What are some things I should be expected to know as a senior year nursing student

Jolie, BSN · Jul 31, 2008

For any nursing student, awareness and practice of basic safety measures is always the most important thing! Proper ID of patients, the "rights" of medication administration, always looking up medications prior to administering them, fall prevention, etc.

For the senior nursing students I precepted, my concern was that they understood normal A+P as well as the basic pathophysiologic processes involved in the care of our patients. (Common things such as diabetes, renal failure, congestive heart failure, pneumonia, etc.)

That basis of information will allow a student to critically think his/her way thru patient care needs, expected lab values, anticipated medications, specialty consults, etc.

I wouldn't get too concerned over the "mechanics" of various procedures. Most students simply don't get the clinical time necessary to become proficient at everything, including IV starts, foley insertion, ng insertion, etc. BUT I fully expect any student at any level to request the P&P manual and review any procedure prior to approaching a patient.

I guess my biggies would be patient safety, critical thinking, and the intitiative to inform oneself of proper P&P needed for patient care.

Rainbowbright77 · Jul 31, 2008

Thanks. I feel better. Those things, I know. :)

xlxmegxlx, ASN, RN · Aug 1, 2008

First, take a deep breath....be confident in your knowledge and your skills, and know that you are going to do great. I am a new graduate nurse so I'm still familiar with all of the fears of senior year. I worked as an extern for a year before my senior rotations started, so I did have one hand up on some of the other students in my class. HOWEVER, no matter how well you do in school, or how good your clinical skills are...you cant, and wont know everything in the beginning. Dont worry about the hemostats, your still a student and still learning. Sometimes the older, or "more experienced" nurses forget that, only because it eventually becomes second nature to them, and it will to you too!

One tip I can give you, is buy yourself a pair of hemostats and bandage sizzors and always keep them in your pocket. You never know when you'll need them, and chances are, someone else may ask you for them too! It is also helpful to grab a roll of paper tape to hang on your stethescope, and stick a black sharpe marker and a wad of alcohol swabs in your pocket. Those are a few things you'll be using frequently. You will learn that the names of different products (i.e, bandages, cotton wipes, ng tubes, etc...have different names from one institution to another) so you'll finally get used to calling it something at one place, and then the next place will have no clue what your talking about! Before doing any type of procedure, like foley insertion or trach suctioning, make a list of everything you will need first. When you grab a foley catheter kit....grab two!, incase you miss on the first try. Read the boxes to see what the kit includes, because it may not have everything in it. And always have a couple exta sets of sterile gloves on hand when doing any type of sterile procedure! You'll need to know the different IV bags, and tubing that goes with them.

Some of the common terms I noticed a lot of the students were unsure of are these: Teds-compression stockings to prevent blood clots, Sequential Teds (sequential compression device SCD)- An electronic intermittent compression device that velcrose around the calfs. Medlock/Heplock-the IV, used for IV infusions, or as a site for potentially needed emergent meds. (usually anyone admitted to the hospital will receive). Swabs(mouth swabs)-the spongy foam toothbrush/mouth cleanser that can be used for patients that are NPO and need to wet their dry mouth, patients on vents that need their mouth cleaned out, elderly pt without teeth..etc. Piggy backs/piggy back tubbing-a solution or dilution given through a secondary line, meaning it is connected to the line running as the primary infusion (for example NSS). Piggy backs are always hung higher than the primary infusion, and an extension hanger should be included in the set of piggyback tubing (secondary tubing). Heplock flush- although some hospitals refer to their IV catheters as heplocks, do not assume that if they ask you to flush it you need a heplock flush, they may only need a saline flush. Hep Flush is a syringe prefilled with heparin, or a small plastic vial containing heparin to be withdrawn. It has a lower concentration of heparin, intented only to maintain the patentcy of the catheter. And always remember, when flushing any central line, (i,e. PICC) you ALWAYS need to use a 10cc syringe, even if you only need to push 2 cc's.

