I can remember my first day of clinicals in nursing school like it was yesterday. It was 5:00 am when my alarm went off, but my eyes were already open. I quickly got dressed in my ugly white scrubs, kissed my wife goodbye, and rushed out the door. I didn’t have to be there until 6:30, but I wanted to make sure I had enough time to throw up if I needed to. I could already feel those butterflies in my stomach and I hadn’t even made it out of the driveway yet.
When I pulled up to the hospital, a wave of fear came over me. I almost shut down my entire nursing career right then and there. I could just turn the car around, move back to Florida, and go back into sales. But when I said goodbye to the cubicle, I said goodbye for good. I was going to be a nurse, no matter how hard it was, or how nervous I got.
If you haven’t been in the clinical setting yet, you are probably almost as nervous as I was. Most of this fear comes from the unknown, especially if you haven’t worked in the medical field before. I’m not going to make it seem like it’s a piece of cake and there’s nothing to worry about. But the good news is that it probably won’t be anywhere near as bad as you are picturing in your head. There are a few things you can do to set your self up for the greatest amount of success.
1: Get There Early (but not too early)
it’s important to make sure you get there on time, allowing at least 15 minutes extra for traffic jams, weather, etc. Plus, you likely don’t know exactly where you’re going once you get to the hospital, so that could delay you some. Make sure you devote enough time to use the restroom to “release” any butterflies that might be fluttering around.
Every nursing school does things a different way, but often you will first meet with your class and the clinical instructor before you go see your patients. You don’t want to be the last one to arrive for this “pre-conference.”
It may sound crazy, but don’t get there too early. The only thing worse than not having enough time to think before you get there is having too much time. If you are just sitting there waiting for the clinical “torture” to get started, you will drive yourself crazy. All of that extra time will just make you more nervous than you already are.
If you find that you have a few extra minutes, use that time to your advantage. Study up on your class notes or look up more about your patients’ illnesses. Don’t just sit there in silence.
2. Be Prepared
Most schools will inform you of your patient assignments the night before. If this is the case, make sure you have looked up all of their history and have something intelligent to talk about in your pre-conference. Know the medications they’re on and what each one does. Know their diagnoses and the pathophysiology behind each one. This will not only help you each day in clinicals, but it will help you in the classroom and as a nurse overall.
Have a pen and paper ready to take notes. Your clinical instructor and your preceptors will have several little nuggets of helpful information for you throughout the day. You can also learn a lot from your patients. Talk to them about their hypertension or their diabetes and find out how it affects them personally. They will often confirm what the nursing books tell you, but sometimes they might be able to provide insight on their condition that isn’t in a book.
Have some way to look up information. Ideally, the smart phone that is probably already in your pocket is the way to go here. You can download drug guides and manuals, and search for anything you don’t already know. The problem is that some schools won’t allow cell phones to be used during clinical (ridiculous, I know). If that is the case, find a small pharmacology guide that will fit in your pocket and keep a booklet of notes that you can reference throughout your day.
Finally, know how to access the resources at the hospital. There are usually a stack of reference books on each unit that you can look up information in. The hospitals intranet will likely have easy to access reference information, or at least a way to search the Internet.
3. Establish expectations with your preceptor
When you first meet your preceptor, introduce yourself and let them get to know you. Make sure that it’s clear that you are there to learn, not make their lives harder. Most preceptors will be very pleasant, but there will be a few here and there that will be difficult to deal with. Some nurses just want to come to work, do their job, and go home. In their eyes, you are simply a distraction and are sure to get in the way.
Don’t take things personally. There isn’t much you can do with a preceptor who doesn’t like students. Just do your best and try to be helpful. Whatever you do, don’t talk back or lose your composure. You will just be fueling their fire and the only thing that will come from it is your punishment from the school.
Try to establish expectations with your preceptor and make sure you don’t overstep your boundaries. Some nurses would rather you simply observe all day, while others will want you to do everything. You don’t want to start putting in a foley when you’re with the “hands-off”nurse. At the same time, you’ll look lazy twiddling your thumbs while the “get your hands dirty” nurse is putting in an IV. Being flexible is important as nurse, as things can change rapidly. Don’t assume anything.
4. Know the basics
Likely, everyone will know you have just started clinicals,as evidenced by the bewildered look on your face. Don’t make it worse by not knowing the basic things that you’ve been taught so far. Your preceptor knows that you haven’t started IVs or changed dressings, so it is assumed that you will struggle with these things. But you should be able to answer questions about basic nursing concepts. You are going to get asked lots of questions, and the less wrong answers you give, the better.
Of course you aren’t going to know everything they ask you. That would be silly for anyone to think that. After all, that’s what you’re there for…to learn. If you don’t know something, say so. Don’t dance around guessing and giving half answers. This won’t go over well. Sometimes you just have to say “I don’t know.” Write it down and tell them you will look it up and get back to them. Make sure you follow up. When you get home, look it up and discuss it with them the next day. You can even write up a little report about it to hand to them if they don’t have time to talk (nothing big, but a couple paragraphs).
5. Write things down!
As you go through your clinical day, it will all seem so vivid that you couldn’t possibly forget the things you saw or talked about with your preceptor. This is a mistake. You might remember some things, but it will be impossible to retain it all, especially after a few days. This is why it is important to write things down right after they happen. Keep a small notepad in your pocket and scribble things down as soon as you have a chance.
This isn’t just to remember nursing stuff like medications and procedures. It will also help you remember nursing school stuff that will make your life much easier. Write things down like the different codes for the med room or the break room. Write down your password for the computer. Make note of everything each preceptor does differently and the things they prefer. If you are ever paired with them again, you will know exactly what to expect and you’ll look much more prepared.
You can also keep these things in your phone if your school allows them during clinicals. The many “notes” apps can come in very handy. The information would be a lot easier to find in this format also. Rather than sifting through several pages, you could just scroll down or search for what you’re looking for. If it’s quicker and easier for you to write things down on paper, you could always transfer these notes into your phone later. It’s up to you. The important thing is to find a way to backup the information in your head so you can get to the information you need quickly.
