how long till you're good?

  1. With all the skills i have been taught in nursing school and limited opportunities to use them during clinicals, i feel somewhat intimidated by the prospect of using those skills when i become licensed. How long would you say it takes for a new nurse to build their skill level to a point where they are good at what they do? What are the expectations of a newly graduated and licensed nurse? I would appreciate input from people at all levels of nursing. Thanks....chris
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  2. 31 Comments

  3. by   Sleepyeyes
    wow....tough question.

    I am excellent at some things, good with others...and with some stuff, I totally suck.

    For instance, I'm really good at getting NG tubes in. OK with IV starts, but I haven't gotta clue as to how to titrate a pitocin drip.

    I'm excellent with geriatrics and lungers, and only ok with teens and livers. Suck at drug-or etoh=dependent patients, and psych patients but I really rock with Alzheimer's folks, Hospice and GI problems.

    Go figure....

    How long til you get good at it? hmmmm... I dunno about anyone else, but I just take it one day at a time. Some days, I feel like I did a great job; other days, I feel very inadequate. Spurs me on to study and learn more.
    Maybe someday I'll think I'm excellent. But not yet.
    Last edit by Sleepyeyes on Oct 10, '02
  4. by   SmilingBluEyes
    Tricky question.....I am not sure I can put a time on that. You just work and gain experience...stay current, keep reading and studying and then you click. I am not sure when it happened for me, but I feel fairly confident in my speciality--OB/GYN after 5 plus years in nursing now. It just depends on the person, how he/she processes information/learning styles, and how well he/she takes advantages of learning opportunities. I can say w/o reservation my TRUE learning began AFTER school and ON THE JOB! Take it one day at a time, and do your best, keep you eyes and ears wide open and be a sponge. I wish you the best of luck!
  5. by   spineCNOR
    When I graduated from school I found that it took a good year for me to feel really comfortable in my job and with my skills. Of course after 20 years of nursing , I am still learning. There are things I am very knowledgable about, and other areas of nursing about which I am totally ignorant. There is so much to know that no one can ever "know it all". So just be patient with yourself and you will begin to feel more and more comfortable as time goes by.
  6. by   adrienurse
    Are you aware of Benner's theory of Novice to Expert? This is a good thing for you to read. With anything you take on, there is always a learning curve. Some skills are learned quickly, other ones take years to understand and master.
  7. by   JonRN
    Another thing that makes this question difficult is that people vary widely, some learn much quicker than others.
  8. by   nurseguy74
    thanks for the responses so far. i can see how this is a difficult question so i'll rephrase. how long did it take you personally to feel confident in your profession? my fear is taking a new job and trying to perform a procedure on a real person that i have only practiced before in lab. What are the expectations of a new nurse as far as competency in their duties? Is there a "breaking in" period where mistakes are anticipated and the new nurse is under some form of supervision? Feel free to share stories about what it was like when you first started out.
    thanks again........chris
    Last edit by nurseguy74 on Oct 10, '02
  9. by   whipping girl in 07
    I started in ICU straight out of school. I had a 12 week orientation with a preceptor and then relatively "easy" stable assignments for a month or two after that. I still don't feel completely comfortable in every aspect of my job; I feel confident in my assessment ability (although I still have a lot of trouble picking up heart murmurs unless they are really loud). I feel confident in my interpretation of EKGs and telemetry since I took my EKG and ACLS classes. I am not that great at starting IVs, because I don't get that much practice and when I do, it's usually these little old people with no veins. I am pretty good at putting in foley catheters and NG tubes. If I get into a sticky situation, I find a more experience nurse and get a second opinion. I find that I often DO know what to do, sometimes I just need some validation of that for the sake of my patients' safety.

    Any skill gets better once you get some practice doing it. The main thing, I think, is to know what to expect and what is different. For instance, if the nurse tells you in report that the patient is AAO, and you walk in and he thinks you're the devil and he's in the grocery store, that's a significant change that warrants investigation. It's important we recognize changes in our patients so we know what to report to the doctor. Assessment skills are way more important to master than technical skills, so when you are in school, use the opportunities you have with patients to really assess them and figure out what's wrong with them, what physical symptoms they have that are indicative of their illness (they're pale=they're anemic?; they're barrel-chested=they have COPD; they have 3+ pitting edema in their lower extremities=they have CHF?; etc). Sometimes you'll see things in patients that you don't expect for their illness, and you need to be able to recognize that as well.

    Don't get me wrong; technical skills are important, too, but they will come in time with practice. And some people just seem to have a knack for certain skills. There's a guy I work with that could start an IV on a stuffed animal and get a blood return!:chuckle Another girl I work with can get a fecal bag to stick to anyone without leaking (I didn't even KNOW such a thing existed before I started in ICU).

    Good luck to you and enjoy school.
  10. by   Rustyhammer
    I've been nursing for...hmm...17 years and there are still some thing that I'm not comfy with. But I'm confident enough that I will give advice on the things I know and confident enough to ask for help in the things I'm unsure of.
    -Russell
  11. by   Vsummer1
    You asked the question that has been on my mind for a while now. Thanks for posting this thread!

    Thanks also to all the responders who have helped me to realize that I am not EXPECTED to come out of school knowing just what to do!

    Whewww... cuz there is just no way I could begin to do all the stuff they are teaching me in the short clinical times we have. I was starting to think there was something WRONG with me for feeling like I wasn't getting it, and maybe I should quit...
  12. by   sjoe
    Around a year or so.
  13. by   sharann
    Originally posted by Rustyhammer
    I've been nursing for...hmm...17 years and there are still some thing that I'm not comfy with. But I'm confident enough that I will give advice on the things I know and confident enough to ask for help in the things I'm unsure of.
    -Russell
    Rusty nailed it. The smartest nurses I know ask questions when they are unsure.

    I think 1 year is a fair amount of time to feel "pretty comfortable" but still feel like a New nurse. We learn daily.
  14. by   Rustyhammer
    We all realize that new grads don't know anything (no offense intended) but a good nurse will teach them to be confident and coach them on their skills, people handling, and time managing.
    I have seen nurses who have fallen into bad habits after years of practice and others who have kept their skills sharp.
    Some things you learn in nursing school you will remember and use forever and other things and other things are far from reality.
    You will do fine.
    -Russell

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