Are new nurses adequately prepared? - page 2
:confused: As a nurse, I see more and more new grads who have little clinical experience and who are overwhelmed, more than I was and that was a lot. Many have had no more than 1 or 2 patients during... Read More
Nov 8, '02I think my school is awesome. While we learn all of our skills on the dummies with 3 inch wide urethras, we always have ample opportunity to practice them at clinical. If there is a pt that needs a foley or IV started, a nurse will ask us, even if it's not our pt. I guess the clinical hospitals in my area are just great in that degree. Sure, we get some crabby nurses that don't want us there, but our instructors just won't assign us one of their pts. BTW, when we learned IV starts, we started them on each other. Didn't you?
Nov 9, '02As an experienced RN, I can teach a new RN clinical/technical skills. What is most important is that they possess a solid theory base, and the ability to integrate their theory into practice via solid critical-thinking skills. Organization and prioritization (and often reprioritization) are vital -- and a new RN may need direction in these areas.
Nov 9, '02I think the level of preparedness of new nurses today depends in large part on where they went to school, and how much emphasis the school the nurse attended put on clinical experience. The school I attended (Wichita State University) was beginning to focus more and more on community nursing. I graduated in 1996, and fortunately still had a pretty good clinical experience. But, the faculty believed that the future of nursing was community, rather than hospital, based. Therefore, they were putting greater and greater emphasis on community nursing. Well, I guess it turns out they were wrong. There is a greater need for hospital nurses now than ever before. And a large number of their graduates have expressed they wish they had spent more time on hospital based clinical experience over the community nursing.
Nov 9, '02Although I did go through the basics in, I agree that the best experience is learned on the job. Even if you do suctioning, for example, once or twice in school, you still are not going to be comfortable or an expert at it months later when you face it on the job. Those things come with time and experience.
The craziest thing about my school, however...a BSN program, btw...
We were NEVER taught how start an IV! At the time, the local hospital here had an IV therapy team, so I guess the line of thinking was that we would never have to start them anyway. Duh! Well guess what? After graduation, I went straight to the nursing home where I needed to know how to start IVs. When I went to work at that same hospital two years later, there was no more "IV therapy." The nurses started all the IVs.
At the time, as a student, I was quite happy about it. Now I realize the importance that should have been placed on it. To this day, I am still very uncomfortable doing IV starts, as I haven't had to do it that often.
Nov 9, '02I'm an 'old' nurse and I believe the stories of mean old nurses are exaggerated...yeah sure there will be a few mean old nurses but there are some mean 'young' nurses as well, and mean docs, etc...
The point that today's staff nurses are overstressed is a valid one...a needy student or new grad may be perceived as one more responsibility in her day when she is already overtaxed. A little understanding here will take a student/new grad far.
Who would expect a new grad to 'know it all' as far as basic skills and theory...that would be a rididulous expectation. A willingness to learn and grow and a sense of personal responsibility in this area is what makes or breaks a new nurse, IME.
The student (and new grad) who always seems to look for the easy assignment with the least meds to look up and the least complexity will be 'slacker nurses'...the kind we all hate to work with.
Today's students would be wise to look at clinicals as their opportunity to 'get their hands dirty and get get their hands on every situation they can, IMHO, and see theory put into practice.
In my program (back in the dark ages) the STUDENT shared responsibility for hunting down and finding skills and situations in which to practice. My old diploma program made it clear IF we did not seek our own opportunities to learn, we would have to go 'on call' with the staff in off hours. Needless to say, we jumped in and found good experiences ourselves so we'd have our off time to ourselves.
Also I trained in a big teaching hospital where it was the norm to teach; everyone was in 'teaching mode'...see one, do one, teach one was the motto. This helped immensely...there were student docs and nurses of all levels and we were ALL learning...which reduced our panic...LOL!.
I don't believe seasoned staff nurses as a whole mind doing a little handholding with new grads...for awhile...but 'a little' and 'awhile' are the key words here.
