Are new nurses adequately prepared?

Nurses General Nursing

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:confused: As a nurse, I see more and more new grads who have little clinical experience and who are overwhelmed, more than I was and that was a lot. Many have had no more than 1 or 2 patients during clinicals. Many have told me that their nursing programs included role playing, seminars, and such events as teaching kindergarteners how to wash their hands as manditory clinical days. Is this a trend? Shouldn't there be more practical experience and teaching of critical skills, especially since patients are more acute? Many of the new nurses have never suctioned or used any of the complicated equipment common on the clinical floor. Would appreciate feedback.

Also, I see experienced nurses who are less than helpful with new grads, taking the position that 'if I had to learn the hard way, so can you.' We all had to learn the hard way but we need to remember the acuity level of today's patients, the additional skills new grads must possess, and the increased stress levels. Have any of you observed any of the above?

Although we are only doing clinicals one day per week for now, we are able to participate in anything that walks through the door...just about. It's tough being a student, and wanting to perform skills, but the opportunities just don't arise! We have worked with vents, trachs, hanging blood, even got to watch a code.

Our instructor and hospital staff (well, some of them) are always eager to share their knowledge with us, and even ask us a few questions. We do more than just work on mannequins in a lab.

Originally posted by kelligrl

So I don't know if it's just my program, or just in Cali, or what, but I'm finishing up my ADN program (7 more da-ays, 7 more da-ays:D) and our last portion of clinical is a preceptorship with an RN in which I work her schedule (3 12's) for 3 1/2 weeks. I take her patient load (yep, all of it), she's just there to make sure I finish it all (procedures, meds, charting, review of orders, etc, etc)and that I don't get too overwhelmed. We're required to be able to handle sufficiently 75% of the RN load in order to pass. I feel it's giving me a way better idea of what to expect, and it's also kinda nice to have someone with experience to give you tips on time management, organization, etc. (Of course I may be biased because my preceptor is AWESOME!!) So do all programs get to do this, or should I feel lucky??

Sounds like our program! We work hard, and don't have much time to sit. In fact, we take over the patient and all the paperwork that goes along with them.:eek:

We are supervised just because ultimately, the responsability falls on the facility at the end of the day.

By the way, Kellie....CONGRATS!!!!!!!!!!!!!!!:balloons:

I will be done in MAY!:balloons:

Originally posted by UVaRN2Be

I know that I will make a darn good ICU nurse one day. Right now I need to prepare for that day.

UV...your great attitude alone tells me that one day you will be! :)

I am a grad of LPN for 2 years. I started a new job yesterday...and was "promised at least 10 days of orientation". I was at a LTC before...but everyplace you go is a bit different.. Well.. last night (first day of orientation) it was dropped on me that I may have to manage 50 pts by myself...and I am scared!!

I may start a thread on this...so pleeeeeeze visit and give me your opionions(sp):eek: :eek: :eek:

dddd dddddd I have survived 13 years of being a certifiable nursing assistant and I have seen/trained more new nurses that I care to think about! I am about to get paid for what I know when I graduate later this year:). Anyway, the nurses I see are book smart, can pass a paper test with no problem, but when they have to change thier first dressing or deal with someone going critical on them the newbies are at a loss without a clue in the world what to do for the most part( most forget the ABC's so fast it makes my head spin!!). I believe in more clinical experience and less book learning would do most newbies a world of good, being a CNA first should be a requirement and then we wouldn't have the newbies dropping out of nursing(after all the money on tuition and time in school) within 5 years of graduation. I spent 2 1/2 years on a step down unit and 1/2 med/surg and the experience I got there as a CNA can not even be touched by the clinical experiences I am supposed to be getting now. I worked with pts on nitro, lido drips, vents, head trauma, post-op.... anyone at high risk in other words. I had a group of nurses who were kind, paitent, and educators and what an education I got:)(even got paid for it!). That is how I learned to be a great nurse and how I teach others to be as good or better than I. To teach is to show love to one another.

I'm glad to be reading all the posts from students who ARE getting good clinical experiences...as it seems that so many new nurses today feel they did NOT get sufficient clinical experiences.

Kellie, Mish and UV...sounds like you're in awesome programs!

Good luck to you all..altho it sounds like you won't need it! ;)

I started in a bsn program and finished with an adn due to $$$. I got into practice, then a year later a girl i had gone to class with came to work at my hospital on my floor having just graduated. Boy could i see a difference. We both seemed to be able to dicuss reasoning and so forth, but i had a much more hands on experience than she did in school, and you could tell when it came time to perform proceedures. The skills lab has a place, but a small one. You learn the steps in the proceedure. But it is the first hands on experience that count. I had 2 8 hr clinical days per week throughout my education. By the end I had 8 pts at a time. I was not however, adequetly prepared to fill the charge role. The thinking at my school seemed to be that ADN's didnt fill that role, so we didnt cover anything about it. The reality in this day and age is more like, "You an RN? Good, your charge precepting starts Monday"

I don't start school until spring, but the school I am finishing my prereqs at (not the school I will attend for my training) is notorious for graduating students that are totally unprepared for working in any healthcare setting. The RNs are always griping about them and telling them that they need to go back to school. Not surprising to me after hearing some of the comments made from the 3rd semester students in my Micro class......

I just hope MY program isn't like that. Even if it is, though, I'm gonna do my darndest to learn everything I need to know. I'M not gonna be a slacker nurse.

:nurse:

Specializes in ICU, nutrition.

I agree that a lot of the clinical experiences I got in nursing school were jokes. We had to do vision & hearing screenings for the parish public schools for one of our peds days, for god's sake. And some of our community clinicals were a waste of time, IMO. But I think I came out of nursing school knowing how to take care of patients, and a pretty heavy load to boot, because of my second med-surg clinical instructor, who would not pass us unless we could handle a six patient assignment. The nursing school that I attended is changing the cirriculum to include hospital clinicals in the last semester and longer rotations in specialty areas. (I had community and psych during my last semester of nursing school, and I hadn't touched a patient except to do vital signs since April 2001, when I started my job in Jan. 2002.) I think it's an improvement.

However, back in the day when my mom went to nursing school, they came out much better prepared because student nurses were free labor for the hospital! They did clinicals every day and classes every afternoon, after being in the hospital for six or seven hours. You can't expect today's nurses to be as prepared to take care of patients when nursing programs have clinicals two days a week and (at least in my program) the minimum number of patients to be cared for at once by a student nurse is three by the end of the second med-surg clinical. I was fortunate that I had an instructor that wanted to make sure we REALLY knew how to take a realistic hospital assignment, but she was the exception, not the rule. The other clinical instructors got by with the minimum.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

no.......you don't get "prepared" til you get your on the job training.......i don't know of a single new grad who was fully prepared for it all.....including myself.

Specializes in LDRP; Education.
Originally posted by charissa

I started in a bsn program and finished with an adn due to $$$. I got into practice, then a year later a girl i had gone to class with came to work at my hospital on my floor having just graduated. Boy could i see a difference. We both seemed to be able to dicuss reasoning and so forth, but i had a much more hands on experience than she did in school, and you could tell when it came time to perform procedures.

If I am reading this correctly it appears that this girl came to work with you a year after you'd already been working on the floor. Is this even a fair comparison? Do you suppose her inability to perform skills as well as you could be due to the fact that you had been working already for a year?

Just asking...

I agree with smilingblueeyes

The only way you will ever be the most prepared is after you start to work. No amount of school can do that.

Also, there is always going to be a first time someone does something. You can't just be born knowing how to do things. I have encountered many helpful "older" nurses. I will have my BSN come this May, and my best preceptor was a diploma RN:)

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