What are Nursing Clinicals?

Nursing clinicals — it’s a phrase that strikes fear into the hearts of nursing students everywhere.

Clinicals come up fast in nursing school. One moment, you’re reading about basic health assessments. The next, you’re in a clinical, and a nurse preceptor expects you to do an assessment. On a real patient!

Nursing clinicals sound scary — and we’ll be honest, they can be — but in reality, they’re the most valuable opportunity you have to learn about nursing. In a clinical, you take what you’re learning in class and apply it in a real-world healthcare setting.

Best of all? There’s a teacher there to help you.

What are Clinicals in Nursing School?

A nursing clinical is a hands-on class that happens in a hospital or healthcare facility. During the clinical, you and other nursing students shadow a registered nurse (your clinical instructor or a nurse preceptor) on the job. At first, clinicals give you the chance to see what nurses actually do at work. Eventually, you’ll get to practice nursing skills on real-world patients — under the supervision of the nurse preceptor, of course.

During your clinicals, your school will assign you to a facility. Often, nursing students start out in a long-term care facility working with geriatric patients. Later, you might move on to an emergency room, med-surg wing, or even a community health center. Many nursing schools move students through clinical rotations in different facilities. That way, you get more experience in all areas of nursing.

Nursing clinicals are the most valuable part of your nursing school education. They help you learn to take care of patients safely and efficiently. This is the only time that you’ll have a teacher by your side on the floor — someone whose only goal is to answer questions and help you learn how to be a nurse. Plus, since you’re working in different healthcare institutions, clinicals are a great way to decide what kind of nursing to go into after graduation.

What do Nursing Students Do in Clinicals?

During your first clinical, you’ll shadow a nurse. Watch carefully — this is a great way to see how nurses interact with different types of patients. You’ll also get to see what nurses do every day: passing meds, assessing patient health, doing wound care, managing nurse’s aides, and giving report.

As you progress in clinicals, you’ll get to practice the skills you’re learning in nursing school. Sometimes, this happens on the first day; other times, you’ll need to wait. The actual skills you use depend on the facility you’re in.

Often, your clinicals conicide with your classwork. So, if you’re learning about behavioral health, you might do a nursing clinical in a psychiatric facility. 

Some things nursing students do in clinicals include:

• Make beds
• Give bed baths
• Charting
• Take vitals
• Pass medications
• Read blood pressure
• Insert IV lines
• Transfer patients
• Care for wounds

When do Clinicals Start in Nursing School?

Clinicals usually start during the first or second semester of nursing school. Don’t worry — you won’t be tossed into a hospital without any practice!

Many nursing schools require students to practice their skills in a lab setting. Usually, this happens using manikins that are specially designed for teaching. Before you go to your first clinical, you might use the skills lab to practice:

• Transfering patients from a bed to a wheelchair
• Maintaining a sterile field
• Administering medication orally, by injection, topically, and more
• Assessing a patient’s health
• Practicing hygiene tasks, including giving baths and changing bed pans
• Changing wound dressings
• Inserting catheters
• Inserting IVs

Some nursing schools also require you to pass certain exams before you can start clinicals. Some exams are practical — you might need to insert a catheter in front of your instructor or show that you can give meds correctly. In other cases, you might need to pass an exam about calculating medication dosages. It all depends on your nursing school’s rules and regulations.

What to Expect in Nursing Clinicals

There’s no getting around it — nursing clinicals are scary, especially on your first day. It’s normal to be nervous! Your nurse preceptor and the other nurses on the floor know that you’re students — they do not expect you to know what you’re doing.

This doesn’t mean that you can afford to coast, however. It is crucial to come prepared, pay attention, and do whatever is asked of you. (Yes, even if that’s a bed bath.) Spend plenty of time practicing in the skills lab, reading about your first nursing specialty area, and researching the facility where the clinical rotation is happening.

