What do you do in Clinicals?

Posted
by Rini456 (New) New

Brekka, ADN, RN

Specializes in Geriatrics. Has 6 years experience. 85 Posts

I'm only just finishing with the second of four semesters, so I don't know what is expected in the third and fourth semester. Also, schools tend to differ somewhat on what they expect out of students during clinicals.

For my first semester of clinicals, it was basically giving us a foundation, and we were taught how to read a patients chart, where to find information, how to document, etc. Learning and applying your physical assessment, interview techniques, and communication was also a big part of first semester. During our first semester we did many physical assessments as well as interviews. This helped you to be able to form a basis to learn off of, and alterations in these tasks would later be applied as needed when you learned more.

Right now as I am finishing up the second semester, the clinicals involve what we've learned in the first semester and allow us to add onto it. A big thing we're being taught this semester is time management and prioritization. We started the semester being responsible for one patient, and as the semester has progressed, we were soon responsible for the care of two patients, and are likely to be assuming the care for three patients over our last clinical week.

The full care involves the initial assessment upon the start of the shift to provide a baseline for the rest of the shift, the administration of the medication, documenting, and anything else the patient or family needs. This involves more critical thinking, as medication administration depends on the patients situation, labs, etc. Health concerns alter the physical assessment and interview to include applicable questions and assessments.

Clinical task aren't completely solo, as you have your classmates with you, and may likely be teamed with them for the first couple of clinicals until you get comfortable. After that you still have classmates and your instructor to confer with, and you are there to learn and apply the knowledge that you have gained. Your instructor is there to provide support and guidance and help you learn.

I wish you great luck if you do decide to follow the nursing path!

rickelli

115 Posts

We started block 1 with classroom lectures and lab. We learned basic skills in the lab portion and then once we were signed off (had to be signed off by a certain date) then clinicals started. We went to our local hospital and did all the skills that we learned or tried to do the most skills we could. Each block you do more but block 1 and 2 is nothing compared to blocks 3 and 4. Blocks 1 and 2 we had to do almost all of our skills with our clinical instructors not the nurses on the floor. By the time your in your 3 and 4 block your lab time is short and clinical time starts pretty quickly. Nurses are usually expecting you to know more and trust you more now. Most of your skills can be done with your nurse instead of having to call your instructor to come and do skills with you (much faster doing things with the nurse on the floor) Block 4 was the most amazing which is critical care for us. I learned and did so much in this block and really felt like a nurse. At this point I think we only had one lab day (simulation day) and then straight to clinicals. Oh and from block 1-4 we had to pick patients and do care plans every week. Once we passed the program then we had preceptorship for 8 shifts we follow the same nurse and take care of her patients and of course she is there but we are trying to be independent at that point. Nursing school is great but at the same time over welming but worth it in the end ? Good luck. And all schools do things differently, this is how it was for me.

Anne36, LPN

1,360 Posts

I just started and we are completing vitals(daily)and baseline as well as all 11 sections of our Gordons(some daily) + a Careplan all in 1 week! We are with the same patient for 4 days and it does not seem like enough time. Not allowed to bring any paper and pen or assessment questions tools in room with us so it is taking me a long time to chip away at this, it is hard to approach all these topics.

2ndyearstudent, CNA

Specializes in CNA. 381 Posts

Rini456 said:
I am considering nursing as a career and was wondering what kind of tasks you have to do during clinicals. Do you have have to interact with patients from the very first day? And what kind of tasks do you have to?

Things I have done in Clinical and yep, we gots patients right away:

ADLs (get them cleaned up, dressed and to breakfast)

Assist with feeding (Regular or Tube Feeding)

Head to Toe Assessments

Run a Mock Care Conference

Glucose checks

Palliative Care (Pt and Family. Talk to/Comfort/Spend time/Answer questions)

Report appropriate data to RNs/Instructor

Vital Signs

Neuro Assessments/Focused Assessments

Straight Cath

PO, SL, transdermal, ear, eye, rectal, vaginal Meds

Bladder Scans

PEG Tube, GT Med Administration

Mental Health Assessments

Blood Draws

Run Protocols (K+, Mg2+, Insulin..)

OB Assessments (Fundus, Lochia)

Give a newborn her first bath ?

Assist new mom with breastfeeding

Telemetry Interpretation

SQ and IM injections

Wound Care (Aseptic, Clean, Wet to Dry, Assess incisions)

Pt Transfer (Stand Pivot, EZ Stand, Hoyer)

Order stuff from the pharmacy as needed

Hang IVs (Fluids, Meds)

Apply Restraints and monitor/assess

Physically restrain 300 lb pt above when he started thrashing while restraints were removed to assess skin.

IV Push meds

Monitor multiple IVs and sites (I think my record is 6 pumps at the same time)

Rectal Tube care

ET/Vent Care (Suction, Assess, Reposition..)

ECG placement

Pt and Family Education (Asthma, Immunizations, Diabetes, CHF, CVA, CJD, Crohn's/IBS...)

Accompany/Assist/Carry Out PT/OT treatments (Ambulation, CPS, ROM, AROM...)

Assist RNs with any dang thing they want

Stay out of MD's way.

Receive and give report

Chart all the above crap either by hand or on the computer

Theres probably more. Have fun!

Rini456

4 Posts

Dang! The only part of that that I liked was giving a newborn their first bath... but I am only interested in being a neonatal nurse. Thanks for all the information it really opened my eyes.

rickelli

115 Posts

In this economy you really have to be willing to do anything. NICU, PICU and nursery is usually just a small portion of your clinical experience.

VioletKaliLPN, LPN

1 Article; 448 Posts

It would be vital for you to know that many of the nursing fields require med/surg experience before you would be considered for the position.

meltnpointofwax

189 Posts

Every school and professor has different rules/expectations of you in clinicals. My experience has been pretty good so far.

My first semester was kind of ehh. I felt more like a tech than a nurse, because we had to do bed baths, linen changes, basic things like that. I got to give a subq injection and also an im injection which was very exciting! We befriended a tech who taught us how to use the accu check machine and gave us advice on simple things (like rolling a flat sheet and chucks under a patient. You may not know what i mean but when you see it you'll be glad you learned it lol)

second semester was much better. We got to start iv's, mix iv mini bag meds, give more injections, take out ng tubes and foleys (still haven't put one in yet), more assessments, etc.

My advice to you is talk to people: nurses, techs, everyone that works there! Your clinical experience is what you make it. You can follow your nurse around and ask her questions and learn as much as you possibly can... Or you can be the student that sits in the longue most of the day finishing their care plan. I was kind of shy the first few weeks but once i opened up and tried to make my experience better by asking questions, following nurses around, etc, it became more exciting.

Diddledi

30 Posts

I am just wrapping up my first semester. We learned some basic skills like making an occupied bed, bed baths, etc. and then it was time to go to the hospital! First two times, we were working with a fellow student and the rest of our clinical days we were on our own. We were given one patient and did assessments, took histories, did all AM care, vitals, the works. We could not give meds as we were in the midst of going through check offs on these skill areas. I am excited about passing meds this next semester and know that the intensity will increase but hey, we didn't get into this to sit and have an easy job. It already has a sense of being soul satisfying when you can provide comfort for a patient! Good luck on your decision.

grace_lorraine87

Specializes in PEDS. Has 7 years experience. 18 Posts

Haha if only you would just be bathing them!