Clinical Tips for Nursing Students (from Experienced Nurses!)

I recently started a has tag on Twitter asking experienced nurses for their input on clinical tips for nursing students.  I thought the response was incredibly helpful and valuable and I wanted to to share these clinical tips with you!



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Experienced nurses – What other tips for nursing students just starting clinicals do you have?

Current and prospective nursing students Check out this masterpost from us at about everything you need to know for nursing school clinicals!

How Nurses Can Transform Health Care

This post is sponsored by Capella University.

Please see my disclaimer page for more information on our partnership. 

The theme for the 2016 Magnet Conference in Orlando, is Empowering Nurses to Transform Health Care.  I was trying to think about what that means to me… how can nurses truly transform how health care is delivered in this country? And then I thought about two scenarios…

Hospital 1

At hospital 1, the nurses clock in and out on time. Their meds are passed, call lights are answered. Patients get admitted and eventually discharged. The nurses answer questions when asked, but relatively frequently, things get lost in translation. Policies and procedures are reviewed, but not routinely. A nurse does not sit in on the process of completing policies and procedures. Because of this, they are written in a way that does not make sense to the practicing bedside nurse, and are therefore rarely utilized. The nurses on the floor learn how to do most procedures by just doing what their preceptor told them to do. Their preceptors were never properly trained to precept, and many were trained to do this 10+ years ago and therefore the policies that they were trained with are out of date anyway.

Health care is delivered…but it’s not really care. It is sterile. It’s mechanical. It’s transactional.

Hospital 2

At hospital 2, nurses clock in and out on time. Meds are given on time, call lights are answered. Interdisciplinary rounds happen routinely and nurses lead them. Nursing care plans are discussed in rounds. Nurses have a care plan established for their patient at the beginning of their shift and work with members of the health care team to assure these goals are realistic and that they are progressing towards them. The committees that review policies and procedures have appropriate representation from each service line, including nurses. When asked to have input on policy and procedural updates, these nurses take it seriously. They utilize resources from professional organizations and databases, and consult their shared governance to balance what is the latest evidence based practice along with what’s practical and cost effective.

Preceptors have gone through a formal training. Utilizing policies and procedures is a regular occurrence and they are based on the latest evidence because it’s engrained into their culture. “We’ve always done it that way,” is considered a 4-letter word.

Patients get discharged sooner because nurses are aggressive with the care plan implementation and progression. Patients have better outcomes. Patients are more satisfied because the nurses educate them at every step of the way so that they can play a more active role in their recovery.

This hospital network also regularly meets with members of the community to see how they can play a part in better patient care and meet the needs of the community best.

The entire community is cared for by this hospital, whether or not they’re a patient.

Which would you choose?

Now, tell me which hospital will transform health care? Which hospital will have a better impact? Which hospital would you rather work for? And most importantly, which hospital would you rather have your loved ones receive care from?

Nurses have the power to create these cultures. Nurses have the power to drive policy change. Nurses have the ability to create patient-centered care plans to progress patients to discharge sooner and ensure better outcomes.

Nurses can transform health care.

Magnet 2016 Conference

Are you going to Magnet in Orlando? Be sure to check out booth 1323 where you can learn about Capella University’s 8785_magnet2016_ppt_final-shirtnursing programs! Also, Capella is sponsoring the Magnet Lounge where they are doing something pretty cool to help impact the local community. Within the lounge, you will have an opportunity to assemble a hygiene kit that will be donated to a local women’s shelter.  Each participant will receive a t-shirt as a thank you from Capella.  They are hoping to assemble 900 kits over the 3 days.

See graduation rates, median student debt, and other information at




Why My Heart Hurts for Charlotte and Our Nation

As I have been watching the news on TV and social media, my heart has been grieved. It is painful to see a city, and a nation, suffering so. I am a white American. I do not feel what black America feels. I can only hear about the experiences of others and attempt to understand.

