Question for any nurses or nursing students out there

[Dina]

I'm starting nursing school in September, and I have the schedule of nursing classes/clinicals that I need to take over the next two years. I remember being in college and having friends in nursing, and I remember them having clinicals(I went for education, and taught for 6 years but now I want a career change), but I never knew exactly what they did while on their clinical. I know you go to the hospital-- are you actually working?? Do you do some of the grunt work so to speak?? Or are you observing nurses? I always figured it was sort of like doing my field placement/student teaching when I went for education-- anyway, I was just wondering, what exactly you do in your clinicals. Thanks!!

 

[laurie31]

Student teaching is a great analogy.


You aren't there to "work" - students generally aren't a help to the staff because it takes them twice as long to do half as much. However, it's okay, because you are there to learn not help them out

In your first class, clinicals will be simple things like doing vital signs, assessments, bathing patients and changing beds. And of course, charting. I hope you like to write if you're going to be a nurse Actually lots of places have on-line charting now, though, but it's still a lot of documentation, whether with a pen on paper or entering data into the computer.


As you progress, you will do more and more patient care, giving medications, injections, starting IVs, inserting catheters and NG tubes etc. You will practice these things in skills lab before doing them on a live patient. Back in my day (LOL) we actually practiced some things on each other, but I think that's not so common any more, except with things like blood pressure and such. Noninvasive stuff. Skills labs have realistic mannikins that you practice IVs and other procedures on. Once you're checked off there, you can do the procedure in "real life" - with your instructer hovering over you, of course.

Finally, you will shadow a nurse and do what she does. Your clinicals will take you into every area of nursing - medical/surgical floors, ICUs, Labor and Delivery, Psych, community health (I had a really fun time going with the nurse to inspect restaurants! I didn't even realize that was a nursing job!), the OR, ER, and even management. This will help you decide what area you would like to work in. Nursing is so diverse. You can get a job doing chart review at an insurance compant, a job as an expert witness with a legal firm, you can work in a outpatient surgery unit (no weekends, no holidays), so there's lots besides the traditional hospital jobs- although I was a staff nurse for 14 years and loved it, before shockingly and unexpectedly (lol) going into management 4 years ago.

Most schools of nursing allow you to do a "preceptorship" before graduation, where you spend a certain number of hours assigned to a real nurse who works in your area of interest, and you work her schedule and do her job along with her (or him - sorry guys!) with direct supervision. Then you graduate, take state boards, and get your self a job. There will be jobs thrown at you for about a year before you graduate. You will be wooed with sign-on bonuses and other such things. Think of those things as you suffer through nursing school - lol It's a lot of work and very intense but it's worth it

PM me if you want more gory details! I'll tell you about my first time in the OR!
(and no, students don't do anything in OR except OBSERVE!)

 

[Dina]

Laurie--- thank you so much!!!!!!! I really appreciate all of the information!!!! That helped alot!!!!! Now, I have to ask-- what happened the first time you were in the OR??? I didn't even realize I'd get to go in the OR! I think I would like that!

Thank you so much!!!!

 

[laurie31]

You're welcome!


And yes you will go to the OR

As a staff nurse if your patient goes to surgery, you just count yourself lucky that you have one less patient to take care of for the several hours that they're gone, but as a student, you get to go with them and observe the procedure. It's really interesting. I saw lots and lots of surgeries, including open heart, when I was doing advanced clinicals in ICU. It's fun to dress out in scrubs and all that. It's very very different from floor nursing.

Okay, so you asked.


Warning to anyone squeemish - click your back button now!











If you're still here, you have been warned. (Also to any Hipaa nazi's out there, I checked with out Hippa Compliance Officer and it is legal to tell patient anecdotes as long as the patient is in no way identifiable.)


Okay, on with the story (I hope you're not disappointed now, after all that build-up - lol)


My VERY first time to go to the OR, I was a brand new student, it was maybe my second clinical day EVER, and my patient was an elderly lady who was diabetic and having a below-the-knee amputation of her leg.

I was very excited and very nervous.

The surgeon offered to let me tie his gown for him (they have to have someone do that for them, as their hands are sterile) and I accidentally broke off one of the ties! I was sooo mortified! But he was very nice about it. The real nurse there ran and grabbed him a new gown and life went on. The procedure itself was interesting, but when they cauterize bleeding vessels, the smell is like...burnt barbecue or something. It's gross. Open heart surgery was the worst for the smell. And yes, they really do play the surgeon's choice of music and all that.

