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!
It is frustrating. I've had 2 or three "professional development" classes that will help me only minimally on the floor (and I'm being diplomatic). That time and money would have been much better spent cementing skills. I'm disappointed in my accelerated program. And I hate feeling that coworkers will think it is my fault, due to laziness/dumbness/whatever, that I am not prepared. I still have a year to go, but it scares me silly to think I will not be competent to care for patients when I graduate and get my license.
At least they are good on making sure we have our math down...they are fully preparing me for that...thank god!
I'm going into 4th semester of an ADN program and have always complained about the lack of ability to use what I just learned in skills. I've never had the opportunity to start an IV but I have changed tubing, given meds, and drew blood (not needle stick though). I have also never had the chance to put in a foley, call a doc and take orders, or many of the other many nursing skills I will need to develop. I am told the same thing as another poster that there isn't always a pt that needs any of these done. I am busy during Clinicals, but I often feel like I'm learning next to nothing. I tell my instructor if something interesting pops up to let me know (when I have a good instructor), but at other times (not so good instructors) I try to fly under the radar. This certainly doesn't help me on a professional level. I get tired of hearing how my I'll get my fair share of IV starts when I'm in orientation. The poor place that gets me will have to stick me in day surgery for a month! I have tried to 'shadow' in day surgery, but because I'm not an employee and a rn, I can't touch the pt at all. Nurse extern positions are few and filled so in a few weeks, I'll be back practicing in the lab on that fake rubber arm with bulging veins that have been stuck by hundreds of students over the years.....ugh! At least I know I'm not alone.
I just want to be clear- I'm not faulting the students as to thier lack of skills. I just think as a profession we need to re-evaluate the way we teach clinical skills. The students deserve better than what is currently being offered.
Well you all have made me fell like I am either lucky or just assertive enough to have had the chance to practice most of my skills. In clinical I have done several dressing changes, started too many IV's to count, I've done blood draws, placed foley's (one on a pt. writhing in pain), I've done IV push meds, many many IM injections, I attempted placing an NG a couple of times but even the nurse I was working with couldn't get it in we wound up having to insert it as an OG tube.
I will have to admit though that I didn't get most of these opportunities on the med/surg floor (and I agree that opportunities there seem to be few and far between), I was able to get these things done in my ER and ICU rotations. I knew I needed to practice these things, and luckily I was always with a nurse that wouldn't let me watch them do it I had to do the skill if the opportunity presented itself. I also let the other nurses know that if they had a pt that needed any type of skill performed that I would be more than happy to do it for them. And guess what I found myself getting more opportunity than the other students in my clincal group, because I vocalized my desire to learn. I had nurses comming to find me to ask me if I wanted to do XYZ with their pt. Luckily I had a clinical insturctor during this rotation that did not make us wait for him to perform skills.
My best advice to you guys is to let the other nurses on the floor know what types of things you are able to do, and that you would love to practice your skills on their pt.'s as needed. Just remember that you do have to have an idea of what is going on with the pt before you just go in there doing things. Good luck to all of you! Remember you aren't quite done with school yet so you still do have the opportunity to practice before you get out in the workforce. Once you get a couple IV starts under your belt it makes you much more confident and it doesn't seem as intimidating.
I've done more foleys by kind nurses pulling me out of the monitor room at my job to allow me to give it a go than I did my entire first year of clinicals. Same with other skills.
I agree that amount of practice wasn't enough, but in my case I think it's because my CI was quite conservative in what we could and couldn't do compared to other CIs.
As for wanting to go to med/surg, you can perfect skills in ICU just as easily in M/S, and if you're lucky the patient will be sedated to take off some of the pressure.
Our biggest problem is that we have to have the instructor with us to perform most skills. The nurse is not enough. With ten of us sharing the same CI, that got difficult to get the time. Because we were spread out in four different units in our OB/Peds rotation, no skills got checked off, so all our check off had to be completed in the second half of the semester. The CI just ran from student to student trying to get them all done.
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Oz2
101 Posts
It is frustrating. I've had 2 or three "professional development" classes that will help me only minimally on the floor (and I'm being diplomatic). That time and money would have been much better spent cementing skills. I'm disappointed in my accelerated program. And I hate feeling that coworkers will think it is my fault, due to laziness/dumbness/whatever, that I am not prepared. I still have a year to go, but it scares me silly to think I will not be competent to care for patients when I graduate and get my license.
At least they are good on making sure we have our math down...they are fully preparing me for that...thank god!