Clinical Days!
Clinical days start off slow. Like painfully slow. Death by powerpoint, lectures, learning how to take vitals, blood sugar checks, changing linens. You’ll be itching to get into the hospital and be hands-on, but let me tell you: enjoy this time, trust me. You won’t start careplanning just yet, so please please enjoy the pace, because once you start careplanning, you’ll think back to yourself, “I miss learning vitals and fixing linens.” I know I did once I was deep into careplanning. Honestly, the most useful thing I learned from early clinical days was how to fold a fitted sheet. I still use the same technique today. Lol.
When you first start, clinical instructors will have a laundry list of what to do and not to do. “Wear only solid colored shoes with no logos, only one ear piercing, shower every morning, use unscented deodorant, no jacket, bleh, bleh bleh.” They seem pretty strict at first, but you’ll come to learn that some of those things don’t matter, mostly because you’ll find that you have no time for that in the morning because you barely get any sleep and are way too tired.
I followed all the rules in the beginning because I had anxiety of getting sent home on my first day of clinicals. I woke up super early just to shower, prepped my face and hair, wore my bulky Dankso clogs because they were all black, wore my unscented deodorant I bought the day before at Target, and froze my ass off because I didn’t bring my jacket. I felt great because I followed the rules. Then I walked in and saw Nike shoes, smelled perfume, saw multiple ear piercings, and saw other students wear jackets. I have never seen anyone get kicked out or sent home because of the little things. In my third semester, I wore Nikes to go careplanning and during clinicals. Throughout my clinical journey I slowly transitioned to my comfort level because real hospitals don’t care about that at the end of the day.
baby nursing student maggie, what a dork.
Once I started careplanning, I woke up 15 minutes before I had to leave because I wanted to maximize the amount of sleep I could get. I washed my face, put my hair in a ponytail, put on my uniform, grabbed my supplies, and I was out the door. I always had my stuff prepped on the dining table the night before right after I finished printing my careplan. I had my foldable clipboard with my careplan, my pen holder with a clamp and scissors, my watch, stethoscope, my badge, and a post it that said “don’t forget your lunch!” By the way, never ever print your careplan the morning you have clinicals. Print that the night you finish.
Here’s a breakdown of things you should have on your clinical days.
Careplan, careplan, careplan
Uniform
Comfortable shoes
Stethoscope
Badge/ID/wallet
Don’t forget your careplan
Lapel watch
Pen/Sharpie
Small notebook/post-it pad
Clamp
Scissors
Foldable clipboard
Lunch
Did you grab your careplan?
Another life hack I discovered was to iron your clothes with the dryer. Saves time and less effort. I use that for practically all my clothes because I’m too lazy to iron them.
I was always anxious on clinical days, a little excited, but mostly anxious because I had so many thoughts running through my mind as I was getting ready, “Do I have everything?”, “I hope my careplan is good enough,” “I am so tired,” “I hope my nurse is nice,” “I hope my patient is still there.” Completely normal to have those thoughts. This is the one day out of the week where you can actually care for patients. All those hours careplanning on one or two people just to care for them for 7 hours after barely getting enough sleep, if you got any at all.
Clinicals weren’t as stressful compared to careplan days, but what was stressful was not knowing what to expect. It does get better as you complete each clinical day because as you gain more experience, you become more knowledgeable and confident.
Clinical days start off with pre-conference, aka pre-con. This is where you meet with your clinical group and instructor to briefly go over your careplan. Instructors tell you which medications you’ll do with them, scan over your careplan to see if it’s up to par, and discuss your goal for the day. You won’t start doing medications with your nurse until you get the approval from your instructors. That usually happens during second semester after you do a few med passes with them and prove to them that you are competent.
After pre-con, find the nurse(s) and nursing assistants, if the hospital has them, that are assigned to your patient(s) and introduce yourself. Nursing assistants can also be referred to as patient care assistants, techs, or certified nursing assistants depending on the hospital. Always tell them what semester you’re in, what you can and can’t do, and follow their lead the entire day. There are some nurses who really enjoy students who welcome you with open arms, and can provide so much knowledge. On the other hand, there are a small percentage of nurses that kind of “eat their young.” It sucks because those nurses aren’t approachable to ask questions and don’t provide any guidance or insight on being a real nurse. At that point, you can’t do very much other than watch and learn as much as you can.
