When students begin clinical, they frequently face feelings of uncertainty and doubt, especially if they have no prior healthcare experience. First and foremost, I want you to know that this is completely normal. It's actually a positive thing! Being concerned about your clinical performance just shows that you care about your education and your patients. So let's agree to give yourself some grace and realize that what you're feeling is normal.
But, of course, I know you're looking for some concrete methods to help you feel more secure throughout your clinical rotations. Here are some of my finest clinical confidence recommendations.
Show Up Prepared
The first step toward clinical confidence is to arrive prepared. This entails finishing all of your clinical preparation work ahead of time and ensuring that you have all of the tools you'll need to complete your job. A stethoscope, two to three pens, a pair of hemostats, a pair of scissors, a clipboard for your clinical paperwork, a brain sheet, and something to help you organize your day (like my "Run Sheet") are the major items I recommend you bring. Some students find badge reference cards useful, but you may also carry a tiny notebook with your own notes on important facts.
Know What to Expect
Prepare ahead of time by doing your homework so you know what to expect from your clinical experience. What kind of device is it? What is the average number of patients a student at your level sees? What are your responsibilities? Will you be dispensing medications, checking blood sugar levels, assisting with ADLs, and collecting vital signs? All of the aforementioned.
Review Any Relevant Skills
Review any skills you think you'll need before your clinical day. You may be asked to practice insertion and removal of Foley catheters, IV removal, dressing changes, and NG tube insertion. I assure that if you go over the instructions the night before, you'll feel much more comfortable practicing on a real person.
Know What Medications Are Typically Used in That Unit
Administering medications is one of the most dangerous skills you'll learn, it's critical that you know everything there is to know about each one. Reviewing the most prevalent drugs for that particular unit is a terrific approach to get a head start. If you're going to a surgical unit, for example, remember your opioid and non-opioid pain meds, as well as reversal agents and stool softeners. Know your anti-seizure drugs if you're on a neuro unit. Are you about to go into labour and delivery? You'll also need to know about oxytocin, magnesium, terbutaline, and misoprostol (to name a few!).
Plan and Prioritize Your Day
Participating in the change-of-shift report is essential for gaining an overview of the patient's needs, identifying current concerns, and maintaining a consistent plan of treatment. Use a report sheet and practise using as many abbreviations as possible... Those nurses speak quickly!
Take a moment to look up some critical information on each patient after you've received their report. The better you get at navigating the EHR, the faster you'll be able to do this task. The following are the important pieces of information you'll need for each patient:
- The most recent MD status report
- The latest RN progress note (commonly referred to as a "end of shift summary")
- Laboratories (looking for abnormals and those most relevant to the patient)
- Dressing changes, PT, activity limits or orders, diet orders/restrictions, blood glucose tests, and so on are all important orders.
- Due dates for medications (simply note down the dates and timings so you can plan and prioritise your day)
Next, make a quick list of each patient’s main problems or risks.
Make a commitment to DOING as much as possible
To tell you the truth, what you get out of clinical is directly proportional to what you put in. Get in there and DO whatever you can, even if it's a skill you've already mastered six times... Get in there and make it happen.
On the other hand, there's the skill you've never done before yet are afraid to try. Fearful of making a mistake, of appearing inept or uncomfortable in front of the patient, and of appearing unsure in front of your clinical instructor. What's more, guess what? This is how you gain knowledge! Take a few moments to go over the skill again.
Using clinical journal is one of the quickest ways to 10-X your clinical learning. You can take what you learned in clinical and apply it to future circumstances by thinking on what you saw and did.