What are Clinicals In Nursing Schools in The USA?
Nursing clinicals are either your favorite part of nursing school or the most dreaded aspect of your education. It’s 100% normal to be anxious about clinicals, especially as a nursing student who has never treated a patient before.
When a nurse is in clinicals, it means they’re working under other nurses in a hospital as part of their training. Clinicals allow nursing students to follow RNs in their daily jobs, practice skills and gain feedback.
You usually start clinicals during your first or second semester of nursing school. It seems so early, doesn’t it? But because clinicals are a core part of your education, it’s important to familiarize students with the hospital environment as soon as possible.
Over the next two to four years (depending on their degree), students will do clinical rotations in different parts of the hospital. As a nurse-to-be, you’ll get to build confidence in a real hospital setting, so you’re more prepared for actual work as an RN.
This guide will cover everything nursing school students need to know about clinicals. We hope this helps ease your nerves. Of course, you will make mistakes, but you’ll grow as an even better nurse.
No one expects nursing students to know everything, so just do your best, follow your training, and listen to your nurse mentors.
First, let’s talk about nursing clinicals as a whole. Why are they mandatory for aspiring RNs?
Why are clinicals important during nursing school?
Clinicals introduce nursing students to the hospital environment. They give you a realistic idea of what your job will look like after your degree. If nurses only studied in a classroom or online, they wouldn’t be prepared for the dynamics of working with real patients.
During clinicals, you will usually work 8 to 12 hours, shadowing other nurses performing their duties. They will assign you tasks based on each patient’s needs.
Nursing clinicals teach you how to work with patients and communicate in a healthcare setting. They also teach you how to work in compliance with health regulations and guidelines.
While you’ll use dummies during your skills training in class, clinicals are all about working with real patients. This is scary at first, but it’s essential to becoming a nurse.
No matter how often you practice skills in a lab or class, you need to work with real people to perfect them. Clinical teach you how to apply what you’ve learned in school to the workplace.
What do you do in nursing clinicals?
During nursing clinicals, you’ll perform various nursing jobs depending on the shift. Like registered nurses, nursing students are given shifts lasting 8 to 12 hours each. These will look different depending on what they’ve been assigned to do on that given day.
Some of the responsibilities nursing students have are:
Changing bed linens and prepping hospital rooms
Keeping medical charts for patients
Obtain vital signs and record them in patients’ charts
Perform complete physical examinations
Conduct health assessments, gathering medical history and other information from various patients.
Assisting RNs with procedures such as inserting an IV or Foley catheter
Calculating medication doses and reporting them to the nurse in charge
Administering medications in different ways according to nurse instructions
Your first clinical rotations will have less hands-on care as you get familiar with the environment. Usually, a group of nursing students gets assigned to one nurse who they’ll job shadow.
You can expect to work several clinical shifts each week, and you’ll have to write a nursing care plan during each one. The nursing care plan covers all the stages of nursing care:
Assessment
Diagnosis
Planning
Implementation
Evaluation
Note that you will not perform any medical procedures or make diagnoses independently. For example, registered nurses don’t perform treatments or diagnose patients alone — they work under a physician.
Do you take care of patients in clinicals?
Yes, you will work with real patients during your clinical rotations. It is nerve-wracking the first time, but you grow comfortable with practice.
It’s normal for some patients to refuse care for a nursing student. While this can be off-putting, don’t take it personally. People in the hospital or clinic are under stress, so it’s okay for them to only want treatments from a licensed RN.
Early clinicals are less hands-on and focus on observation and education. You'll be assigned actual patients as you gain more knowledge and confidence. However, you’ll still have the support of your nurse supervisor to help you navigate care.
Clinicals are designed to scale with the student. As your education grows, so will your responsibilities. You’ll always watch an RN's procedures and basic nursing duties before you do anything yourself.
How are clinicals graded in nursing school?
Factors such as attendance and participation play the largest role in clinical grading. However, the quality of your nursing care plans will also play a large role in your grades.
Make sure you study well, draw from your lessons, and apply what you’ve learned to everything you encounter in clinicals.
