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It is no question that nursing school can be a little nerve racking. But what can be most unnerving part about it is going into the clinical environment.
Nursing clinicals are scary at first, but it gets easier and easier with each week. I’ve worked with nursing students in a few environments (critical care, stepdown, and the floor) and it was always inevitable that one student would pass out.
People get so nervous, forget to eat breakfast, and then as soon as they see blood or some sort of medical procedure, or get asked a question they don’t know they answer to.. they just..
We’ve all wondered at some point if we will survive nursing school.
So how do you avoid a change in your LOC? How do you prevent this from occurring in the first place?
The key is being both mental and practically prepared.
How to be Mentally Prepared for Nursing Clinicals
Mental preparedness is essential. The more familiar with something, the less likely you’ll be anxious about it. It’s a bit scary learning about patients for a while and then all of a sudden you’re in front of them and you feel like you should know everything, but you don’t.
Nursing school clinicals are not a performance to show your instructor and classmates everything you know and get every answer correct, it is a time to learn.
However, mental preparedness starts before you arrive. Make sure you know where you’re going, arrive early, EAT SOMETHING (even if you’re not hungry!), and not only have your resources handy, but know how to use and navigate them quickly.
I’ll talk more about some practical items to have with you later.
Know Your Resources
It is essential to understand your resources, so that you can utilize them to answer questions and provide the appropriate care, and ask when you don’t know something or how to do something.
Having your resources with you is half the battle, the other half is knowing how to use them quickly. This means knowing what information is on them and where, so if you’re asked a question and don’t know the answers off the top of your head.. You know where to look quickly to see if you’ve got the answer readily. And if you don’t, you can say you don’t know.
Clinical tip! Never take out your cell phone in clinical unless the instructor has said it is okay. Some are particular about it, even if you’re just using an app for clinicals. This can give them a bad impression of you, so make sure you either wait for the green light or ask first.
Nothing frustrates nursing professors, clinical instructors and nurses more than someone trying to guess or come up with an answer because they don’t want to admit they don’t know something. Always be honest and admit when you don’t know something. This lets the instructor know where the knowledge gaps are so they can educate better.
Let’s go through an example… let’s say you’re in the middle of your labor and delivery clinical and your clinical instructor asks you how many veins and arteries are in the umbilical cord. You’re not sure if it’s 2 veins and 1 artery, or 1 vein and 2 arteries.. But you know you’ve seen that somewhere.. AH HA! You know it’s on your laminated reference card in your scrub pocket. So you grab it..
“Um.. let’s see, I don’t know that off the top of my head, but let me look here at my card…”
“Ah yes! Here it is! There is 1 vein and 2 arteries in the umbilical cord!” you say.
“Nicely done, young grasshopper.. Great job using your resources,” your clinical instructor says, as he brings you in to see an actual umbilical cord from someone that just gave birth 17 minutes ago..
The Dirty Little Secret of Clinical Instructors and Nurses
You see, we love to teach. It’s important to us that we know what you don’t know so we can educate appropriately. Therefore, when we ask you a question and you can’t quickly spout out the answer, that’s okay. Realistically, you’re not going to remember every little thing you learn in school and be able to regurgitate it at a moment’s notice.
One of the marks of a good nurse is not knowing every little piece of information off the top of your head… it’s knowing how to use your resources quickly and efficiently to find the answer. Therefore, if you’re in clinical and can navigate and utilize your resources QUICKLY, it really demonstrates that you value your resources and have put in the time to understand them.
Ok, now for the secret. When you don’t know something, but say, “I don’t know that, let me look it up…” and you stand there, fumbling around your clinical guide for 9 minutes, or leave the room for 15 to go look something up at the desk.. We get impatient and that is precious learning time lost. The important to be able to look things up quickly. So, if you really don’t know something and your resources can’t tell you that information quickly, let us know so we can educate and move on to the next awesome thing.
If I ask you how many arteries and veins are in the umbilical cord and you ponder for a minute and then head out to the desk for another 20, slowly grabbing your textbook, looking in the index, reading a few paragraphs, then walk back to the room… you’ve wasted a TON OF TIME. And OMG I’m so annoyed! Let’s go young grasshopper, hop!
When you’re asked a question and don’t know it.. Admit it, look through your resources quickly, and get back to the instructor with an answer so they can educate, elaborate, and move on.
The moral of the story.. have your resources handy (like in your scrub pockets) and know them backwards and forwards.
Fulfilling that Student Nurse Need
Our team at NRSNG realized this issue of needing resources that fit in the pockets of nursing students, that would stand the test of time and need to be able to be cleaned of various bodily fluids, that were also easy to navigate.
((shameless plug coming..))
