Bedside Clinic

BEDSIDE CLINIC
& CASE
METHOD
JOANNA RACHEL PM
M Sc Nursing 1st year
ACON
DEFINITION
“A bedside clinic is a process in which a clinical
teacher and a group of learners sees a patient, elicits
or verifies physical signs, discusses provisional
diagnosis, diagnostic or therapeutic options in the
clinical setting”.
GABERSON
• As we all know planned teaching should not be restricted to the classroom
alone.
• It is one of the best methods of teaching.
• This method is helpful, when members of the group are unfamiliar with
the client or when there are special observations, to give the discussion
more meaningful.
• The group visits the client or the client may be brought to the conference
room during the discussion.
PURPOSES
 To provide a learning experience for the nursing student to collect information

about the patient with tact and skill.
 To improve the students ability to solve nursing problems by detailed study
and analyses of nursing situation.
 To realize the need for understanding each patient as an individual in order to

appreciate his problems and outlook.
 It helps students to do observation in an organized systematic way.
• To ne able to work out a nursing plan to fit the needs of individual
patient on the basis of hid special problems.
• To be able to recognize opportunities for health teaching in the hospital.
• To understand certain types of apparatus being used on patients.
• To improve the quality of nursing care.

STEPS INVOLVED IN
PLANNING BEDSIDE CLINIC
PLANNING TECHINIQUE
Place date and time of clinic to be held and what topic the students have to
come prepared.
Select the patient for whom the students have given care.
Secure the consent and cooperation of the patient.

 CONDUCTING BEDSIDE CLINIC:
After pre plan the next step is conducting the actual clinic.
The clinic should be conducted in the ward or in a classroom, which

is adjacent to the ward.
If such conveniences are not available the clinic should be held
apart from other patients providing sufficient privacy in a comer of
the ward.
Client should feel at ease; embarrassment of the client should be

avoided.
The number of students should not exceed 10-15 in numbers.
The clinic usually last for 30 mins.
The discussion relative to the bedside clinic consists of three phases.
1) INTRODUCTION PHASE
2) PATIENT CENTERED DISCUSSION
3) POST CLINIC EVALUATION

INTRODUCTION PHASE
 It serves to acquaint the student with the patient:
 Background
 Presenting nursing care situation
 Purpose of the clinic
 Significant observations to be made
 Type of question to be asked
PATIENT CENTRED
DISCUSSION
 Few simple question are asked to obtain the needed information from the patient.
 No questions that hurt the feeling of the patient should be asked.
 Allow the patient to verbalize the needs and how he perceives his particular
problem.
 Soon after the end of the second phase patient should be sent to the ward by
thanking him for his cooperation.
POST CLINIC EVALUATION
 It offers excellent opportunities for the student to evaluate the patient
behaviour.
 Ability to solve his own problems and various other aspects.
 The student can be evaluated in terms of their ability to meet the stated
purposes of clinic through their observation and ability to use problem
solving technique.
FACTORS TO BE KEPT IN
MIND
 Establish rules of conduct for bedside clinic early in the rotation.
 Make appropriate introduction between the patient and the learner.
 Ensure the setting of the room is suitable for learning.
 Demonstrate appropriate communication technique and provide
opportunity to clarify case presentation.
 Be careful about asking question to the student that they are unable
to answer.
 Avoid shop talk.
 Portions of the physical exam give them difficulty, then discuss and demonstrate
proper techniques.
 As the bedside presentation closes leave the patient with an overview of the
disease process.
ADVANTAGES OF BEDSIDE
CLINIC
 This method strengthens learning
 Uses all senses to learn more about the patients problems enhances
psychomotor skills.
 It allows clarification of history and physical examination in the
presence of learner.
 It is considered to be a good method to introduce sophisticated
equipment in patient care.
 It allows role modelling.
 This method helps preceptors model effective ways of asking

questions and demonstrating sensitivity to patients comfort and
concerns.
 It is essentially the only method in which the teacher has opportunity

to observe patients care directly and give immediate feedback.
 Bedside clinic involves patients in the care of his own.

DISADVANTAGES OF
BEDSIDE CLINIC
 It is a time consuming process.
 It is appropriate for a small group.
 This method may be the source of discomfort for the patient in the terms of
loss of privacy and freedom.
 The method requires specific skills and techniques.

