nursing skills in every setting they put you into. You will not do skills that you haven't demonstrated an ability to do those skills in lab. As to cleaning people up, well you're in for a rude awakening on this: Everyone wipes the butt. The simple reason is that if you can't get to it because it's dirty and you need to assess it, you clean it so you can do your job.
3. Will I have to be on my feet the entire time during clinicals? I have some issues with foot pain when standing for longer than 3 hours at a time.
You will likely be on your feet the majority of the time unless you're at a computer workstation doing your charting. Once you are actually working you will likely spend MORE time on your feet than you ever did in school unless you're charting (and even that's only if you're not at a mobile workstation). There have been many shifts where the only time I ever sat down was if I was giving discharge instructions or actually taking lunch.
I would appreciate any and all insight into what clinicals are really like! Thank you so much.

Since you want to work as a mid-level practitioner and NOT have to do any bedside nursing, your only really good path to this goal is to become a Physician's Assistant. Being an NP basically requires that you do time as a bedside nurse before you begin NP school because the programs do NOT want to have to teach you how to provide care for patients. PA school will teach you and you very much likely will spend a HUGE amount of time on your feet during school, in your rotations/clinicals, and later when you're working.

Nursing School clinicals really are about slowly taking you from having never done many patient care activities to someone that has done pretty much all basic skills and is ready to learn more in a very controlled manner. I was a Paramedic before I became a nurse so I was already very familiar with many of the skills. The focus and application of those skills can be very different from that of a Paramedic and very much geared toward becoming good at time management because you'll have (usually) more than one patient at a time as a nurse.

verene, MSN · Mar 6, 2017

I'm going to reply in-line to your stuff below to make my responses easier to follow. Since you want to work as a mid-level practitioner and NOT have to do any bedside nursing, your only really good path to this goal is to become a Physician's Assistant.

Not sure this is actually the case. I looked into PA school while I was still deciding which health profession I wanted to go into. Most PA programs want somewhere on the order of minimum 1,000-2,000 hours of healthcare experience providing direct patient care at the time of application. My local program outright states that most competitive applicants have approximately 6 years of hands-on direct patient care experience with many choosing CNA or EMT routes to PA school. You aren't going to avoid bodily fluids or hard work in either of those roles!

jtboy29 · Mar 6, 2017

I'm in my last term of LVN school and through our 2nd-4th terms we spent on average about 6-7 hours in clinicals, except for our Maternity Rotation we actually spent the full 12 hours and it was just one day. Some programs give you a choice and some programs don't however, be prepared to do clinicals at the site you're assigned to or by preference. Before you think about becoming an NP, just like any nursing student goes through the same thing of doing hands-on from doing enemas to cleaning people up after elimination. Like some posters have said, consider PA school because it looks like and I could be wrong however; you're expecting nursing school to cater to you and it's not gonna be that way. You're going to school to get you to where you want to be and you will have to do the basics before thinking about advanced practice.

vintagemother, BSN, CNA, LVN, RN · Mar 6, 2017

I love my AllNurses Peeps! There's nothing I could say to add to the conversation, you have all said it already!! í ½í¸‚

countrynurse09, LPN · Mar 6, 2017

Nursing and medical care in general is about taking care of people. If you find that isn't something that you would be comfortable with, please don't enter this profession in ANY capacity. Your patients and co workers deserve better. It's not like anybody wakes up I the morning and thinks, "Oh I hope I get to clean up a C-diff blow out today!". Yes its unpleasant, but it's part of the JOB of a health care worker! Before you get into advanced practice, you will have to pay your dues in the trenches.

Meowzers · Mar 7, 2017

Unless you are able to get some sort of early entry option, most FNP programs require a year of bedside nursing experience before they will accept you to their program. That is pretty standard for most MSN programs.

Embrace the "yucky" stuff and get used to it - it will make you a better nurse. When someone is lying in their mess, it can cause a whole host of problems. Think about it as part of their care. I have seen RNs and others jump in to help the CNAs when messes happen. You don't want to leave someone lying there while you wait for someone else to handle it. Understanding what the patient is feeling, and what everyone in the care team goes through in their duties is crucial.

And there is really no way to get around being on your feet for clinicals, even at the FNP level. Invest in some good shoes, and talk to your doctor to see if there is anything that can be done to find the cause of it or relieve some of the pain. If you truly have a medical issue, they may be able to work with you a bit to work breaks into your program. But most nursing jobs are going to involve being on your feet.

akulahawkRN, ADN, RN, EMT-P · Mar 7, 2017

Not sure this is actually the case. I looked into PA school while I was still deciding which health profession I wanted to go into. Most PA programs want somewhere on the order of minimum 1,000-2,000 hours of healthcare experience providing direct patient care at the time of application. My local program outright states that most competitive applicants have approximately 6 years of hands-on direct patient care experience with many choosing CNA or EMT routes to PA school. You aren't going to avoid bodily fluids or hard work in either of those roles!

This is true of most programs though it's very much possible to get into a PA program (or MD program for that matter) without having done any healthcare experiences. This is not true of NP programs, even if they don't require any time as an RN. Why? It's because you will get hands-on experience doing patient care during Nursing School.

Now I must absolutely must say that I disagree with the notion that someone should be able to go directly into a healthcare field without having had any experience. Getting healthcare experience in a relatively significant amount means you've had a good "gut-check" as to whether or not you want to really do patient care for a living. I've said it many times before: Everyone Wipes the Butt! If you're allowed to do direct patient care, you are expected to be able to wipe butts.