Soon to graduate and still don't know what I'm doing

[greyL]

My graduation will be in April. I only have my public health clinical and my preceptorship left. Even though graduation is near, I still don't feel confident in my skills. I've had the chance to do an IV twice, and I screwed up both times, I've never had to cath a female, I've never had to put in an NG-tube... I feel like my clinical experience is severely lacking, and it's not because I'm not being proactive about getting to do things at the hospital. I'm usually the one that does things that no one wants to do. So far, I've given 5 suppositories and I've helped with an enema. Most of my classmates have never even given a suppository. Why? Because they don't want to do it. They think it's gross though I don't know why. It's just people's butts. If there was poo involved then they wouldn't be needing a suppository... >_>

Is this normal? Have others graduated without much hands on experience? My mom is an RN and I asked her about it and she said that she didn't get much hands on experience in school either and that she learned everything after she was hired by a hospital. That doesn't seem right to me.

I still have my preceptorship left, but what is that exactly? It's extremely difficult to get any information from people at school.

[Despareux]

I graduate in March and feel the same--not enough clinical experience. But we probably have a decent foundation, enough so, where we would require little instruction; as opposed to someone with zero exposure to all we have learned.

[ImThatGuy, BSN, RN]

I think clinicals in nursing school are ridiculous. I just see their design as being conducive to learning anything. I haven't done any urinary catheters on anybody and really don't want to. However, if I did the experience has never manifested. The same goes with the NGT's the OP mentioned. I don't care though since I'm not in it for procedures. I'm thinking outpatient mental health is the way to go, lol.

At any rate, I feel one should finish all of the didactics for a semester and then move into clinical rotations at the end so everyone gets the opportunity to put into practice everything covered during the semester.

[greyL]

I think they are a joke too. We have few clinical hours at very small hospitals, with nurses who don't want to teach us anything. It's so frustrating. During one of my clinicals, this one nurse had us do vital signs the whole time and nothing else, and then when she asked me to do something and I didn't know how, she started telling me that I should know how to do something like that by now.

How am I supposed to know when all she did was let me do vital signs???? Ugh

[MN-Nurse, ASN, RN]

My mom is an RN and I asked her about it and she said that she didn't get much hands on experience in school either and that she learned everything after she was hired by a hospital. That doesn't seem right to me.

Nursing school prepares you to pass the NCLEX. Diploma programs taught you bedside nursing, but those don't exist anymore. So you learn on the job or through direct patient care experience working alongside RNs.

My occupational experience complimented my clinical experience quite nicely.

[greyL]

I only learned about diploma programs recently. If I had known that those existed, I would have tried to look for one because there are still a few out there. Why are they dying out? Diploma programs make a lot more sense to me.

[SnMrsSmiley]

im in first semester and have only had two clinical days. I have done everything we learned in lab and lecture in those two days already. Some of my other classmates havent had the chance yet (i picked complicated patients not the walkie talkies) iv done NG, enemas, colostomy care, inserted foleys, d/c IVs, fingersticks and insulin, hep, all PO meds, IM vaccs, the works. My second clinical day I didnt see my patients RN at all except for morning report and then to report off to her when we were leaving for the day. Hell, when the Dr made rounds I had to go over the morning details with him she didnt even show up for that. I gues the amount of experience you get depends on the hosiptal you are in and the program you are in. Im in a tiny hospital that noone in my class wanted to go to because they said it would be boring. Now they are in the big hospital and arent allowed to do anything but bed/bath and VS.

[Pneumothorax, BSN, RN]

From what ive been told, we are going to learn the most of our "hands on skills" once we start working as RN's. I understand the didactic part is necessary, but I personally learn SO much more when im on the floor and i can see s/sx manifested in the patient.

its unfortunate that we cant have the experience of practicing our skills on every patient but i guess it comes with time.

[chevyv, BSN, RN]

It's totally normal! In my last semester I felt so ill prepared. I've been working as a RN for over a year and still haven't had a female cath (I do work in behavioral health though) but I've learned so much. I'm also the first one to speak up and ask if I could do a more medical procedure because I never really had the chance to do some things. Everyone has always been really good about it. I think they like it when I'm on because they know I'll do the cath (male only so far :) or whatever else needs to get done. Most of my classmates felt the same towards the end of school as well. Funny though, I didn't feel it the first yr at all. Maybe because I was learning so much. Good Luck to you

[iPink, BSN, RN]

I graduate in May and felt as you did until I met some former students who graduated from my program. They were hired as new grad RNs at the hospital where I do my clinical. They have told me they are learning on the job. Nursing school clinical is just a very small part of what we are going to be doing in the hospital setting. As long as we get a great preceptorship, we will be fine. They already know we really don't know anything.

[tokyoROSE, BSN, RN]

I am graduating in December and haven't done a lot of skills. But I'm not worried, you can EASILY learn skills. In my preceptorship, I am more focused on being a nurse. That means prioritize, organize and think critically. IMHO, that's what preceptors should be teaching and not fret about skills. The things that I'm being taught now is going to protect my license. Example- if you get report that the pt can eat, you still need to check orders to verify that. Don't trust what you hear. If pt is NPO, that means NPO. If pt has PO meds, you need to call the doctor to see if they can have sips of water. If pt is intubated, it is your job to make sure they are on DVT prophylaxis. (Well, duh, right? But this other nurse I was with hadn't thought of that ALL shift.) If pt hasn't had that much output, you need to do something about it, not pass it onto the next nurse. (Again, I've witnessed this.) See where I'm going there?

[KimN]

I completely agree with the above poster. I used to be that first year student that complained about not doing catheters, etc. (although payback has been a you-know-what this term .. it's been catheters galore!) And although I do still think practicing skills is very important and helps with confidence, now that I am almost done I am more concerned about things like prioritization, full patient assessments, critical thinking on my own, and just complete patient care. I am more worried about making sure I am competent enough to provide safe and excellent care to my patients on my own. I really wish that we did have more opportunities in clinicals, but I think you will do great! :)