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?

For the CNA's who are working part time at the hospital and going to nursing school full time, yall are special. Imagine you worked all summer as a new med-surg cna at the best hospital on earth, on the best floor on earth.. All the super power nurses at work know you are going to be a nurse, and help you with questions you might have. They have seen you from day zero of your health care career, and they see you now, bending your brain to learn to be the best nurse on earth.

I am such a lucky person to have gotten a super great job as a cna on a med-surg floor and have worked there several months before full time RN school started in Sept02. It's takes so much of my mental power to consider the great foundation my school is laying for me with theory, lab and other clinicals, and to relate it to the super magical nurses I have observed on the floor where I work. Processing all relationships of all this is powerful stuff. Like, I have seen all bits and pieces of what a nurse does and now i am getting the foundation and seeing it fit together, and it's alot!

For example, watching a nurse handle syringes is one thing. Learning and testing on parenteral meds and injection sites and dose computations is another. Honestly, sometimes I am just quiet and still and not thinking about anything during the day, but i know my brain is totally turned on. It's really something.

I love and admire all you nurses, and especially allnurses.com, because yall or part of my HOLY TRINITY: RN school, med-surg cna, and all nurses.com complete my holy trinity of life at this particular time. AMen!

I am finishing up an ADN program, graduate in May.

Right now we're each taking a team of patients on a telemetry unit... that's 5 or 6, depending on acuity.

Next semester we also have a preceptorship where we take on an RN's patient load and work our preceptor's hours (usually for a total of 6 12 hour shifts).

I think you also get out of clinical what you put into it. All the nurses on the floor know that I'm eager for whatever experience I can get and they'll come get me if they have an interesting procedure or something for me to try. Its cool.

Can't wait to graduate... hopefully I won't be too much of a pain in the orifice with my overwhelmed new grad self.

:D

Well I for one have to say ON THE JOB experience is superior to schooling experience, however I will NOT knock those "dummie" demonstrations. I was in an RN refresher course, and the only skills lab I took was on trach care, not having done ANY of that in Home Health, WELL wouldn't you know one of my FIRST patients had a TRACH!!! So that REALLY WAS a good skill to take.

But when I went to nursing school the first time in the 60's, we learned skills then practiced them IF we were lucky. The majority of my actual "hands on" came on the job.

New nurses should NOT be afraid to TELL IT LIKE IT IS...." I am NOT familiar enough to do that would you help me?" You will gain FAR MORE respect from long term nurses with that confession, than if you try to do something you really are not comfortable with, mess it up, then another nurse has to FIX the problem...

I am new back on the floor after 12 years in Home Health, and BELIEVE me it is SCARRY!!! But my fellow nurses are SO HELPFUL and supportive.... never underestimate them!!! And if they come across difficult look at the whole picture, they are probably STRESSED out!

That tis all I have to say for now!!!

:) ;)

As a CWOCN (certified wound, ostomy, continence nurse) I now specialize primarily in wound care but remember in nursing school I did one dressing change!!! Very sterile procedure with mask gloves...the works... Found I wanted to get into the field so took as many classes as I could to learn the ropes before precepting with someone in the same speciality.... and taking a two month course... If you have an area you are not feeeling comfortable with see if any instruction is offered.

Cory :nurse:

That is so true, Cory, I really don't remember doing ANY wound care as an SVN, OR as an SRN. Course did my SHARE of wound care OUTSIDE of school.... I KNEW technique.... it was DRILLED into me my my first nursing instructor, Mrs. Piel at the county program in Oroville back in the 60's.

When I think how MUCH wound care has changed.... Alot of the older time nurses here will remember the good old HEAT LAMPS!!!! MERCY! Hey it worked, though knowing what I know NOW, I don't know how!!! :o) Those were the days!!!!

At our hospital, my problem is I KNOW what the wound needs, but still have to call the WOUND CARE NURSE!!! That is hard after 12 years of doing wound care!!! But that is ok, I am happy!!!

Kathy

I've said it before and I'll say it again: you don't learn nursing until you get out on the floor and DO IT!! And keep doing it until you've got it etched into your brain.:eek:

It doesn't matter how many degrees a person has, or how many letters after their name. If you don't know how to do trach care, a MSN won't give you a clue.:o

I regret not being able to attend a diploma program. They are practically non-existant, even around Chicago. I know nurses who had that opportunity and they had days of clinical, not just 4 hours twice a week in their final year. When they started their job, they knew how to run a unit because they'd done it while in training.:) What a concept!!:chuckle

I guess I am lucky. I come from an old school 3 year diploma nursing program that focuses mostly on clinical.(people can say what they will about diploma programs but we take thesame boards as everyone else) I have given tons of injections, inserted foleys, NG tubes, suctioned trachs, did major wound care etc. A new grad I work with came from a program where she never got the opportunity to do any of those things. My instructors always make sure to assign us pts who have a lot going on, as often as possible and as students we seek out challenging patients. It also helps to work in a hospital setting so you can realize the difference between clinical and the real world. I am graduating in June and I am still overwhelmed so please don't be mean to me. And Matt's mom, sadly, a lot of seasoned nurses can be quite nasty to newcomers without just cause. I am a person with a thirst for knowledge but find a great reluctance on the part of nurses who want to teach me.I can't learn EVERYTHING from school. It's really not that much of an exaggeration, unfortunately. I wish it was.

Specializes in Telemetry, Case Management.

I have been an LPN for eighteen years. We were taught NG care, how to do iv's, read monitor strips, trained to be charge, all that in clinical. I have to say we had a very gung-ho instructor, which I didn't care for at the time, but she did us good in the end! I have seen brand new RN's come to me who didn't know what sort of things to use in a dressing change, who didn't know alot of clinical skills. I don't mind to show them when I have time, but on the other hand, what the heck are the schools teaching them besides theory. Theory is fine for lessons, but nursing is hands on unless you are going straight to research or teaching. Helloooooo!!!!!

I am an LPN, ADN student, and I have met LPN's that are "supernurses". I was even told by my clinical instructor that LPN's shouldn't even start IV's, because they don't understand all that comes along with them. I was PI*$ED.

I have respect for all those nurses who work hard, regardless of their title.

nothing can prepare you for nursing in the real world.i will say that i was given the basics and thought how to think as a nurse. this i build on. i have had wonderful preceptors, professors, nurses etc. everyday i learn something new

As a former nurse educator in the hospital setting, I know that the new grads coming our way were not really prepared for what they were facing. . . either in theory OR in clinical skills. We could teach equipment, procedures, and special skills in orientation and the work setting, but the critical thinking component and the attitude that learning must be on-going are essential to workplace success. Sadly, there were still a percentage of newly hired RN's who chose to "blow off" orientation information, and even the opportunities we provided for hands-on practice with mentors and patients. I've had nurses make cell phone calls in the middle of explanations about code procedures! Most new grads, though, are willing and actively seek out learning opportunities. The old-fashioned skill labs in nursing school would be better if they weren't so sadly out of date with their equipment and even their procedures.

This coming quarter we have clinicals three days a week. I think the important thing for students to remember is when you get the opportunity to do something, DO IT! Students need to be active learners and try to get all the experience they can, even if they are afraid. Practicing something in clinical is sooo different than practicing in the lab, where you could throw the Foleys in the plastic models from across the room! I agree that most of what you learn is on the job, but clinicals can be a valuable experience too, if you try to get everything out of them that you can.

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