Understanding the Mentality of the Oppressed

While violence and rioting is never the answer, I’d like to share with you the way that Tupac explained the mentality of the oppressed to hopefully shed some light on what may get a person, or a people, to that place.

(This is paraphrased and elaborated in various areas by myself)

Imagine you’re in a restaurant, quietly sitting and waiting for the waiter to come bring water and see what you’d like to eat. You slowly notice that the wait staff has come to every single table except yours.  

You notice not one of the wait staff has acknowledged your presence. They have all come and gone to each and every table multiple times. You’re hungry and thirsty. You flag a waiter down and he ignores you. You raise your voice… “Excuse me! Sir! May I have a glass of water and a menu! Sir!” … You’re ignored again. 

You stand up. You try to have a conversation with a waiter to see why no one will pay attention to you. You have been polite for hours, and now it is time to be firm. You speak to the manager, they tell you to be patient. They try to appease you, calm you down for a little while longer. You go from being assertive, to being loud just to get someone to pay attention to you.. you plead with the person at the next table, “Sir, you’ve had an entire meal and even sent back the soup that wasn’t hot enough.. can you get their attention for me? I am starting to feel faint…”

“Just be polite. Do the right thing. Stay in line and wait,” he says, and rolls his eyes while he rejoins his party.

You feel defeated.. frustrated.. exhausted.. hungry. You’re trying to do the right thing, but no one is listening to you while you suffer. You get desperate. You make a scene. You break a glass. You yell. You demand service. You demand your basic need be met.

You demand justice.

You have continually been oppressed while those around you have not only been treated fairly, but been given the benefit of the doubt.

You are so caught up in demanding this justice that listening to reason and constructive solutions in this place of desperation is too little too late. Why should you calm down when the people that have been ignoring and depriving you of equality haven’t been held accountable yet? You’re so desperate for justice that it may potentially cloud your judgment…

Here’s the link to the 1:08 video in which Tupac explains this mentality.

This Hurt Is Engrained

You see, this mentality was not just adapted overnight. It is deeply engrained into the black community after many years of being treated different… of being less.

The Sixties, miniseries directed by Tom Hanks, originally on CNN and currently available on Netflix, has an episode (Episode 5: A Long March to Freedom) that I felt really did a good job of explaining the civil rights movement in a very real way.  And one of the most shocking aspects about this is… it was only 50 years ago.

Let me repeat that.

The civil rights movement was only 50 years ago.

Remember the first black girl that went to an all white school?  Many are very familiar with this picture:

Public Domain

Public Domain

That little cutie’s name with that adorable bow in her hair is Ruby Bridges. Today, she is only 62 years old.  This is her in 2010:

By Infrogmation of New Orleans - Photo by Infrogmation (talk) of New Orleans, CC BY-SA 3.0,

Photo by Infrogmation (talk) of New Orleans, CC BY-SA 3.0,

She walked into an all white school on November 14, 1960.  She could only eat food from home because someone threatened to poison her every single day.  Seriously.  Someone threatened to poison a 6-year-old girl every single day she walked to school.  The US Marshals were dispatched to ensure her safety.  Someone put a black baby doll in a coffin and stood with protestors outside of the school doors.  She had to have weekly counseling sessions.  Her father lost his job.  (Source)

For many of you reading this, Ruby is the age of your parents.  Can you imagine your mother enduring this when she was just trying to go to school?  Just trying to go to 1st grade and learn about adding and subtracting… how to read.. how to tell time.. but every day someone threatened to murder her?

Schools in America have only been integrated for 56 years.  That’s it.

It is really, really important for us as a society to remember that.

Why #BlackLivesMatter is Important

I think one of the most vital aspects of the nation’s progression to change is for the population of white America that does not regularly have meaningful engagement with the black community to stop having an opinion on the matter… stop denying that systematic and institutional racism exists… and stop over-simplifying this issue by saying, “All lives matter,” and “Just act right,” is not only unhelpful, but it’s insulting.

