Date Published: May 24, 2017
Clinicals are a time for you to put your nursing knowledge into action. After all, nursing is a hands-on profession. Clinicals are real life – they’re not a simulation. They’re not a lecture. You will be taking care of real patients.
Nervous yet? That’s a normal feeling! To give you some peace of mind, it’s important to remember that clinicals take place in a controlled environment, where you will be under the guidance of an experienced nurse. But it is your responsibility to your patients that you’re well-prepared for your clinical day, and clinical instructors won’t hesitate to send you home if they think you’re unprepared. Take the time to prepare for your day and you’ll not only be more confident, you’ll learn more from your time on the hospital floor. Here are seven steps you should take to prepare for each clinical day.
Step 1: Understand Your Patient’s Chart
Are the nerves setting in? That’s a normal feeling!
Also, know that your instructor will give you specific instructions regarding the preparation that is necessary for your clinical experience. When you get your patient assignment, be sure to read the chart and note any valuable information about his or her needs. This includes critical items, such as admitting diagnosis, past medical history, and prior testing results. When reviewing the patient’s chart, there may be terms that you don’t recognize. Be sure to look them up!
You will also want to refer to the Kardex, the card-filing system that provides quick access to the medical needs of each patient, because it is updated at every shift change, this will be helpful in understanding the medical care, treatments, and required procedures for your patient.
Step 2: Plan Your Care
Plan your clinical day! Anticipate the topics and situations you may face. Read and research to be sure that you understand the medical diagnoses, diagnostic tests, laboratory results, and prescriptions. Spend time in the library if needed. It is extremely important that you are confident that you know your patient. They are your priority.
Step 3: Understand Medications
Familiarize yourself with the medications that your patient has been given. You will want to make sure that you understand the reason the patient has been prescribed the drug, the dosage range and administration schedule (how often is the patient administered routine drugs, and how often the patient can receive intermittent or PRN drugs). When it comes to medication, you will also need to recall the desired effects and common side effects of the patient’s response to the therapy.
Step 4: Understand the Procedures
It is common for patients to undergo surgical or therapeutic procedures during hospitalization, this can be anything from laparoscopy to open heart surgery. Take the time to review your knowledge of the surgeries or therapies your patients’ have undergone. This includes learning the reason for surgery and expected outcomes, and understanding the risks and potential complications related to any procedures. This will help you anticipate your patients’ needs and plan their care.
Remember, it’s okay to ask questions. The nurse that you are paired with is one of the best resources you will have.
Step 5: Understand Laboratory Tests
This is a common pitfall for new nursing students. Nearly all hospitalized patients have lab work done. Review the most common lab tests (and a few less common) so you understand why they are performed, and their expected normal ranges and values. Compare these ranges and values with your patients’. Determine if it is normal or abnormal, high or low, positive or negative. Try to figure out how the patient’s lab result relates to his or her diagnoses. Be aware of potential findings you may need to assess in relation to any abnormal results or health implications.
Step 6: Understand Diagnostic Tests
This area is often considered a struggle area for students, but it will give you an opportunity for skill honing. From chest x-rays to MRI to a colonoscopy, understand your patient’s’ diagnostic tests. When you prepare for your clinical day, research each test, understand the reason why the test was performed, analyze the findings to see if they are normal or abnormal and be aware of any abnormal implications in your findings.
Step 7: Pack Your Equipment
One you’ve done your share of patient preparation, you’re ready to prepare yourself for the clinical day! We recommend packing your bag the night before. While your instructor will provide you with a list of required equipment for your clinical experience, you’ll never be sorry you have these essentials:
- Black pen
- Memo pad
- Wristwatch with a second hand