Surviving Clinicals During nursing school, you have to complete clinical rotations. A certain amount of hours must be completed before moving on to the next semester. The clinical rotation hours vary every semester. There is usually no letter grade, just pass or fail. Almost every nursing school has lecture, lab, and hospital and community clinicals. On the days you don’t have to attend lecture classes, you will find yourself at a hospital, mental health facility, community center or a shelter trying to figure out what your supposed to be doing. During your first semester, the nursing school may require you to pass certain competencies before starting clinicals. These are skills that you will have to perform in the real world of nursing. One university in Jacksonville has its students attend a nursing home for the first clinical rotation. This gives the students a chance to get used to talking to patients and performing assessments. For the first semester, the only competencies you will probably be performing are health assessments, how to give bed baths, changing bed linens, patient transfers, and using certain lift equipment. These skills are taught during lab and at the end of the semester, and one of your professors will proctor and watch you to make sure you can perform this task. This is a very stressful time for students since the professor is standing over watching every move you make. However, this does count as a class grade so try to take a deep breath and have faith in yourself. The second semester will have about the same amount of clinical hours required. In lab, you will be taught more skills such as Foley catheter insertion, sterile dressing changes, and nasal gastric tube insertion. Alot of these skills will become useful during a rotation at a rehabilitation facility. You will also have clinicals at a psych facility where you will use your ability to teach patients psychosocial skills and monitor mental health status based on diagnosis such as schizophrenia, dissociative disorder, and attention deficit hyperactivity disorder. Yes, that means you’ll even be working with children in these mental facilities. Depending on how many semesters you have, you will probably be in your adult health or pediatric clinical rotation by the fourth or fifth semester. At this point, you may be taught how to insert an IV, give enemas, and of course medication dosage calculations in pediatrics. By this time you should know how to give different types of injections such as, intramuscular, subcutaneous, and intradermal. You must know all the sites that a subcutaneous and intramuscular injections can be given. Before starting clinicals, you need to review these steps before attempting to give injections. Before going to clinicals, your professor should have given you a patient assignment, usually the day before. You will be well prepared if you research the patient information ahead of time. Become familiar with the diagnosis and learn specific interventions and teaching that would be good for the patient. Look up all the medications and know the pharmacology such as side effects, generic and trade name, dose ranges, and absorption. If you have enough pockets on your uniform, take a drug guide and a small tablet for notes. Please don’t forget your pen light, a watch with a second hand, a sharpie and a couple of black ink pens.  If your professors are like mine were, they will quiz you on the spot, so be well prepared to know everything about your patient’s diagnosis, history, medications and interventions.

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