No IV Practice / Little hands-on practice in clinicals - page 3

Hello all, I am half way finished with my 1 year accelerated BSN program, and so far I like it for the most part. Our classes have been really interesting and in depth regarding disease processes,... Read More

  1. by   Vespertinas
    Once you're hired, you can ask to spend like 5 hours in the ED doing nothing but sticks. They'll appreciate it and you'll get plenty of exposure
  2. by   nursejen07
    I think most nursing students worry they aren't going to be proficient with the "hands-on" skills once they graduate. Luckily, no one is expecting you to be! Yeah, we've all dealt with the crochety old nurse that doesn't want to show you how to do something then yells at you when you don't know how to do it. But grumpy people are a part of life, and most nurses are more than happy to answer questions or help you out if you need it. Never be afraid to ask questions or be worried you're going to look dumb if you don't know how to do something. I'd much prefer to work with a new nurse with lots of "dumb" questions than with one that thought they knew everything.

    As far as school goes, it may help to keep a list of skills you want to accomplish and go over it with your preceptor/instructor. My school was touch-and-go when it came to teaching me skills and it was kind of up to the students to throw themselves out there in order to get experiences. It all depends on the nurse you are shadowing. Sometimes you get a surly one that couldn't care less whether you learn anything or not, but keep your eye out for the great ones that actually *want* to teach you things. I'll never forget the nurse I worked with in day surgery that asked me what I wanted to learn that day. When I told her we had been learning IVs in lab but I'd never gotten a chance to do one on an actual person, she brought me to the nurses station and announced "This is my student and she wants to learn IV inserts today! Anyone who needs an IV start, come find me and we'll do it for you!" The floor was grateful for the help and I was grateful for the experience.

    Also, it helps to keep an ear out for opportunities that other nurses on the floor can provide. No one says you have to stick to your nurse like glue, especially if you have a, um, less-than-helpful one. If you see the blood bank drop off some blood, grab the nurse that picks it up and ask her if you can watch her hang it. Heard about a patient that's going south? See if you can tag along as they (hopefully!) transfer him to the ICU. Don't get in the way, but wait until things have quieted down a little on the floor and ask all the questions you had along the way.

    I know it's easier said than done in these situations. I remember the stress and anxiety of nursing school and feeling like I didn't know bupkus when I graduated. But you will learn it eventually, and as long as keeping your patients safe is your #1 priority, you'll do fine!
  3. by   Klimpys
    I have being doing pre-reqs for the nursing program of a local community college. I will start actual nursing classes this fall. One of the pre-reqs was to get your NA 1 license. My adviser said one of the reasons they started requiring it was because they only accept 25 students a year, and they always had some that later dropped out because they didn't realize that part of their job was to wipe butts, make beds, clean vomit, etc...When a student eventually dropped out, the school could not fill that open spot. Our NA 1 clinical was at a nursing home. My school also decided to give a extra points towards being accepted into the nursing program if you earned your NA II, which I did. During that class, my RN teacher told us how she learned to do blood draws (in a break room with fellow classmates sticking each other.) I decided that I would take a phlebotomy course. I am so glad I did, because I have learned of the damage you can do when you don't know what you are doing. These side classes have cost me some extra money, but I feel they will help me in the long run in feeling more confident in what I am doing during my nursing classes. If I can land a part-time job at the hospital as a tech it will help me get my foot in the door.
  4. by   umcRN
    pretty common. I never put an IV in until I started working in a NICU. In the NICU nurses did all their own IV's so we were very encouraged to just start doing them. Now I work in a peds cardiac ICU and I would say almost all the nurses who were new grads within the past 5 years have no idea how to place an IV, they all use the hospitals IV team (or me when they learn I know how to put IV's in!)
  5. by   tothepointeLVN
    Quote from nursejen07
    if you see the blood bank drop off some blood, grab the nurse that picks it up and ask her if you can watch her hang it
    oh yes this was a very successful strategy for a classmate of mine and myself. the nurses would love it they could hang and we would do the vitals checks and sit with the patient in case anything went afoul. volunteer yourself up for scut and you might get some perks too.
  6. by   BuckyBadgerRN
    My school requires that you take the CNA course before you can apply to the nursing program. I heartily agree with what you are saying!!
  7. by   subee
    Why do we even have accelerated programs? Jobs are scarce anyway. Do we need people who are rushed through a bare bones program merely to rush them through a NP program to assemble an "advanced practice" nurse with no nursing experience? For what purpose?
  8. by   Klimpys
    I just wanted to add to my previous post regarding the NA course and phlebo. These classes are offered in the Continuing Education department and were two nights a week. They lasted anywhere from four months (phlebotomy) to six months (NA II). I took them at the same time I was taking my curriculum classes. They did/will not slow me down from getting my RN.
  9. by   threebrats46
    I didnt learn how to put in IV or draw blood until my first job. Most nursing programs don't teach it. You aren't incompetent at all...all the skills will one day be so natural to you and you will think back and laugh. I felt exactly the same way you felt when I graduated nursing school.
  10. by   shortnorthstudent
    Quote from Cuddleswithpuddles
    Assessment is nothing without intervention. A is only one letter in ADPIE. It's just as important to do a thorough head-to-toe as it is to know what to do, then do it well.

