Anyone else feel like they haven't praticed enough skills?

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Specializes in General adult inpatient psychiatry.

Okay guys, this may sound like a silly question but here goes anyway. I'm learning why people recommend doing a year of med/surg after graduation: time management, perfecting skills, etc. I'm a nursing student tech in an outpatient surgical unit and while I know exactly how to comfort kids when they come out of the OR in full on delirium, I'm not exactly practicing the skills that I learned back in skills class almost a year ago. The only skill I've done in clinicals aside from bed baths and making beds is inserting a foley (which I did once in OB this past semester). Somehow I haven't had to do any dressing changes or anything! My school has told me that we may not get to do alot of skills in clinicals and that we should expect alot of on the job training. I know people who have done skills in clinicals but the opportunity hasn't really arisen. I know working as a student tech or CNA on a unit will get me the experience I need but here's a question for you guys. Seeing as I've been checked off on the skills, there are two major issues. One is that I haven't practiced the skills and am no longer proficient and the second one is that because I've been checked off, I'm theoretically expected to be able to perform the aforementioned skills. I'm afraid that even if I get a job now on a med/surg unit I'll be judged for not being so proficient and I'm afraid that perhaps I never really learned them in the first place. I know I want to work in Pediatrics (general med/surg) when I graduate in a year. I'd like to try to work as a med/surg tech now so I can have a bit of a handle on time management as a new grad and go straight into Peds.

Do they expect us to come out of school and have to re-learn skills during RN orientation or are they expecting full retention whether or not we've actually been required to use those skills in clinicals? I have learned how to calm down even the most difficult kids and I can do decent patient education, but I even have trouble feeling competent with opening and donning sterile gloves. I guess interpersonal skills are good but I wonder what's the point in learning the skills if I haven't been able to apply them yet!

One last thing...am I a bad nursing student if I'm not the biggest fan of med/surg? It's not that I don't like adults, I just love kids!

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First, you are not a "bad nursing student", how far in your program are you? I have yet to meet anyone who loves general med-surg, but some want to do it for the diverse experience.

I am with you I love kids. Try to get the most out of your experience at clinical, help all the nurses. Let them know you are looking for things to do and they will come find you. Sometimes your clinical experience is what you make it.

If you can work as a tech do it. I did not, but I learned so much during the internship I did over the summer it was amazing.

You are not expected to know everything when you graduate, there is a huge learning curve. The more you know the more confident you will be, so really try to get that experience.

Can you go into open lab and practice skills like sterile field???

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Specializes in geriatrics,emergency,hospice.

LOL, this is exactly what I am feeling. i graduate in december and havent done one single IV start, Foley, or blood draw...Everyone says this is normal, but I dont know. It's frustrating, thats for sure!

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Specializes in Ortho, Neuro, Detox, Tele.

I did exactly 2 IV sticks, 1 Foley, and barely any skills in clinicals....then I got to the floor...and I spent a day doing IV sticks in surgery center, and I've done a str. cath on someone already, and I'm getting better at this whole assessment thing...LOL. You'd think I was back in school with all these skills I've been doing.....my point is that it takes time, and before you know it, you'll have 3-4 things going on and they'll just become "old hat"....

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There is never enough skill practice in clinicals. You cannot make a patient need a Foley, IV, or dressing change. Things just happen when they happen. I always found that things were just done on the last shift or weren't needed when I was in clinical. Everyone says nursing is more of an on the job learned profession. But definitely when you are in the clinical setting, speak up and let the nurses you are working with know that you are looking do do procedures. Sometimes just being in the right place at the right time will give you an opportunity. If you have the chance to pick your patient, look for those that may require frequent procedures. During my med surg rotation I lucked out and chose a patient with a spinal cord injury that required an I&O cath q 6 hr. So for my two days that week, I was able to perform the procedure 4 times. During my OB rotation, I made sure to speak up to my nurse that I wanted to place the Foley on my C-section patient. I've done a few dressing changes, but am not the least bit confident or proficient. And now during my preceptorship, I look out for every opportunity to help out with other patients who need things like replacement IVs or other things. Your learning experience is what you make of it. Good luck.:D

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Specializes in General adult inpatient psychiatry.

As far as going to open lab, we only had that during semester one. I'm entering semester three of four and I will graduate with a BS in nursing. Skills are learned first semester and then that's it. At least I'm not alone! Thanks guys!

