What do you do in Clinicals?

notadoc · Jun 7, 2007

Brandi8,

My first clinical rotationwas this past spring in a Gyn Med/Surg floor (all females, most recovering from gynecological surgery, though we also cared for post C-section and cancer patients). By the end of the five weeks, we were doing pretty much everything. We could not start IV lines, nor could we administer blood products (whole blood, plasma, packed cells, etc). Beyond that, though, we did it all, usually with only minimal supervision. That included eveything from physical assessments and routine patient care (bathing, ambulating, feeding) to oral and IV medication administration (which is a whole lot more nerve wracking than you would think - LEARN THE FIVE RIGHTS!!!) to foley catheter insertion/removal and wound care.

I am in an internship right now (eight weeks this summer) before my final two semesters of nursing school. The only things I cannot do are administer blood products and adminster IV push medications. In the last few weeks, I have performed blood draws, performed ostomy care, removed sutures, and assisted with outpatient surgical procedures (just me and the MD) and administered meds by very route available (all of them!)

Clinicals are a lot of fun, but they are deadly serious business. It can be frigthening at times, but I have really had a ball. Learn your anatomy and physiology. You will be seeing pretty much all of it in clinicals. Know you chemistry (especially acid-base). You will need that as well. Probably most importantly, though, pay close attention to the psyc classes you undoubtedly have to take. The biggest challenge for me has not been the science. That comes with study and a little practice. The human dimension is by far the hardest part of nursing. Even that is a blast once you get the hang of it.

Study hard and review often. You will be fine. Now, as for care plans... Depending upon the requirements of your school's program, they can either take up a lot of you time each week in clinicals, or they can take up a WHOLE LOT OF TIME each week in your clinicals. A care plan is basically a comprehensive assessment and analysis tool completed by you for whatever patient (or patients, later on in your studies) you are assigned on your clinical day. Our cover a complete health, physical, and psychosocial history, current medications (med, doseage, route, mechanism of action, reason prescribed, and any and all information on that medication that might be pertinent to care), a thorough physical examination in each of seven areas (neuro, musculoskeletal, cardiac, pulmonary, GI, genitourinary, and integumentary), along with a complete review of systems in each area, and (this is the best) one nursing diagnosis in each area, complete with problem statement, goal, expected outcome, analysis of outsome, outcome modifications, physiological signs and symptoms of the problem(s) addressed by the nursing diagnosis, a nursing intervention (with rationale), and a pharmacological intervention (with rationale). They take forever to write (at first), and you usually only have one day in which to write them, but they are pretty valuable tools for the student nurse, since they force you to focus on areas that really do affect patient care, and they REALLY make you learn your meds. I cannot say that I particularly enjoy writing them (since they still take a while, even though I have written a bunch of them), but they do help me when I am an the floor.

Sorry for the long reply. I hope this helps. Good luck with you studies.

TheCommuter, BSN, RN · Jun 7, 2007

When I was a student, I did several tasks during my clinical rotations. I passed medications, dressed wounds, did care plans, did head-to-toe assessments, checked vital signs, administered breathing treatments, gave injections, removed sutures, emptied urine bags, gave baths, ambulated patients, used hoyer lifts, gathered information, and so on.

Clinical rotations are the perfect chance to learn nursing skills hands-on, use them, and hone them as needed.

TazziRN, RN · Jun 7, 2007

In some ways it's difficult because now you have to put together everything you've learned in the classroom so far and try to have it make sense. In other ways it's easier because seeing the pt can help with putting it all together so that it makes sense.

I know.....I didn't help, did I?

kmarie724 · Jun 8, 2007

I just finished up with my first round of clinicals. Since this is only our first semester, we weren't expected to do any really complex tasks and we needed our instructor or a staff nurse to supervise us anytime we gave meds. Our responsibilities included: administering PO, IV, IM, and SQ meds, taking VS, checking BG, assisting with ADLs (bathing, toileting, eating, etc.), physical assessments, and charting what we did (with our instructor or a staff nurse cosigning any meds recorded on the MAR).

The actual clinical itself (i.e. being at the hospital and providing patient care) wasn't so difficult. The care plan was the pain in the butt part. notadoc did a good job explaining care plans, and my head still hurts from writting mine (I turned it in yesterday), so I would bore you with all the details again!

HTH. Good luck!