You see, we’ve all been there. We’re all nurses that have been through nursing school and understand that having resources at the tip of your fingers that we can quickly look through to get the answers that aren’t at the top of our heads. We get that many, if not most, clinical instructors do not allow students have phones out in front of patients. And we get that clinical instructors ask most questions in the room in front of these patients.
We also get that nursing students don’t have the time to type, format, and laminate all of the practical information that’s needed for cards. Also, printing them back and front in full color, color coded, is expensive! We also know that while pocket clinical guides are great, you really only look at a few pages of them.. So why bring the whole book with you to weigh down your scrubs?
Our solution is Scrubcheats
50 full-color laminated nursing reference sheets with the top information that you’ll need in the actual clinical environment.
Separated out into color-coded sections, you can bring the whole thing with you… or simply grab the ones you’ll need for various clinical environments.
Topics range from cardiac, lab values, respiratory, OB/pediatrics, critical care, fundamentals, pharmacology, and there’s even a medical Spanish card in there. They come in a cool little NRSNG box with a ring to keep them organized in your pocket.
We created the resource we wished we had in nursing school. If you have ever silently wondered . . . How to survive nursing school . . . here’s your tool!
How to Be Practically Prepared for Nursing Clinical
Alright so that shameless plug is over. But it is truly shameless because this resource is just that awesome.
But there’s more to being practically prepared for clinicals. We want to give you the full picture of the must-have items for clinicals.
However, we realize nursing school is EXPENSIVE. We want you to know if you really really need something, or if it is more of something that’s nice to have and makes life a little easier. We have compiled a list of the top 14 items to have, but we’ve included a necessity scale.
The Scale of Necessity
Think of the Scale or Necessity like the pain scale. Zero is no pain (or you don’t need this at all) and 10 is the pain that is so bad you are losing consciousness (or you cannot get through a single clinical without this item).
See below for the rest details of the scale.
You don’t need this at all, but it’s cool
You really want this and it most likely will make things easier
You really want this, and it will definitely make things marginally easier
You really really want this and it will make things noticeably easier
You really really really want this and it would make things significantly easier
You actually should buy this (but you won’t fail without it)
You kind of need this
You need this
You really need this
You really really need this
You must have this for your student nurse heart to continue beating and you’ll probably fail a thousand times over without it
15 Must Haves for Nursing School Clinicals
If you are wondering how to survive nursing school and nursing clinicals in general . . . this is your list of tools.
Item #1 – Scrubcheats
Scale of Necessity Rating – 9
While you won’t fail without your set of Scrubcheats, it’ll make clinicals exponentially easier. You’ve got a ton of information at your fingertips, just sitting in your scrub pocket. There’s no worry about them getting damaged because they’re laminated and you won’t be cramming a bunch of information on a notecard the night before clinical just in case you need it.
MDF also makes some really high quality scopes as well. They are a little heavier, but they are more cost effective (you can get a seriously legit one for $50).
My personal advice from buying and using various brands:
Do not get the cheapest, but don’t get the most expensive unless you truly truly need it.
There are specialized scopes that you can get for various areas. If you’re a respiratory therapist, you may want a really high tech one. If you’re a neonatal intensive care nurse, you won’t want or need the regular adult stethoscope. I recommend getting a middle of the line scope for school, and then if you get a job in a more specialized area, you’ll be able to get a scope that works for it and not be bummed you shelled out $200 in nursing school for a scope that you don’t even use. I also recommend getting it engraved with your name. You won’t wear yours around your neck for those 12 hour shifts. You will inevitably set it down and forget about it, and someone else will grab it. If it’s got your name on it, someone may return it to you. I’m really glad I spent the extra money for the engraving because I’ve lost mine and it’s been returned about 5 times now.
Item #3 – Pen Light
Scale of Necessity Rating – 10
You must be able to assess pupils in clinical. You do this by shining a light into their eyes. The most effective way to do this is to have a pen light.
Yes, your iPhone has a light on it that technically does work for this, but your instructor may not let you pull it out in front of a patient. Plus, if the patient is on isolation, you’re not going to want to take your phone out of your pocket when you’re all gowned up.
I have a small one on a keychain that is connected to my badge. It’s wonderful because I’m never without it. You can get penlights from scrub stores and whatnot, but my favorite one comes from AutoZone. It’s a penlight people use while working on cars and it’s awesome. Sturdy, bright light (but not too blindingly bright) and cost effective. I also took some nail polish and put a dot on mine so no one would steal it. You’d be surprised how many physicians (neurologists and neurosurgeons included!) want to steal your pen light and forget to give it back!
Item #4 – Small notebooks that fit in your scrub pockets easily
Scale of Necessity Rating – 4
Many times in clinical, you’ll hear something you want to remember and want to write it down. This could be something as simple as a good way to remember something (bedside nurses are great at coming up with things to help you remember important information!), what something stood for (what’s an AVR again…?), good talking points you overheard (how a nurse explained atrial fibrillation to a patient, for example), care plan ideas, or the name of a staff member that you want to ask for a recommendation later.
