My advice to ALL nursing students!

Nursing Students General Students

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Hello!

I am a 3rd year nursing student (3 of 5 semesters) and I come from a corporate background. I have no previous nursing experience except of what I've learned in clinicals until NOW.

I have taken a job as a Nurse Intern II (basically a PCT) on a very busy Med-Tele floor at a small hospital (only 64 beds). I've just completed my first 12 hour shift (more like 13 hours) and let me tell you, it's NOTHING like what we've learned in nursing school or even done in clinicals.

I was responsible for 12 patients, getting VS q 4 hrs, blood sugars by 16:00, charting my OWN VS and blood glucose readings, removing foley's and IV's, doing bed changes and bed baths, recording intake and outputs on 6 of my patients, also watching for my dementia patient that has a bed alarm that PT forgot to reset and as a result, he fell out of bed. All of this in a 13 hr shift and I've learned more this day than I've EVER learned in nursing school up to this point. It's very real and when we were in clinicals, we were only there for 7 hours and it was mostly following a nurse around and sitting at the nurses station, that's about it. There were days that the floor was kinda busy, but there still wasnt any hands-on experience.

Nursing school is just the BASICS, kinda like boot camp. If you want real world experience, I suggest every nursing student takes a PRN position as a PCT or tech, or CNA, or Nurse Intern, whatever, just to get a feel of what the real world of nursing is like. Also, get in a groove to get your time management skills down, because you are going to need them in the real world. Although it was my first day on the floor, I tried to get my VS Q 4 hrs atleast one hour ahead of schedule so I can get them charted for the nurses to see when they passed meds.

And for the record, I only got a 30 minute lunch break and one 10 minute break towards the END of my shift prior to giving report.

But, I can say I LOVE IT! I love giving patient care and the teamwork between the nurses and the PCT's. Everyone works together to care for the patient and it's great!

But just be prepared, that nursing school does not even TAP on the real world of nursing. If you want experience where you can relate it back to school (careplans, tests, paperwork, etc), take a job as a tech, you will be glad you did.

Sounds like you will be very well prepared when you start your career officially as a nurse!

Thanks for sharing, I am thinking of looking into similar position or possibly as a GPN.

Best wishes and also Happy Holpdays!

Specializes in Cardiac Telemetry, ED.

I can appreciate your perspective. I worked as a CNA prior to my admission to NS and during my first year of NS, until I passed my NCLEX for my LPN licensure. I'm currently working as an LPN while I finish up my second year of the ADN program.

When I first started clinical, those of us who had already been working as CNAs, particularly those of us who had already been working in the hospital, had a huge advantage. We already knew the ropes at that particular institution, so we already knew where the towels were, how to work the beds and the bedside tables, etc. Since during our first term of clinical the only nursing skill we practiced was passing oral meds under the direct supervision of our clinical instructor, that left us functioning for the most part as CNAs, so those of us who had already worked in that capacity were already comfortable with that role. During first year, the most patients I had in clinical was two, while working as an aide, I had anywhere from ten to sixteen. Now, as an LPN, I have anywhere from three to six (three if our census permits and my charge nurse is being kind, and six if we're getting slammed with admits).

It's true. Clinical did nothing to prepare me as an LPN to care for a full load. But the nice thing is that my job makes clinicals seem like a cake walk. Also, I am very content to NOT have a full load in clinical because this allows me to take my time and learn. When I'm working and caring for four patients, I am often so busy that I become task oriented and am working so hard just to keep up that I don't have time for learning. I just have to do. In clinical, we have more time on our hands and less responsibility, so we can step back and look at the big picture and walk away having learned a great deal. I don't always have that luxury when I am working.

I guess what I'm trying to say in a roundabout way is that I agree that clinicals don't prepare us for real world nursing. But, I am okay with that, as I get plenty of real world nursing experience on the job, and I want clinicals to be about learning, not just trying to keep my head above water. I am paying for my education, after all, and I am an adult learner. I want to get through NS with a solid foundation of basic knowledge so that I can put it into practice when I hit the floor as an RN. I don't see how I can learn so much about pathophysiology, assessment, medications, labs and diagnostics, etc., if I am carrying a full patient load as a student. I have learned a great deal on the job, but I find for the most part that my focus is on getting my work done and charted. It doesn't help that I work in a hard unit. None of the other LPNs that are currently working at the hospital want to work in my unit because it is too scary (cardiac).

I think that ADN programs that don't offer an LPN option after the first year are doing a disservice to the students. However, not all students opt for the LPN anyway, for various reasons. For me, it has given me a huge advantage in NS, and I'm glad I took the option. I don't always feel so glad, especially after a rough shift. But one important thing that I'm getting out of the way is the "reality shock" of the transition from student to nurse. I get to watch my fellow students who did not opt for the LPN go through it when they are new grads, while I will already have gone through it. I hope I can be of help to them, like so many have been to me.

Also, I was getting tired of being a CNA. I won't ever regret the experience, as I have learned so much and grown so much from my contact with patients. It never ceases to amaze me how some people, even when at their worst, handle things with such grace and dignity. But as a CNA, I didn't feel challenged mentally. I appreciate the mental challenges that nursing presents. Also, organizing my time as a CNA was very different from organizing my time as a nurse. When first started as an LPN, I had to relearn time management skills, cause what worked as an aide did not work as a nurse.

Overall, though, I do agree that nursing students seem to do better when already exposed to the health care environment. Some of our students work as CNAs, some do transport and orderly work, others have worked in doctors' offices, some have worked as EMTs, and some have not worked in health care at all. For the most part, those that are immersed in the health care environment through their work do seem to spend less time looking for towels and experience less anxiety with patient contact. But there are a few who don't have the health care background who really shine. It just depends on who you are, I guess.

