Were there any nursing skills that you didn't get to do in nursing school?

[Plagueis]

Hi. I'm a CNA who's due to graduate from LPN school in June. Even though I am not finished with the clinical rotations yet, there are some nursing skills that I haven't done yet on actual patients, such as inserting a cathether or performing trach care. When I mentioned this to some of the nurses who I work with (both LPN and RN), they all told me that they graduated from nursing school without performing some nursing skills, and that most of the skills they learned occured on the job, not in school.

Therefore, I just wanted to ask you nurses out there: when you graduated from nursing school, were there any nursing skills that you were not able to do in clinical for whatever reason, and if so, what were they? Any how long did it take for you to get comfortable doing those skills? Thanks! :)

[pagandeva2000, LPN]

I didn't get to do trach care, dressings, tube feedings, catheterization, to name a few. Since graduation in 2006, I had gotten to do trach care on a home case I had, worked per diem in the Step-Down unit and got a chance to do the tube feedings. Catherization, twice. I primariy work in a clinic, so, I don't get to see as much.

[MelissaPhoographerRN]

Yes, sounds typical.

I've been out of school for a little over a year and a half and I'm yet to have to do trach care on anyone.

While you're in orientation you'll get to practice the procedures that you will do the most on whatever floor you work on. Even after I got out of orientation I had to do some stuff I had never done before, I would just go ask one of the more seasoned nurses to come in the room with me in case I needed help. No big deal.

We also didn't get to start IVs on real people while we were in school. I had one great clinical instructor that let me start a few in clinicals. Now it's one of my favorite things to do.

[RNperdiem, RN]

I had no skills in communicating with doctors.

When labs are abnormal or there is a change in a patient's condition, do you:

page the doctor?

text page the doctor?

wait until the docs come on rounds and mention the issue then? When are rounds?

Wait and see?

I knew nothing about cross-coverage, answering services, which speciality to call(anesthesia, critical care etc).

I had to learn the clinical ladder from med students to senior attendings.

I had to learn what information to have handy when calling.

After some missteps and stress, I did learn.

[pagandeva2000, LPN]

The clinic setting forces us to communicate with doctors, but I was poor at it for quite some time as well. However, the more times I was humiliated, the better I had gotten...it did pay to have as much relevant information for the patient available as possible. I can still laugh at my earlier communications...they should be sold on YouTube!

[firstyearRN]

I'm kind of concerned about not really knowing any skills from nursing school. I'm the kind of person that takes a lot of practice and I'm still unsure how to do just about everything! I hope this is not of great concern. I graduate shortly!

[Irene joy]

Uh, let's see, what have I done in real life and not just lab. I've hung IVF and set pumps, given IV pushes, a couple subQ injections, some PO meds, discontinued a catheter, IV flushes, catheter care, blah, blah. Not much really. I'm officially half way through nursing school and I feel like I've forgotten half of my skills already. It does'nt help that I had one instructor that just really wanted us to focus on assessments the whole time. Hello! I'm in third quarter and I can't give a PO med evan with you standing there? I hope I'll have more opportunities in advanced med surg next quarter!

[Vito Andolini]

Leadership. I never really learned leadership in school. And several patient care skills, like NG tubes. It's been quite a while since school, so I really don't remember all that much. I did, of course, learn a lot on the job. Don't worry, you will, too, I'm sure.

[caliotter3]

In my final semester of clinical, which was done as a preceptorship, we were told that we were to conduct ourselves as if we were graduate nurses beginning our first job and that we would be treated as such. However, we were made to sign a statement that restricted us from doing eight procedures, one of which was IV push med administration. I mean, really, who goes to their first job and signs a paper stating they are not allowed to do eight aspects of their job. We were shortchanged and everyone knew it. This was just an additional hold back to the usual realm of you get to do it if it comes up with your patient and your instructor allows you to, otherwise, wait until you go to work. I did many things for the first time on the job. I didn't feel that clinicals that consisted mostly of CNA duties were useful to me to prepare me for my job. My coworkers and supervisors also told me that they didn't feel they should have to teach me to do what should have been covered in my BSN program and I agreed with them.

[lovehospital]

1.Things I have done.

1.Hang couple of antibiotics.

2.Change IV bag

3.Flushed couple of hep-locks

4.Numerous SC injections.

5.One IM injection

6.One dressing change.

7.Discontinued and removed IV

Things I havent done.

1.foley catheter

2.start iv

Things I still would like to do but slim chance (telemetry rotation)

1.Definitely more dressing changes.

2.Foleys.

3.More IV experience

[loricatus]

My university was so bad that I never knew how to prime tubing or use a pump; however, I could write some mean research papers. Thank goodness the hospital that hired me out of school knew the reputation of the school and was prepared that I had no real nursing skills, even though I got to start out in the ICU. It was certainly was a trial by fire.