Alright, I dont want to overwhelm you. These are just some of the more common things I learned, or observed my classmates learn through senior rotation. Remember, always assess the pt before giving meds, know when certain drugs should be held based on your assessments, and not only should you know what each drug is, but know why YOUR patient is receiving it. You will do great, so dont stress about the little things, they come along the way! Good luck with your last year!!! :nurse:

xlxmegxlx, ASN, RN · Aug 1, 2008

First, take a deep breath....be confident in your knowledge and your skills, and know that you are going to do great. I am a new graduate nurse so I'm still familiar with all of the fears of senior year. I worked as an extern for a year before my senior rotations started, so I did have one hand up on some of the other students in my class. HOWEVER, no matter how well you do in school, or how good your clinical skills are...you cant, and wont know everything in the beginning. Dont worry about the hemostats, your still a student and still learning. Sometimes the older, or "more experienced" nurses forget that, only because it eventually becomes second nature to them, and it will to you too!

One tip I can give you, is buy yourself a pair of hemostats and bandage sizzors and always keep them in your pocket. You never know when you'll need them, and chances are, someone else may ask you for them too! It is also helpful to grab a roll of paper tape to hang on your stethescope, and stick a black sharpe marker and a wad of alcohol swabs in your pocket. Those are a few things you'll be using frequently. You will learn that the names of different products (i.e, bandages, cotton wipes, ng tubes, etc...have different names from one institution to another) so you'll finally get used to calling it something at one place, and then the next place will have no clue what your talking about! Before doing any type of procedure, like foley insertion or trach suctioning, make a list of everything you will need first. When you grab a foley catheter kit....grab two!, incase you miss on the first try. Read the boxes to see what the kit includes, because it may not have everything in it. And always have a couple exta sets of sterile gloves on hand when doing any type of sterile procedure! You'll need to know the different IV bags, and tubing that goes with them.

Some of the common terms I noticed a lot of the students were unsure of are these: Teds-compression stockings to prevent blood clots, Sequential Teds (sequential compression device SCD)- An electronic intermittent compression device that velcrose around the calfs. Medlock/Heplock-the IV, used for IV infusions, or as a site for potentially needed emergent meds. (usually anyone admitted to the hospital will receive). Swabs(mouth swabs)-the spongy foam toothbrush/mouth cleanser that can be used for patients that are NPO and need to wet their dry mouth, patients on vents that need their mouth cleaned out, elderly pt without teeth..etc. Piggy backs/piggy back tubbing-a solution or dilution given through a secondary line, meaning it is connected to the line running as the primary infusion (for example NSS). Piggy backs are always hung higher than the primary infusion, and an extension hanger should be included in the set of piggyback tubing (secondary tubing). Heplock flush- although some hospitals refer to their IV catheters as heplocks, do not assume that if they ask you to flush it you need a heplock flush, they may only need a saline flush. Hep Flush is a syringe prefilled with heparin, or a small plastic vial containing heparin to be withdrawn. It has a lower concentration of heparin, intented only to maintain the patentcy of the catheter. And always remember, when flushing any central line, (i,e. PICC) you ALWAYS need to use a 10cc syringe, even if you only need to push 2 cc's.

Alright, I dont want to overwhelm you. These are just some of the more common things I learned, or observed my classmates learn through senior rotation. Remember, always assess the pt before giving meds, know when certain drugs should be held based on your assessments, and not only should you know what each drug is, but know why YOUR patient is receiving it. You will do great, so dont stress about the little things, they come along the way! Good luck with your last year!!! :nurse:

DreamingTree · Aug 3, 2008

You've already been given some good advice, but I'd like to recommend a handy little reference guide:

http://www.amazon.com/Rnotes-Nurses-Clinical-Pocket-Guide/dp/0803613350

I purchased RNotes during my second semester and found that it was a good guide to refresh my memory on the basics. It has a little of everything in it.

Other than that, the best advice I can give is to relax. There's no way that you can prepare for every possible scenario. I'm a recent graduate still working with my preceptor, and I find that I learn something new everyday. Stupid things, really. My clinicals were at a different hospital, so the equipment was all different. It's just the way things work when you are new.

Also, I survived nursing school & the clinical setting by displaying a confident attitude no matter how nervous I was on the inside. Before I would start a new procedure, I would ask my instructor if I could do a verbal run through to make sure I was mentally prepared. And my drug guide was (& still is) my best friend. Even now, no matter how busy I am, I will always stop & look up meds I don't know.

Good luck!