Clinicals, really not prep for real world?

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I am about to enter my third semester of nursing school in August, and I will be in OB/PEDS. I am so nervous about my final last semester because I really have not done "that" much in clinicals? I have maybe gave meds once!!! I have given one insulin shot, and one lovenox shot. I have taken out one central line, and attempted to insert one IV. I have not even really hung an IV bag!! I have yet to insert an NG tube either!! Mostly, I have done baths baths and more baths!! Not that I mind that, it's just really? I feel like I am going to be murdered when I get a job because I have hardly done any of my skills. Oh yeah forgot one, foley cath!! I am so scared.. Someone give me reassurance? I have tried to apply for summer jobs and have not had any luck and this is really the only time I can get a tech job. Encouragment? Word of advice anyone?

I really appreciate y'alls encouraging words!!! It really helps me realize more about what the true importance of being an RN is. When I wrote my one page summary on why I wanted to be a nurse to send off to be accepted into nursing school, I wrote about my experience of touring St. Judes in my Allied Health class in high school. Sometimes it's hard to not get into a mindset (especially in school) that skills are so important because teacher's do emphasize it a lot. It is about the patient. I need to always remember that. My favorite thing to do really in nursing school is to sit by my patient when I have no more things to do for them and talk to them about their daily lives. I love hearing about what they love to do and about their families. I just know I want to do my best to be good at a lot of what I do. It just gets scary at times I guess having all the responsibilities I know I will encounter. Not that I care, I want to have those! I just want to be good at it. I am sort of a perfectionist but most of all, I want my patient's leaving that hospital saying "that woman took such good care of me." I just hope I am half the nurses y'all sound like y'all are!! Full of wisdom! I hope I get a mentor like that when I find a job. Someone who will take me under their wing and show me the ropes and show me what nursing is really all about!

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Specializes in Pediatrics, Emergency, Trauma.
Are you in a BSN program? I find that typical for a BSN program but a lot of ADN programs you pass meds at every clinical after you check off on the skill. I was in second semester of an ADN program and had pregnancy complications so I withdrew three weeks before finals. Now I have transferred to a different program. Meds shots, IV bags were every day things for us. Foleys, IV insertion, and other things were hard to come by depending what floor we were on but we still got to do them. I haven't started the new program yet but I so hope it's similar to my old program.[/quote']

^Same things are done in a BSN program. Check offs, opportunities to learn. Two patients each week, 3 in our senior year. It is TOTALLY dependent on the clinical instructor and the school.

OP, you still have to learn those skills=TASKs at the facility you will be working in because of policy. You foundation of your practice: Assessment and Clinical thinking and judgement using the nursing process REALLY puts it together. You will get it... :)

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Actually, the best way to have patients leaving the hospital thinking you took care of them is to take care of them and make sure their needs are met. Too many nurses sit on their computers or talk at the nurses station instead of helping the patients.

I would have a talk with your program about passing meds. There is really no excuse for you to pass meds just one time. We would take two or three meds and we still managed to pass meds last semester. The semester before we were hit with low census so we were stuck with one or two patients.

Honestly, talking does so much for the patients. It can crack me up when I have patients come back and they know me from the ER and I see them at the larger hospital or vice versa (we transfer patients to the larger hospital a lot).

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As a new graduate (as of May 11th), I found the very same things for my BSN program. My 3rd clinical I had a wonderful instructor who took me under her wing, but I also had given her an in-depth email about how nervous I was and how the previous semester I had a bad experience and so wanted to do more "skills." Well, I got much more practice with meds and some things, but still not much experience with IV's, initiating IV meds/fluids, etc. We had a critical care clinical and was lucky to be on a different unit every week (including ED, several ICUs units in Heart Hosp, etc). I got so much more one-one time with the RN and never really saw my instructor except beginning & end of day. I also was fortunate to get a spot in an externship where I did everything an RN could do, except give narcotics and some other more invasive procedures (I was in neonatal ICU). The externship opened up a whole new world of nursing for me. Maybe getting a little off-topic there, but the head of my externship program always reminded us that SKILLS CAN BE TAUGHT (to monkeys), that those things will be taught in your first job, but what is important is learning how to critically think, learning the core material, etc. I am going to be starting my first nursing job very soon, and am still worried about my skills, but I know experience is key with skills and practice makes perfect. Most employers know that new grads (esp. from BSN programs) do not have lots of practice with skills. You will be a great nurse and will learn how to do those skills in your sleep. :) Best of luck!

