Eek, lost some nursing skills!

[LAM2010, BSN]

I graduated in Dec. '09 and in my clinicals in nursing school (4-year BSN program), I started some IVs and lots of priming, hook-ups, etc. Now that I am a circulator, I haven't started any IVs, haven't hooked up any tubing - I spiked and primed a few here and there, but never started the drips.

So the other day, I happened to be interviewing a patient in the holding area, helping out the staff, and the anesthesiologist looks at me and gives me a verbal order for a bag of Vanc. I thought, "yikes!" - #1 - It's been a year since I started IV bags and #2 - I have only ever started them on pumps -- in our holding area and in OR, there are no IV pumps! So I felt like a giant dummy - never thought about maybe learning how to start IVs like this! (I got someone to help me and eventually the anesthesiologist ended up finishing it himself...*sigh*).

Then, I was helping one of the ORAs pick up a patient in their room on the floor (which I haven't done a lot), and the ORA asked the floor nurse if the patient had a hep lock. The nurse said no, so the ORA said, "That's OK, she [pointing to me] is an RN, she can do it." Yikes again - I've never hep-locked. I'm sure it's easy, but I've never done it and don't know what tubing I need. The patient's nurse couldn't do it either - she didn't have the tubing - so we ended up having the CRNA do it when we got to the holding area.

Anyway....I miss floor nursing and using those skills! They told me when they hired me that the OR nurses usually do a rotation on the floor for a week or so, but they skipped it for me. Now I see where I could have used it... But in the 3 months I've been here, last week was the first time this came up.

While I know I lost some skills, I am gaining a whole set of different ones :). But still holding onto old ones - today I drew up a patient's pre-op Heparin injection, and I asked another RN to check it (as we learned in nursing school) - she looked at me like I was crazy. I told her why I did it though, and she just shrugged and said "OK".

I am still glad to be an OR nurse and not a floor nurse, though.

[llg, PhD, RN]

So now I hope you can really see the problem that nurses have who "climb the career ladder" and become managers, teachers, etc. There is simply no way we can keep all of the bedside skills we used to have and still have time to do our full time leadership jobs. But that doesn't make us bad nurses. We have simply developed new skills that we focus on while retaining the memory -- but not the technical proficiency -- of the old skills we used to know so well.

[BillyMae]

You really are still a new grad. Nursing is on the job training in the area of choice, I think you expect too much from yourself. There is soooo much that you will learn over time, don't ever be embarrassed to ask for help, or ask a question. Good luck :)

[BridgetJones]

I wish people would stop making such a big deal about "losing your skills" working in the OR. You need a different skill set working in the OR, but you are still thinking critically and advocating for the patient, which is what nursing in all about. Ironically enough, I'm better at both IVs and foleys now than when I worked on the floor, but I am most proud of the fact that I've learned to manage a case myself, prioritize tasks, and advocate for patient safety throughout the process.

That being said, LAM, ask your educator if you can spend a day or two in the holding area...it would be helpful if you felt comfortable setting up IVs. Good luck and enjoy the OR...it's a great place! :)

[LAM2010, BSN]

Thanks! :) I guess it is a new-grad type of thing to hate to lose the skills. But I do realize the OR has a whole

different set of skills, I manage cases, prioritize, etc.

[jessrene, LPN]

There is a lot to learn and orient to as a new grad, new place new people, new sub set of nursing skills...Stay in the moment and prioritize. All you can do is what you can do.