Again, many instructors will not let you pull out your phone mid-clinical. While you can scribble this on a piece of paper, what are the chances are of you keeping track of all of the little pieces of paper you collected throughout clinicals?
If you have a small thin notebook in your scrub pockets, you’ve got a centralized location of collected information throughout the semester. It is easily accessible during clinicals and easily referenced later on. While this is not something you’ll fail without, it will make easier. For how cheap small notebooks are, it is definitely worth the cost.
“Ummm… am I reading that right? Did this chick just mention my unmentionables?”
Yes, yes I did.
You would think I don’t need to bring this up… but I do. Many nursing schools have white scrub uniforms. Scrubs are not like normal clothes, they are typically pretty sheer and you can see right through them if you bend over.
In clinicals, you will be bending over a lot… to plug in an IV pump, a sequential compression devices, pick up items that fell on the floor, helping your patient stand up, leaning over the bed to roll them onto their side… the list goes on an on. Moral of the story: if you are wearing light colored scrubs, you need underwear that matches your skin color.
Otherwise, everyone will see your undies. While people may not mention it to you, they will notice. I’ve seen patients say things to nursing students before when they’re wearing white scrubs and bright pink underwear. It’s quite embarrassing and can throw your game way off. Also, it looks unprofessional.
Item #6 – Backup uniform
Scale of Necessity Rating – 8
Scrubs are important to have, but when you’re in clinical you’ll most likely have to wear your school uniform scrubs. I know nursing school is expensive, but I really recommend buying a backup set of pants at least. You may be thinking… “No worries, I’m an expert at stain removal!”… and while that’s wonderful, if you get peed/puked/poop/bleed/spit on during clinicals, you need something to change into until you can get home to treat the stain.
I always kept a backup set in my car, and now I keep a backup set in my locker at work. People think it will never happen to them or they’ll just be really careful, but you never know what kind of situation you’ll walk into.
I’ve heard of people emptying JP drains and walking to the bathroom with the cup full of bloody output, concentrating really hard not to spill it, only for someone to run into them and knock it all down their scrubs. Or the patient that you walk the bathroom who sneezes and pees on you. Or the patient who looks totally fine, you walk up next to their bed and they grab your leg with a poop-covered hand. Or the patient with a trach that coughs and flings a big glob of sputum all the way across the room, which gracefully lands on the bottom of your scrub pant as you slow-mo react screaming, “Noooooooooooooo!”
In just about every single group of nursing students that have come through the units I’ve worked on, one student has either passed out or gotten really close. Many times, the student was so nervous that they didn’t eat anything before coming in. Their nerves are high, the stomach is empty, at at the first sight of a needle or procedure, they hit the deck.
Also, sometimes clinicals get really busy. Your patient has a lot going on, or you want to see various procedures, and you find yourself going hours without food and suddenly you need something to eat STAT! Also, students may get the opportunity to observe in the OR – which is an amazing experience! However, time is a factor in the OR. You won’t be able to leave for 45 min to heat up your perfectly packed lunch. Typically when they ask if anyone wants to go observe, you go straight there with no stops!
It is a really good idea to have a backup snack or two that you can eat quickly. I recommend a granola bar, almonds (or some other nut), crackers.. Just something you don’t have to refrigerate that can fit easily in your bag or even a scrub pocket. Also, it’s a good idea if it’s something that’s wrapped up.
Item #8 – Good pens
Scale of Necessity Rating – 1
You can get through clinicals without the best of the best as far as pens go, but it makes it nicer to write when you have a legit pen. Also, it’s nice to have a pen that writes well on the various surfaces that you need to write on. You will most likely have to write on regular paper, but some facilities have lab labels (a label that goes directly on the lab specimen) that may have a slick surface and your favorite gel pen may smear if you use it. Or you may need to write on labels for pharmacy, supply, and so forth.
Also, this may sound weird, but a good pen is a little bit of a moral booster as well. When I’m having a crazy day and need to write a bunch of stuff down, it’s always a nice to write with a pen that just flows perfectly. Is it at all relaxing to you to write with a pen you really like? It is to me… I enjoy it. Like the sound of someone opening a soda… the crunch of a fall leaf under someone’s step… or when you’re taking off a patient’s dressing and it all comes off at once. It’s the simple things, people.
Item #9 – Good shoes
Scale of Necessity Rating – 7
Appropriate shoes are really important, but you can get by with not so awesome ones. This isn’t something to go into debt for if you have shoes that will work, but it really does make a difference when you have good nurse shoes. Some nursing programs may make you have a specific color, some may not. I’ve tried out a LOT of nursing shoes.
