How prepared did you feel?

Nibbles1 · Jun 28, 2014

I went to a recert class on IV's and PICC lines. My instructor was a graduate from Excelsior. She is a trauma nurse for Baylor in the Dallas region. She said that with her past experience being an EMT really helped her. She oriented with other nurses when she got out of nursing school. I was the same way when I got out of LPN school. I went to clinicals for 8 months and still didn't have a clue.

ScudderRN31 · Jun 28, 2014

Most places require so much acute experience before they ever let you step near critical care. Any type of clinicals are more basic care and my opinion may differ from others but I don't think clinicals teaches much. I learn by getting in there and doing it which they restrict a lot of the doing to students, it's basically assessments and med pass is all they allow you to do. If a patient requires a lot of care that you could learn from odds are the facility won't allow that patient to be taken by students. If you're not use to bedside care weekly clinicals could make you more comfortable but I don't know that it'll help with learning more or giving you experience facilities expect of acute/critical care nurses. Until you have patients that are severely sick or crash on you you won't get that experience and should you patient do that during your weekly clinicals the staff is going to push you out of the way and you may get to watch since they are ultimately responsible for that patient. Or at least that's what I would do in the acute setting I work in. From my understanding the preparation for CPNE is critical and if you don't know your stuff you won't pass it, it's a test not a learning session as weekly clinicals are. Make a simple mistake in weekly clinicals and they correct you, make a mistake at CPNE they fail you. Either should prepare you the same, it's whether you are able to learn on your own or if having an instructor is better for you

nolanurse88 · Jun 28, 2014

Thanks Nibbles1 for the response. I feel like depending on the type of experience one has, like your instructor had EMT, excelsior would be great way to get your RN but for someone like me who doesn't have experience in that field and also doesn't have a clue I might be better off having more clinical time. I wish excelsior offered more than just the weekend CPNE.

Nibbles1 · Jun 28, 2014

I agree with Ahiman. I didn't get the real experience until I was in charge of having to do CPR or whatever the case was. Some of my clinical days we were there to hold up the wall.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 29, 2014

No facility expects a new grad to feel prepared to work in acute care. That's why they want that one-year of PAID hours. Having x-amount of clinical hours has nothing to do with it. Being comfortable in clinicals and working in acute care are two totally different worlds. What I'm learning in my BSN program through research assignments is that some nursing organizations are 'talking' about addressing nursing school curricula because of the culture shock that new grads experience once employed in acute care. We hear so many times from very tearful new grads that state "they didn't tell us it was gonna be like this in nursing school":nailbiting: :cry: There are even threads on this site where some new grads left the profession altogether because of such a huge difference in your role as a student nurse versus being an actual nurse in acute care. If you are employed now, do NOT leave that job until AFTER you've secured a position as an RN.

I had 24 years as an LPN, with the last 10 years being primarily in acute care (I kept a nursing home job on the side for back-up). I also had an agency position that I used as PRN work at area hospitals. One I became an RN, that agency told me that since the hospitals were familiar with me and my skills, they could continue to send me to those facilities AS AN LPN, but I would need that one-year paid experience as an RN before those SAME hospitals would agree to acknowledge me as an RN on payday. :devil: I left and never looked back (mind you, I still kept my same hospital job that I had during my Excelsior College education), even though I later understood the rationale behind this. Once I became a licensed RN, I received a $10/hr raise the day my license number showed up!

If you are fortunate enough to secure an RN position as a new grad in acute care, they will train you to function in the role. That is your opportunity to gain all that you need to feel comfortable by not only doing what is asked of you, but also volunteering to do certain tasks that come up with other patients on the floor, with the guidance of your preceptor. That's how your comfort level is going to improve.

Believe it or not, TO THIS VERY DAY, each of my employers have failed to orient me to the role of RN because (1), my very first hospital job knew of my skills as an LPN when they made me a new badge, so it was business as usual with the "oh, you will be fine" syndrome, and (2), by the time I had that one-year of paid RN experience under my belt and made the decision to leave in search of someone who would realize I was a new RN and should be treated as such, my experiences as a veteran LPN of TWENTY-FOUR YEARS was taking the spotlight once again. :banghead: So, as comfortable and experienced as I was in the acute care setting, as I advised you, I had to volunteer to do other tasks IN-BETWEEN taking care of my patients when I heard that there was something new (to me) happening on the floor that, as an LPN, prevented me from learning.

