Multiple IV's for one student, none for the rest... Is this usual during clinical?

  1. Hey guys,

    I'm just wondering about your clinical experience in terms of gaining real-world experience with skills such as IV insertion, foley's, etc... The trend seems to be that certain people get multiple IV's (4 in two days for two students as an example) but none for any of the other students (there are 12 of us on this rotation). We kind of hoped this was a first-semester thing but now we are midway through the second semester and here we go again. Anyone else experience this and if so, how did you handle it?

    Thanks in advance!
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    About Sherijo71, CNA, EMT-B

    Joined: May '13; Posts: 13; Likes: 18

    44 Comments

  3. by   ItsThatJenGirl
    How do your clinicals work? Are you paired with a nurse, or assigned tasks by your instructor?
  4. by   caliotter3
    If there is some form of favoritism behind it, then yes, that can be a common denominator. But more than likely, someone is not in tune with what is happening. Why not bring it up in clinical conference? Be polite, of course.
  5. by   OcMurse93
    It is your responsibility to seek out learning opportunities. IV insertions are the hardest to do in school because a lot of patients don't like students doing them. Speak to your professor expressing your desire for more opportunities for IV insertion.
  6. by   Double-Helix
    Sometimes it's just the luck of the draw that those two students happened to have multiple patients that needed an IV. I would definitely mention to your instructor that you're looking to gain experience with IVs and ask if you can be brought in if she hears of a patient that requires one.

    For what it's worth, students were not allowed to start IVs when I did clinical, and it's very common that students will not have real world opportunities to practice every skill before graduation. The bulk of your skills learning will take place after you graduate.
  7. by   Sherijo71
    Neither really. We are assigned a patient and then we are given the name of the nurse who is officially assigned to that patient and told to let the nurse know that we will be taking care of said patient for the day and what meds if any, we will be doing.
  8. by   Sherijo71
    Quote from ItsThatJenGirl
    How do your clinicals work? Are you paired with a nurse, or assigned tasks by your instructor?
    Neither really. We are assigned a patient and then we are given the name of the nurse who is officially assigned to that patient and told to let the nurse know that we will be taking care of said patient for the day and what meds if any, we will be doing.
  9. by   Sherijo71
    Quote from caliotter3
    If there is some form of favoritism behind it, then yes, that can be a common denominator. But more than likely, someone is not in tune with what is happening. Why not bring it up in clinical conference? Be polite, of course.
    Yeah, I'm not sure there's any favoritism at this point; I'm thinking not. In fact, prior to getting accepted to this school, when I was working as a Psych Tech, I had 4th semester students rotate through our psych unit and they shared the same concerns only they were 4th semester and either they'd never had an opportunity to practice a skill on a real patient or they knew people who had too may opportunities to count and never shared the love I guess is what I'm trying to say. I do think bringing it up at post-conference is a good idea. I did talk to our clinical instructor on a side after we finished and she said that it's just the 2nd week but she's new clinical instructor and this is actually the theme I explained as it also happened in 2st semester so....
  10. by   Sherijo71
    Quote from OcMurse93
    It is your responsibility to seek out learning opportunities. IV insertions are the hardest to do in school because a lot of patients don't like students doing them. Speak to your professor expressing your desire for more opportunities for IV insertion.
    That's an interesting way of looking at it OcMurse93. I don't disagree and feel like I have done just that. Most definitely have spoken to my clinical instructor and do make myself available as to half of the other clinical students who experience the same things.

    I see that you are an RN now; what did you do as a student to seek out these opportunities aside from speak to your professor?
  11. by   Sherijo71
    Quote from Double-Helix
    Sometimes it's just the luck of the draw that those two students happened to have multiple patients that needed an IV. I would definitely mention to your instructor that you're looking to gain experience with IVs and ask if you can be brought in if she hears of a patient that requires one.

