Sept. 20, 2020

8 Tips To Get The Most Out Of Nursing Clinicals

8 Tips To Get The Most Out Of Nursing Clinicals
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If the hospitals in your area are allowing students to come in, then you’ll likely be starting your clinical rotations soon, if you haven’t already. Today I’m going to share some tips that will help you really get the most out of your nursing clinicals.

Tip #1: Daily Goals Post-it-Note
Tip #2: Ask to Watch or Do
Tip #3: Don't correct the Nurses or Techs
Tip #4: Be Brave
Tip #5: Don't Cry
Tip #6: Be a Team Player
Tip #7: Keep a Clinical Journal
Tip #8: Embrace Failure


8 Tips to Get The Most Out of Nursing Clinicals

Hey there everyone! Welcome back to the Nursing School Week by Week podcast. Today I wanna talk to you about how to get the most out of your nursing clinicals. I know with all the Covid precautions going on, a lot of you may not even be having clinicals this semester, and you may just be using a virtual simulation program. But if the hospitals in your area are allowing students to come in, then you’ll likely be starting your clinical rotations soon, if you haven’t already. I’ve done 2 weeks of clinicals so far, and I’m gonna share some tips that will help you really get the most out of your nursing clinicals.

Alright - Tip #1: Write your own goals for the clinical day. After my 1st clinical shift was over, I felt very overwhelmed. Actually, even before the shift was over, I found myself comparing what I had done that day to what other students had done. I had taken my patient’s vitals and completed about half of a physical assessment, because I was too scared to ask my patient to lean forward so I could listen to his lungs from the back. But, another student in my group was just going room to room, taking everyone’s vitals and doing assessments like it was no big deal! I drove home that night without even turning on the radio. I just felt so defeated and in over my head. But luckily, I have an hour-long commute because as I thought about it more, I asked myself, “Melanie, are you proud of what you accomplished today?” And the answer was, “Yes! I had done way more than I thought I’d be doing on day 1 of clinicals. I thought we would be just observing the 1st day, but I did way more than that, and it was just because I was comparing myself to someone else that I was feeling like I had somehow failed. And it turns out, that student, who’s now my friend, has been working in the hospital for a long time already, so of course, it was an unfair comparison.

So, don’t do that. Don’t compare your accomplishments to others. After that night, I started coming to clinicals with a list of goals for myself that I wanted to achieve on that shift. It’s usually about 5-6 things and I just write it out on a post-it-note. These have been things like: Do a full physical assessment, or do a glucometer test, or watch a foley catheter insertion. But the list keeps me focused on what I want to get out of that day. It’s also nice to have, so that when a nurse asks me, “What do you need to do tonight?” I’m not just standing there going, “Oh, umm, well.” I can just refer to my list. 

So each clinical instructor is different, and some may give you specific things to do or watch, but mine is very much, “Here’s your patient for the day, have fun!” and we keep ourselves busy. So, the list reminds me what I want to do, and it’s so satisfying to cross things off as I go.

Alright. My next tip is to ask if you can watch the nurses or the CNA’s do things. Doesn’t matter what it is. It doesn’t matter if it’s the nurse that’s working with your patient. You don’t even need to know their name. Just walk up to them and say, “What are you about to do?” Then, when they tell you, say, “Can I watch?” If it’s something that you’ve been checked off on in skills lab, say, “Can I do it?” Even if you feel like you might vomit because you’re so nervous. Remember, nursing is a hands-on profession. The best way to learn is to just jump in. Just make sure you tell them if you’ve never done the skill before, so they can help you out if you need it.

Also, if someone asks you if you want to see something or assist with some procedure, the answer is always, “Yes!” Even if you’re nervous.

Tip #3: Don’t correct the nurses or the techs. As nursing students, we have a lot of the latest, greatest, book knowledge crammed into our brains, and sometimes it’s hard to keep quiet when you’re in clinicals and the nurses aren’t doing things the way you’ve been taught is the best way. You may be tempted to just say, “In class, we were told to do it this way.” But just don’t. I actually struggled with this a couple days ago. So, I used to work as a phlebotomist, which is the person who draws your blood when you go to the lab. And 3 nights ago, at clinicals, I was watching a nurse trying to draw blood from a patient. The turnequet was on the patient’s arm when I came into the room and the nurse left it on for at least 5 minutes while he stuck the patient 2 times to get blood. Any phlebotomist knows that that’s way too long for the tourniquet to be left on. By leaving it on longer than 60 seconds, you start getting a hemoconcentrated sample, which throws off any glucose, protein, or cholesterol readings. I really wanted to yell, “Take the tourniquet off before you try again!” But I didn’t. That would not have gone well. Unless your patient’s safety is in jeapordy, just let them do things the way they want. You can do it differently when you’re a nurse.