I'm just rambling now. I've got a touch of insomnia and came on here hoping I'd get sleepy.

Specializes in med/surg, telemetry, IV therapy, mgmt.

I'm glad you are coming away from your job with a positive experience and insight. However, please understand that the work of a Nurse Intern, or PCT, is not the same as the work that is done by an RN. The duties and responsibilities are very, very different between the two. While time management is something that is common to both, the types of things that have to be time managed by a nurse intern and an RN are very different. You are lucky you got a lunch break and two other breaks. There were many times when, as an RN, I couldn't take a break because there was too much going on and I couldn't leave the unit for some reason or another and time just got away.

Getting q4h vital signs an hour ahead of time was OK with the nurse you were working with?

Specializes in Cardiac Telemetry, ED.

I agree they're not the same, but I think some form of exposure to the environment of an acute care facility, if that's where one's clinicals are likely to be, can be of great benefit to the student. I think that was the main point.

First year, I noticed a big difference in the confidence level of the students who had CNA experience and those who did not. Now that we're all second year and some of us are working as LPNs and some chose not to, I notice a very large gap in clinical performance between the two groups.

And I know there is a difference between functioning as an RN and functioning as an LPN as well. I am looking forward to finally being an RN so I don't have to find someone else to do my IV pushes through central lines or hang my blood, or initiate a care plan, or assess a sheath removal site for me.

But overall, some experience in patient care, even as a PCT, will prepare a student for the clnical experience better than none, with a few exceptions. Some students take to it well without the experience.

Specializes in Cath Lab/Critical Care.

I think I was fortunate, my NS clinicals started 3 weeks into the first semester, and we had 12 hour clinicals. Of course we only had 2 patients at a time maximum, but by the last semester I was doing two 12 hour shifts a week, and I had a baby during Spring Break, back doing my 12 hour clinicals the following week! It sucked, and gave me a good idea of what I was getting myself into! (but I LOVED it) YIKES! :lol2:

Specializes in med/surg, telemetry, IV therapy, mgmt.

I am not intending to discourage you at all! But, I do want you to be clear that there is a difference in what you are doing as a nurse intern (technical skills) compared to an RN (critical thinking, problem solving, patient management). There is a big difference between doing technical skills and the critical thinking and problem solving that you will be required to do as an RN. That critical thinking and problem solving is something that is hard to prepare for in prior jobs other than to try to kind of "play" along with the nurses you are working with and observe. Still, you can't be inside their heads to know what their thinking process is. That is something you have to learn and discover all on your own.

I'm glad you are coming away from your job with a positive experience and insight. However, please understand that the work of a Nurse Intern, or PCT, is not the same as the work that is done by an RN. The duties and responsibilities are very, very different between the two. While time management is something that is common to both, the types of things that have to be time managed by a nurse intern and an RN are very different. You are lucky you got a lunch break and two other breaks. There were many times when, as an RN, I couldn't take a break because there was too much going on and I couldn't leave the unit for some reason or another and time just got away.

Getting q4h vital signs an hour ahead of time was OK with the nurse you were working with?

The nurse seemed ok with the PCT that was precepting me to do it that way. But it didnt happen anyway because I was still 30 minutes behind schedule.

And I do agree, the jobs of a RN and Tech are totally different. The point of my post was to say it's NOT anything compared to clinicals and if one has not had ANY prior experience in the medical field (such as myself), it can really open their eyes to what to expect in the future and really trying to stress getting time management skills NOW.

I wasnt trying to compare a Tech job to a RN job and it's not my intention for this forum to go in that direction.

Specializes in ED.

when we are in clinical we do all of the nursing jobs that a RN would do, so it is much like you descibed. we definately do not work on care plans or sit at the desk, we would be told to leave if we did that!

Good for you for taking that intern job... it sounds like a valuable experience. (And remember to take that lunch break!!)

I have taken a PRN job as a PCT on the oncology/med floor at my hospital. I took the job because i wanted more hospital experience and exposure. I had never worked in the med. field before and I'm graduating June of 08. I find the experience very valuable. I know it is completely different than what I will be doing as an RN but I am learning how to manage more than one patient at a time. Sometimes I have 28 if I'm working a night shift. Usually 13-16 on a 3-11 shift.

Along with the time management, I am learning better communication skills with my patients since I am rather shy and we are also responsible for all the blood draws. That in itself is wonderful. I am not the best or very confident at drawing blood but I know that by the time I graduate I will have at least that under my belt.

I also highly recommend nursing students to take a PRN job as a tech if they can.

As for starting VS an hour early. i do the same thing or else it I will really be behind. Most of the time when I enter a room to get them there are several other things the patient needs and that takes up valuable time. None of the nurses have said anything to me about taking VS early.

I also do foley's, EKG's and several other things that I never really had exposure to do while in school.

Specializes in geriatrics, mental health.
I am not intending to discourage you at all! But, I do want you to be clear that there is a difference in what you are doing as a nurse intern (technical skills) compared to an RN (critical thinking, problem solving, patient management). There is a big difference between doing technical skills and the critical thinking and problem solving that you will be required to do as an RN. That critical thinking and problem solving is something that is hard to prepare for in prior jobs other than to try to kind of "play" along with the nurses you are working with and observe. Still, you can't be inside their heads to know what their thinking process is. That is something you have to learn and discover all on your own.

hello,

I donot know how to pm or use this site too well but can you give me some advise on what you just posted above.

this is the reason i could not pass the nclex and i have been an lpn for many years but as you stated our position is very different. help me if yu can it will be greatly appreciated sareebadi

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