Ward Class

An Online Resource Site For Student Nurses


Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

Site Announcement

The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.

New Downloads for Nursing Students

Here's another batch of useful downloads, dear nursing students. I'm not so sure if this 3-part Basic Care compilation is in time for your RD (return demonstration) on Basic Care/Hygiene but I'm certain this will be very useful for those who have started or about to start their clinicals sometime soon.

Since nursing students do not have the luxury to choose their placement schedules during clinicals (or am I mistaken?), you might as well be prepared to provide your patients with mouth care and a complete bed bath as part of early morning care. Your really conscientious clinical instructors or preceptors from the hospital's nursing staff may expect you to do just that before they will allow you to leave the floor if and when you'll be assigned to the 11pm-7am shift.

Aside from the procedure checklist, do give more attention to the special considerations especially on Foot Care. For student nurses who will be lucky enough to provide nursing care to patients with a diabetic foot, this entry's cram sheet on Foot Care will prepare you for the challenges ahead. Still, for nursing students who are frequently assigned MGH patients (may go home, what else?hehe), the dos and donts in foot care in relation to conditions such as Diabetes Mellitus and circulatory disorders are, in themselves, very valuable clinical pearls.

To get a copy of this batch of nursing downloads, just click on the links provided below. All of Ward Class' nursing downloads are in PDF format so you will be needing Adobe Reader to open the files. Click here to download and install a copy of Adobe Reader (If you don't have it, that is).

Basic Care: Mouth Care
Basic Care: Foot Care

Student Nurses' Guide to Performing Well During Clinical Rotations

Not performing well enough during clinical rotations? Hating those days of the week when you have to spend eight laborious hours in the ward, delivery room, operating room, or ICU attending to patients and performing procedures instead of laguidly sitting in class?

Inasmuch as you would probably want to do away with having to spend shift after shift working closely with doctors, nurses, and ancillary personnel in the hospital, you must admit that clinical rotations are part and parcel of your life as a nursing student. To put it bluntly, if you want to have a fruitful nursing career after graduation and passing the nursing board examinations, then you should start taking clinicals seriously.

And so to help you and the rest of our readers with very stressful clinicals, here are few tips that will help you to think and perform like a professional nurse does. Here goes:

  1. Think of clinical rotations as learning experiences. Come to think of it, clinicals were not included in your nursing curriculum with the intention to punish you. The main purpose of clinical rotations is to provide you with the necessary exposure and training to prepare you for your career in nursing.
  2. Profile your clinical instructors. One way to get ahead during clinicals is to know your clinical instructors. I remember vividly this experience I had with a clinical instructor. I was kind of apprehensive since she had this reputation of being a terror on the floor. And so I asked a classmate what were the exact things that the instructor expected of student nurses. I was told that the instructor wanted the work area spic and span and that she hated seeing nursing students idle and chatting with other students. Equipped with this vital piece of information, I had renewed confidence and actually performed well that week.
  3. Double-check your schedule and be punctual. This is pretty self-explanatory. You don't want to be late for clinicals. Tardiness will be the start of a very long and stressful week. Aside from the inevitable demerits, it will surely affect your overall performance. Also, make sure to check the schedule and area of assignment for each and every clinical rotation that you have. Some student nurses often check the bulletin board haphazardly at the last minute and so end up copying the wrong thing. I actually know somebody who was 12 hours early on his first day of clinical rotations. Boy, was he embarassed!
  4. Prepare your uniform and paraphernalia ahead of time. Preparing the things that you need to bring ahead of time will actually help you avoid anxiety-inducing situations. Student nurses have to remember that the ability to be prepared, stay organized, and plan ahead of time are very desirable qualities of an efficient nurse.
  5. Know the nursing concept at hand and if possible, read on it in advance. The goal here is not be your group's mister -or miss-know-it-all. You just have to read on what is necessary. Say, for example, if that week's concept is on oxygenation, then at least read on the basics of oxygenation. It will also help if you have those little notebooks or pocketguides with all the laboratory values and bits of information you will need while on duty.
  6. Learn to prioritize and manage your time. The ability of student nurses to prioritize things is the key to performing well during clinical rotations. If, for example, you are assigned to a patient fresh out of the recovery room, make sure that you have performed the necessary assessment and procedures before you start worrying about your patient's linens or the nursing assessment tool or whatever forms you have to submit to your instructor at the end your shift. Remember, safety comes first.
  7. Be courteous. Be polite to patients, your clinical instructors, nursing staff, and your groupmates. Maintaining a good working environment during clinicals will give you that extra motivation to perform well and achieve learning goals.
  8. Ask for guidance. Nursing students must remember that during clinical rotations, they are under the supervision of their clinical instructor --a licensed nurse. So when in doubt, you should ask your clinical instructors or the nurses in the unit for guidance and instructions. Never mind if they breathe down your neck or be downright condescending. Just remember that patience is a virtue and as I always say, it is better to be safe than sorry.
  9. Take your requirements seriously. During clinical rotations, nursing students are also graded basing on the quality of the written requirements they submit to their instructors. One way of earning a few more points in your favor is to submit neat and well-constructed paperwork such as nursing assessment tools, nursing care plans, drug studies, and journal readings. By neat, try submitting your requirements using templates bearing your name, your school's name, your clinical instructor's complete name, and other data required by your instructor. Believe me, neat and well-made requirements will definitely help pull your grades up.
  10. Lastly, be attentive during ward class. Post-duty conferences or ward classes are designed to enhance new learnings acquired on the floor. It is every nursing student's opportunity to ask questions and make clarifications on procedures or the concept at hand.
Indeed, clinical rotations may be very stressful for student nurses but if you report for clinicals prepared and knowledgeable, you will definitely lessen your anxiety, perform really well, and ultimately get better grades. Well-planned learning opportunities during clinical rotations will not only help you achieve desired learning outcomes and the necessary nursing competencies but will also enable you to start thinking and acting like a professional nurse does.

