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Clinicals Survival Tips

Oh clinicals. Those dreaded hours where SRNAs, no matter how old or how experienced, can feel so lost and hopeless. Hands down, clinicals are the toughest and most emotionally exhausting part of school. Not only because of the high expectations, but mainly because this is when you are finally, actually putting your hands on patients. In turn, you finally, actually have patient’s lives in your own hands. No matter how many years you spent in the ICU, or critical situations you’ve been involved in, I assure you this is a way different ballgame. That being said, your past experiences will come into play and you will learn to rely on those instincts you developed as a bedside nurse. Unfortunately, and I promise you this with certainty, you will have bad days at clinicals. Whether it’s a tough surgeon, a day spent with a CRNA preceptor who has the personality of a raccoon, or simply showing up unprepared for the day, you will have days you wish could be erased from memory. Luckily for you, below is some advice on how to not only survive clinicals, but look good doing it. These key points helped me have more good days than bad ones during my clinical rotations.

  • BE READY- Being ready for clinicals involves many things. But first, let’s work on your attitude. What I mean is, let’s work on your approach and expectations for your clinical experience. You might be expecting every CRNA that precepts you to be this amazing pool of knowledge and experience, waiting eagerly to share their love of anesthesia with you, and do everything in their power to make sure you have a great and beneficial learning experience. In truth, while those preceptors do exist, they are certainly not the norm. Most of your preceptors are regular CRNAs that have never actually been taught how to teach, let alone teach effectively. You will learn a great deal from all of your preceptors, no doubt about that, but you have to put in a lot of the effort too. Asking the right questions and making good observations is key. One thing I did notice during school is that it is just as important to learn what not to do, as it is what to do. In other words, it was important for me to pick up on my preceptor’s habits that I did not like or agreed with. When I became a CRNA I knew I would avoid doing them.

  • OR CULTURE- If you’ve never worked in the OR before you might be in for a culture shock. The OR functions like no other place in the hospital. The lines of professionalism and common decency are often blurred during surgery. Be it because of the highly intense nature of surgery, or simply because surgeons never take a manners course during training, sometimes things can get a little uncomfortable. Don’t be surprised if you hear vulgar language, or experience toxic work environments. This may happen from time to time. My point is, be ready to bend your lines a bit. Don’t ever let anyone (surgeons, RNs, even your preceptors) cross the line with you. However, the line is totally where you set it and feel comfortable with. I don’t believe that ALL ORs, not even MOST ORs, are like this, but you will, in the course of school or your career, come across them. Be ready, don’t ever let anyone say or do anything that you are uncomfortable with and stand up for yourself.

  • CARE PLANS- These pesky requirements can keep you up all night. Every school has a different care plan format they want you to use, and sometimes individual facilities have ones too. Some CRNAs love lengthy care plans that describe everything in details, other days you will work on your care plan all night long and it will be a work of art, but your preceptor won’t even look at it the next day. The struggle is real my friends, the struggle is real. Care plans, in all honesty, are meant to help you be better prepared for the day. Your main goal is to knock out as many care plans in the first six months of clinicals as you can, and make sure they are thorough. Whether your preceptor likes them or not, or even chooses to check them, does not matter at all. Treat your care plans as “cheat sheet” study guides for yourself. Eventually you should have enough care plans to cover most of the procedures you will see during school, and if you make them good enough from the start they will be all you look at before you go to clinicals. So, the night before you are doing a whipple procedure, for example, you won’t even have to crack a book open. You will sit down and review your amazing care plan once or twice and be ready for the day. In my care plans I used to add a list of items I would need for the case, a review of major A&P related to the surgery, and even pasted photos and charts. This way most of the questions I was asked the next day were from information I gleaned from my own care plan.

  • A DAILY JOB INTERVIEW- If you haven’t heard it by now, you will be sure to hear this during school many, many times: “The anesthesia world is a small world, everyone knows everyone.” You should really keep this in mind as you float through clinicals. Treat every day as a job interview where it is your job to impress everyone. Even if you don’t end up working at the place where you rotated as a student, you will certainly need letters of recommendation at the end of the program. It is up to you to make a good impression throughout your clinical rotations, and make sure you maintain your reputation all the way to the last day you are there.

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