I Feel Like A Complete Moron

[NTPinky]

I'm doing my preceptorship at a home health agency and I've always known my nursing school was mediocre, but I'm realizing now just how little I've learned in nursing school.

My school is very theory-happy, and we've learned very few clinical skills. We had skills lab for the first two semesters, but we used antiquated equipment, and the IV pumps didn't even work. We never had open lab hours where we could practice anything because we don't have enough faculty. Today I listened to a patient's breath sounds, and I couldn't tell that he had crackles on the left side. My preceptor had to point it out.

I've NEVER started an IV, drawn blood, etc. The only skilled stuff I've done is ONE straight cath, remove 2 Foleys, and inserted one Foley. That just seems ridiculous. In talking with my classmates, most feel the same way. My friend is doing her preceptorship in pediatrics, and her preceptor asked her, "Well, haven't you ever hung plasma before?" And my friend said she felt like an idiot because we had never done that in our clinicals.

Our nursing professors love to talk about how great we are because they're teaching us to become "critical thinkers" and how our education is based on theory, but hey, we need skills too! I just feel like such a fraud. I'm in an accelerated MSN program for people who have Bachelor's degrees in other fields. So I'm going to (hopefully) graduate with an MSN and not know jack! It's embarrassing. I had applied to a 2-year school, which was my first choice, but they get more applicants, both because they're cheaper, and around here, many hospitals seem to prefer community-college grads because they're very well-trained in skills. I wish I had gotten into the local community college!

Another problem is that hospitals seem to dislike students from my school. Nurses have said to me, "Oh, I've heard the program is pretty bad at your school." Maybe this explains why so many nurses at hospitals where we've done our clinicals treat us so badly and won't let us practice any skills. Also, I have yet to meet ONE student in my program who actually has something good to say about it.

I'm constantly second-guessing myself lately. I'm thinking I've chosen the wrong career to go into. I feel totally incompetent and riddled with self-doubt. I don't know how I'm going to pass the NCLEX in January. The school has given us loads of theory, but seemingly little else.

Am I pursuing the wrong goal? I don't know if I'm qualified for this career

[kahumai, RN]

I've NEVER started an IV, drawn blood, etc. The only skilled stuff I've done is ONE straight cath, remove 2 Foleys, and inserted one Foley. That just seems ridiculous. In talking with my classmates, most feel the same way. My friend is doing her preceptorship in pediatrics, and her preceptor asked her, "Well, haven't you ever hung plasma before?" And my friend said she felt like an idiot because we had never done that in our clinicals.

I'm not sure what semester you're in, but I'm graduating in December and I have never straight cathed a pt or drawn blood, have only inserted one foley (during OB), and removed one foley (at work, which had nothing to do with school). There is only one girl in my program who has started an IV on someone, and that was only because she was doing a rotation in the ER and our instructor wasn't near her to tell her it wasn't in our "student description" of what we're allowed to do. We aren't able to hang plasma, blood, or do many other things for that matter. Looking back, it does seem unfair that we aren't allowed to do certain things, but as you go through your program, you'll do so many other nursing tasks that you won't even realize that you haven't had much experience with foleys and that. And besides, your clinical description sounds similiar to many others I know of in my area that my other friends are in. It'll get better. As far as you being unhappy with your program: is it too late to switch? Does any other school near you offer to BSN-MSN program like you're in? You sound like you're interested in doing the nursing tasks and like you want to learn; I'd hate to see you give up on such a great profession because you're unhappy with the program. And as for those mean nurses, just tell them to shove it! Good luck with your clinicals! Hope they get better!

[Hellllllo Nurse, BSN, RN]

This is kind of what I thought might happen with all of the accelerate BSN/MSN programs for people with degrees in other fields.

[LeesieBug]

I'm not sure that you really have anything to panic about.....you may just require a more supportive atmosphere.

I think there is no way to feel EXCEPT ignorant at times when you are doing preceptorship. You are smack in the middle of seeing just HOW MUCH you haven't learned in school....which is actually a given. You cannot POSSIBLEY learn EVERYTHING in school, no matter how wonderous the program may be.

I am attending a program with a good reputation, my preceptor and all the nurses I work with tell me I am doing GREAT, but 3/4 of the day I am asking questions...feeling like a dip-stick... that's how you LEARN!

The reputation of the school may be something difficult work work past, but if you study hard, seek out new experiences, and just plain do your best to prove the nurses around you wrong, you may start to get a warmer response once they get to know you, whether you are lacking "skills" experience or not.

[elizabells, BSN, RN]

This is kind of what I thought might happen with all of the accelerate BSN/MSN programs for people with degrees in other fields.

With respect, not all BSN/MSN programs are like that. I'm in my second round of clinicals, and I've given meds, injections, hung bags/dealt w/ pumps, started/DCed foleys, packed wounds, unclogged J tubes, flushed PIVs and PICCs, done endless assessments/bedbaths/AM care, taken a gazillion blood sugars, observed blood hangings, and lots of other skills I can't think of right now. The thing about some of these programs, which they will tell you flat out, is that they are NOT preparing students to be floor nurses. They are preparing you to pass the NCLEX and immediately move on to NP studies. It's important to find out what your school's emphasis on clinical skills is. My particular program (Columbia) knows that a lot of students will work on the floors or units during the Master's portion, and many will take time off to work btwn phases to pay off the ridiculous loans we take out. So they do prepare us to work on the floor. The prejudice the OP has spoken of (and that a lot of us have experienced) does not help anyone.