Bad Clinical Experiences - Little to no hands-on

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Hey everyone, I posted this is the student forum for current students, but I'd also like current nurses to weigh on this too, since you've all been through nursing school and can share some insight. Here's a copy of what I posted in the other forum:

I am half way finished with my 1 year accelerated BSN program, and so far I like it for the most part. Our classes have been really interesting and in depth regarding disease processes, etc. and I'm doing quite well. One thing that is starting to worry me however is what I perceive as a big gap between the didactic and our clinical component. Clinicals, quite frankly, kind of suck. Mainly we just shadow nurses, very little hands on. The only hands on stuff I've done (after 4 months of clinicals now) is remove an IV catheter, take vitals, do an assessment, and give out a few medications. We can only give out medications if our clinical instructor is with us, and with 6-9 students per instructor, we are lucky to give out medications once per rotation. I've given one shot - a vaccine. We're not allowed to do anything with IV's at all - we won't have ever inserted an IV or practiced a blood draw when we graduate aside from a 20 minute lab dedicated to it (we stuck a dummy arm once). I just feel like when I graduate I will be totally incompetent and it's scaring me a little. Anyone have a similar situation?

The odd thing is, my program is supposedly very well regarded. We are ranked highly as far as nursing programs go, and hospitals in the area prefer our grads over any other school around. I don't understand what I'm missing here. Is it common for nurses to have little hands on practice before graduation??

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Specializes in Critical Care; Cardiac; Professional Development.

It sounds like you are right on par with most nursing students. Opportunities in clinicals can be few and far between. Make sure the nurse you are paired with for the day knows what you can and cannot do, what you are hoping to get to try and then be as helpful to her as you can. Part of not getting to try things is whether or not opportunity presents, the other part is whether you are ready and vocal about wanting to jump in and get to attempt things if there IS an opportunity. And part of this is just that you are only a first year student. Hopefully in the next part of your accelerated program you will be pushed to do more.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

for the programs now a days.......yes. that is why so many hospitals are not hiring new grads until they receive some sort of residency program (hopefully paid for by another hospital).

overhauling nursing education: does nursing education prepare nurses for the real world?

medscape: medscape access requires registration but it is free and is a great resource.

nurses are talking about: jobs for new grads

medscape: medscape access

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Your clinical doesn't sound unusual for an accelerated BSN program.I am an instructor in my hospital's 7 month Critical Care Nurse Residency program. We hire associated degree grads and BSN grads (associates degree only for the SICU, both for the ther units). We have come to expect having to send our BSN grads for extra hands on "clinical". We don't do this with the associates degree grads, though they do get some extra patho classes. We don't seperate them by degree, we test (written & skills) everyone and tailor their orientation based on how they preform. Most of the BSN grads end up needing to learn very basic skills, most importanly assessment skills. SOme of them seems to have no idea at all what they are supposed to be listening for when they use a stethascope. Even how to preform a head to toe assessment seems like something they have never learned.

Our local associates degree program gives students a lot of hands on clinical time. I don't know if it is the same for other programs.

With our training program they all even out after 4-6 months. It is more expensive for us to train the BSN grads.

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Specializes in Hospital Education Coordinator.

If you learn nothing but how to do a great physical assessment your clinical time will be of benefit. Compare your findings to what the licensed nurses saw/heard. Ask "why" frequently. Attach yourself to ANYONE caring for the patient (CNA, Respiratory, Educator, Case Mgr.). I have seniors follow Dietician one day to learn what they teach and how they develop formulas for people on vents, getting tube feeding and so on. Good luck!

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Specializes in Adult/Ped Emergency and Trauma.

I was a VERY AMBITIOUS student in clinical, I always "tried" to get to do something. I remember checking the IVs to see if they needed the 72 hour change. Then you had to wait on your instructor, and hope everything would fall into place. I almost got to put in that first IV on BEAUTIFUL veins, but guess what? I had passed the skill off in Lab, and ANOTHER STUDENT WHO NEEDED TO PRACTICE GOT TO DO IT FOR A PASS ON THE SKILL:madface:!

THEN CAME MY INTERNSHIP!!!!!(Some schools call it management, but the one during school last semester). If not for the internship I would have graduated without ever placing an IV, Inserting a Foley, Changing a Sterile Dressing, Preparing a patient for Surgery, Helping take care of a post surgical patient, Suctioning, trach care, and Ostomy care ON A REAL HUMAN BEING!!!!!

I HAD A WONDERFUL PRECEPTOR (also the nurse present at my own birth who delivered me before MD showed up! SMALL WORLD)!!!!!!!!!!! Back when General Hospitals did everything!!!!!!

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Specializes in OB (with a history of cardiac).

This is a problem I see with many LPN programs too- for our RN program we had a REAL hard time getting placed for our externship. Many didn't get to go to their first choice hospital- I was lucky enough to get placed where I wanted to be. But when I was going through for my LPN, we were restricted pretty much to LTC and TCU. I was in the lone group that got to go to a hospital for 2 rotations, but even as we did our rotations at the hospital, they had stopped hiring LPN's.

The biggest kick in the butt was that I wanted nothing but to work in a clinic. In peds. Out of 45 students, 10 got to go to a clinic for their peds rotation (one of the clinics being the one I ended up working at after graduation, and in turn precepting the subsequent students). Guess who didn't get to go to a clinic for her peds rotation? Guess who got to go to a day care? Guess who had just come from working in child care for 8 years?!?! Felt like I was back at work!!! OOOOOO I was so mad!!

But now, I don't even think they go to clinics, I think they are left to find a day care to observe at, or they write a paper for the peds clinical portion. I know they do for OB.

It's an ugly community, nursing has become. Like something out of a weird fantasy/sci-fi novel....hmmm...huhhhh, I've been inspired!

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I wouldnt say your situation is too uncommon, I just graduated and thought exactly like you after my first year. But you should get a lot more hands on opportunities your second year, especially your last semester. There was such a huge change during my last semester, beforehand no one wanted to let me do anything and then during the last semester every nurse was like "oh you're graduating? go ahead!" It was great :) Also, I would very HIGHLY recommend trying to do an externship which you should be eligible for now. I got a LOT of assessment and other experience during my externship at my VA hospital, it was a really great experience.

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My BSN program was very poor as far as clinical experience was concerned. All of us knew it at the time and most of us were worried about it. Like most of my peers, I got my initial "real thing" education on the job. The trick is to survive the first job(s) long enough to learn something!

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Specializes in ICU/PACU.

I didn't get hardly any hands on experience until my very last semester (BSN 4 yr program) during my preceptorship. My school has the highest nclex pass rate in the state, and it's a great university IMO. I chose a teaching hospital, trauma ICU for my preceptorship. I think I worked about 6 shifts? Anyway, it was great. I do remember being in school and being nervous about experience and I was under the assumption that the ADN programs had more clinical hands on opportunities.....but yea, now I'm glad I got my BSN. Don't worry about it, you will get it.

I think 3rd semester was good....I was handing out more meds and starting to feel a bit more comfortable, but funny thing is I remember being nervous to give a bath and still pretty slow. That last semester was a pretty big shift for me.

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