Note: Image courtesy of Nurstoon.com

Career Spotlight: Medical/Surgical Nursing

During my clinical rotations as a nursing student, more often than not, I was assigned to the medical/surgical floor. Of course, I had been inside the OR and DR units but considering the number of nursing students who vie for the much-coveted OR and DR slots, my exposure to the said areas were short and infrequent.

Frankly speaking, I prefer to work in a medical/surgical unit. If I am to choose an area of assignment, the med-surg floor would win hands-down for me. It is one great area to jumsptart a fresh graduate's nursing career. Working as a medical/surgical nurse will provide entry-level nurses with basic nursing experience and the opportunity to interact with adult patients with a wide variety of conditions. Medical/surgical nurses care for adult patients recovering from surgeries, patients hospitalized due to acute illnesses, or even patients with chronic diseases.

For student nurses who consider a career in medical/surgical nursing, the following may interest you:

What do medical/surgical nurses do?

Medical/surgical nurses work with a variety of medical and surgical patients. They conduct patient assessment, develop and implement individualized nursing care plans, provide patient and family education, and coordinate closely with other health care professionals on matters pertaining to the patient's recovery and progress.

What type of health care organizations employ medical/surgical nurses?

Medical/surgical nurses can work in a variety of settings. They may seek employment in hospitals, long-term care facilities, and outpatient clinics.

What are available specialty areas in medical/surgical nursing?

Health care facilities may have separate units for similar ailments or clinical conditions. Thus, a medical/surgical nurse may work in a variety of specialty areas such as the cardiac, pulmonary, oncology, orthopedic, and neurology units.

What is the expected salary range for medical/surgical nurses?

Online sources say that a medical/surgical nurse in the United States earns roughly $55,000 to $75,000 per annum. Figures, however, vary from state to state and may be affected by a variety of factors. While we don't have the figures for countries such as New Zealand, United Kingdom, Australia, and Canada, we can safely assume that nursing is a high-paying job in these countries even for entry-level positions.

And so, our beloved nursing students, I hope you found this blog entry helpful. However, if you are determined to work as a medical/surgical nurse in the Philippines right after graduation, be forewarned that it won't be as financially-rewarding as you would want it to be. Still, it will be a great opportunity for you to hone your nursing skills.

On Living Wills and Advance Directives

If there is something I remember clearly about my Nursing Management and Leadership class which I had years ago, it has to be the topic on living wills and advance directives. So for those who have had readings on Professional Accountability, I have this question to ask:

Is a living will an advance directive?

The answer, of course, is a resounding yes. A living will is a type of advance directive.By definition, it is a written, legal document which states the type of medical treatments and life-sustaining measures a person does or does not want. This may cover mechanical ventilation, tube feeding, dialysis, end-of-life treatments, and resuscitation. A living will may also be called a health care declaration or health care directive.

While a living will is an advance directive, not all advance directives are living wills. Advance directives are more than just living wills. By definition, an
advance directive is an instruction given by an individual specifying what should be done for his or her health in the event that he or she is no longer able to make decisions. Advance directives may include:

  1. living wills
  2. durable power of attorney--> appoints a health care agent or proxy who will make medical decisions for the principal (patient) in the event that the latter is unable to do so; a health care proxy is usually a family member, a friend, or a family physician whom the principal trusts to have his or her best interests (the patient's) in mind.
  3. DNR (Do Not Resuscitate) orders--> requests not to have cardiopulmonary resuscitation in the event that the patient's heart stops or if the patient stops breathing.
  4. organ donation

Anyone aged 18 and older may prepare an advance directive. Two witnesses must attest that the patient is of sound mind and signed the document on his or her own accord, free of duress or undue influence. The witnesses must be of legal age and are not designated as the principal's health care proxy.

Advance directives such as living wills and DNR orders are attached to the patient's chart.