Remember, you’re a student. Being a student is one of the best things to embrace during clinicals. You are there to start building your foundation, practice, and just learn. Nurses don’t expect you to know everything, but can be helpful in testing your knowledge. Instructors, however, will drill you, ask a lot of questions, and will expect you to know the answer to all of them. This is what makes clinicals stressful...especially during med passes. I absolutely hated med passes.
For example, you’re doing a med pass with an IV antibiotic. There are some things you are expected to know and look at before administering it such as, what kind of antibiotic it is, what class, where is the infection, what rate does it infuse at (med math, have your equation solved and ready to go), what are the most recent WBCs, if it’s vancomycin, what is the vancomycin level. Just an insight of what to know but it’ll change for every medication you administer.
Some instructors are really nice and accept the answer “I don’t know” and honestly, that should be fine because you’re a student! You are not supposed to know everything. This usually happens on the first med pass, but as you continue your med passes with your instructors, you’ll know all the answers to their questions and impress them with your knowledge. Other instructors can be a little cruel and make you feel dumb becuase you don’t know the answer. If they make you feel like that, it’s okay. You’re gonna get better and they are really just trying to push you to be your best. It’s harsh but it’s tough love, in a way, because they know the potential you have within yourself. Don’t let the one comment they say define your entire day. It’s a learning process.
One thing I should’ve looked at more as a student were the nursing orders. Nursing orders are what nurses look at to follow and use to care for patients. You’ll see what needs to be done for the patient such as do they need blood sugar checks and how often, what kind of activity can they do, which electrolytes to replete, what kind of diet, etc. It’s tremendously helpful to know and follow.
After clinical day, you’ll meet with your clinical instructor and group to do post-con. This is the time where I said, “I survived today.” So much weight off my shoulders until the next careplanning and clinical day. Post-con is where you talk about your clinical day, hear other people’s experience, and share stories. Share anything you saw: interesting, sad, gross, what you learned, what not to do, all the good and bad that happened in your day. Sometimes, you do a learning session like reviewing ABGs or discussing a disease process. At the end, you finally turn in your careplan and go home. You think you would be done, but not just yet. You still have to do a reflection. Reflection is easy though. You get a small prompt of what were you strengths and weaknesses in the day, what and how you would do things differently, and goals for the next clinical day. Once you turn it, then you are free!
Throughout your clinical journey, you do get a couple of free days of no careplanning. You get special assignments where you’ll have the opportunity to be team lead, where you help other your clinical peers organize their day and communicate with your instructor. Others allow you to visit the OR and watch operations occur or see how chaotic the ER can be. Pediatric speciality days are really cool where you go into NICU and PICU. You do careplan for these days, but like I mentioned before, pediatric careplans are super short. These days can really help peak your interest in which unit you want to pursue to precept in.
You may not know it or feel it now, but students are so so helpful to nurses. Every little task you do that you think is minute helps us out tremendously. Performing blood sugar checks, doing I/Os, passing out trays, completing vitals, etc. I encourage all of you to do as much as you can, but if you can’t do it, watch and learn as much as you can. You’ll get to see cool things as a students like ERCPs, go see MRIs, CT scans, angiograms, etc.
Not only are you supporting the nursing staff, you are also there to care for the patients in a big way. Nurses don’t have the time to really sit down and talk with the patient. We can make conversations as we’re caring for them but we always have the next patient to see. Students are able to focus on one or two patients only so they really get to know the patient. You get to be with them every step of the way and can help with a lot of teaching even if it’s only 7 hours. Especially since COVID, visitors have been restricted so students can provide company and support to the patient throughout their hospitalization. It may not seem much to you, but it means a lot to the staff and patients to have students.
Clinical days can be really fun and rewarding. Even though you’re only there for a few hours, you can perform a lot, or at least see a lot. If you can’t do it, then watch it. Embrace the purpose of being a student. It’s okay to make mistakes and not know everything. Don’t be too afraid to do things because you will be on your own eventually. But don’t be overconfident to be independent. There’s plenty of new things to learn everyday, even as a license RN. You never stop learning. You are just as important as anyone else on the team. You careplanned on these patients and know them in detail and can be a resource for the nurses.
Instructors can be cruel, not gonna lie. Don’t sweat the small things and don’t let them make you feel like you can’t be a nurse. They may scold you and teach you things in a harsh manner but don’t let it get to you. You are on your own path and you’ll make it as a nurse in one way or another. Keep learning and ask questions. Always, always do your best. Remember your best varies everyday and that’s normal! Have fun in clinicals! One step closer to becoming an RN!
<3 Mags
thank you Em!