KEY POINTS TO REDUCE
PATIENT DISCOMFORT
 Take prior permission from the patient.
 Explain patients role in teaching learning activity.
 Make the patient comfortable during examination.
 Be precise and do not stretch the session in front of the patient.
 Do not carry out discussion in front of the patient, as it may add to his anxiety.
 Thank the patient for hs cooperation during the teaching learning activity.
DEFINITION
 Case method also known as case study is the blueprint of the

nursing care rendered by a nursing student to a selected patient for
a particular period by following nursing process approach with an
intention to develop nursing care abilities.
TYPES OF CASE METHOD
WRITTEN
ORAL
Written forms helps the student to develop the writing skills along with
understanding the case.
Oral case study provides the learner an opportunity to gain speaking

behaviour.
Learner has the feeling of achievement while presenting the case.
Teacher can evaluate the performance of the student immediately.
It is time saving, as the student does not have to copy down the material
from various sources.
CASE METHOD IS USED IN 3
FORMS
 CASE STUDY/ CASE PRESENTATION
 Student is given opportunity to provide nursing care for specific client

 After 4 to 5 days of careful study, case study is prepared by comparison with
text
 Student presents the case before the batch of companions.
 Followed by discussion.
CASE ANALYSIS
 A concrete case for analysis and discussion by a group of students under the
leadership of the instructor
 Sufficient information is presented to the student to make judgement of problem or
situation in case analysis.
CASE INCIDENT TECHNIQUE
 A critical incident technique which requires immediate decision and action is

taken from a case and presented to the students for their analysis and decision
 No background information is given to them regarding details of the incident at
the time it is presented
 The instructor will have the facts about the case, can be given as requested by the
students
PURPOSE OF CASE STUDY
 To learn nursing skills using problem solving approach.

 To identify patients problems.
 To provide individualized nursing care to patient.
 To develop critical and reflective thinking while solving the patients
problems.
 To provide feedback for the action taken and decisions made related
to patient care.
 To find out the relationship and cooperation of various agencies interested in the
patients problems
PRINCIPLES OF CASE
STUDY
 It should be based on actual care provided to the patient.
 The selection of the patient should be done by the teacher and student together
keeping in mind the experience and capabilities of the student.
 Special emphasis should be made on patient learning.
 It should serve as a excellent tool of demonstrating nursing skills and scientific
knowledge.
 It should encourage critical evaluation of the solution proposed by the student
for the patient.
ADVANTAGES OF CASE
METHOD
 It helps student to learn individual differences between patients.
 It provides an opportunity to the student to express himself in writing.
 It gives him an experience to write the paper in scientific manner.
 Written material can be the source of reference for future references.

DISADVANTAGES OF
CASE METHOD
 It does not give chance to the student to branch out and incorporate new ideas
once the study is completed.
 Lot of time is required to rewrite the case study in an acceptable form.
 Oral case study cannot be used as record for future reference.

DEVELOPING CASES
 Case method and study have two components:
o A case description
o Questions to answer about the case or its analysis
 Cases can be written for the development of specific cognitive skills.

EXAMPLES
 Case intended for decision making
The charge nurse on night shift assigns a nurse new to the unit to work with Ms
P an experienced RN. Ms P, however is irate that she needs to orient a new nurse
when she is busy herself. She tells the new nurse that she is too busy to work
with her tonight . When learning this, the charge nurse reassigns the new nurse
to another RN.
 Case for problem solving
Ms G a 56 year old patient admitted for shortness of breath and chest pain is
scheduled for a cardiac catheterization. she has been crying on and off for the last
hour. When the nurse attempts to talk to her Ms G says “don’t worry about me I
am just tired”.
 Case for critical thinking
You are a nurse practitioner working in middle school. Ms S a 16 year old comes
to your office for nausea and vomiting. She says she feels ‘bloated’. She confides
in you that she is pregnant and asks you not to tell her parents.
UNFOLDING CASES
 A variation of case study is unfolding cases in which clinical situation changes,
thereby creating a simulation for students to analyse.

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BEDSIDE CLINIC

• It is one of the best methods of teaching.

 To provide a learning experience for the nursing student to collect information

 To realize the need for understanding each patient as an individual in order to

• To be able to recognize opportunities for health teaching in the hospital.

• To understand certain types of apparatus being used on patients.

• To improve the quality of nursing care.

Secure the consent and cooperation of the patient.

The clinic should be conducted in the ward or in a classroom, which

Client should feel at ease; embarrassment of the client should be

The clinic usually last for 30 mins.

The discussion relative to the bedside clinic consists of three phases.

2) PATIENT CENTERED DISCUSSION

3) POST CLINIC EVALUATION

 No questions that hurt the feeling of the patient should be asked.

 Ability to solve his own problems and various other aspects.

 This method helps preceptors model effective ways of asking

 It is essentially the only method in which the teacher has opportunity

 Bedside clinic involves patients in the care of his own.

 It is appropriate for a small group.

 The method requires specific skills and techniques.

 Case method also known as case study is the blueprint of the

Oral case study provides the learner an opportunity to gain speaking

Learner has the feeling of achievement while presenting the case.

Teacher can evaluate the performance of the student immediately.

 Student is given opportunity to provide nursing care for specific client

CASE INCIDENT TECHNIQUE

 A critical incident technique which requires immediate decision and action is

 To learn nursing skills using problem solving approach.

 It helps student to learn individual differences between patients.

 It provides an opportunity to the student to express himself in writing.

 It gives him an experience to write the paper in scientific manner.

 Written material can be the source of reference for future references.

 Lot of time is required to rewrite the case study in an acceptable form.

 Oral case study cannot be used as record for future reference.

o Questions to answer about the case or its analysis

 Cases can be written for the development of specific cognitive skills.

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