A friend of ours said, “Not a day goes by that I’m not reminded I’m black.” Another friend, Beni Atibalentja, said “It’s hard to forget you’re black in America. It often feels like everything we do is in the context of being black.”  When a white man succeeds, he succeeds.  When a black man succeeds, he’s doing good for a black man.

Beni also said something else really profound to me when we were discussing this issue and how some people in America just don’t seem to understand or believe that black people are treated differently. She said, “Usually the largest barrier to acknowledgement is our inability to look past our privilege.. to believe that others don’t have the same experiences we do.”

I remember years ago, before the #BlackLivesMatter protests began when we were talking about racism in America. She said that whenever she goes to a party or a gathering, she’s frequently the only black woman there. She said it is palpable when you walk into a room full of white people because you know they are waiting to see if you’re going to fulfill the stereotype of black people they have and you get this reaction of approval when you don’t act the way they expect you to. I’ve never felt that way walking into a room. I tried to put myself into that situation and the feelings of stress that came with it would be enough to make me want to avoid it honestly.

(Side note…are we done with #AllLivesMatter yet? Yes, all lives do matter… just like all of the bones in your body matter. But if you have a broken bone and you go to the doctor and she says… “I realize that bone is broken… but actually all of them matter so we’ll treat them all the same and hope it heals on its own,” that doesn’t address the problem at hand. Everyone’s life is valuable, but black people are systematically treated like theirs do not. That is why #BlackLivesMatter is not only valid, it is important and those that respond to it by saying #AllLivesMatter are missing the issue entirely.)

Therefore, if you live in a predominantly white community and your only experience with black America is when you watch TV or when you see one black person at the grocery store every other week…it is not only hard to understand this massive issue or have enough experience to be able to deny racism exists in this country, it is absolutely impossible.

A physician can’t merely peek into a patient’s room and say, “That patient has a heart murmur, depression, and a low potassium level,” and begin to write orders for medications, treatments, and therapies.  No, they must walk into the room.  Meet the patient.  Talk to them.  Learn about them.  Perform a physical assessment.  Order diagnostics.  Listen to their heart.  Only after this, can they definitively say whether or not these issues exist.  Only then can they know what to do.

I feel like those that do not regularly engage with the black community, but are extremely vocal about denying the existance of institution racism and coming up with solutions are just like that doctor.  They take a look at a patient from a far and make a diagnosis without any diagnostics, physical assessment, conversation, or relationship with the patient. They act like they know it all, know what’s best, and push this treatment plan that doesn’t make sense.  How can we create a treatment plan if we never even assessed or acknowledged the problems in the first place?

I recently heard Nina Turner  who is a member of the black community, wife, mother of a son who is in law enforcement, and senator, articulate this in this interview.  (Go to 5:10 to hear her thoughts specifically)

Good Nurse, Bad Nurse… Good Cop, Bad Cop

I do want to make sure to say that it is important to acknowledge and appreciate law enforcement who put on their uniforms each day and put their lives on the line to protect and serve, and do so with the utmost integrity. I work in a neurosciences intensive care unit, where life and death is a normal day at work. I cannot imagine putting on my scrubs and also putting my life on the line every single day to just go do my job. Knowing my patient’s lives are in my hands is enough.  I cannot imagine if my own life was on the line as well.  I sincerely, with all that I am, appreciate those this do with honor and integrity.

However, I realize that not all uphold the law with honor and integrity. Like Nina Turner said, it didn’t start with the police… but it is system-wide, institutional issue.  There are many honest and wonderful law enforcement officers out there that are part what is right… who are in the middle of the storm enduring anger from both sides while they’re trying to hold steady.  Again, I cannot imagine being in that position and am so humbled and thankful for them.

