Probably most people would admit that this doesn’t sound easy. Still, for many, it’s even harder than it sounds. Clinical rotations are filled with both logistical and experiential challenges. Knowing what these are can help improve your overall experience.
In this article, we take a look at the commonly overlooked challenges in your first clinical rotation.
Lack of Support From the School
Nursing clinical rotations are designed to give you a real-world taste of the profession. Psst—nurses don’t have former teachers hovering over them to ensure they do everything correctly. On a clinical, you won’t either.
You will have a clinical instructor who checks in, but keep in mind they may be responsible for dozens of students. In some cases—especially for remote students—your instructor might not even be in the building. They may drop in remotely or touch base after your rotation. Even when they’re nearby, the responsibility falls on you.
Your closest supervision will come from the RNs you’re working alongside. Don’t expect them to hold your hand. Nurses are results-driven. They understand the urgency of their work and won’t delay it to create a teachable moment for you.
This lack of supervision can feel like being thrown into cold water—shocking at first. But if you’re a good fit for the job, that initial discomfort will fade. You’ll never lose sight of the enormity of your work, but you will gain confidence in your ability to do it efficiently.
The Shifts
Nursing shifts are famously—or maybe infamously?—twelve hours long. Hospitals structure their schedules this way primarily out of necessity. When staffing is an ongoing challenge, it’s easier to manage two long shifts per day instead of three or four, even if it means the same number of people are doing the work.
Longer rotations are also believed to improve continuity of patient care. Patients tend to do better when they build trust with their healthcare providers, and developing that familiarity takes time.
Regardless of the reasoning, working twelve straight hours in an already demanding profession can be more challenging than many nursing students initially realize. You’ll be physically exhausted. Your feet will hurt in a way you didn’t know was possible. Eventually, the work may even lose its initial sense of urgency. That doesn’t mean you’ll care less about your patients—just that the adrenaline rush you first felt as a student stepping onto a hospital floor will start to fade. You’ll feel tired and burnt out, but the work will still be there, just as urgent and demanding as ever.
Experiencing these marathon-like shifts as a student is difficult but ultimately beneficial. You want to understand the reality of the job before you step into it as a full-fledged professional.
Personal Accountability
As a student, no one is going to say, "Quick, save this life. We’re getting coffee." There will always be registered nurses in the room with you, ready to step in if necessary. Still, you’ll be expected to take responsibility and rise to the occasion.
This means recognizing that your actions have real consequences—especially for the patient. If you’re making decisions that impact someone’s health, you also need to accept a certain level of personal accountability when things don’t go as planned. That doesn’t mean leaving the hospital feeling crushed every time you make a mistake. It does mean understanding that this is serious business.
Books Are Not People
They might both have spines, but patients are not books. As verified humans, they will have emotions, opinions, and behaviors that can be difficult for new nurses to navigate. They might be argumentative. You might be completely sure of what they need—after all, you learned it in your (very expensive) education. But they might strenuously disagree.
They might also just be... unfriendly. It’s an underreported fact that nearly 100% of nurses experience some form of verbal or physical abuse at some point in their career. Depending on the type of placement, that abuse might be frequent.
Healthcare problems are nice and simple in books. You get the problem and the solution all on one conveniently un-argumentative page. Working with real people? That’s always going to be harder.
Maintaining Perspective
It’s easy to get discouraged during your clinicals. You walk into the occasional horror show that any hospital can become at the drop of a hat and leave thinking, “Oh. Turns out being a nurse is an impossible nightmare.”
The work is hard. It’s not insurmountable.
Finally, it’s important to remember that this is ultimately practice. Clinical rotations serve as a valuable tool for weeding out candidates who aren’t the right fit. However, struggling in the beginning doesn’t mean you won’t be a great nurse. If anything, it means you’re taking the work seriously.
Don’t get discouraged by the initial challenges. Like anything else, starting at the bottom is tough. But as you push through the discomfort, you’ll develop the confidence and familiarity that make the job easier.
Do Nurses in Graduate School Need to Complete Clinical Rotations?
They do. That can be a real challenge for people who are trying to become a nurse practitioner or join a different advanced practice career. All graduate students will have already completed undergraduate clinicals and probably even worked as a nurse.
The challenge for them is balancing these rotations with other responsibilities—like a job.
Conclusion
Are clinicals hard? Sure. They are supposed to be. Nursing is hard. Healthcare is hard. The point of clinicals is that you can experience the first leg of that learning curve under careful supervision.
Instead of showing up at the hospital as an RN with no idea what you are doing, you get to learn the job in a lower-pressure setting.
Ok. It might not feel low-pressure when you are living it. That’s also part of the experience. Accept that stress as par for the course. Certainly, it’s not going anywhere.
If you are worried about your upcoming clinicals, consider speaking with someone who has done them before. Another nursing student. A friend or family member. Even a trusted professor. Most likely they will be happy to hear your concerns and offer personalized recommendations.
Remember that every nurse you’ve ever met has been in the exact position you are in now and come out the other end alright. You can do this.