They carefully cut away the muscle and then when they got to the bone they brought out this little flexible wire saw. It made this noise which totally grossed me out...sort of a fingernails on the blackboard kind of thing...and then, when they had sawed through the bone, her leg was placed in a big plastic bag and taken out of the room. Somehow the sight of that lady's leg being carried away was a bit too much for me (but no I didn't pass out! I had friends that did, though...lol) However, I survived

This lady was very alert and understood what operation she was having; as we wheeled her into the OR she said "Goodbye, foot!" and I thought that was so sad. But when she woke up in recovery, she was quite high from the drugs and she had no idea where she was. We told her she'd had an operation and it was over and she was doing well...and she was SO alarmed! She insisted that she had NOT had surgery and we had the wrong person! it would have been funny if she weren't so worried about it. I tried to explain it to her, but I didn't get it then, that you can't explain stuff to people who are off in "la la land" (and she was just fine mentally when her happy drugs wore off).

So there it is. I don't remember the lady's name, but I will never forget her face.

I found observing in the OR interesting, but not what I wanted to do as a job. People that do it really love it, though.

I hope you enjoy nursing school, although you will have moments when you wonder what the heck you were thinking! But as I said before, it's worth it! Nurses have the privilidge to be present for the most intimate times of people's lives - birth, death, and crisis. You have the power to make a real difference in someone's life. (and yes, teachers have this power too and so do lots of other professions, but they generally aren't around for the moments of birth and death, which is a really moving experience.

 

[DawnCt1]

Laurie, you brought back fond memories. I just want to add the CARE PLAN. there is a CARE PLAN for everything and everyone. AND those drug cards. detailed descriptions of every drug that the patient consumed while hospitalized. we had to do all of that prior to giving our one patient his two hour bath!

 

[Dina]

Thanks Laurie!!!! Wow, seeing a leg amputated had to be tough-- the thought of the smell is really grossing me out!!!! Thanks for sharing that!!! I'm really really excited!!

 

[denisenh]

I loved clinicals.

You will probably be assigned your patient(s) ahead of time so that you'll be able to review their chart for pertinent info and research their illness/situation. You will be expected to look up what medications that they are taking and learn everything about them, indications, contraindications, forms of the drug, usual dose, etc, etc, etc ....this really does help build your knowledge and its amazing how much you can cram into your brain when you think that you can't hold anymore.

I really enjoyed most of my rotations and experiences. How exciting for you!!

 

[DawnCt1]

my best nursing student moment was during labor and delivery rotation. i was standing in the hall excited about having the opportunity to see another baby's birth when the OB walked by and said, "why aren't you scrubbing, you are going to deliver this baby". i was so excited. i stood by until the mom went to sleep (a lot of mom's had light general anesthesia in 1970) and i took my place at the end of the table with the doc behind me. first the head crowned, rotated, he told me to lift up on the head to deliver the lower shoulder and once that shoulder came out, out came the baby. it was so slippery,especially with the gloves i was terrified that i would drop it. i couldn't wait to put it in the warming bassinet. i keep saying it because to this day i can't remember if it was a girl or a boy. the mom had no clue that an 18 year old delivered her baby that day.

 

[Dina]

Thanks Denise!

Dawn-- that's a great story!!!! Thanks for sharing!!

 

[Cool-Beans]

In Anatomy, when you don't know the answer, pick something hepatic. In nursing, when you don't know the answer, pick "open an airway," or "airway first."

Clinicals at first are basically polishing your ****-wiping skills. Then you get to do a little wound care/meds. Later you get specific, like peds, ob, critical care.

If you are on a waiting list, take a pharmacology class (if it isn't already required.) It'll pay off.

The best thing you could possibly do would be to get an aid job or a tech job. You learn so much more in the real setting that you do reading about it in a book...things click (and stay in your head) when you've actually done/witnessed them.

I remember my first day of clinicals. It was our first week in nursing (sink or swim for us, no background!) and I walked into the room - my patient was sleeping, but I was still in a panic. I froze totally. All I had to do was tell him who I was and get a set of vitals, but I couldn't.

Went out in the hall and looked around at my classmates who all knew exactly what they were doing (or so I thought), calmed down, got it together. Went back in, froze again! Stood there like a deer in the headlights thinking something was wrong with me and I should just drop out, because I was clueless...turned around and walked out.

Finally composed myself and went in there and woke him up and spent about 20 minutes taking one set of vitals! Then came the aforementioned 2 hour bath.

I saw lots of cool surgeries in clinicals, and got to help deliver a couple babies, too! I just loved all my clinicals, honestly, even psych.

Get ready to see and smell a lot of stuff you aren't prepared for, even though you think you're totally prepared.


Don't sweat it. Study hard, but go easy on yourself! Good luck!

(and if you ever need care plan ideas, pm me. We have them online at work. )

 

[ilovepcot]

Wow! All this took me back to another time, another place. Some of the best times of my life were during clinicals. You'll experience every emotion over and over again as you experience your different patients. Some you'll be sooo glad to be rid of but many will bring a smile or a tear to your eye for a lifetime.