It seems like a lot to take on, but you will get more comfortable balancing school and clinicals with practice. Of course, you can always rely on your fellow students and mentor for advice.
What can you do if you fail a clinical assessment?
The first thing you should do after failing a clinical assessment is to speak to your clinical instructor. They can provide feedback on why you didn’t pass and what you need to improve on. You will get to work on clinicals again, so it’s not the end of the world if you fail one assessment.
There are a few things you can do to improve your chances of passing a clinical assessment:
Participate as much as possible during skills lab in orientation
Ask questions to your clinical instructor and the shift nurse early-on
Always look up medications, and make sure you are memorizing as many as you can
Make drug cards on medications related to your clinical setting, e.g., psychiatry, OB, or ER
Focus on understanding the why behind your clinical tasks. Knowing how to do them and why they’re important are two different things.
Clinical instructors evaluate students based on preparedness, competency, and understanding. A student who can get through clinicals with moderate to intense supervision is not equipped to work as an RN later.
The goal of clinicals is to build your skills and make you capable of working as an RN on your own after the NCLEX. So, it’s normal to be graded harshly after a certain period. For example, students in their second or third year must be far more independent and skilled than first-semester nursing students.
Although it is frustrating to get a failed assessment, recognize it as a learning opportunity. This setback will help you improve your nursing, provide better care to your patients, and, ultimately, be a better nurse.
What clothes do I need for clinicals in nursing school?
Nursing school students should wear uniform scrubs and comfortable shoes. You’ll be on your feet for at least 8 hours, so make sure you have shoes that are supportive and high-quality socks to prevent blisters.
Your uniform should match your school’s requirements. For example, these may be scrubs in your school’s color or a specific shade of blue. You will also need to apply a patch to identify yourself as a nursing student.
If you don’t already have one, invest in a high-quality, durable backpack. Having a separate clinical bag makes it easier to keep all your supplies organized.
There are other supplies you’ll need to bring to clinicals, and you should keep a checklist on your phone or near your bag, so you’ll never turn up empty-handed.
Stethoscope
Drug guide and nursing cheat sheets
A small binder for all your clinical paperwork
A refillable water bottle
Some healthy snacks. Avoid ingredients with a high risk of contact allergies like nuts and shellfish.
A notepad and pen.
Your school ID and regular ID.
Your instructor will cover what to bring before your first clinical rotation. You’ll also be told what you’ll need ahead of skill labs. Keep a note in a planner or phone. You can also call or text a classmate and ask what they’re bringing.
Do nursing students get paid for clinicals?
No, nursing students aren’t paid for clinicals. However, your clinicals are a part of your degree program, just like classroom lectures and skills labs. Although they are time-consuming, they aren’t considered separate from any other part of your nursing curriculum.
What are clinical rotations in nursing?
Clinical rotations are shifts you perform in different parts of a hospital and, sometimes, in various clinical settings. Moving between other departments helps nursing students develop skills in various healthcare specialties.
Doing clinical rotations is a great way to experience different types of nursing. You may discover one that really speaks to you and decide to specialize in it in the future.
The Benefits of Nursing School Clinicals
Clinicals have a lot of benefits for students beyond just teaching them essential skills. Here are some more ways they’ll help you along your path to being an RN.
They Give You Networking Opportunities
Nursing students might feel invisible sometimes, but you aren’t! Introduce yourself to managers and charge nurses. It can make a difference later, especially if you’re applying to jobs in the same facility you’re doing clinicals.
Even if you don’t want to work in a specific department, make an effort to be outgoing. Getting over social anxiety is another important part of becoming a good nurse.
Learn to Work as a Team
Nurses work together to care for their patients. The flow of healthcare relies on a tight-knit group of nurses all working together. But it can be challenging to learn how to work on a team when treating patients.
Nurses need to work under the shared goal of helping patients continually. With a team-oriented approach, you’ll also be more receptive to feedback. You know that every nurse has strengths, and you’re more willing to ask for help when needed.
Gain Confidence
If there’s one thing most first-year nursing students feel, it’s anxiety. Doing clinicals, even two or three years into your degree, can be nerve-wracking. Then, when you start in a new department and have a new clinical instructor, you may feel entirely out of your element once again.
