Getting experience with skills

[midcom]

I am a member of several Yahoo groups & on one of them a member wrote telling us that she was now 6 weeks into her preceptorship & had finally gotten to insert a catheter for the first time. She is a RN & didn't get to do it on a human during school. Another member wrote & said she had inserted her first IV finally a few weeks after graduation.

Today, I was telling one of my instructors about this & she said that it wasn't all that unusual to not get to do the skills we are supposed to know how to do. She said that she never gave a shot to a person until she was working as a RN.

I just assumed that we'd get that experience. I know that much of our learning will take place after starting our first job but this really scares me. My teacher said it's kind of scary because by the time you are a grad, you're expected to know how to do these things & so if it's actually your first time, you don't have the excuse that "I'm a student."

Now I'm really glad we got to practice injections on each other & that I've been given the opportunity to put in a foley & to straight cath, as well as suction & do g-tube meds & feedings. I'd hate to have to learn them whiel on the job.

On the same subject, I have been told that students who go right into BSN program get less patient contact than the normal LPN student, that LPNs are more hands on training & BSN is more theory. I asked a fellow student who was dropped from a RN program 3 years into her training if that was true & she feels that in the 9 months she has been in our program she has had more patient contact. She doesn't regret the theory part she learned in the previous program but she's happy to have the expereince she is getting with us. Not trying to start any controversy with this question, just courious.

Dixie

[Kathyz]

I just finished my first semester in an ADN program. There were four different clinical sections to choose from and I got the BEST instructor!! We gave shots, did wound care, pass meds, hung IVPB and G-Tube feedings (which we didn't even learn in lab). One other clinical group didn't even give shots. It all depends on the hospital and what type of patients are there (they were on the rehab floor) and the instructor.My instructor went out of his way to make sure everyone got a chance to do these things, even if it was on a patient other than ours. We had the best time and the RN / CNA staff at the hospital loved us b/c we did everything.In the fall I'm worried b/c I won't have him again. It's just the roll of the dice.....so that info really doesn't surprise me. It's unfortunate, but not at all surprising.

[gradRN2007, BSN, RN]

I just started working as a New RN and I had given shots but its been 8 months so I feel like I never did anything. I never did a foley or IV but I have orientation for 6 months and have told the nurses to use and abuse me so I can get my skills in...hopefully will happen..I did remove a foley last night. and did a new addmission so it's starting to happen..thank goodness I love my floor and preceptor..

[llg, PhD, RN]

There is a lot more to nursing than just the technical skills -- and in some jobs, those technical skills being mentioned in this thread are only a very minor portion of the role of the RN. Each program and each situation is different: each provides a different pathway to acquire the skills necessary to do the job.

The important thing is that the nurse keep growing and learning with each new experience, whether it be primarily a technical experience or an intellectual one. The particular pathway is far less important than the continued effort to go further down that path towards expertise over the years.

[marilynmom, LPN, NP]

I am a member of several Yahoo groups & on one of them a member wrote telling us that she was now 6 weeks into her preceptorship & had finally gotten to insert a catheter for the first time. She is a RN & didn't get to do it on a human during school. Another member wrote & said she had inserted her first IV finally a few weeks after graduation.

Today, I was telling one of my instructors about this & she said that it wasn't all that unusual to not get to do the skills we are supposed to know how to do. She said that she never gave a shot to a person until she was working as a RN.

I just assumed that we'd get that experience. I know that much of our learning will take place after starting our first job but this really scares me. My teacher said it's kind of scary because by the time you are a grad, you're expected to know how to do these things & so if it's actually your first time, you don't have the excuse that "I'm a student."

Now I'm really glad we got to practice injections on each other & that I've been given the opportunity to put in a foley & to straight cath, as well as suction & do g-tube meds & feedings. I'd hate to have to learn them whiel on the job.

On the same subject, I have been told that students who go right into BSN program get less patient contact than the normal LPN student, that LPNs are more hands on training & BSN is more theory. I asked a fellow student who was dropped from a RN program 3 years into her training if that was true & she feels that in the 9 months she has been in our program she has had more patient contact. She doesn't regret the theory part she learned in the previous program but she's happy to have the expereince she is getting with us. Not trying to start any controversy with this question, just courious.

Dixie

I don't know, I'm in a BSN program and can't even tell you have many Foleys, IMs, NG tubes, etc I have done-- a ton. I'm also very proactive and JUMP at the chance to do skills.

But you can't really compare LPN education with BSN education, of course we get more theory. Partly that is part of the difference between an LPN and an RN right? Assessment and pathophysiology type of differences. I'm sure LPN student do get more hands on skills time with patients, but there is so much more to being an RN than skills...those are not hard to learn as most of the techs I know can do all the skills that nurses do, the whys and the theory and education behind everything is very very valuable. When I'm managing a vented patient and his/her o2 sats are dropping, his HR is increased or dropping, his Eco2 is high I need to know what is going on, what I as an RN can do, more than I need to know how to put in a Foley. Now that I am working in an ICU I can see how valuable my theory and pathophysiology, critical thinking, assessment (big time) skills come into play far far more than anything else.

I really think so much has to do with your clinical instructor and the nurse your working with during clinicals as well. I have had nurses they let me do everything which is fantastic, and other nurses who are so protective of their patients they won't let a student touch them.

Also, any place I have ever worked knows that new grads are not super experienced and that is why you have an orientation period. And part of being a nurse (LPN or RN) is ongoing learning...I know where I work, even the veteran RNs will tell me they learn something new every single day, see things new, deal with disease processes they have never even heard of. That is what I love about nursing and the medical field! :)