But this disparity between people doing their job well and poorly applies to all fields. However, the stakes are higher in health care, and higher in law enforcement. Job performance is not just something that affects the performer, but it profoundly effects those that we perform our job on… and also the integrity and honor of our profession and country. This is why it is essential to have professional accountability. Just like if I see another nurse doing something unsafe, it is my duty to intervene, correct, and educate. The same should hold true in law enforcement. If a coworker is not following the protocols, is too rough, is blurring the lines, then a colleague needs to call them out so that it is not continuing to be engrained into the culture.

The Deepest of Wounds 

I truly believe that fixing policies and protocols is only a band-aid.

To use nurse-terms, I believe this issue of race relations with law enforcement is like a large Stage IV pressure ulcer.

(Don’t know what that is? Here’s a definition.)

These wounds are life altering. Yes, your arm may work just fine, but if you have a Stage IV pressure ulcer on your coccyx, if it is not addressed, it will eventually be your downfall.  These wounds are not just on the surface. They penetrate deep… literally to the bone.

The hurts and injustices of the black community run deep… deep into the bone of America. They are not easily and quickly healed by simply acting right.  The healing that is needed is incredibly difficult and labor-intensive. You can’t just put a big piece of gauze on it, secure it with nursing tape, and wait.


These wounds must heal from the inside out. These wounds heal very slowly with very diligent and deliberate action.

We Must Start With Empathy

So what’s the solution? I honestly don’t know what this should look like, but I do believe empathy is the key to the beginning of healing and progress.

(Not sure what empathy really looks like?  Remember, it very different from sympathy.  It’s not feeling bad for someone, it’s feeling with someone.  Going to and understanding their pain and experience without an agenda.  Here’s a powerful and quick explanation. I honestly didn’t really understand true empathy until a few years ago.)

We must be able to feel with one another. We must feel one another’s pain and experiences, without trying to tell each other how to feel, what to do, or how to just fix this problem so we can move on.

I also believe that part of an empathic response to someone’s suffering and pain is acknowledging it. Again, I am not black… but I am trying to imagine what it would be like to live my life surrounded with injustice. And I am trying to imagine what it would be like to try to communicate this to others, and instead of trying to validate my feelings, they tell me it’s not an issue and refuse to acknowledge it. I would need to hear them say it. I would need to hear them verbalize that I am oppressed. I am suffering. My suffering is real, even if it’s not their experience.

I believe empathy and acknowledgement of the issue is the beginning. Accountability and justice must follow. Accountability for those that literally murdered defenseless people… accountability for situations in which law enforcement was antagonized…accountability for flaws in police protocols and procedures… accountability for throwing rocks and bricks into the faces of police officers just trying to do their job.

Do leaders from the black community and law enforcement in all cities of the country, as well as rest of the community, need to sit down with each other, acknowledge injustices, own up to mistakes, talk through past scenarios, miscommunications, frustrations, and hurts? I don’t know. I’m not a member of the black community. I am not a police officer.

But what I do know is  that whenever hurts have occurred in relationships, there must be acknowledgement, accountability, justice and forgiveness before there can be healing and progression.

We must heal from the inside out.


 A whole lot of hurt, anger, bitterness, and hatred is evident in people. We all have preconceived notions, agendas, and belief systems that we want to be validated. But how many of us actually want truth? Not truth about a police case or murder, but the truth of our own racist, prideful, and bitter attitudes.  The truth is, we are all prone to sinful, prejudiced behavior and attempt to simplify the narrative to fit our prejudices.

I can’t help but notice how many are encouraging others to pray for Charlotte. I agree that we should pray for Charlotte, and our entire nation. But I also believe that we should not only stand in prayer, but also wait on the Lord to see His response to our prayers… Allow His response to our cries make us more empathetic, soften our hearts, enable true forgiveness as we once were forgiven, and give us a knowing on how to actively participate in healing and the solution… only then can we seek out justice without hatred or prejudice in our hearts.

Justice without forgiveness and grace is revenge.

Judgment without empathy is ignorance.


