Clinical Rotations for Nursing Students – What to Expect

by | Mar 13, 2023 | Nursing Student, Nursing Student Featured | 1 comment

If you are a new nursing student and confused about clinical rotations, don’t worry, you are not alone. Many students have a lot of questions and feel nervous. As you pursue your education in the nursing field, you will have to complete clinical rotations.

Clinicals are designed to give you hands-on experience in a real healthcare setting. During clinical rotations, you will be working with patients under the supervision of a licensed nurse who works on the unit, or your clinical instructor. It is an opportunity for you to put into practice what you have learned in the classroom.

In this guide, we will talk about what you need to know about nursing school clinical rotations, including some do’s and don’ts. If you want to learn more about clinical rotations or just want to be prepared for what’s coming, keep reading!

Clinical Rotations for Students - What to Expect

What are Clinical Rotations?

Clinical rotations are a required part of your nursing education. Before starting at a healthcare facility as a student, you likely will need to spend time in a sim lab on campus and get checked off on various skills.

During clinical rotations, you will work in a healthcare setting and gain hands-on experience working with real patients. This is most often a hospital, but can also be nursing homes, psychiatric facilities, prison systems, community health settings, and even school nursing positions.

You likely will be assigned to a licensed nurse who works on the unit your clinicals are on, under your clinical instructor, or both. You will also have the opportunity to work with other nurses and healthcare professionals, like nursing assistants.

Nursing school is typically divided into three major components: didactic, simulation lab, and clinical.

Didactic

Didactic learning encompasses physically being in a classroom, discussing the textbook foundational knowledge required to function safely as a nurse. You will physically sit in a classroom, or may take a few online as well, but the focus will be learning knowledge and being tested on it.

Simulation Lab

Simulation labs provide nursing students with opportunities to practice nursing skills in a controlled setting, often on mannequins with real equipment. Various nursing skills are demonstrated, such as medication administration, and nursing students can practice them with their instructor and get feedback in real time. It’s helpful to practice these skills prior to being in a clinical setting where you’re dealing with real patients.

Clinical Rotations

The clinical component is where you will gain hands-on experience working with real patients in a healthcare setting. Clinical experience is a critical aspect of your educational development, as you will be able to put what you’re learning in the classroom directly into practice. You’re not sitting in a classroom, you’re providing nursing care directly to patients.

What to Expect During Clinical Rotations

You likely will be required to come in the evening before to get information about the patient you will be responsible for the next day. This means reviewing their chart, taking note of important things like the medications that are due, any diagnostics or procedures, chief complaint, and major events from the admission.

You’ll arrive and report to your clinical instructor who will give you instructions on what you will do for the day. They will tell you what skills you can perform, show you around the unit, explain different things, and get you and your group comfortable on the unit.

You’ll likely then speak with the patient’s primary nurse. You’ll inform them what you have experience with, and what experiences you’d like to see.

You will provide care to the patient. This includes performing an assessment, giving meds, dressing changes, starting IVs, trach care, bed baths, feeding patients, ambulating patients, providing education, and more.

You’ll be required to document what you did. You’ll feel really slow and clunky with it, which is normal as this is the first time you’re ever doing it in real life.

Simply get used to being in the hospital and functioning in that very unique workspace.

How to Prepare for Rotations

Before I dig into my main list, I did create a comprehensive resource to help you prepare practically for clinicals. The link to that is here. Ok, on to my list!

  • Know where you’re going, often you have to go to different clinical sites. make sure you know which hospital to go to and where to meet. It may help ease anxiety to do a practice run the day before of driving to the clinical site, get a feel for the parking situation, and know where to walk.
  • Know what unit you’re working on and brush up on those topics. So, if it’s a neuro unit, look up common disease processes of hospitalized neuro patients. Don’t go crazy in-depth, but refresh a bit.
  • Pay close attention to what kinds of procedures, disease processes, and skills are required of the nurses on that unit. Then, if you are able to, practice those in the sim lab or look them up in your off time. Open a note in your phone and keep a running list of different types of patients and procedures.
  • Eat something before you go! Even if you’re not hungry. Students tend to be nervous, then not eat before, and this is a recipe for disaster. They are ramped up in their fight or flight response and then end up passing out. Even if you’re not hungry, have a small snack before. Then, bring some sort of snacks that you can quickly access if you start to feel woozy (granola bars, for example).
  • Get the most out of your Sim Lab time. Use the equipment. Practice. Don’t just do something once and move on. Get reps in (like you would at the gym) to start building muscle memory for these very specific skills.
  • Try to calm your mind the night before. We tend to be really nervous because we don’t know what to expect. Take a good walk, exercise, or enjoy some time with loved ones so you’re not ruminated on being scared.

How Are Clinicals Graded?

The grading system for nursing school clinicals may vary depending on the specific nursing program and school. However, it is common for nursing school clinicals to be graded on a pass/fail basis, especially for the actual performance and skills demonstrated during the clinical experience.

During clinicals, nursing students are expected to meet specific learning objectives and demonstrate their ability to apply theoretical knowledge to real-life patient care situations. Clinical instructors will evaluate the student’s performance based on various criteria such as clinical skills, communication, professionalism, and critical thinking.

The grading system used may also depend on the level of the nursing program, with higher-level programs such as graduate programs often using more nuanced grading systems. It’s important to review your nursing program’s policies and procedures to understand the grading system and requirements for passing clinicals.

Getting ready for nursing school clinicals, but feeling unprepared?

