Clinical Challenges- Assessments vs Skills (finding the balance)

[Samantha.G]

I am in my last clinical (acute care) before I continue on to my preceptorship, and I am finding it to be challenging.

The instructor that I am with wants us to concentrate on one patient and do as much research on them and perform the appropriate assessments (which is totally fair). The challenge is that I end up researching for the whole time I am at clinical (lab work, pathophysiology, medication) and do not have the opportunity to perform skills (unless it applies to the patient we are assigned too). This means that I have not had a lot of opportunity to work on skills.

My instructor announced that she doesn't want us concentrating on our skills as much as our assessments. While I can see her point of view (assessments are very important!), in a few short months I will be completing this program (hopefully) and needing to be able to also perform regular skills in the workplace (ex. d/c IV, inserting catheters, specimen collection, wound care).

I am just trying to find the balance. :S

Has anyone had an experience like this before?

Thank-you in advance

[Fiona59]

Do you know who your patient will be in advance?

We usually found out who our patient was the night before and had to complete the research before arriving on the unit for our shift. Then we focussed on the care needs of the patients. As a student, I accompanied my patient to the OR (and was permitted to watch the procedure) and then observe the recovery room process. I went with them to scheduled MRI's to observe the process.

Offer to do the research the night before and see what your instructor says

[Soupysoup]

I'm a fairly new grad - and looking back, in nursing school, skills seemed so important. It's hard to put it in perspective but skills don't really matter. Take that with a grain of salt, but let me explain. Anyone can do a skill, putting in an IV, cath, wound care - there's not much thought that needs to go into it. It's just following a series of steps. What is really really important - is knowing about medications, patho, how to do a solid focused assessment, know what to do if your patient is having chest pains, etc.

You'll have forever to learn skills, and you WILL have them mastered in a few months/tries. All that critical thinking and knowledge about disease process - you're not going to have time to look that stuff up while you're on the floor, so you might as well do it now.

It's frustrating because when you talk to the other students you can't say "I learned about the treatment plan for patients who have bacterial meningitis!" then your buddy says "I inserted a cath today, and then put in an IV". It doesn't sound as cool - but it's more substantial IMO.

Trust me in a few months no one is going to impressed with how many wounds you cleaned- they will be impressed when you notice a trend in labs.