The importance of learning and knowing nursing procedure in parenteral administration specifically on intramuscular, subcutaneous and intradermal are

very crucial not only in a nurses career but also to the patients. Problems and difficulties experienced by the participants in the clinical setting may lead to their failure to learn. For instance, students felt strongly that what they had been taught in the classroom was too ideological and not functional in the real world. The students observed quite early in their education that what they were taught in theory did not always equate in practice. Initially, this led to conflict until the students were able to accept the differences. Accepting the differences required the students to be versatile in how they performed on clinical practice. Many factors that affect the competency level of the participants and it shows that being too anxious or nervous to perform the procedure were considered, anxious or nervous because many of them are first time to do parenteral administration and lack of experience during the clinical area, sometimes in the whole eight (8) hours of duty the participants dont have the chance to administer parenteral medication on intramuscular, subcutaneous and intradermally. In addition, they perform the procedures according to the book, and some differences followed by according to the protocol of the hospital. Furthermore, the performance of the students in the ward works hand in hand, with the retained knowledge they have during the skills laboratory discussion, the cooperation of the patient and the mastery which will be obtained in repetitive practice of the said procedure. Also, the attitude of their respective clinical instructor towards students, some clinical instructor is too strict and sometimes the participants are fear to ask.

Recommendations: *It is important to establish rapport to the patient and watchers, to gain their trust. * To sustain the knowledge or learning that they have gained during the discussion in the classroom and in clinical setting. *To set aside a period of each day where you do nothing but worry. Also, prepare yourself as much as possible prior to the event. You are much less likely to feel anxious if you are confident and in control of your situation. *To encourage the group to have daily ARAS (Action Reflection Action Session) for them to verbalize their feelings, concerns, learning and difficulties during the exposure on the clinical setting. *To re-evaluate the capacity of students to do proper nursing care independently and to re-ensure guidelines from clinical instructor for more accurate application of clinical laboratory procedure in area. To implement and practice clinical laboratory procedures to the actual area of exposure such as basic procedures. To conduct similar studies in different year levels having duty in different wards to have more conclusive and evaluative results.