Nov 9, '02I try to also help the new grads. or nursing students; in addition, I always try to help the med students and residents at the teaching hospital I work at. That is one of the main reasons i work in an academic setting, I enjoy learnig and teaching. We as nurses need to support the new nurses and students as much as we can if we hope to make this a more desirable profession. This old attitude of throw them to wolves has to change.
Nov 9, '02I hate to say it, but I did not appreciate the program I graduated from (I finished in April). I stayed at home and went to school at the local college here, but I got my degree from a University...it's a collaborative thing we have here...don't know if anyone else does that. Anyway, the class sizes just keep getting bigger and bigger, and our hospital is not big enough to hold all of them. That means that sometimes they are now having to sacrifice precious clinical time because they can't have too many students int he hospital at one time. And since I did the degree program, I also did CBL, I feel we wasted a lot of time doing "airy fairy" stuff and not enough clinical time. My sister went to the same college from 1994-1996 for the RN program. I went through the BScN RN program in 4 years, and I could almost bet that she had more clinical time than I did...sad but true.
Nov 9, '02So I don't know if it's just my program, or just in Cali, or what, but I'm finishing up my ADN program (7 more da-ays, 7 more da-ays) and our last portion of clinical is a preceptorship with an RN in which I work her schedule (3 12's) for 3 1/2 weeks. I take her patient load (yep, all of it), she's just there to make sure I finish it all (procedures, meds, charting, review of orders, etc, etc)and that I don't get too overwhelmed. We're required to be able to handle sufficiently 75% of the RN load in order to pass. I feel it's giving me a way better idea of what to expect, and it's also kinda nice to have someone with experience to give you tips on time management, organization, etc. (Of course I may be biased because my preceptor is AWESOME!!) So do all programs get to do this, or should I feel lucky??
Nov 9, '02Sounds great but not the norm! You must have a very progressive curriculum and I am so glad that your preceptor is "Awesome." That does not appear to be the norm in many cases. Good luck and congratulation, you sound like you will make a terrific nurse!
Nov 9, '02We attend clinicals twice a week. Each week we submit our goals for upcoming week. My goal is always... Do as many hands on procedures as I can do. When we get on the floor for clinicals, our instuctor tells them if there is something to be done she will find one of us. I really like this approach. If I am uncomfortable with something I say I need to do this or that again. I have never had a pt with a chest tube or drain so that is what I want. (When I write it down I feel like I am going to place my order for the flavor of the day:-) I know there are some things I will not get to do. I would like to work in critical care eventually but I feel as a new grad that I would be doing my pts an injustice not having experience, the assessment skills, and tuned up critical thinking skills to use in that type of situation. I may be a 4.0 student but that means I know how to test and have a good memory
I know that I will make a darn good ICU nurse one day. Right now I need to prepare for that day.
Nov 9, '02Although we are only doing clinicals one day per week for now, we are able to participate in anything that walks through the door...just about. It's tough being a student, and wanting to perform skills, but the opportunities just don't arise! We have worked with vents, trachs, hanging blood, even got to watch a code.
Our instructor and hospital staff (well, some of them) are always eager to share their knowledge with us, and even ask us a few questions. We do more than just work on mannequins in a lab.
Nov 9, '02Originally posted by kelligrl
So I don't know if it's just my program, or just in Cali, or what, but I'm finishing up my ADN program (7 more da-ays, 7 more da-ays) and our last portion of clinical is a preceptorship with an RN in which I work her schedule (3 12's) for 3 1/2 weeks. I take her patient load (yep, all of it), she's just there to make sure I finish it all (procedures, meds, charting, review of orders, etc, etc)and that I don't get too overwhelmed. We're required to be able to handle sufficiently 75% of the RN load in order to pass. I feel it's giving me a way better idea of what to expect, and it's also kinda nice to have someone with experience to give you tips on time management, organization, etc. (Of course I may be biased because my preceptor is AWESOME!!) So do all programs get to do this, or should I feel lucky??
We are supervised just because ultimately, the responsability falls on the facility at the end of the day.
By the way, Kellie....CONGRATS!!!!!!!!!!!!!!!
I will be done in MAY!