    For what it's worth, students were not allowed to start IVs when I did clinical, and it's very common that students will not have real world opportunities to practice every skill before graduation. The bulk of your skills learning will take place after you graduate.
    Actually, that's worth a lot so thank you for sharing. I'm stressing out, obviously, and fearful that I won't have the skills that I think I need to be employable and a great RN in a year from now but it's nice to know that this isn't uncommon for multiple reasons.
  12. by   MotoMonkey
    As a student I know that there may be skills I am never able to practice prior to my practicum or prior to working as a nurse. I have been lucky enough to place three IV's in my last acute care clinical. It was partially luck based on the patient group I was caring for and partially because I was very upfront with my nurse about the experience I wanted to have and the nurses were receptive to finding me these opportunities if possible.

    Over all, and maybe this is just a function of my program, I am not very worried about being a master of skills. I am much more concerned about developing my depth of knowledge and critical thinking ability. As a student I feel like it is easy to focus on physical skills because it is something I can use to "show" someone else my proficiency. Like if I place a foley or hit an IV the first time it will show the nurse im working with just how "good" I am. Where as it is much harder to impress someone with my critical thinking or clinical judgment, which is far more important.

    I suppose my take away is to be vocal to your nurses about the experiences you would like to have, but at the end of the day your critical thinking and clinical judgment is a far more valuable skill.
  13. by   JKL33
    Quote from Sherijo71
    That's an interesting way of looking at it OcMurse93. I don't disagree and feel like I have done just that. Most definitely have spoken to my clinical instructor and do make myself available as to half of the other clinical students who experience the same things.

    I see that you are an RN now; what did you do as a student to seek out these opportunities aside from speak to your professor?

    It wasn't a matter of letting an instructor know. It had a lot to do with relationship-building. People who seemed to find more opportunities coincidentally were the ones who put themselves out there - to help staff with linen changes, answering call lights, toileting, personal care, refilling waters...basically anything to show that we were making the most of our time there. I worked hard on trying to build a few relationships with the staff nurses, or stuck close to one or two with whom I happened to "click." I'm pretty sure they went out of their way to help me with opportunities. I personally don't think any benefit I may have received as a direct result of rapport-building is transferrable upon demand.

    I'm sure you're not sitting around waiting for someone to "give" you an opportunity. Just the same, things have changed and there are a lot of students who sit (even looking at their phones sometimes) or stand around chatting with whomever when they come to the ED (where I now work); it's slightly mind-boggling. I tell you this to point out that if you are pleasant, observant and interested, and ready to learn and help, and if you reach out to the nurses and get involved in what they're doing, you will likely stand out amongst your peers, and you will get opportunities.

    Good luck ~
  14. by   KelRN215
    Quote from Sherijo71
    Actually, that's worth a lot so thank you for sharing. I'm stressing out, obviously, and fearful that I won't have the skills that I think I need to be employable and a great RN in a year from now but it's nice to know that this isn't uncommon for multiple reasons.
    You don't need IV insertion skills to be hired as a new grad RN. FWIW, some seasoned RNs don't know how to and have no desire to place IVs. Many hospitals have an IV team for that purpose.

    Even if you are trained on peripheral IVs in school, wherever you're hired will likely have their own competency in it. I took a peripheral IV insertion work-shop when I was a senior in nursing school because it was required. The instructor who taught it wanted every senior nursing student to make peripheral IV insertion a goal for their preceptorship. The hospital I did my preceptorship at (and was later employed at) didn't allow students to insert IVs because you had to take their course and do supervised insertions with an IV nurse.

    Student experiences are highly variable in school. I, for example, got a ton of feeding tube and central line experiences in my pediatric clinic and preceptorship but none of either in med/surg. The only Foley I ever inserted was on a laboring woman. And in 11 years of being a nurse I've only inserted a handful of them- the only one I remember doing was on a baby with spina bifida whose existing Foley fell out. Most of the patients who needed them when I worked in the hospital had them inserted in the OR. We occasionally had chronically cathed patients with spina bifida who straight cathed during the day and inserted Foleys for overnight but they usually did it themselves if they were old enough or their parents did it since they did it every day.

    One of my clinical instructors used to always say that these kinds of things are just tasks and not all that nursing is about. I agree with MotoMonkey, focus on your knowledge and critical thinking skills. The tasks you need to perform for each specific job can be taught then. It's not necessary, for example, to become proficient at accessing a port in nursing school. If you get a job in oncology, you can perfect that skill then. Many other environments you work in won't require that skill.

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