Push through your worries, and let clinicals help you develop confidence in your nursing abilities. Of course, it takes time, but every nurse has been in your shoes.
Get Feedback on Your Nursing
Clinical evaluations can be harsh sometimes, but it’s for your greater good. While some instructors focus on strengths, others focus solely on telling you what you need to improve. Both experiences are valuable.
You’ll quickly learn that feedback makes you more alert, responsive, and attuned to your patients. In addition, being open to constructive criticism helps you grow. But, ultimately, you’re only told what you need to succeed.
Whenever you hear something you don’t like, accept it and look for an opportunity to improve. Your goal is to deliver the best possible care to your patients.
Develop Your Nursing Approach
Nurses all have their unique styles and bedside manner. Unfortunately, you won’t know yours when you just start, which is why clinicals are so important! Imagine getting your RN license, showing up at a hospital, and having to treat a patient for the first time! Without prior experience, you’d likely feel awkward, uncomfortable, and too anxious to focus on your job.
As your confidence grows in clinicals, you’ll become much more comfortable around patients. You’ll improve at asserting yourself, offering support, and being an advocate and ally to your patients.
Frequently Asked Questions About Nursing School Clinicals
Are there any specialties in clinicals?
Yes! Clinical rotations take nursing students through all the different specialties in healthcare. You’ll get to work in many fields, including:
Emergency care
Critical care
Labor and delivery
Pediatrics
Perioperative (Surgical)
Psychiatry
Community health
Don’t pressure yourself to fall in love with every specialty. You’ll find some you love and others you can’t wait to be done with. However, every specialty is important and has something to teach you.
No matter what you’re currently working through, be fully present and open to learning as much as possible from your instructor, staff nurses, and your patients.
Can you miss clinicals in nursing school?
Nursing students must complete clinicals before they can earn their degree. The NCLEX exam requires students to complete a certain number of clinical hours based on their state. In most states, students must complete at least 500 hours of clinicals before finishing their program.
If you undergo significant life events impacting your clinicals, speak with your instructor. It’s important to be as vocal as possible and make alternative arrangements. However, you should never skip clinicals as this will result in a failing grade.
Why are nurses so mean to students?
We must be honest — not all staff nurses are kind to students. It isn’t personal. They are so focused on their work that having students around can be frustrating. They may not want to collaborate, and some will exclude you from their work.
One thing to keep in mind is that this is a universal experience. All nurses have worked with other nurses who didn’t treat them well. Likewise, nursing students have all encountered some other nurses that weren’t welcoming or helpful.
Remember that this experience is about you and your journey. Don’t allow one mean person to fill you with self-doubt or question your career path. Remember, you’re here to learn and grow. That takes time. You will face challenges, but you can overcome them.
How do I survive nursing clinicals?
The best way to make it through nursing clinicals is to take care of yourself, prepare as much as possible, and stay positive. Reach out to other students as well. You can be a major source of support and encouragement to one another.
Self-care is extremely important. You’ll often work in fast-paced, high-stress environments. Imagine standing 12 hours in an ER with only a few hours of sleep and poor hydration. You can’t care for patients properly if you don’t look after yourself first.
Lastly, a positive mindset can differentiate between feeling empowered and feeling defeated by clinicals. You will have bad days; every nursing student does. Doctors performing their residence have bad days, too.
And when you’re an RN, negative encounters and experiences will also occur. However, what matters is that you focus on your higher purpose in nursing. Why are you there? Your “why” is much more important and meaningful than one bad day or mean patient.
How can I stop being so nervous about clinicals?
Give yourself time, and practice some coping strategies. For example, whenever you’re feeling stressed or anxious, use deep breathing to ground yourself in the present. In nursing, you’ll learn that most shifts have to be taken minute by minute.
Focus on your tasks, and be kind to yourself. You won’t know everything, and you won’t get everything right the first time. It’s okay!
Allow yourself to feel nervous, and remember that you aren’t alone. All nursing students have anxiety during clinicals. You will get more comfortable with time.
Remind yourself of all the things you get right. Let positive experiences build your confidence, and you’ll be well on your way to being the best nurse you can be.