Clinicals in nursing school are an exciting, yet nerve-wracking time. You finally get to work with actual patients and see what it’s like to be a practicing nurse, but there are a lot of unknowns. To help you navigate and survive your first clinical rotations, our team of experienced nurses put together the following guide. Once you know what to expect, it’s easier for everything to fall into place and for you to achieve success.
What Are Clinicals in Nursing School?
Nursing school clinicals are when you get to put your classroom knowledge and lab training to the test with real, hands-on patient care. They consist of rotations in different clinical settings and specialties, allowing you to gain a diverse range of experience and narrow down what type of role you might want to pursue in your career.
When do nursing students start clinicals?
Nursing clinicals begin at different times depending on your school and program length. A student in a two-year program might have their first clinical rotation during their first semester, while a four-year student might need to wait until after they complete their general education courses (usually the first two years of their degree path).
How do nursing clinicals work?
Nursing clinicals require students to take on real nursing duties under the supervision of an RN clinical instructor. They usually involve 4-6 or 8-12 hour shifts of shadowing or assisting practicing nurses, which may vary depending on your setting and instructor. You will typically have several shifts per week.
Always come to clinicals prepared, act professionally, double-check your work, and don’t be afraid to ask questions!
How many clinical hours are required?
Required clinical nursing hours vary by state, but most boards set the bar at 500 hours for a student to finish their program. This means that students can usually expect to work 120 to 140 hours per semester over a two-year period.
Do nursing students get paid for clinicals?
No, nursing students do not get paid during clinicals. While time-consuming, clinical rotations in nursing school are considered part of your degree program. They act as an extension of your classroom and lab training and give you the opportunity to develop your skills in a controlled environment.
If it helps, you can think of clinicals as an unpaid internship. You get on-the-job training, exposure to various clinical settings, and a chance to network with potential employers.
What do nursing students do in clinicals?
The specific tasks you perform in nursing clinicals will depend on your rotation and setting. For example, you may be in a hospital, clinic, community health center, nursing home, assisted living facility, or home health agency. Nevertheless, there are several rotations and tasks that the vast majority of nursing students will experience:
Common Nursing Rotations
- Long-term care
- Emergency care
- Labor and delivery
- Community health
Common Nursing Tasks
- Taking vital signs
- Recording patients’ medical histories
- Performing dosage calculations
- Administering medication
- Placing IVs
- Inserting catheters
- Assisting with daily functions (e.g., bathing, changing clothes, using the restroom, walking, etc.)
- Making beds
- Communicating with patients
- Completing patient assessments and care plans
What is a nursing care plan?
A nursing care plan documents a patient’s needs and provides a roadmap for effective care. They’re very important, ensuring all parties remain on the same page throughout treatment. Below is an example of what a student’s care plan may look like, with additional steps to explain your thinking. However, we encourage you to clarify what’s expected with your clinical instructor:
Preparing for Nursing Clinicals
The best way to achieve success in nursing school clinicals is to be prepared mentally and physically. There will be ups and downs as you navigate your rotations, but being proactive will help you provide the most effective patient care.
Maintain a curious, professional mindset
Clinicals are your time to learn on the job. For many students, they’re both highly rewarding and occasionally exhausting. Before each shift, remind yourself of the “why” behind your goal to become a nurse. This will help you enter a positive state of mind as you start your duties.
During your shift, be attentive, polite, and present in the moment. It can be easy to let your fatigue get the better of you, but keeping a positive attitude will reflect well on you, encourage your patients, and improve your grade.
Also, don’t go into clinicals expecting to have all the answers. You’re not going to know everything, and that’s ok. It’s actually expected. Be ready to receive criticism and advice, and take the feedback constructively. Put another way, develop a growth mindset. The best nursing students come forward with questions that will improve the effectiveness of their patient care, so remain confident and curious!
Be ready for rotations physically
Nursing clinicals require you to work long hours on your feet, perform innumerable tasks, and do it all while maintaining a smile. It can be tough, but there are a number of small things you can do to make your shifts easier and improve your overall performance:
Clothing and Personal Items
- Wear scrubs in your school’s mandated color (you will receive guidelines)
- Wear comfortable compression socks and high-quality, closed-toe shoes
- Bring a refillable water bottle and snacks (preferably with low-risk ingredients in terms of allergies)
- Bring your nursing program’s badge and regular ID
- Bring the badge from the healthcare facility you’re working at
- Consider purchasing a high-quality backpack and separate clinical bag
- A notepad, spare pens, and a penlight
- A stethoscope
- Nursing report sheets
- A drug guide and other nursing cheat sheets
- A binder or folder for your clinical paperwork
- Show up rested and on time!
- Ensure your hair is neatly pulled back
- Always try to present a professional appearance
Your clinical instructor should cover these basics with you before your first rotation, but it never hurts to be prepared. It’s also helpful to create a checklist on your phone or in a planner to make sure you don’t forget anything.
Common Mistakes in Nursing Clinicals
Even the best of us make mistakes, and you’re bound to make a few during your rotations. The best thing you can do when they occur is learn from them with a positive mindset. After all, you’re in clinicals to gain experience and learn. To start you off on the right foot, below are some common mistakes that nursing students make during clinicals:
- Medication Errors: Double, triple, and quadruple check your medications and dosages before administering them. Fatigue leads to mistakes, and this is a critical one you don’t want to make. If you have questions, ask!
- Avoiding the Instructor: It’s easy to think that keeping a low profile will make clinicals easier, but the opposite is often true. You’ll ultimately learn more and receive a better grade if you seek out your instructor, ask questions, and actively try to learn from them.
- Not Getting Enough Rest: Nursing hours can be difficult and definitely require an adjustment period. Make sure you get enough sleep each night, or the physical and mental stressors of the job will catch up with you, eventually leading to mistakes.
- Improper Documentation: Creating accurate care plans, nursing notes, and charts takes practice. If you have questions on how to fill out medical documentation, ask your clinical instructor. This is a skill you’ll need to develop to deliver safe, effective care.
- Falling Accidents: Always be mindful of your patient and their physical condition. Falls occur regularly, even in safe environments with level floors, leading to further complications. Remain attentive and never make assumptions about your patient’s physical abilities.
- Infections: If the proper sanitation measures are not taken, or if you’re hasty in making them, the risk of a patient getting infected increases dramatically. Take standard sanitation precautions seriously to avoid causing your patients unnecessary harm.
- Failing to Report Mistakes: Making a mistake is bad enough, but what if it goes unnoticed? It can be tempting to try to keep it under wraps, but doing so is highly unethical and can lead to serious consequences for you and the patient. Always report errors as soon as possible so that corrective actions can be taken and you can learn from them.
Final Tips for Nursing School Clinicals
Nursing clinicals can be a whirlwind when you first get started. You’ll be put into situations where everything seems new, and it can be a lot to take in. So, take a deep breath and keep the following tips for success in mind:
- Arrive a few minutes early
- Always treat your patients respectfully
- Don’t be afraid to ask questions
- Remember HIPAA and patient privacy
- Actively work on your critical thinking and clinical-judgment skills
- Always double-check your actions with your assigned nurse or instructor
- Don’t worry if a patient refuses care from a nursing student
- Wash your hands often
- Have confidence!
Nursing rotations truly give you a taste of what you signed up for when you decided to become a nurse. Every day, you’ll have unique opportunities to better yourself and the lives of others. Try to make the most of it and don’t forget to enjoy the process!