Starting your very first clinical rotation can be nerve-wracking, if not downright terrifying. Wondering what to expect in first semester clinical? Then this post is for you!
Before First Semester Clinical Begins
Before clinicals even start, you’ll need to learn a TON of new skills. This will most likely be done in your skills lab course, so be prepared to have a lot of reading, quizzes, prep and check-offs in your first couple of weeks of classes. Before you are set loose on real patients in the hospital, you’ll need to learn:
- how to chart using your hospital’s specific charting system
- dosage calculations (though it may be another week or two before you’re allowed to give meds)
- the right way to get people on/off bedpans (believe it or not, there’s actually a method to this)
- how to accurately measure I/O (ins and outs, which is basically how much fluid did they take in, and how much fluid came out the other end).
- how to empty Foley bags
- how to make a bed with a patient in it (the coolest nursing trick ever)
- basic assessment (vital signs)
- how to safely get a patient up out of bed, into a chair, onto a commode and back into bed
- how to give a bath
- how to feed a patient safely
- how to provide oral care
- how to set up and use the oral suction catheter
- and more!
Basically, in your first one or two clinical shifts you will be operating at the level of a CNA. Do not underestimate the importance of solidifying these skills. The TLC side of nursing is vitally important for patient safety and comfort. On your first couple of days on the floor, introduce yourself to the nursing assistants (if your floor is lucky enough to have them) and ask them how you can help. These men/women are excellent at what they do and you can learn a lot from them. They will also save your bacon more than once as you take on more responsibilities and become “too busy” to always take care of basic patient needs. CNAs are the angels of the hospital, please treat them as such!
Your first shift will also likely include a “scavenger hunt” type of task. This is designed to get you familiar with where things are…dirty utility, clean utility, linens, supplies, glucometers, the tube system, meds, etc… Pay attention and learn as much as you can…especially the clean utility room. This is where the majority of the supplies you will use are located and you’ll make yourself extra useful to the nurses if you can fetch things for them.
Each week you will likely have new “skills” to be checked off on. You will likely already have been checked-off in skills lab, but now you need to be checked off when working with a real, live patient. Some first-semester clinical check-offs include:
- Head-to-toe assessment
- Giving PO medications (PO means “by mouth)
- Checking blood sugars
- Giving injections (subQ will be the most common ones…insulin, heparin)
- Hanging IV piggyback medications (antibiotics usually)
And a Bunch of Other Cool Stuff
In addition to the required check-offs, you’ll want to start keeping track of basic skills. Many of these will need to be done under the supervision of an RN. Believe it or not, Foley catheters don’t get placed every single day, so if you see an opportunity…jump on it! Skills you’ll get to practice if the occasion arises include:
- Placing Foley catheters (your patient will be grumpy)
- Removing Foley catheters (your patient will be happy)
- Wound care
- Setting up tube feeds
- Inserting NG tubes (your patient will probably try to punch you in the face)
- Removing NG tubes (your patient may throw up on you)
- Inserting a fecal management system (the other nurses will love you)
- Removing IVs
By your last shift or two, you will feel pretty darn nursey and probably be having a really great time. You’ll also be starting to wonder how on earth anyone can take care of 4-5 patients at a time (that’s the ratio for acute care in California). In other states that don’t have ratios you could be caring for more patients than that. It’s all a juggling act, which is why you must pay attention to time management even when you’re just taking partial care of a couple of patients.
Before you know it, you’ll be through your first clinical rotation and excitedly looking forward to Advanced Med/Surg clinicals. Want to know what that’s like? Stay tuned!