Clinicals

Since I'm in an accelerated program, my first clinicals took place this last semester. We had 5 weeks of clinical in the lab at school and then 3 weeks in the hospital (twice a week). Mostly the stuff at the lab was pretty boring, but we did learn how to do all the basic skills: bed baths, changing an occupied bed, vital signs, ROM, assessments, giving meds (not IV or IM), etc.

The check off's were nerve wracking... but I passed them all. I know that you have to learn the things somehow, but it seemed like things were so different in the hospital that I'm not sure how useful it all was.  There's only certain things you can learn by pretending to do them on a fake patient..

My clinicals were on a general med-surg floor that also included some renal and trauma patients. Overall most of the nurses that I interacted with were really nice. Some of them were more willing than others to teach, let us in on cool procedures and take the time to help us out. The most recent graduates seemed to be the most willing to help us out and teach us, since they were just in school not that long ago. Mostly the nurses were grateful to have another set of hands, since we were basically the ones taking care of our one patient.

It seemed to me that clinicals (for fundamentals at least) pretty much consist of getting your feet wet, getting used to going into patient's rooms and talking to them. You try to see what else is going on on the floor to see if there's something interesting to see, but otherwise you feel like you're in your patient's room or stuck in the hall trying to find something to occupy yourself. The worst was that there was literally no place we could go that was out of the way, where we could sit or chart if we had free time. This was sort of okay for a 5 hour clinical but it may kill me when we start 12 hour clinicals the second 8 weeks of the spring semester. Ugh.

Procedures accomplished

- Bed baths. Managed to get lucky on my first two patients and they were ambulating and didn't need help bathing, but I helped a fellow student with a bed bath on her patient the second week and that was just plain tiring because the woman basically couldn't help  us at all. My third week I had a partial paralysis guy who didn't do much of anything for himself so I had to give him two full bed baths, luckily with help from fellow students. He was also a complete gem in the fact that he was so out of it. I couldn't figure out if he had dementia (he was being treated for it), was trying to be funny, or was just that inappropriate. Whatever the reason, he was a challenging patient.

- Flushed an NG tube on a patient

- Passed oral and transdermal patch meds to my patient the last week. Not super hard... but I got to use the Pyxis so I guess that was exciting

- Sort of assisted my instructor with an ostomy. We didn't put the new one on because the ostomy nurse was called for it.

- Vital signs twice a day on each of my patients.


Procedures witnessed

- Nurse pulled a foley catheter on a woman after I got to deflate the balloon.

- Watched the nurse give IV and IM meds, give meds in the NG tube

- Watched my instructor empty a J-P drain.

- Changing out an ostomy which the ostomy nurse did (after my patient's ostomy bag exploded all over the floor while I was with her. Twice. Have I mentioned I'm a figurative and literal shit magnet?)

Care plans

Yup, they suck. They're an epic waste of time in my opinion. But they're apparently a necessary evil in nursing school and perhaps after. The hospital we're at actually has nurses doing a sort of care plan for their patients. Really they're just stating nursing goals and interventions and that stuff...

Care plans are just time consuming and boring. But whatever, they must be done and so I do them.

Creating a schedule

I commented in my first semester survival post about time management and getting organized. Here are some of the ways I managed my time this semester. 

My weekly planner. In the beginning of the semester I sat down and wrote out all of my due dates for each week. I ended up not using this as much as I thought I would. I ended up using my weekly to do lists and the schedules for each class that I had printed out.

My monthly calendar was more useful. This allowed me to see what was going on each day at a glance. I knew when I was working and when I had clinicals, a test, etc. For the most part I put all of the dates into ical first and then transferred to my planner. This was because pretty much all my stuff came from emails, my online classes, etc so I was already on the computer. Below is a screenshot of my ical from November. I've got days I'm on call, tests, clinicals, study groups, everything that I need to remember and can't seem to keep in my brain.

The time map that I talked about I kept for the first couple of weeks of the semester. This just allowed me to see how much time I was using for what. This can help if you have a super busy schedule and are trying to find times to squeeze in studying around school, work, family, etc.