Wondering what nursing clinicals are like? Here’s what you can expect during your first clinical rotation in nursing school:

• You’ll be nervous: Yes, it’s important enough to say it twice! If you expect it, you can take steps to combat your nerves — control your breathing, review your notes, do a power pose in the bathroom, and remember to smile.
• Things move fast: The situation on a hospital floor changes quickly. If you think you have time-management down after a few weeks or months in nursing school, think again. You’ll need to learn exactly how to manage timing so you can take vitals, assess patient health, and administer medication on time. This can be overwhelming at first, but you’ll get better as clinicals progress. (We promise!)
• You’ll constantly feel behind: Behind in skills, behind in knowledge, and behind in experience. Are students in your nursing school class who have worked as CNAs? You’ll probably feel even more behind, since they’re already familiar with being on the floor. Again, this is normal! Everyone’s experience is different based on the patient they get or the floor they’re on. Just focus on improving your own skills and you’ll be fine. 
• Talking to patients is harder than you expect: Even when you’re a people person, communicating with patients can be challenging. You’ll need to communicate medical information without using complicated nursing jargon — that’s the biggest challenge for many students.
• The smell is intense: Hospitals and nursing homes can be smelly places. Patients vomit. Defectation and flatualation happen. Sometimes, patients may have less-than-ideal hygiene. Then, you add in the smell of the cleaning fluid, and you have a recipe for a stinky work environment. Be prepared, and you can avoid an unprofessional reaction in front of a patient.
• Your feet will hurt: Nurses spend a lot of time on their feet — great shoes are essential. Don’t slap on your running shoes and expect everything to be fine. Instead, invest in a pair of great nursing shoes. Your feet will thank you!

Goals for Nursing Clinical Rotations

The main goal of a nursing school clinical is to learn to be a nurse in a hands-on environment. That’s not the only reason; some of the other objectives of your rotations are:

Practice Skills on Real Patients

As a nursing school student, your most important goal for clinical rotations is to learn how to practice skills in the real world. By the time you finish your last clinical, you’ll have experience in many of the tasks you’ll do as a nurse. You’ll know how to draw blood, take vitals, give bed baths, and many other nursing skills. This is important because it gives you confidence; it also teaches you how to execute a care plan safely and in the patient’s best interests.

Learn How to Communicate with Patients, Families, and Coworkers

Sure, nurses practice healthcare — but one of their main responsibilities is communication. During your clinicals, you’ll learn how to communicate with everyone in a healthcare setting. You’ll figure out how to talk to patients to make them feel comfortable and supported. You might get to chat with families; at the very least, you’ll get to watch how professional nurses work with families to ease their fears and help them become valuable partners in their loved ones’ treatment. And finally, you’ll get to see how to interact with aides, doctors, housekeeping, lab techs, and other nurses — a vital skill in working as an effective healthcare team.

Experience a Real-World Nursing Work Environment

Working as a nurse is very different from nursing school. That’s why clinicals are so great — they let you see what it’s actually like to be a nurse. Even better? You get to experience different nursing specialties. You might discover that you love working in med-surg, but not long-term care. After graduation, this information is huge — it makes it much easier to go after a job that you’ll love.

Make Sure Nursing is the Right Career for You

Not sure whether nursing is for you? Clinicals will help you figure it out, and fast. Many students discover that they love interacting with patients as a nurse, even when clinicals are hard. If you’ve never worked as a CNA, this experience is especially important. 

How to Survive Nursing School Clinicals

Worried about clinicals? It should go without saying that you should be prepared, on time, and dressed appropriately. To help you survive your clinical rotations in nursing school, we have some additional helpful tips.

Make Friends with Nurses, CNAs, and Students

The biggest thing you can do to survive nursing school clinicals is to make friends. Start with your fellow nursing students — they are your teammates and your support system. Plus, you’re going to be spending a lot of time together over the next two to four years, so you might as well be friendly! By building strong relationships right off the bat, you can help each other get through clinicals and school.

How can you make friends? Offer to help! If you’re having a slow period, volunteer to help another student with their patient. Notice that another student is missing something? Let them know. See someone struggling? Ask how you can help them get through.

Don’t forget about the other staff at the facility. If you have some time, ask a CNA if you can lighten their load (this is a surefire way to make friends). You can also offer to help the nurses on the floor, but do so carefully. Soon, you’ll be able to identify which nurses don’t mind answering questions or accepting help.

Eat Before Your Nursing Clinical

Clinicals are hard work for nursing students. You might be running to answer call lights, passing meds, or checking in on patients — which means a lot of walking. If you’re starving, it’s hard to do your job correctly. That’s why it’s important to eat before your shift and stay hydrated throughout the clinical. That way, your body and brain will be alert and prepared.

Drinking coffee or eating a strong-smelling lunch? Be sure to bring a pack of mints so you don’t irritate patients with bad breath.