Skills Refresh 3 1

Nursing Skills Refresh from FreshRN is a self-paced video course for both new and experienced nurses. Whether you’re preparing for your first clinical experience, or need to brush up on your nursing skills, this course is for you. Each lesson walks you through the basic tasks and concepts you will experience in the clinical setting. Once completed, you’ll feel comfortable in a hospital setting, understand the basics of what the bedside experience will feel like, and know insider tips and tricks that will make you feel confident and in control.

What is the Purpose of Clinical Rotations?

The purpose of clinical rotations in nursing education is to provide nursing students with hands-on experience and exposure to various healthcare settings to develop their clinical skills, critical thinking, and patient care abilities. Clinical rotations allow students to apply theoretical knowledge and practice clinical skills in real-world settings, working alongside experienced healthcare professionals.

Some of the specific purposes of clinical rotations include:

  1. Develop clinical skills: Clinical rotations provide nursing students with the opportunity to develop their clinical skills, such as taking vital signs, administering medication, and performing nursing assessments.
  2. Apply theoretical knowledge: Students can apply the knowledge they have gained in the classroom to real-life situations, helping to reinforce and enhance their understanding of nursing concepts.
  3. Exposure to different healthcare settings: Clinical rotations allow nursing students to experience different healthcare settings, such as hospitals, clinics, long-term care facilities, and community health centers. This exposure helps students to gain a broader perspective on the nursing profession and potential career paths.
  4. Work alongside experienced professionals: Clinical rotations give students the chance to work alongside experienced nurses and other healthcare professionals, providing mentorship, guidance, and a valuable learning experience.
  5. Develop critical thinking skills: Clinical rotations challenge nursing students to think critically and make informed decisions based on patient assessments, clinical data, and nursing practice standards.

Overall, clinical rotations play an essential role in nursing education, providing students with the practical experience and knowledge necessary to become competent and compassionate nurses.

Clinical Rotation Do’s and Don’ts for Nursing Students

During your clinical rotations, there are a few things you should do proactively and avoid. Here are some dos and don’ts to bear in mind:

Do’s of Clinical Rotations

  • Arrive early at your clinical site on your first day – aim to arrive about 10 minutes early
  • Dress professionally – know your dress code, and don’t push the limits of it. Now is not the time to show off your style or cute scrubs. It’s the time to show you can follow simple directions, like that of a dress code.
  • Be respectful and professional; this is a work environment.
  • Ask questions, but be respectful of other’s time.
  • Be a team player, ask how you can help.
  • Maintain a positive attitude. Do not look miserable.
  • Think about questions before asking them; sometimes you can answer your own question if you slow down.

Don’ts of Clinical Rotations

  • Be late
  • Wear skin-tight, see-through, or wrinkled scrubs
  • Eat anywhere except the breakroom
  • Provide too much personal information; this is a work environment, so talking to your patients about your latest break-up, biggest insecurities, lack of sleep, etc. is inappropriate
  • Use your cell phone unless your instructor says it’s okay to use to reference things
  • Ask a bunch of questions during an emotionally charged or clinically complex situation; wait until the dust has settled
  • Repeatedly interrupt nurses with questions; try to cluster your questions to reduce interruptions
  • Think that just because an experienced nurse is doing something that it’s perfectly acceptable for you to do the same things. Not all nurses follow the rules, and maybe their manager is aware and they’re figuring out the best way to handle the situation. They also are employees with their own nursing license at this point, so (hot take here) it’s not appropriate to assume that a student can just function at that level immediately and just do whatever the experienced nurse is doing.

Clinical Rotations for Students – What to Expect (Video)

FAQ’s

Will I Have My Own Patients?

Yes and no. You will be assigned your own patient(s) to perform the skills that your instructor has signed you off on, but you will not be solely responsible for patient(s). The patient will always have a primary nurse (who is employed by the hospital) and you will be working with him/her.

How Long are Clinical Rotations?

Most clinical rotations last between four and eight weeks, but this can vary depending on the school. In terms of shifts, you can have shifts as short as four hours, or as long as 12 hours. It all depends on the class, instructor, clinical site, and availability of nurses.

What Happens If I Fail A Clinical?

This depends on the situation and size of the school. Failing a clinical likely means you’ll fail the entire class. You may be able to repeat the class the following semester, if it is offered again. Not all schools offer these courses every Fall and Spring. For example, my nursing school was very small, so if you failed a class you had to wait an entire year to retake it.

Failing a clinical results in increased expenses and delays graduation, therefore it is a very costly mistake, but is definitely one you can come back from. Often, nursing schools will not allow you to progress in the coursework unless you’ve passed all of your courses, so you may have to wait around to try it again.

If you failed clinical due to a serious clinical error, that may result in expulsion, however that would be extraordinarily rare.

Therefore, take these seriously!

How Can I Use Clinicals As A Powerful Networking Tool?

While you’re on the nursing unit for clinical, make connections and build rapport with the staff. Be kind, gracious, and offer to help even if you don’t have to. Express gratitude when staff assists you, and be curious (while being socially aware). Simply making a good impression on the nurses and nursing assistants on the unit is a powerful networking tool. At the end of clinical, you can ask them to write you a recommendation, be a reference, or even write an endorsement for you on LinkedIn! While references from clinical instructors are great, references from nurses you worked with during clinical are even more powerful.

And if you have the chance to work side-by-side with physicians, advanced practice providers, or other healthcare team members for an extended period of time, ask them too! It seriously cannot hurt to ask; the worst they can do is decline. And if they say yes, you have an AMAZING reference to use when looking for a job as a new grad.

More Resources

Picture of Kati Kleber, founder of FRESHRN

Hi, I’m Kati.

Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

Connect with her on YouTube, Pinterest, TikTok, Instagram, and Facebook, and sign-up for her free email newsletter for new nurses.

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