Tip #4 to get the most out of nursing clinicals is to be brave. The 1st few times you need to go into a patient’s room can be scary. You don’t know what you’re going to find and you have no idea what you’re doing yet. But, you’ve got to just put one foot in front of the other and get it done. After my clinical instructor tells me which room my patient is in, I find the nurse and ask them to give me “report” on my patient. That means tell me about the patient. Why they were admitted, do they have any procedures coming up, anything I should know before I assess them? Then, I make myself walk into the room and say, “Hi, my name is Melanie, I’m a nursing student and I’ll be helping with your care today. I’m going to go grab my supplies, and I’ll be back in a few minutes to take your blood pressure and temperature. Is that alright?”  This way, when I come back, I’m a familiar face to them, and it gives them a few minutes to prepare.

Then come back and get the vitals, write them down (cause you won’t remember later), and then do the physical assessment while you’re still in the room. You want to cluster the care as much as possible, which means you want to get multiple things done everytime you go into their room, so you don’t have to pop in and out all day long. So. What if your patient is sleeping? Do you wait and come back later? No. You have to be brave and wake them up. I know you don’t want to, and it feels mean, but the habits you learn now in the beginning will help you later. Right now, you’ll only have one patient, but eventually you could have 5 or more. You need to work on your time-table. Don’t let your patients dictate how your day will run, or you’ll constantly be running behind and stressed. Also, it’s actually in the best interest for your patient to stay on your schedule, otherwise if you let them sleep when you should be assessing them, it’s gonna to push everything back and they might not get their medications on time.

Ok. Tip #5: Don’t cry. Clinicals can be tough. You’re going to make mistakes. You’re going to feel like an idiot and embarrass yourself. But you’ve got to keep it together and be professional. Just this week, I was chewed out by a CNA when I used the vital signs machine that she had been using. Her code was still in the machine, so the vitals I was taking were going into the system under her name. She was pretty upset and she let me know it. Now, I am naturally a sensitive person, and I walked away from her feeling pretty fragile. I was walking down the hospital hallway telling myself, “Don’t cry Melanie, don’t cry. It’s fine.” I found a quiet corner and charted by myself for a few minutes until I had it together. If you need to, find a bathroom. I actually made myself go up to that same CNA later and ask her how I could help, and I’m so glad I did. She let me move a patient out of bed and into a wheelchair and then transport him to radiology which is an opportunity I would have missed if I had broken down and then just ignored her for the rest of the night. So, yeah. Don’t cry. Or do it quietly in the bathroom.

Tip #6 to get the most out of nursing clinicals is to be a team player. Help your classmates. Getting into nursing school is competitive, and can become cut-throat, but once you’re in, you’re all on the same team. Especially when you’re working together on the hospital floor. There are 8 students in my clinical group and we are very supportive of each other. I mean, we get out of clinicals at 10pm, and the other night, I needed to go to the bathroom as we were leaving the hospital. Every single one of my classmates waited for me because they didn’t want me walking through the parking lot at night alone. It was really sweet. Also, share your patients with each other. If your patient has some wheezing sounds going on in his lungs, ask your friends if they want to listen. If your friend has to change her patient’s diaper, help her out, and then they will do the same for you. 

Tip #7: Keep a clinical journal. Your clinical instructor is going to try to assign you to patients who will be in the hospital for a few days, so you can really get to know their conditions, so do your homework. When you go home after your shift, research what diseases your patient has and write about them in your clinical journal. I also like to include dates and descriptions of the skills I’ve practiced, and any things I want to try do differently next time.

Alright, my last tip is to go easy on yourself. No one expects perfection from you and you shouldn’t either. We learn more from our failures than our successes. If you mess up, just shrug it off and move on. The main goal of clinicals is to learn how to be a nurse and failure is just a natural part of that process.

Alright you guys, those are my 8 tips for getting the most out of nursing clinicals. Thank you so much for making time in your day to listen and I’ll talk to you again next week. Have a great day.