Observe, Observe, Observe

One of the most useful things you can do during a nursing clinical is to watch the healthcare staff. How do the floor nurses handle combative patients? What tone do they use to soothe patients who are terrified? Don’t forget about technique — a CNA can teach you volumes about how to change a bed pan without spilling. By watching an experienced nurse, you can perfect your technique for finding veins.

Your fellow nursing students are also great resources. Everyone has different strengths. If you’re struggling with patient communication, watch a student who always leaves her patients smiling.

Ask Questions During Nursing Clinicals

During nursing clinicals, your instructor or preceptor is always on hand. Don’t be afraid to ask questions! Even if they sound silly, it’s better to ask than to endanger a patient. A clinical is not the time to fake it until you make it.

When it comes to other nurses on the floor, be respectful. It’s fine to ask questions, but you should pick your moment. Don’t do it when the nurse is racing to a code;  wait until they’re hanging out at the nurse’s station. As a student, you’re the lowest on the totem pole, so it’s a good idea to lead with respect. A simple, “Do you mind if I ask you a question about IVs?” or “Do you have a moment?” can work wonders. Don’t worry — if the nurse doesn’t have time, they’ll let you know.

Prepare for Emotional Swings

Nursing school clinicals are hard. You’ll make mistakes. You’ll see patients die. You’ll feel like you know nothing. You’ll accidentally say something that offends a patient.

This is normal!

Instead of berating yourself when clinicals go poorly, just feel the emotion. (Just for a little while; don’t dwell.) Then, look critically at the situation and figure out what you can learn. How can you do better the next time? Is there something you can do differently to avoid the same outcome in the future?

Read Patient Charts Carefully

When you’re assigned a patient for a nursing clinical, your instructor will give you the person’s chart. Study the chart carefully! If you don’t recognize a word, look it up. This is especially true for medications — it can help you identify if the patient is a fall risk or let you know if they might be disoriented or sleepy. Be sure to check the care plan and treatment history, as well. It’s also helpful to review the patient’s lab test results; you may need to look up the reasons doctors order the test, as well as what the results mean. This can give you insight into the condition and ongoing care.

Once you have the chart, you can make a plan for your day. Have a question? Ask your preceptor; that’s what they’re there for.

Take Every Opportunity to Push Your Boundaries

The fastest way to learn is to try new things — even if you’re nervous. Especially if you’re nervous. Take every opportunity to practice a new skill during nursing clinicals. You’ll learn faster and you’ll become more confident. Before you know it, other students will be coming to you for help!

How Long are Nursing Clinicals?

The length of your nursing clinicals depends on your school’s requirements. At Finlandia University in Michigan, students are required to put in 3 clinical hours per clinical credit hour each week. That means if you have a 3-credit clinical class, you’d have to do 9 hours of clinicals each week. 

How long your nursing clinicals are depends on a variety of factors, including:

• The schedule of the healthcare facility
• Your nurse preceptor’s work schedule (where applicable)
• University requirements
• State licensing requirements

Nursing Clinicals Schedule

The actual schedule for your clinicals depends entirely on your nursing school. Some schools allow students to work 5-hour shifts twice a week for most of the semester. If you’re going part-time in the evening, you might work shorter shifts during the late-afternoon or night shift

Other nursing schools schedule clinicals during specific weeks of the semester — if your school follows that model, you’ll first complete the classroom work on a specific topic. Then, you’ll do clinicals in a healthcare facility for several weeks. For a 12-week semester, that might be 9 weeks of class and 3 weeks of nursing clinicals.

The schedule of your preceptor and the facility also has an impact. If you’re doing a clinical in an urgent-care facility, you might work 9-5 on weekdays. In hospitals and other long-term care facilities with 24-hour nursing coverage, you might work 7am-7pm. Since some nursing schools do split shifts, your clinicals might last for a half day: 7am-1pm, for example.

Do You Get Paid for Nursing Clinical Rotations?

In most cases, nursing students do not get paid for nursing clinicals. In fact, since you’re earning credit, you’re probably paying for the clinical rotation. Between lectures, homework, studying, and clinicals, you can expect to spend a minimum of 40 hours per week on your nursing school work — many students spend closer to 60 hours.

This is an important thing to consider when you’re looking at nursing schools and clinical schedules. If you need to get paid, you might want to consider a part-time evening program. That way, you can work during the day and compete your nursing curriculum during evenings and weekends.

When you’re attending nursing school, clinicals are a big part of your education. When you understand what nursing clinicals are and what to expect, you can be ready for your first day on the floor.