Here's a copy of my weekly to do list. I would sit down at the beginning of the week and go through each class's syllabus/schedule and write down what was supposed to be completed or was due that week. This helped me prioritize and I got to cross things off so I felt like I was actually accomplishing something. Not everything got done for each week... but at least I could carry it over to the next week's to do list.

Here's another example of my monthly calendar view,  from November (or hell month as I called it.)

So there ya go! What helps you get organized? Do you have a system so that you don't forget things?

First semester survival tips

My first semester:


1st 8 weeks:
- Human Nutrition
- Professional Nursing Concepts
- Abnormal Psychology
- Professional Nursing Concepts
2nd 8 weeks:
- Fundamentals of Nursing clinical
- Dosage Calculations
All Semester:
- Pathophysiology
- Pharmacology

Time management, time management, time management. 
Figure out what works for you and do it. I read before I started school that learning how to manage your time is actually one of the hardest things to do in nursing school. If you're in an accelerated program I think this is especially true. You have to keep track of 8 million due dates and figure out when you're going to read, listen to lectures, study, do assignments, prepare for lab/clinicals, have a LIFE. It sucks.... and its not really that easy. 
One way that I dealt with this in the beginning was using a time map. This lets you visually see where you are spending most of your time and it also helps you see where you have free time. I also had a calendar where I wrote down all the important things going on: tests, due dates, clinicals, etc. Mostly I would sit down at the beginning of every week and write out a to do list for that week and go off of that. I miraculously only missed one due date I think the entire semester.

Schedule relaxation time
As much as you'll hate it you do have to relax at some point. Or at least I did. There was no way it was going to be healthy for me to go full steam at this for four months. I would have lost my mind more than I already did.
Schedule time where you go to the movies, hang out with friends (if they haven't all abandoned you :D), DRINK (this one is important...), go out to dinner or just sit and read a book. Aimlessly surfing the internet is allowed too. As much as you will feel guilty for NOT STUDYING, just do it. You have to take time to take care of yourself or you will burn yourself out super fast. Know yourself, know how much time you need and what you can spare in your schedule/study load

Find a study group/ support group
*If these things help you* I mean I think everybody can benefit from a support group, but study groups are on an individual basis. I found a couple of fellow students to study with and I think it helped me. Also, its nice to be able to blow off steam and you can all relate because you're complaining about the same program! Just having someone that can talk you through an assignment, help you answer a question or simply commiserate with you is super nice. 

Know when to ask for help
Also, know where to find help. Do you need a tutor in a class? What about a study group? Ask the professor, ask your academic advisor, ask a counselor, ask your fellow students. 

Figure out how you learn best
This one was super hard for me. I'm not sure that I ever learned how to study that well in school and my previous degree. Also, the way that I studied kind of changed for each class. But experiment, figure out what works for you and what obviously doesn't. 

For example I used notecards for nutrition and pharm. I tried notecards for patho but it didn't really seem to work (although I just kind of sucked at patho all around). I used the resources that came with the textbook for fundamentals and answered al the NCLEX style questions it provided. I also did the study guides for fundamentals because her tests were exactly from her study guides (other classes not so much). 

Honestly it's never to early to start working on NCLEX prep or NCLEX style questions. All of my fundamentals test were nclex style... and a lot of people struggled with them. If you've got access to Kaplan use it. Although it sucks because it will look like you don't know anything (you dont! it's your first semester), it can be helpful. 

The thing I kept in mind most of the semester was: I will get through this. Every other nurse has done this and so I can too (especially the ones that don't seem particularly bright...). I would also remind myself that this will be so worth it in the end, when I graduate and get the job that I want. 

What are your first semester survival tips? How did you make it through?

Update

Hello!

I know I've neglected this poor blog... I've got lots of partial blog entries and ideas jotted down that I'm hoping to get blogged after finals next week. I've got all kinds of fun stuff coming, so stick around!

Good luck to all the other students taking finals!! May the odds be ever in your favor!

What finals do you have this month?