Nursing programs teach its students theory. Pre-licensure nursing programs teach theory and introduce the students to just a very small fraction of the skills they will need to gain in order to work competently and independently in acute care. The BULK, the REST, is on-the-job training as a bolus dose first and then the maintenance/titrated doses throughout the remainder of your nursing career. Facilities know this and they all, or most of them, want someone else to invest in training you to be an RN now that the nursing programs have educated :bookworm:you on becoming one. This you will encounter no matter which college or university grants you an ASN.

This is is not to dissuade or persuade you to do Excelsior's program. This is just to tell you what 'is'. I hope it helps to clarify.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 29, 2014

Just thought I'd mention that the CPNE is not a training session for a weekend. It is an EXAM in NURSING to test you on whether or not your PERFORMANCE in a CLINICAL setting is following their study guide (which offers directions, instructions, and other resources to help you pass) in a manner that earns you the right to receive a degree from them so that you can sit for the NCLEX.:) The nurse with you is there to give you your assignment and to evaluate your ability to follow the instructions that you have already been preparing for using the study guide, ensuring that you don't harm the patient. S/he is not there to instruct or teach. To be enrolled in EC means that you already possess a background in a qualifying healthcare field and that you understand that you will be EARNING a degree that allows you to be able to expand your competencies in field of nursing....if and ONLY if you pass the NCLEX.

nolanurse88 · Jun 29, 2014

Just thought I'd mention that the CPNE is not a training session for a weekend. It is an EXAM in NURSING to test you on whether or not your PERFORMANCE in a CLINICAL setting is following their study guide (which offers directions, instructions, and other resources to help you pass) in a manner that earns you the right to receive a degree from them so that you can sit for the NCLEX.:) The nurse with you is there to give you your assignment and to evaluate your ability to follow the instructions that you have already been preparing for using the study guide, ensuring that you don't harm the patient. S/he is not there to instruct or teach. To be enrolled in EC means that you already possess a background in a qualifying healthcare field and that you understand that you will be EARNING a degree that allows you to be able to expand your competencies in field of nursing....if and ONLY if you pass the NCLEX.

Thank you for taking the time for that thorough response to my post. I work on a skilled unit in the hospital currently so once licensed as an RN I plan to just transfer to a different unit like med surg or tele get some experience then apply for ICU or ER. Once we are employed there it's pretty easy to transfer. I guess my concern is everything that I don't know that I should know if I had went to RN school would of made it so much easier. I had one person look at me crazy when I asked what a BIOZ was and she replied with shouldn't you have learned this in school... I felt really stupid many times bc it was stuff I should have known had I been taught this in school. Even if I'm not able to do any skills I feel like just having that opportunity to see how other nurses do things on other units it would make me much more prepared. I would feel very lost and incompetent right now if I was to work on one of those units. Excelsior to me is for nurses who have the experience and the confidence in themselves to move on to being an RN. I have neither.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 29, 2014

So, exactly what IS a BIOZ?

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 29, 2014

FYI: if a nurse is your preceptor, it shouldn't be her concern as to what you did or did not learn in nursing school. She should be training you on what you need to know in order to be sufficient at your facility. Nursing school cannot possibly teach ANYONE every little detail there is in nursing. Sounds to me as if she was either having a bad day or grand-standing by making you feel just as you said you did after her comment.

nolanurse88 · Jun 30, 2014

Any time the doctor orders these on our unit is to check the patients thoracic fluid content but they can check many other things almost like an ECG, but I had no idea the first time I seen it ordered. It taught me that I will never be that rude if asked a question about something they didn't know.

Nalon1 RN/EMT-P, BSN, RN · Jun 30, 2014

Even after you explained it, I still don't know what BIOZ is.

I guess I have just been lucky, every question I have ever asked has been answered without any judgment.

Heck, just today I was talking with a nurse I was working with and asked him to explain Rhabdomyolysis to me. Should I know know what it is, sure, but not something i deal with on a regular basis (only 2nd patient in 9 months with it).