Congratulations for stepping out and starting down this journey.

 

[laurie31]

Laurie, you brought back fond memories. I just want to add the CARE PLAN. there is a CARE PLAN for everything and everyone. AND those drug cards. detailed descriptions of every drug that the patient consumed while hospitalized. we had to do all of that prior to giving our one patient his two hour bath!

LOL!!! How could I have forgotten to mention that!! Maybe I blocked it out

Yes, we were assigned our patient the day before our actual clinical so we could go do "preclinical" - where you review the chart and medication orders, then go home and write up the pathophysiology of his disease and then you make little cards for all the meds listing indications, dosages, routes of administration, side effects, adverse effects, drug interactions, etc.

I sometimes stayed up for hours doing preclinical stuff. And yes, care plans. These are nursing interventions that you plan for the patient based on his individual needs. You yourself assign the patient "nursing diagnoses" which sometimes go along with his medical problems and sometimes are related to other problems, for example a patient who has religious dietary restrictions needs that taken under consideration when planning a diet. You learn to see the patient as more than just their diagnosis With each diagnosis, you need to plan specific interventions to address that problem. You will get a book with examples...I hope I didn't overwhelm you too much

And wow, Dawn, that's a really cool story about getting to deliver the baby!

and I also used to give those two hour baths! LOL!! That's what I meant about taking twice as long to do half as much. I remember one very elderly man, whom I took FOREVER bathing, changing, shaving, etc, got the bed immaculate, got him back in it, and he immediately proceeded to pee everywhere. He announced in surprise, "I'm a-peein'!" So I had to start all over...

I hope you have fun times!

 

[WebmasterAlex]

We had to do clinicals for Paramedic school but this was in the real early days and nobody was quite sure what to do with us. Unlike nursing students they didn't bother to send instructors either.
My first clinical was in the ER of a major hospital. I reported to the head nurse like I was supposed to. She puts me on the Triage desk by myself!
Another time I was with the IV team. This was a big hospital and they had about a half dozen nurses with the team. They assigned me to one nurse but at the morning meeting told the other nurses that if they had something that would be interesting for me they should page the nurse I was with. I get a page and go up to the floor and the IV team nurse tells me to go try room whatever.
I can't find a vein to save my life when the patient tells asks me if I'm some kind of specialist because I'm the FOURTH person to try! I went out and told the nurse that probably wasn't a good selection for my second IV ever.
My favorite though was a doctor on the night shift in the ER. He decided to teach me how to suture so I could help him with the drunks that night!
Ahh fond memories

 

[mommy*RN]

Laurie, you brought back fond memories. I just want to add the CARE PLAN. there is a CARE PLAN for everything and everyone. AND those drug cards. detailed descriptions of every drug that the patient consumed while hospitalized. we had to do all of that prior to giving our one patient his two hour bath!

UGH! Care plans...drug cards...who could forget! I should have sold those things on ebay for a mint!

I don't have any funny clinical stories. I got to see a baby born for the first time (I cried more than the baby!). I also got to see a woman have a breast reduction (okay surgery, but boring during the 2nd part because it is just like the first half). I had some really great patients and some not so great patients. The nurse aides are happy you are there because you lighten their load since you are doing the bed baths and toileting and such for them. My first IV experience was okay. I missed, but it was a 17 year old kid with awesome veins...but he had very dark skin. He was a trooper and let me try another time (missed again) and then let my classmate try (who worked as a tech in the ER of a hospital and did IVs all the time)...thankfully she missed too so I didn't feel like such a dolt.

My first code was during clinical prep day. I arrived at the hospital with my notebook and business casual attire. I started writing drug information and diagnose stuff down and I noticed a med student kinda banging around in the room. He sort of "shot" out of the room and was walking briskly down the hall when he tripped an almost fell. I supressed a giggle. I finished and walked across the hall to my next patient's chart area. Just then the med student came running back into the room and starts throwing boxes of gloves around. I still didn't know what was going on, but thought he was very odd. Then I heard "Code 4, 5NT room blah blah". I looked and it was the room where the med student was (he was joined by 3 nurses who were taking control of the situation). It just was so odd because not once did the student say anything to me like...CALL A CODE...or I NEED HELP. I had no clue what was going on in that room.

Otherwise my clinicals were mostly unremarkable. I had the opportunity to work in the NICU one day and was given a preemie patient. That was very interesting.