    I believe the OP's schooling is not conducive to this but, sadly, not the exception among nursing schools nowadays.
    I disagree with you. Assessment is absolutely important. However, you are missing the boat on interventions. Those skills that many are so interested in are not independent nursing actions. You cannot drop an NG, start an IV, put in a foley, pass meds, etc. without an order. The interventions that are within the nurse's independent scope of practice are not those skills. As the nurse, you can do SO much to help your patient based on your assessment and those are the interventions that you need to be focusing on in nursing school. Knowing that your patient is going to breathe better if you put them more upright, that you can prevent pneumonia by teaching the patient to use the incentive spirometer and making sure they use it, ambulating your patient and so much more. Those aren't the sexy skills, but it is the bread and butter of critical thinking and is what makes an RN different than someone who has simply been trained to draw blood or put in an IV. Plenty of non-RNs are trained to perform the skills that we get so excited about in early nursing school. But, Assessment IS an RN specific skill that we are educated to do. Note the difference in my language between trained and educated. As a nurse on a floor you may never have to insert an IV (depending upon your type of unit). Does that mean you aren't really a nurse? Absolutely not. It means that your time is taken up with responsibilities that the CNA, medtech, phlebotomist, LPN, etc. cannot do.
  11. by   Wrench Party
    I'm in a traditional program and my clinical experience this semester has been great- one of the benefits of
    going at a slower pace is there is more time to learn everything. In the middle of my 3rd semester, and
    we've done trach care, hung blood from the bank and IVs, done wound care, put in and d/c'd Foleys, and now we're learning
    ostomy care.

    I also make it a point to offer to be a runner for the nurse I'm working under- that strategy got me extra
    experience with passing meds, setting up a PCA pump, hanging IVs, doing IV flushes and d/c'ing them, and doing wound care.
    I try to make up for all the extra hassle I caused her by being a pain in her butt.
  12. by   dudette10
    My opinion: The typical hands-on skills can be learned fairly easily, and even if you spend hours upon hours in a skills lab at school, you need practice on real people, which may not happen in clinicals. I think learning skills in nursing school is a highly overrated endeavor.

    I've been working a little more than 6 months. There is a particular skill that I had to perform last night. I didn't know how to do it. Three of the four nurses I was working with have more than 15 years experience. NONE of them knew how to do it. We called a nurse from another floor to come show us. I performed the task under the teaching nurse's direction, while the other nurses watched and asked questions.

    THAT is true teamwork, and no nurse would survive without it.

    For those who gasp and clutch their pearls because a new grad doesn't know how to do something, I'm quite sure feeling of superiority brings immense satisfaction, hiding under the mask of shock and disappointment. There are EXPERIENCED nurses who are courageous enough to change specialties that don't know how to do certain skills.

    Everyone brings up the IV insertion skill, as if that is the Valhalla of nursing skill. If a 10-year experienced nurse in LTC takes an acute care job, there's a pretty good chance that her IV skills would be limited. Experienced OR circulating nurses can do their jobs with ease--and a floor nurse would be lost in that environment--but inserting an IV? Unless they rotate to pre-op, outpatient, or PACU, very little IV experience to speak of. Gasp and clutch your pearls at that.
  13. by   dudette10
    Quote from subee
    Why do we even have accelerated programs? Jobs are scarce anyway. Do we need people who are rushed through a bare bones program...
    I have posted many times on what an ABSN program really is. Accelerated because the first 60 hours of general education are not part of the ABSN program. Accelerated because there are no significant school breaks.

    There is nothing "accelerated" in the knowledge gained. You must take at least 60 hours of nursing coursework in an ABSN program. I did four semesters of an ABSN program in 17 months with no summer break. ADNs at the most popular community colleges take four semesters in their program in 21 months with a summer break!

    What's more is that the local ADN programs have classes included in their nursing programs that were required pre-reqs in my ABSN program.

    All one has to do to understand program requirements is google the various programs in the area and look at the coursework required. Every site I have ever visited has that information on a site page. I am clearly talking about programs in my area.

    On this site, I have never made condescending remarks about ADN programs or ADN-educated nurses. I have, however, defended BSN programs and those universally-hated "fluff" courses which are, by regulation, required in the BSN programs in my state. I just wish others would research facts about the programs before making uninformed remarks about them.