My name is Kati and I am a white American. I am a nurse. I am Christian, wife, mother, and citizen of Charlotte, North Carolina. My husband, John Kleber, also is a white American.  He is also a Christian, father, citizen of Charlotte, North Carolina, and a mental health professional working towards his Master’s in Counseling. Some of the most important people in our lives are black.  We wrote this post together to try to verbalize the deep grief we feel over this wound.

Why Traditional Human Resources Doesn’t Work for On-Boarding Nurses: And Who is Doing it Right

Please note, this is a sponsored post.

All opinions are my own.


It’s 0315 am and your phone rings.

It’s the unit again. They’re getting another critically ill / unstable patient and all of the other nurses not only have a full patient load, but half of them have an extra patient on top of it. All of the nurses are dying. None of them have eaten since before they arrived 8 hours ago.  They probably haven’t had time to go to the bathroom either. They’re calling to see if you want to come in early for your shift to help.

Your 12-hour shift starts in 3.5 hours.

You went to bed at midnight. You stayed late last night because they were short-staffed.


What should have been a 12-hour shift ended up being a 16-hour shift. When you finally got home you had to get your daughter’s lunch ready for school tomorrow, shower off the day of MRSA, VRE, and c.diff, and eat whatever the rest of your family ate for dinner 6 hours ago.

You’re almost in tears trying to keep it together.  You physically can’t take this much longer.

You’re not surprised though. Every single day you have off, the nursing unit calls to see if you want to pick up extra shifts. You’re screwed either way.  You’ll feel really bad if you say no because you know how bad they’re hurting right now, but you just can’t work another overtime shift.  You rarely see your family outside of work and have missed a bunch of family get-togethers because you’re picking up overtime.. not because you need the money but because you know how awful work is right now and you don’t want you coworkers or your patients to suffer.

You’re one of the few senior nurses left.  Most have found other jobs because after being told to “hang on just a little longer”.  At first they said just a month or two.. but that was almost 11 months ago.

You don’t blame them for leaving.

You started looking for clinic positions a month ago. It would break your heart to leave critical care because you love it and you’re amazing at it but this is just unsustainable. You’d rather have a job that may not be what you enjoy but at least you can function on your days off and aren’t constantly overwhelmed and on the verge of tears.

You were told positions were posted. Your manager is trying to schedule interviews and extend offers.

You heard through the grapevine that HR took 4 months to post the current open positions and the last candidate accepted another job because it took HR 2 weeks after the nurse manager gave them the green light to extend an offer.

After being at your wit’s end the last 6 months, it’s a real gut-punch to find that out.

Even if a qualified nurse applied this second, it would take HR a week to get to the application.. another week for them to verify licensure.. another week to get it to the nursing manager who is already completely overwhelmed as well.. and another week to get an interview completed. It could take anywhere from days to weeks for the official offer to be extended.  Then they would need to do their corporate orientation before starting their unit orientation. Depending on their experience level, it’s another 3-12 weeks before they’re taking care of patients on their own.

The industry standard of time to fill is 45 days.

It takes an average of 45 days to fill nursing positions, and many nurses and nurse managers reading this know that it realistically takes much longer than 45 days.

The bottom line is that the traditional human resources processes do not work for nursing.

When nurses are needed, they are needed now. Not in a month and a half (if you’re lucky) they are needed immediately because there are patients that need their expert care right this very second. And their future coworkers are sweating, exhausted, and almost ready to break while trying to bar the door until they arrive.

The name of the game at the bedside is working with the minimum number of staff we need to care for our patients safely and no more.  Over-staffing does not exist because it’s simply too expensive. Therefore, when a position becomes available, it must be filled immediately to get back to having enough people to safely care for patients and avoid burnout and turnover of existing staff.   Let’s address this problem by removing the HR barrier between prospective candidates and the nursing units that so desperately need them.

The solution?