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Specializes in General adult inpatient psychiatry.
There is never enough skill practice in clinicals. You cannot make a patient need a Foley, IV, or dressing change. Things just happen when they happen. I always found that things were just done on the last shift or weren't needed when I was in clinical. Everyone says nursing is more of an on the job learned profession. But definitely when you are in the clinical setting, speak up and let the nurses you are working with know that you are looking do do procedures. Sometimes just being in the right place at the right time will give you an opportunity. If you have the chance to pick your patient, look for those that may require frequent procedures. During my med surg rotation I lucked out and chose a patient with a spinal cord injury that required an I&O cath q 6 hr. So for my two days that week, I was able to perform the procedure 4 times. During my OB rotation, I made sure to speak up to my nurse that I wanted to place the Foley on my C-section patient. I've done a few dressing changes, but am not the least bit confident or proficient. And now during my preceptorship, I look out for every opportunity to help out with other patients who need things like replacement IVs or other things. Your learning experience is what you make of it. Good luck.:D

Ahh yes, I keep forgetting that between this semester I'm approaching and my final semester I have a preceptorship. I'm really excited about getting that in. I know at work I keep begging to start IVs and I'm getting really good at taking them out, although that's not a skill they taught us in school.

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Specializes in rehab, long-term care, ortho.

I agree, you are definitely not alone with feeling you don't have the skills down. I'm thinking that hospitals are rather expecting it after what I've read hear, at least I'm hoping that's the case.

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As far as going to open lab, we only had that during semester one. I'm entering semester three of four and I will graduate with a BS in nursing. Skills are learned first semester and then that's it. At least I'm not alone! Thanks guys!

Then we are in the same place in our programs!! Congrats on making it this far, I am actually graduating in Decemeber with BSN, just finished preceptorship/internship in the NICU, it was great...you will learn so much!!!

Hang in there!! The program I am in is probably smaller, only 24 a semester and we can access the labs anytime, we are always learning and practicing skills!

I would love to hear from you after your preceptorship to hear about all the new skills you learned and practiced!:yeah:

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Specializes in Post Anesthesia.

Both our clinical staff and our staff development department have had the same complaint. What are they teaching in nursing schools now-a-days. Most of the new grads we hire have almost NO I.V. skills- despite that being a big part of the RNs job duties. They are fuzzy on meds, they may have never given an IM injection. They most certainly have never called a doctor or taken an order. Asking them to interpret telemetry strips is like having they predict the future by reading tea leaves.

What are they doing for 4-5years in school? Discussing the relative merits of different theorists? Compairing relationship based care model with evidenced based practice? Exploring cultural differences as they impact the practice of Nursing?

I know a lot of instructors read this forum- please take note of the number of posts looking for ways to better prepare new nurses as they begin thier career. With the acuity of patients in todays in-patient setting the RN has got to be able to hit the ground running right out of school. Nursing programs are getting more and more restrictive with who gets in. If you are going to demand that only the best get in then you owe the students an education that enables them to practice at least basic nursing without remedial education by the orientation staff. We need to set aside the argument over BSN vs ADN vs Diploma and decide on what constitutes basic nursing skills and how to teach them.

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Specializes in General adult inpatient psychiatry.
Both our clinical staff and our staff development department have had the same complaint. What are they teaching in nursing schools now-a-days. Most of the new grads we hire have almost NO I.V. skills- despite that being a big part of the RNs job duties. They are fuzzy on meds, they may have never given an IM injection. They most certainly have never called a doctor or taken an order. Asking them to interpret telemetry strips is like having they predict the future by reading tea leaves.

What are they doing for 4-5years in school? Discussing the relative merits of different theorists? Compairing relationship based care model with evidenced based practice? Exploring cultural differences as they impact the practice of Nursing?

I know a lot of instructors read this forum- please take note of the number of posts looking for ways to better prepare new nurses as they begin thier career. With the acuity of patients in todays in-patient setting the RN has got to be able to hit the ground running right out of school. Nursing programs are getting more and more restrictive with who gets in. If you are going to demand that only the best get in then you owe the students an education that enables them to practice at least basic nursing without remedial education by the orientation staff. We need to set aside the argument over BSN vs ADN vs Diploma and decide on what constitutes basic nursing skills and how to teach them.

Heh, I'll tell you what I'm supposed to be doing in the second half (the nursing part) of my BS program...only 1 semester of med surg and the rest is specialty training that I may not ever use! I know it's good experience to know about Peds, OB, and Psych, as well as community health, but I feel it would be much better to have more Med/Surg experience and skills training. I definitely think we should do more skills practice/application!

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Last semester in clinicals, we had difficulty in finding the skills we had to do to pass to the next level. I have gotten more exposure to these skills as a PCS in the local hospital. The nurses are not suppose to let us help with the procedures, but since they have all been there and expect to get us when we get out of school, they do it anyways.

To suanna: Yes we are taught mostly theory, pathophisiology and steps required for the care of given medical conditions. 2 hours go to lab to show us the basic skills and then check us off. If we get exposure during clinicals we are lucky. Because we are at the hospital first thing in the morning, most of our time is dedicated to ADLs. By the time you assess, bathe, feed, give meds and write a care plan for 2/3 patients, our time is up. It does not help that we have to have the instructor with us to preform the skills and they are very difficult to find and there is always one student that monopolizes their time to the detriment of the others.

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