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Specializes in ICU.

emafille brings up a great point. Externships are great because you get to perform so many nursing tasks and repeat them over and over again until you are able to do them in your sleep by the end of it. Go for an externship!

I'm also in a BSN program and I worked with IV medications a lot so I'm not sure why you haven't had the same opportunity. Do you get to choose your patients or does your professor choose them for you? In my program, the students choose their patients so I always went for the sickest patient who usually needed total care. Also, run towards any beeping IV machines before someone else gets to it and see if you can troubleshoot the issue. If someone (not your patient) needs to get hooked up back to their IV fluids, volunteer to do it. If your professor choose patients, ask them for patients where you anticipate doing more work for.

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Thank y'all all so much for taking the time to respond to my post! Unfortunately, I missed my chance to do an externship :/. I actually was going to do one with the hospital my university is near, but they recently just dropped that program for now. Also, the nearest externships for me are about 3 hours away. It really isn't too convenient for me I guess you could say because I have no family in that area or anything!! Also, I think the reason why we have not been able to pass meds is because in the above posts I put, twice the hospitals got a new computer system. We cannot give meds unless we have access to the computer. The only time I was able to give meds is when the LPN took us around and helped us give them to random patients. Also, I am on a cardiac floor. Most patients do not have fluid running in their veins except on the first couple of days after CABG surgery maybe! It's so crucial to limit fluid for these people.. Drs mostly ordered PO meds. Those are not as complicated as the piggybacks, and antibiotics! And the truth is, the floor I was on had a tech shortage!! There were mornings where we had to give EVERY patient on the floor and bath because no one else was there to do their job!! It was kind of a chaotic semester for me. I have yet to give an IM shot either. I know those aren't too difficult except drawing them up is what kind of scares me. I really wanted to get some more hands on experience this summer before I start back, but it looks like that is not going to happen sadly lol.. I have applied for so many jobs.. I think its because I live in a rural area.. Most places do not need anyone. Oh well, I will get through it!! I am so thankful for all the sweet words though!! In nursing school, it's always nice to hear those things!

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I'm in a BSN program and the school happens to be part of the hospital, so as students in my current 1st trimester I pass meds every clinical week, have done IV pushes and hung IV bags, it really depends on what my current patient has ordered but we are required to pick a patient with at least 4 morning meds and more the better out instructors encourages us, as for IV insert I think that will be my biggest issue bc most patients already have IVs in when we do clinical so we basically have to ask around the floor to see which nurse might be doing one or replacing a old. As for baths we did nothing but that last trimester and dnt really do that often now, our program wants you to do as many skills as possible, real hands on.

I say speak up and ask, but my instructor that went to another school admits she didn't do many skills I'm school and as a RN she didn't do many hands on skills often either just bc of the floor she was hired on.

It seems to me that many other health professions are doing the skills, you have RT doing trach cleans/care, phlebotomist drawing the blood, IVs being inserted at the ER b4 they go to a floor, PT doing wound care/cleaning. Nurses are big on the critical thinking part of care and also skills but other professions in the hospitals are taking over.

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Read above re "skills": #10. Occasionally bears repeating. :)

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I know I am late to the game but... clinicals mostly taught me to read, write, and think about care plans and interventions. This turned out to be vital in my career as well as being able to critically think on your feet. Textbook information came in second. You need to know WHY you need to do something the way it needs to be done. Anything else can be learned on the job.

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Specializes in Psychiatry.
Real world nursing is not all about skills. However, now I am in my last year of nursing school and I see that skills are not what makes you ready for real world nursing. It is the critical thinking that does. A real nurse is not wrapped around inserting foleys' and NG tubes, a real nurse is thinking about what actions they should take based on what they assess. But what is more important is that you are learning how to critically think.

Great post, Sunflower. AGREE 100%

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Specializes in Psychiatry.
^loved reading the previous comment!

Me too, Jennyn. GrnTea is spot-on.

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Specializes in Psychiatry.
Most employers know that new grads (esp. from BSN programs) do not have lots of practice with skills.

I'm curious as to where you found information to support this hypothesis?

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