Who actually ENJOYS clinical?

[foreverLaur]

i see so many threads on here about people dreading clinical, complaining about clinical, etc etc... what about those of us that love it?

i am a third quarter adn student. this quarter is my first "real" clinical. first quarter we just did head to toe assessments. second quarter we were supposed to be doing po meds and injections (ob clinical) but the census was low and i never got to do any of that. prior to today, the most i had ever done on a patient was a head to toe assessment. this quarter i am on a cardiac intermediate unit. today was my first day i was assigned a patient. my clinical instructor / nurse pretty much let me do my thing and only stepped in to remind me or something that needed done. great lesson in patient management. i admire the nurses that handle 6-7 patients.

my patient today was admitted with dyspnea. he has pitting edema and vascular browning on his shins/feet from peripheral artery disease. he also has chf, right coronary artery disease, and lad stenosis. however, his ejection fraction was great! he's scheduled for open heart surgery on tuesday.

i took his morning blood sugar and it was wnl. i did, however, have to give him 8 po meds for a garden variety of problems. he also got lovenox subq. the doctor also put him on ancef iv (just in case his legs were infected). he had a picc line, but nothing was hooked up so i had to do that for the first time! one of his lumens was clotted off (wouldn't aspirate or flush) so we had to use the other one. when it was done, i had to d/c it and flush the picc again. his lunchtime blood sugar was higher so i had to use the sliding scale and administer insulin. later, the doctor wanted his foley taken out and a ua c&s done to check for a uti so i had to learn how to draw urine out of the tubing of the foley and then took it out. then he had lasix iv due and i gave that iv push. later that afternoon, they were taking out his picc line and starting a peripheral iv and that was really neat to watch. i also got to remove a peripheral iv that was infiltrated of another patient and attempted (and failed) to start an iv.

i loved clinical today and i thought i did and learned a ton! this was only day #1 - i can't imagine what next week holds! :)

just thought i'd share a happy story about a new and eager nursing student!

[KimberlyRN89, BSN, RN]

I love clinical! Wayy more interesting than skills class

[J-NO]

I have 3 days left in my second clinical as a LPN student and I love it. I think it depends were you are working and what kind of instructor you have. Currently Im at a residential care facility c. 92 beds. After the first week I was doing PO/SC meds, insulin and the occasional head to toe; I have 3+ patients. It has been an awesome experience! Our group is lucky, so Im told, we have all had the chance to do several VIT B12 IM injections. I guess as students and in general IM injections are a rarity. Next week Im doing a SC Interferon injection for a resident with MS. On the other hand, I have spoken c. some of my class mates at other facilities and they are only doing PO meds and are very bored. SO I guess its were you are and who you are with that determines your experience. Mine is F^&*(NG awesome so far! Im so stoked

[MedChica]

I like clinicals.

I just don't feel very confident with some things...because we don't get in a lot of practice time.

I try to leap on opportunities, though.

I just hit MedSurg. We haven't started clinicals yet...but I'm eager to start. Kind of scared too. It's the hospital.

I've done well on my tests. But I wont' feel confident until I can actually perform.

Right now, I feel like...passing tests is all that I know how to do.

Anyway - when we hit the clinical sites, we just kind of go it alone. Though, I guess that you can stay under the instructor if you want to...but - you have to take some initiative. To me, this is the time to learn and make the mistakes and rec'v correction and become comfortable in a clinical setting.

Not when we're licensed and actual nurses.

Some instructors had us pair up. Others didn't. I don't...unless instructed because I don't want to get used to having a crutch around.

First day is orientation. Second day, you're running all over trying to get sign-offs and see cool and interesting procedures. If there's nothing to see, you can answer the call-lights and help the aides or the other students. The nurses are so fast that they're usually done with everything by the time that you get around to asking if they need help.

*laugh*

Either way, it beats sitting around, shooting the breeze in the conference room.

The rest of the days? You pick a patient and stay with them. Though, again, if there's nothing to be done you'd help out or look for something to observe.

With my last instructor, we took a new pt every day and charted on them. Y'know...I hate charting.

*laugh*

But - I usually try to grab the pt's with a lot of issues.

If you have a mean nurse? We just get another nurse. I don't know if other clinical instructors make their students attach to certain nurses. Ours doesn't.

SKILLS?

My nurse aide skills are great. That sort of exp has really helped me.

Needles. I don't know what it is about me and needles...but I just LOVE 'sticking' people.

*laugh*

Charting is a challenge...but it's coming along.

My assessment skills need work.

