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Frustrated with clinical experience

Updated | Posted

Specializes in cardiac.

Howdy all,

I'm in my last semester of nursing school and I still fee like I have no clinical skills. In 4 semesters I have only inserted 1 foley and given meds through PEG tubes. I have still never even given insulin! I feel really inadequate when it comes to hands on clinical skills.:down:

In my clinical group there are 8 of us and we have 10 weeks of clinical. Our instructor is only passing meds with one of us each week. The rest of the time we just follow our nurse around while she sees all her patients. I'm really frustrated because that means out of 10 weeks I'm going spending 1 week doing hands on the rest is just shadowing my nurse. :down:

After those 10 weeks we do 40 hour preceptorship where we ARE the nurse and the RN is letting us do EVERYTHING. I feel this is a huge jump and I'm not really prepared for this!

How were things in your programs? I'm wondering if there is another solution to this or if this is how things are done everywhere.

Psilant

Specializes in Onc/Med-Surg, ER, Nursing Supervisor. Has 7 years experience.

Wow. I'm so sorry for you frustration. I have to say that this is not the case everywhere. I've seen where some people have said they needed to be proactive with their instructors. I'm in my last semester as well, but I have had wonderful clinical experiences. I'm still terrified to lose my safety nets, but I feel they have prepared me well.

Wow, I don't know what to say. In my program we have been doing the skills from the first semester. I am also in my last semester, and every clinical instructor that I have had has made us responsible for total patient care. This means we did everything for that patient (meds,foleys IV). The instructor I have now told us last week that we were to do everything except hang blood with the patients primary nurse. Meaning she did not have to be in the room with us. So basically we have started our preceptorship.

The best advice: Watch that nurse and if she is agreeable, try to ask any and all questions you can think of. I had some very good "teaching nurses" and I learned amazing amounts from them. I did have one professor that pulled meds with us then said, "go do it"! That was scary! Try to be where things are happening. For example, if you hear of a complicated dressing change, ask to observe. When you see a nurse with meds, equipment ask if you can watch. And then really watch! Good luck!

HyperSaurus, RN, BSN

Specializes in NICU. Has 8 years experience.

I'm really surprised that you're in your last semester and are still spending 10 weeks just shadowing. Is that unique to your clinical instructor, or is it part of curriculum policy?

We are starting our second semester and we are expected to do total care on a patient: bathing, toileting, changing, feeding, vitals, assessments, med passes, iv maintenance, and any treatments we have been signed off on. In addition, when given opportunities to perform new skills (Pt in 602 is about to get a foley, want to help? or Pt in 516 needs to have her picc removed, would you like to?), we are encouraged to take them.

It may not just be the program either. It might be a policy of the hospital, if it's not a "teaching friendly" hospital where they don't want the students to do too much with their patients. Have you seen any other students while you're there? Know of any friends in other programs that use the same hospitals?

9livesRN, BSN, RN

Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine. Has 2 years experience.

HyperSaurus, SN said:
I'm really surprised that you're in your last semester and are still spending 10 weeks just shadowing. Is that unique to your clinical instructor, or is it part of curriculum policy?

We are starting our second semester and we are expected to do total care on a patient: bathing, toileting, changing, feeding, vitals, assessments, med passes, iv maintenance, and any treatments we have been signed off on. In addition, when given opportunities to perform new skills (Pt in 602 is about to get a foley, want to help? or Pt in 516 needs to have her picc removed, would you like to?), we are encouraged to take them.

Same here... On the fundamental semester, we only did the ADL, beds and assessments, but as they time went on, we got to do more,

On medsurge we worked on a PCU floor, started meds, injections, iv maintenance , piggybacks, foley, pegs, insert NASO gastric tubes... Collecting stool, pee..

Then on advance we started on a multi system PCU and did trach care, and they expected us to be on time with everything, we started going from 1 to 2, maybe 3 pts...

Now on leadership, we get to do iv starts, admission processes, discharges, delegate (there is 4 of us (thank god only 4! My school rocks on spreading people out) so 3 will get patients, and one will be the AP doing tasks, vitals, I and o's, and the person who is the tech (AP) gets to draw everyone's meds (with the instructor) and bag them, label them, and then when the working bees are busy, the tech then goes learn some procedure, dressing changes, start iv, change fluids around people who need them done, foleys, just practicing skills!)

I really love the way we do it, and my teacher give us as much as we can handle, because she said, the more we do, the more we will get used to, and she wants us to have a good impression because we have 96 hours in practicum comes mid February and she wants us to get a job (maybe?)

And when we have nothing to do, she will make sure that we asked every single nurse or tech in the floor if there is anything we can do to help them!

So we always end up, doing extra iv starts, sacral wound changes, admissions for busy nurses, you name it!

I really like it this way, because it gives us the taste of the real thing!

She is really cool, as long as you know what you are doing, and have done your home work on your patients, now... When necessary, she will step in!