I used to use regular nicer tennis shoes but I noticed that after about 3-4 months, my shins started killing me by about hour 6 in my shift. After a few months, you will wear down the support just from walking so much on hard surfaces.
Also, you can’t clean regular tennis shoes well. Bodily fluids don’t come off of cloth easily or completely. I highly recommend getting some shoes that will wipe clean.
After wasting a lot of money and trying a ton of different shoes, I have decided that the Work Wonders line from Dansko is my personal favorite. They’re slightly cheaper than the regular Dansko shoe ($100 vs. $140), fit a little snugger, and have a shorter heel. (I rolled my ankles many times in my classic Danskos!) Those were my main complaints with traditional Danskos, and now that it’s been addressed I have my perfect work shoes! Danksos stand the test of time. I’ve had my current ones for a while, but the traditional ones I had before.. I wore for about 3 years with no shin or leg pain after a 12 hour shift. Plus you can clean them very easily.
Item #10 – Clipboard
Scale of Necessity Rating – 6
Now that I’m a bedside nurse, I don’t use a clipboard often. I’m a less is more kinda person. However, in nursing school I used one all the time. I had to keep track of quite a few papers at once during clinicals, and this kept them organized. I also had to randomly write things down in a pinch, and rarely was there room at the nurses station or various locations for me to actually sit down and write. It was exponentially easier for me to carry a clipboard. You can get through clinicals without one, but I wouldn’t want to.
We at NRSNG have a really great one, developed by nurses who went through nursing clinicals. It has a bunch of frequently referenced information printed directly on it, and it opens up so you can store papers in there as well. Seriously wonderful.
What’s a brain sheet, you ask? A brain sheet is a report sheet. It is a way to organize all of the information you receive from the off-going nurse. It’s great to get used to them early on. Some units have specific ones they use, but most leave it up to the nurse to use the one they like the most.
There isn’t one universal report sheet because each unit may require different information. For example, a report sheet from an intensive care unit would not be the same for a nursing floor. There’s just too much detail in the ICU report sheet and it’s not information that’s necessary on the floor.
We made an entire database of different report sheets. Check it out here! You can download them and print the ones you’ll need and make copies.
Item #12 – Fill in drug cards
Scale of Necessity Rating – 7
These things will make your life much smoother. Many clinical instructors want you to look up your patient’s medications the night before and create drug cards. You may also need to make them for pharmacology courses or other courses. It is a huge time saver to already have a template that you just fill information in instead of creating the entire drug card each time.
You can also color-code them for specific drug classes to enhance memorization and comprehension. It will really help you remember information if they are all formatted exactly the same. Serious time-savers and memory-enhancers!
We also have an NRSNG Drug Card Template that you are free to download and use.
These are incredibly helpful. Nothing is more annoying than trying to type up your care plan and trying to learn Microsoft Word formatting 101 at 2:00 am when it’s due at 8:00 am. Use a care plan template and just plug in your information, print, and you’re good to go! Headaches avoided, time saved.
Depending on your instructor, you may not be able to use your phone while you’re at clinicals… nonetheless, they’re really helpful!
Medscape – a free medical app with tons of information about varying disease processes, drugs, and so forth.
Figure 1 – a free app of medical cases for healthcare professionals. This one is fun to flip through randomly to see interesting cases and read physicians, nurses, and students chatting about what they think is going on and potential treatment courses.
Micromedex – there is a free version and a $2.99 version. I love this one. My hospital actually has it within our electronic medical record so I can access it within their med list, so I rarely use the app. The information is awesome though. I use this most frequently to quickly look up indications or IV compatibility.
Nursing Central – a free app with drugs, definitions, diagnoses, and test info.
Nurse Grid – a free calendar app that helps you schedule your shifts or clinicals. (You’ll quickly learn that regular calendars aren’t ideal for shift work.. especially night shift)
Epocrates – a free medical app that has a ton of great information
SmartFOAM – a free app that is Free Open Access to Medical Education
iStethoscope Expert – a free app that allows you to hear heart, bowel, and lung sounds. This is great for practice!
Item #15 – Compression socks
Scale of Necessity Rating – 7
Compression socks are wonderful. I wear them every single shift. It is rough standing and walking for 12 hours straight, so these really support your legs. My legs feel much better after a shift when I wear some compression socks. Also, these aren’t just for women. There are tons of great options out there for men.
Nursing clinicals are tough. You want to be as mentally, emotionally and practically prepared as possible. These 15 items will make the monumental question How to survive nursing school manageable.
Having really good resources at the tip of your fingers is essential, but it’s even more important to know those resources well so that you can find information fast. Trust the nurses that have been through nursing school… we’ve created the resources we wished we had, and we’ve also tried out a lot of stuff that just didn’t work and found some great stuff that did. We hope this list helps clinicals run smoother and saves you a few headaches and dollars.