What Should I Bring on the First Day of Nursing Clinicals?

Don’t be like me.  A long time ago in an ICU far, far away I showed up for my first day of work with a cable-guy sized storage clipboard and a 5-pound double-belled stethoscope slung over my neck.  I whipped out my brick-sized PDA and licked my stylus (I know) just as I looked around and realized how cool I wasn’t.

overwhelmed

Have you seen my stylus?

Choosing the right tactical equipment for your first day of nursing is a little overwhelming.  I know that I was sweating like a gypsy with a mortgage the night before, stuffing my clipboard with unneeded items.  In America’s online economy of instant gratification, some people wind up with “paralysis by analysis”.  This is when you become deluged with consumer choices.  Throw in a little paranoia about your first day at the hospital and you’ve got a recipe for an overdrawn Amazon account.

Let’s talk about the actual tools necessary to get the job done efficiently, intelligently, and comfortably.  Coming prepared is essential as nurses can quickly become swamped with screeching call lights and overdue order sets.  There are certain pieces of equipment necessary to get the job done, so let’s review a list of things to consider bringing on your first day!

  • The right pen

This is an area of deep obsession and constant modification.  One’s pen is a tool of the trade and a weapon in the arsenal of nursing that is so personal I hesitate to give advice.  I look for retractable, fine point, black pens that are reliable.  Given that this device will be used constantly throughout your shift, affordability takes a backseat.  I recommend the Pilot G2 Retractable Gel Roller Extra Fine Point 0.38mm in black.  This bad boy makes its mark every time, fits into the tiniest of vital sign boxes, and won’t leak on your scrubs.  Make sure you always have backups and order at least 5 at a time.  Or take your chances and lend it to someone, “For just a second, maaaan.”

  • Stethoscopes

This piece of equipment is like a calling card around your neck.  It is the most visible piece of equipment you will own and introduces your level of proficiency before you even open your mouth.  If you’re like me, and you show up with a 5-pound Fisher Price monstrosity, savvy clinicians will notice.  Don’t go crazy and purchase the Littmann Cardiac III right out of the gate ($300).  Start with something manageable and affordable.  I suggest the 3M Littmann Lightweight II S.E.  At first, my only criteria was if the scope was long enough to reach the patient.  Upon further investigation, I approached my next stethoscope with 3 criteria in mind. 1. Value:  This scope is pretty much the same quality as the Classic at a lesser price. 2. Weight: A few ounces can make all the difference, especially over a long shift.  Avoid the anchor-like scopes if you can.  3. Sound: If you want to be able to detect lung, bowel, and S1/S2 heart sounds when the unit clerk is telling her favorite knock-knock joke or the dementia patient is screaming from across the hall, then get this one.  It’s an all-around beast and you won’t freak out if it grows legs and walks (see: taken by an unscrupulous co-worker).

Boy, I wish these were more ubiquitous when I started nursing.  As I mentioned, my PDA with complimentary stylus was super-lame even in my day.  Don’t be that guy.  There are a several apps out there for the resourceful nurses of today.  In the interest of full-disclosure, I’m going to plug two projects that I have created.

Nurse Notes is a powerful iTunes app that sends you audible & visual reminders about patient care and scheduled tasks during your shift.  Since the app also stores data and acts as a “brain sheet”, it helps you chart & assists during report.  With this app you can avoid writing everything down by easily programming the app at the start of your shift.  Take a few minutes at the beginning of your shift to plugin essential, patient specific reminders or simply and quickly select from dozens of distinct choices within the main drop-down lists.

Homepage Nursenotes

75 Nurse Cheat Sheets is a portable eBook instantly accessible on your mobile phone and is one of the largest collections of nursing labs, medications, assessments, procedures, acronyms, diagrams, mnemonics, equations, conversions, scales, graphs, pictures, medical abbreviations, and Spanish translations. This enormous reference can replace all of the expensive and bulky laminated clinical sheets that most nurses mistakenly buy for $5 a pop.  It also includes detailed tables, diagrams, algorithms, and charting tools.

LungvolumesOvsR

Lungvolumedescriptions

 

  • Hemostats & Shears
multitool

Reflex hammer and amputation multitool awaiting patent.

