Clinicals, really not prep for real world?

SopranoKris, MSN, RN, NP · Jun 29, 2013

Speak up when you're on the floor and let the preceptor or charge nurse know you'd really like to get more hands on experience, so if there's an IV, etc., you'd like to do it.

BBB<3 · Jun 29, 2013

Are you in a BSN program? I find that typical for a BSN program but a lot of ADN programs you pass meds at every clinical after you check off on the skill. I was in second semester of an ADN program and had pregnancy complications so I withdrew three weeks before finals. Now I have transferred to a different program. Meds, shots, IV bags were every day things for us. Foleys, IV insertion, and other things were hard to come by depending what floor we were on but we still got to do them. I haven't started the new program yet but I so hope it's similar to my old program.

BBB<3 · Jun 29, 2013

I second the speaking up. If you have taken care of all the needs of your patient and don't have anything to do ask your instructor if its ok to tell the nurses that you are available if they need anything or have anything interesting to watch or even possibly help.

RubberDuckieLove · Jun 29, 2013

In our ASN program we do everything the nurse does. Our instructor is very hands on and gets us involved any way she can. I would bring this up with your clinical instructors and see if you can get more hands on experience

RNnewbie2014 · Jun 29, 2013

Well see the first semester of nursing school, they let everybody gives meds once because the instructor has to be with you.. Well I failed the class portion of this clinical.. And class and clinical go hand in hand together, so I also had to repeat the clinical portion too. Well, the next semester we were not aloud to give meds at all because the hospital was launching the new system. The semester I just completed I was on a cardiac floor with mostly post op CABG patients. Some of the people you have bounce back quickly from that, and some others do not. Unfortunately, I did not have any complicated patients really. Most of them had a few oral meds.. Not many IV meds.. In the middle of the semester though, this hospital launched a new system and we could not access information anymore. I mean I just really haven't got the opportunity to do many things.. Not even a blood draw.. I tried and IV once.. And missed.. I have trouble tying the tourniquet tight.. Scared I am going to tear those little old people's skin!!! Not to mention, the nurses at the hospital just were not very helpful at all... They acted like they really did not like us being there, and there's only one instructor.. And she has to be present for everything.. Which like I said, I did not have deathly ill patients during this semester... So hopefully, ill get a little more experience this upcoming semester.. I just know everything is much different for children and babies.. And yes, Jennyn90, I am in BSN program!!

phuretrotr · Jun 29, 2013

I would not be discouraged. Real world nursing is not all about skills. I use to think it was and it made me feel very anxious when thinking about future jobs and how I would have to preform these skills for the first time, by myself. However, now I am in my last year of nursing school and I see that skills are not what makes you ready for real world nursing. It is the critical thinking that does. Look at the nursing tests you are given; do any of the questions have to do with "how to _insert skill here_"? My tests don't... Does the NCLEX ask you those questions? I don't think so, and even if it did, you would probably only be asked one. What I am getting at is that skills preformed are only a small component a nurse has to possess. A real nurse is not wrapped around inserting foleys' and NG tubes, a real nurse is thinking about what actions they should take based on what they assess.

I am not saying you are or are going to be any less of a nurse than other RNs. I felt really discouraged too when I was not doing all the skills, but then I realized the above. A nurse may be able to follow a step by step foley insertion without even thinking twice about, because they have done it so many times, but does that mean that the nurse will be able to know what to do when they see their patients PTT lab is through the roof? Maybe, maybe not. But what is more important is that you are learning how to critically think.

Even if you don't preform anymore skills and you have to preform some for the first time working as an RN, I am sure you will do it that first time and just be as good as anyone else who has done that skill.

RNnewbie2014 · Jun 29, 2013

Sunflower, thanks for telling me that!! I understand what you mean.. I honestly feel like I am stronger at that part.. Noticing lab values and saying uh oh BUN, Creatinine high? Renal failure? I have reported pain scales and everything to the nurse over the patient before and they literally treat me like I have no clue as to what I am talking about.. That is another discouraging thing.. Nurses acting like I am supposed to either know everything or I am just a nuisance when I ask questions or report something that my teacher tells us that is very important to report!!

MommaTy · Jun 29, 2013

As a PCT I do foley caths insert/remove them, EKGs, blood sugar testing. I start my ADN program fall 2013. I work on a pedi unit in the hospital. I absolutely love it. I hope you get more of what you are looking for.

green34 · Jun 30, 2013

I am the opposite. I don't really remember how to give a bath for the life of me. I know the vague concept of it. I don't really remember how to make those hospital corners. I plan on practicing in my school's lab and I think they are going to groan about it. Most of my clinicals were done in the night time so I didn't deal with bed baths. In the ER, we don't make beds like they do upstairs.

However, you need to remember that overall not every skill will be used. My instructor doesn't know how to use the continous passive motion machine or whatever it is called but she was a nurse in a burn unit. Also, some nurses seem to specialize in certain skills. Foley insertion on females versus IV starts. I am horrible at catheters but I am good at IVs.

I think I've given insulin four times, a flu shot, like 15 other IM shots (I was sent to an ER for a day where they prescribed mostly IM injections), and 10 IV starts in 3 semesters (5 being in the ER).

The whole everyone has to be with the instructor is BS in my opinion. We are required by state law to have a registered nurse pass meds. I cannot pass meds by myself. Our clinical groups are 7 and the instructors pass meds with every single one of us. We can have a lot of meds. The exception is when we float and we pass meds with a registered nurse.

nurseprnRN, BSN, RN · Jun 30, 2013

Deep breath here. What you (and many other students) call "skills" are not skills, they're tasks. We teach those to lay people every day-- how to access their own IV ports, how to run their own peritoneal dialyses, how to suction their kids on home vents; your average junkies are better at phlebotomy than ER nurses ... does that make them nurses? No, it does not.

The reason students focus on those is mostly, in my opinion, because there is that checklist in learning lab you have to get completed. Sure, you probably did them in school. Don't believe the people who tell you they did all those "skills" on patients in school when we went to school with Florence. I promise you that no nursing unit on which you will work will expect you do be proficient at IVs or venipuncture, complex dressing changes, various tubes and wires, sinking Salem sumps, and a host of other stuff; they expect to teach you. And I promise you that one day of hanging IV antibiotic piggybacks will teach you pretty much all you need to know about spiking IV bags.

Believe me, a year after you have been at work you're not going to find any of this stuff that exciting in the least. :)

And I know you won't believe me when I say this, but these tasks are far and away not even the most important things to get out of your nursing education. What you need to learn, and I'll bet you have if you think about it, is how to think through a problem, how to say, "I don't know but I'll find out," how to look things up, how to ask questions like, "Why did you make that decision? How did you prioritize that?" and how to begin to empathize with the pickle your patients have found themselves in being in hospital rooms instead of their own homes so you can really listen to them. All new grads learn tasks eventually, but alas not all of then learn these, the most important things. Nobody expects you to be expert at them either, but they have a right to expect you to be a competent beginner at them, and I'll bet you are.

Look around you. Look around here, even :: peering through the screen back at me :: ::. Every single RN who graduated from any kind of basic nursing program has much more to learn than s/he can even imagine. Really. We all did. We all do. I've been out of my basic program for mumblemumble years and I learn new things every week still. If you have learned to keep learning, then you will be fine. Honest.

BBB<3 · Jun 30, 2013

^loved reading the previous comment!