What are clinicals all about????

glenmar3 · Jun 27, 2008

All good suggestions. It's been a long time since I was in school but I do remember that we got our patient assignments the day before. Look every thing up the night before that has to do with your patient. That includes their pathology, labs, and meds. Also any treatments they may get. I remember doing a med surg rotation with an instructor who had been a major in the Israeli army. She was tough! However, the first time she grilled me about my patient's meds I was able to spit the answers right back at her. After that she pretty much left me alone and when I was caught up with my assignment she would send me other places to see things like in the dialysis and critical care units.

On the job I carry a Tungsten H2 hand held that has a calculator function and epocrates (its like a mobile PDR) loaded into it for reference. A lot less bulky than a drug reference book. I also carry bandage scissors and a straight surgical clamp in my pocket. Comes in real handy when you need a third hand. Add to that a good stethescope and some alcohol prep pads and you should be ready for just about anything. Good luck!

glenmar3 · Jun 27, 2008

OOPS! :smackingf I just re-read my post and I meant to say Tungsten E2 not H2. See what happens when you get old?

trrinatl · Jul 4, 2008

I remember the fun days of clinical 22 years ago in nursing school. The first clinical I got into trouble because I Xeroxed the pages out of the drug handbook instead of hand writing them (which I thought was a waste of time since I had hi-lighted the stuff that was appropriate for my pt). I soon found out that if you study your skills and peform them well, they pretty much left me alone. Sometimes they would try to "find" something wrong and would keep on and on and on and seem to get more and more frustrated when you DID know the answer.

Once I remember this MEAN Med Surg instructor that had me hostage in the med room for 45 minutes over giving an ASA for a pt with a temp of 103. I had already been under the hawkeye during collection of blood cultures and ordering IV ABX from the pharmacy. I finally said, OKAY, just tell me I'm a moran and belittle me so I can get on with giving this patient the med that they need for their fever. She backed off and left me alone. Sometimes you do have to stand up for yourself, but keep in mind, it comes with a cost.

As a nursing instructor for a local program, I came up with a new approach to those old time NURSING CARE PLANS. I told the students, No careplans this week, instead, I have a new approach. Go into the patients room, do your assessment. Tell me the top two priority problems they have today, what you found on assessment that made your rank them highest, what you are going to do to fix it, and what you are going to assess at the end of the shift to see if it's changed.

After a couple of students didn't know that pain at 9/10 with diaphoresis and resp rate of 26 was a higher priority than some crappy nursing diagnosis of "alteration in self image" we soon got everyone on the same page. Just as they figured out that pain was the bigger issue, they also realized that they didn't have a clue as to what the patient had ordered for pain or where their IV site was located. VERY quickly they learned that being able to think on your feet and problem solve was MUCH harder than writing care plans. At the end of the semester they all agreed that care plans were much easier, but that they learned MUCH more by having to be prepared on the spot.

tinktink4 · Sep 15, 2009

How did u make out on your 1st clinicals? I start my clinical 1 tonight and am very nervous. I don't feel i know enough to be with patients yet.

tinktink4 · Mar 31, 2010

Thankyou for your help i did take a deep breath and loved it. I found nursing is def for me after clinicals. I moved on made it to pharm and failed im curently trying to get my school to get my transcrips so i can take test to get certs for cna. I think if i take some time as a cna it will be easier to go throught the lpn program.

honeycakes55 · May 16, 2010

I don't really get what clinicals are. Can anyone be detailed in their explanations?

brownbook · May 16, 2010

In clinicals you will be "working" as a nurse. Whatever your instructor says you are allowed to do (signed off on) you will do, same as a floor nurse. The nurse who is taking care of your patients will be told a student has her patient. She will be told what you will be doing for her patients. How much you do depends on where you are as a student. You might take vital signs, give bed baths, pass meds, change dressings, chart, insert foley's, etc.. Just be sure you are real clear with your instructor as to what you are allowed to do!

notmanydaysoff · May 16, 2010

I am in an accelerated LVN program. We've finished NF and have started Med/Surg in an acute hospital. We have 2 day shifts (7 - 3:30) and 1 pm shift (3 - 9:30) each week, in addition to 2 classroom days.

Each week we have a new chapter/system to cover (ex. respiratory, GI/GU, endocrine, etc.). The instructors have an opportunity to look at the available pts/their conditions before we get to the hospital and try to match us up with whatever the topic du jour is.

This week was respiratory and my pts consisted of someone w/mesothelioma, and another w/suspected TB and a trach that was just removed. We do everything for that pt from empyting urinals, bedpans, chg linens, administer all meds except IVP, go to surgery/accompany to a procedure (if our pt is scheduled), client/family teaching, listening in on the resident physician rounds (sometimes they ask us questions, or where something is, can we get it STAT...and we better know the answers or we look like DSs!!!).

We have to become familiar with our pts from the git-go because we never know who's gonna ask what (like what the code status is, are they on strict fluid restriction, what the fall risk is, etc.).

As for knowing meds, before we can administer a med, our instructors require that we:

1) know what the med is,

2) know class/mode of action,

3) be able to list most significant side effects, and

4) any nrsg implications.

This past week, two of my fellow students witnessed a leg amputation of someone w/cellulitis who was in so much pain that she was screaming for hours for the surgeon to cut off her leg. She is a druggie and even the max amount of morphine did nothing to alleviate her pain. Another student witnessed a cardiac cath on a prisoner.

Hopefully that gives you some detail of what a clinical consists of. As the poster above said, we work as nurses, doing what it takes. I will do everything and anything just to be able to have seen, done it.

TheCommuter, BSN, RN · May 20, 2010

During clinical rotations, my classmates and I practiced hands-on skills in actual healthcare settings such as hospitals, nursing homes, clinics, group homes, subacute facilities, and so forth. My classmates and I also learned by observing the nurses who were working in these places. During a clinical rotation, you are basically putting your book-learning and theory into practical use.

While at clinicals, I gave injections, passed medications, administered tube feedings, obtained finger stick blood sugar tests, suctioned patients, performed tracheostomy care, gave breathing treatments, observed catheter changes, observed wound care, collected vital signs, weighed patients, performed assessments, discontinued IV lines, communicated with patients, and so much more.

jelorde37 · May 31, 2010

basically, clinicals is a time for you practice being a nurse and do nurse stuff(depends on your scope, what material u guys have covered, and how comfortable your instructor is). fun stuff tho. just be prepared whenever you have to pass meds or do procedures.

notmanydaysoff · Jun 1, 2010

I will do everything and anything just to be able to have seen, done it.

must clarify, "everything and anything" within the scope of an LVN's practice!

SweetseRN · Aug 4, 2011

I keep hearing from experienced nurses that when you actually get out on the floor to work, nursing is nothing like clinicals/nursing school. What do they mean?

I enjoyed my clinical experiences but I am just wondering...If you agree that your nursing school experience was very different from real life nursing, can you enlighten me?

In what way is it different? Do you enjoy it more...or less? I would just love to hear what some nurses with a little (or a lot!) of experience have to say...

I should add that I am starting my first job in 4 weeks, super excited but unsure of what to expect.