Good news.  Hemostats are cheap so you should get whatever’s affordable.  A $2 Kelly will grip just as well as the $20 surgical version.  It might wear out a bit faster, but does it matter?  Long before it breaks it will only get lost, stolen, or accidentally dropped into the sharps box anyway.  Hemostats can be used to unscrew a luer lock that is coagulated with smegma or stop an artery from bleeding at the scene of an accident by the side of the road.  Versatile and worth having around!  I recommend Kelly Forceps.

As for shears, quality is a little more important.  The cheap ones will bend if you try to cut anything tough, like leather.  Still, a good pair can be had for less than $10.  I suggest a set of Prestige Medical Fluoride Scissors.  Extra points if you buy the black ones and look like a rogue EMT!

  • Compression stockings vs. Sweat wicking athletic socks

The debate rages on.  Not really.  This one comes down to personal preference, or biology.  If you’re like me, you’re double screwed.  My parents have varicose veins, which I’m doomed to inherit, and my wife says my feet stink.  I’m partial to sweat wicking athletic socks as a person who is obsessively self-conscious about my hygiene.  In fact, I tried wearing compression stockings but with my hairy man legs and sensitive follicles (I can’t wear hats either for this reason) the stockings practically gave me dermatitis and claustrophobia at the same time.  You will be on your feet for brutally-long periods of time, so if compression stockings help your circulation then go for it.  But if you’re gonna wear them, do it in style without looking like an old diabetic lady feeding birds at the park with these Nabee Socks.   I prefer the Drymax sport sock, though.  They wont’ save your feet from a foley spill but they’ll help reduce the sweat, prevent fungus, and cut down on blisters.

  • Snacks

Do your part… Prevent hypoglycemia in nurses.  Really, though.  I’ve gotten so hungry you could hear my stomach during report.  It’s important to fuel up whenever you can as a busy nurse.  Most units don’t allow food but I’m gonna suggest some ninja workarounds.  I like to stash low-glycemic index foods, high in fiber, that won’t make me thirsty, or make my breath reek when I’m going in for breath sounds on my patient.  I prefer plain almonds and, my guilty pleasure, 5-Hour Energy.  There are those times when you just need a pick-me-up and coffee won’t do.  Just be careful not to take it in anticipation of being tired or you’ll be pacing around the unit like a coked-out patient from the ER trying to convince people to fund your new KickStarter campaign.

  • Fanny packs

No.

  • Sharpies!

Yes.  The need for sharpies will always endure.  Make your mark with a nice fine-tipped Sharpie permanent marker.  Get the multi-pack with clips for convenience and visual variety.  You can date your IV bag, label your lines, or scrawl a love letter to that nurse you fancy in the neuro unit.  I go with the Mini Sharpies because I’ve got enough junk in my pockets and these babies, much like hemostats or pens, will get lost or stolen before actually drying out.

  • 2 week’s worth of scrubs (6 sets)

Layered and worn all at the same time for that androgynous yet buff look.  Actually, you’ll thank me when you’re butt is dragging out of bed for your last of 3 shifts of the week and you’ve got a nice clean pair waiting for you.  The last thing you want to do after a long shift is go home and do laundry for your next shift.  Have 3 pair for each week and alternate!  I recommend… whatever you want.  My only real suggestion is that you have plenty of them.

  • Vick’s or tincture of peppermint
oops

Yes, yes you did. Hand me the Vick’s.

On my first day at the hospital I couldn’t have ventured a guess as to what this would be used for.  You’re first code brown, though, will reveal the necessity of this odor-squashing lifesaver.  The smell of poo can be tougher than woodpecker lips to eliminate.  So why not just cover it up until you clean it up?  Spread a little of either of these potions on the outside of a preformed mask then layer another mask on top of that.  You’ll be whistling dixie and hot-trotting around the room oblivious to the wretched stench.

This is far from a comprehensive list, but you get the idea.  A nurse is always refining their tool box.  For instance, I won’t even touch on the lifelong odyssey of finding the right pair of shoes.  It takes a while to get into your groove and get comfortable with the tools of the trade.  Everything about a nurse’s practice continues to evolve so keep your eyes open, learn from your mistakes, and don’t buy that fanny pack.

 

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