Time management is something to work on. I'm good with 'therapeutic communicating' but I don't know how to shush the pt to get the rest of my work done. Maybe I'm too passive when I try to end the conversation?

[butterfly134]

love clinicals :)

[SunshineDaisy, ASN, RN]

Me!! I am having so much fun! I am a 1st semester ADN student as well, so just finished with LTC where we had a group patient. We start subacute next week and I am kind of nervous because we will be solo!

[OB-nurse2013, BSN, RN]

I love my clinical. We're on a med-surg unit and get to see and do so much stuff. I got so lucky this time, my clinical instructer is very nice, a little tough but still very nice and very approachable. The nurses have all been really nice too. I know I won't always have such good luck but I'm definately enjoying it now.

[ImThatGuy, BSN, RN]

I do not enjoy clinicals. Sure, some are better than others, but it's an awkward experience. I'm more of a thinker than a doer anyway when it comes to healthcare/medical-stuff. Patient care really isn't my bag I'm finding, lol. I like reading about it, talking about it, thinking about it, deciding what to do, etc., but doing it....eh, would just assume someone else have that pleasure.

[VivaLasViejas, ASN, RN]

I've been out of school for a long time, but I still remember clinicals very fondly. I loved them! The clinical portion of the program was non-graded, unfortunately, but it was so much more interesting to me than the didactic; I'm one of those visual-kinetic learners who has to see a procedure and get my hands in it in order to learn it well, so clinicals were my time to shine. I jumped into them with both feet and sought opportunities to perform skills every chance I got, and then some.

As a result, I was usually one of the first in my clinical group to be turned loose after being checked off on skills. I was also the first student in the program's history to be allowed to do Foley insertions independently before the end of my freshman year. Everyone else had to do the more advanced skills with the instructor and/or the patient's nurse until well into the first or second quarter of sophomore year. I was also caring for three patients by the end of the first year, while the others were still working with two (and one poor fellow was still having trouble managing a single patient). So yes, clinicals were my favorite part of nursing school......I graduated with a solid 3.4 GPA, but if clinicals had been graded I would've been closer to a 3.8, which was my sister's GPA. Would have been nice. :)

[Brekka, ADN, RN]

I personally hate them, but I know we have to get through them. I'm glad some people enjoy them, and yeah I do try, but my instructors aren't very supportive. Any positive feedback we get, we get from the nurse in charge of our patient. I get huge positive remarks from them all the time, but my instructors ONLY mention negatives.

I go through clinical with my nurse feeling amazing, feeling like "wow, I can actually do this!" Post clinical conference we get no feedback unless it's something we didn't do or should have done differently. Then in our clinical evals we get all sorts of negative notes, no positive, and things that weren't mentioned to us before in post clinical.

We ask for positive feedback, but we don't get any. I spend all my time off of clinicals dreading them, even though I do well and enjoy them, I just hate all the negative feedback. I know I shouldn't let it get to me, but all the negativity really depresses me.

[SnMrsSmiley]

had my first clinical today! im first semester. I did head to toes, hep and insulin shots, removed IVs, discharged patients... It was so much freaking fun. My instructor i AMAZING and really gets in there and teaches. The nurse I had today was FABULOUS she was so nice, and always came to find me to ask if I wanted to watch something she was about to do or she would ask my instructor if I could do things with her assistance.

After reading all the horror stories here I was terrified but it all went great :)

[NCRNMDM, ASN, RN]

I love clinical, and I love my instructor. Our instructor likes us to be independent, so she initially supervises us on a skill, like IV starts, injections, IV push, etc, and once she thinks we are capable of doing it alone, she doesn't come into the room to supervise us anymore. Of course she is just outside on the unit in case we need her, but it feels good to be able to do things on our own. Our clinical group is on a surgical floor that also takes medical overflow, so we take care of a diverse population. My first patient had undergone exploratory laparotomy and several other abdominal surgeries for bowel obstruction, nicked bladder repair, perforated colon, and tumor resection. He had a colostomy, foley, and NG tube. I stayed busy all day taking care of him, but I can't wait for next week. Clinical is my favorite part of nursing school.

[SC APRN, DNP, APRN, NP]

I am loving clinicals. It's been a great experience. I've got the careplan thing down!! I'm not afraid to jump in and do things, so they let me help with other patients not assigned to students. My instructor is great, the RN's and PCA's are awesome, a lot of the RN's on the floor graduated from my school, I love the hospital we have access to a lot on the computer, which helps so much. It's a medical floor and we aren't expected to do any CNA work, but I help whenever I can.

I'm actually afraid of next semester, it can't be this good every semester?