I guess my advice would be is to try EVERYTHING. In our clinicals we got zero peds experience. I always thought I wanted to work at Children's Hospital...so when it was time for us to do our mentorship I chose Children's. I'm so glad I did. I realized I could not work there. It was too heartbreaking and scary since I had a 10 month old at home. Thank heavens for the nurses who could work there, but I was NOT one of them. I chose instead to work in pediatric public health. I love what I do, and I do see kids with disease and illness, but not like I saw at Children's.

Good luck and welcome to the profession!

 

[minkydog]

As Cool-Beans suggested, take a job working as a nurse tech. You will very quickly learn whether this is the career path for you. I started out as a student nurse working night shift on the oncology floor--not a premium job, let me tell you I also floated to every department in the hospital, so I got to try a little of everything. I discovered that I loved Labor & Delivery, NICU, new babies, old ladies, and people who are dying(weird combinations, I know) I also discovered that I didn't like drunk men, burns,adult medicine, ED, or OR. In fact, my first trip into the OR was less than stellar--I ended up lying on the floor during a knee replacement. As soon as I saw them bare the kneecap, that was the end of me And it didn't get any better when I witnessed a tonsillectomy,either.

There is a place for every kind of nurse. When I was in nursing school, I was a weinie. If anyone threw up, I threw up. I fainted at the sight of blood. I was afraid to give shots. I was so shy I could barely talk to people. My teachers were, frankly, amazed that I stuck it out, but I powered through. I graduated at the top of my class.

I've been a nurse for 29yrs, mostly in maternal-child health, with lots of NICU experience. Now I work from home on a computer doing phone triage for a children's hospital. I love it because I can bring all my nursing knowlege and experience, plus my 20yrs of mothering, together to help young parents figure out how to care for their sick kids. I never see or touch a patient these days, but my prior experiences help me visualize and interpret the info the parents give me so that I can make accurate decisions. I will never work in hospital again due to back and feet issues, but I could do this comptuer nursing forever.

Cathy--sits here typing with her foot in a cast and her hand in a brace, just finished an 8-hr shift

 

[laurie31]

Holy Crap, Alex!!! We only let the most experienced ER nurses work Triage! I guess it's sink or swim in those kind of situations, huh?

I remember being SO excited about my ER clinical...and nothing happened. It was so boring. When my roommate's ER day came, I told her to take a book. We joked that with her luck there would be a bus wreck or something. Well, there WAS a bus wreck! They got over 50 patients and they had her doing stuff she wasn't really supposed to do without an instructor. She said she gave tons of tetanus shots, and I forget what all else, but they were so busy she stayed 2 or 3 hours after her clinical time was up, to help out. (and yeah, it was the same roommate that's in my tag! LOL)

 

[TexasCourt]

Just finished my first semester at nursing school (only went to 6 days of clinical on oncology floor though). I only have 1 year left! This time next year, I will be graduating with my BSN!!!

 

[Dina]

Thank you so much, everyone!!!! I really appreciate the stories! It's nice to know what I'm in for. My friend also suggested working as a tech at her hospital-- I think I'll look into that! Thank you all so much!

 

[Chuck65]

It's going to be tough Dina. My wife is getting her RN degree now, she graduates in May, and she spends a lot of time studying. The rewards though are really good. Her graduation present is a trip to Disney. Good luck and study hard!

 

[monorailsilver]

I didn't read all the reply's but this is what I did in school (BTW, I graduated in 1993):

I went to a 2 year RN diploma program at the local hospital in CT (local meaning about 10 min from my house).

At first we did clinical in the classroom such as handwashing, taking temps, b/p's & then we hit the floor with in the first month.

The first year we got 1 patient each. We had to comb thru the charts & get all the info & put it in our 8 page (2 sided) care plan & patient history sheets we had to fill out.

We also had to go & interview the patient, listen to their heart, chest, check their skin turgor, color, etc...a full blown physical assessment so we could write it on some part of our 8 page fun thing we had to do (fun it was not!).

We also had to go to the library in the hospital & get a nursing article that pertained to our patient & read it/copy it & include it with our 8 page pt. info sheet.

When we went home, we had to finish filling out the paper & do the care plan & do a care plan for each diagnosis that the patient had.

The next am we arrived on the hospital floor for 7am & got report from our primary nurse on our patient & then we had to help our patient get washed/dressed if they needed it, confirm their medicine & give it to them, take their vitals, continue to review their chart, etc...

We did not follow the nurse around at all. But if we did have questions some, not all, of the nurses were willing to help since they remembered what nursing school was like.

We had clinical 2 days a week.

The following year we got 2 patients to take care of.

We also had rotations in pediatrics, maternity (& the nursery), OR, ER & psych.

I am sooooooooooo glad I am done with nursing school. It is the hardest thing I ever did but I am so glad I did it since the work is flexible & I can stay at home with my 3 kids & work on the weekend.