Outsource human resources for all nursing positions

Remove the burden of filling nursing positions from HR. Leverage current technology to cut down on wasted time and streamline processes. Stop the phone tag between prospective nurses and HR that eats up precious days, and many times weeks.  Use a system with constantly up to date nursing e-portfolios that automatically verifies licenses and certifications, and enables prospective candidates to self-schedule interviews.

Cut that 45-day industry standard down to 22 days.

22 days.

Go from taking at least a month and a half to hire nurses to just over 3 weeks.

Not only will you save money and time, but your existing staff and patients will get the support they need exponentially faster and you can avoid losing valuable staff members that are at the end of their rope waiting for new hires to start.  Divert the exorbitant amount of HR resources and dollars once used to address filling nursing positions to all other positions.  Become more efficient.

Staff Garden is a company that can take on this important aspect of on-boarding nurses as well as other clinicians.

The Children’s Hospital of Los Angeles has officially started using Staff Garden to fill all nursing positions.

If you are a nurse looking for a job

Check out the Children’s Hospital of Los Angeles Staff Garden page here.  They are currently hiring for the operating room, rehab, med-surg, CV acute, blood bank, NICU, radiology, CTICU, neurology clinic and more.  Fill out your e-portolio and schedule your interview now.  Like, right now.

No filling out an old outdated online application, trying to upload a resume and cover letter that reformats it and makes it look really weird and spending 2 hours to re-do it.  No endless forms.  No waiting months to hear anything back with no way of contacting human resources.

Fill out your e-portfolio and schedule your interview now.

And if you’re not tech-savy, don’t worry.  Staff Garden has tools available to help that are at the bottom of the page of the above link.

If you are a hospital administrator looking to learn more

Click here to see a sample e-portfolio and Staff Garden’s tools.  Click on “clients” on the top navigation to explore the various ways that Staff Garden can support you in quickly on-boarding qualified clinical staff.

As a bedside nurse, I believe this new way of on-boarding clinical staff will spread like wildfire because it is so greatly needed and I want to be a part of the solution.

What Do You Think of When You Hear the Word “Nurse”?

This post is sponsored by Capella University.

Please see my disclaimer page for more information on our partnership.


When you hear the word “nurse” .. what do you think? What do you see? More importantly, what do you feel?

I see a person, standing there in the middle of chaos – with a subtle grin.   Someone that can not only handle the world flying by them a million times a minute, but they kind of enjoy it.

Technology is constantly changing. Residents are in and out. New process, procedures and policies come out so fast you barely had time to learn about that last change. Every few years there are new faces in administration.

But the nurse remains.

The nurse stays steady at the helm.

Because even though things are constantly changing, at the end of the day, there is still a person who craves caring for and being with people – and that’s all that matters.

They crave the one-on-one, “I’m right here for you,” “don’t give up,” moments. The “I know you’re really scared – I’m not going to leave you” moments. The “I don’t care if I make this doctor, administrator, or coworker mad because I am standing up for my patient because they deserve better than that” moments.

They’ll deal with working overtime. They’ll deal with confusing charting systems. They’ll deal with practically humanly impossible requirements for charting and tasks to make sure all of the bases are covered legally for the hospital. They’ll come in early. They’ll stay late. They’ll miss time with their loved ones to go to work and care for people.   They’ll push themselves. They’ll do the things they hate doing (you know…making others mad, disappointing people, frustrating people, annoying people) just to advocate for their patients. And would do so in a heartbeat. A PQRS.

When I hear nurse – I see that confident person in the middle of a crowded room, while the world races by them…sitting there quietly.

They are connecting with a patient, and completely oblivious to the madness around them.

And the patient feels connected.

The patient feels safe.

Capella asked three artists to paint what the word nurse meant to them. Check out this video to see their interpretation.

Aren’t they beautiful?

Capella is partnering with Scrubs Magazine in a contest to giveaway each of these pieces of art. The link to the video contains instructions for how to enter.