Frustrated....

2ndyearstudent, CNA · Feb 2, 2011

By the time your ICU clinical is finished, you will feel very different.

dudette10, MSN, RN · Feb 2, 2011

I have just begun my last semester in nursing school (graduate May 14th) and had my very first clinical in the ICU on Monday. I enjoyed it and all, but it made me realize how UNPREPARED I am to become a nurse in a few short months. I get good grades and I guess you could say I am "book smart", I just feel that my school has NOT properly prepared me for the real world. I have very little clinical skills and I feel this is truly sad with it being my last semester. I am terrified to graduate because of this. I am embarrassed to tell nurses on the floor that it is my last semester because of my lack of clinical skills and confidence. I feel my nursing school has focused too much on book work and has NOT given us enough floor time. Does anyone else feel this way???

I could have written this. I, too, am a bit embarrassed to say I'm in my last semester of school because of my lack of clinical skills. The instructors keep telling us, "Oh, you'll learn on the job."

What I have never done:

hung a primary IV

hung a piggyback

any type of venipuncture

placed a Foley

placed an NG tube

I mean, these are regular nursing activities, and I'VE NEVER DONE THEM!

I do have to say my assessment skills are good, and I'm able to put my assessment findings together with what needs to be done on a regular floor (not ICU or anything like that, though), but that's the only skill that I have any amount of confidence in at all.

I'm beyond frustrated.

kponderRN · Feb 2, 2011

I feel the same way! I still haven't started an IV or put in a Foley or NG tube on a real person! I feel like my school has done everything to prepare us for working in the field but it just all depends on where you are for clinical rotations I think. Most of my experience has been on Med-surg floors where the patients already have IV's, foleys or NG tubes. A lot of the skills are learned on the floor when you are an RN according to some of the nurses I have talked to. You are not alone! I do a rotation in the ER on Thurs and Fri so I hope I get to practice some skills!!

Lovelymo79 · Feb 2, 2011

All I can say is WOW. I'm in my critical care rotation..the last semester for me too and I can't believe you guys haven't done a lot of those things. I'm in a 2 year diploma program and while we aren't allowed to start IVs..we were hanging IV meds (both primary and piggybacks) by 2nd semester of our first year. We've done everything from suctioning/tube feedings, foleys..in some cases IV pushes with our instructors.

While I don't feel like I can handle my own on an intensive care unit (or a regular med-surg for that matter), I do feel that my school has confidently prepared me for my first job. And you WILL end up learning a lot of things on the floor that we weren't taught in nursing school..but you haven't hung ANY primary or piggyback lines?

If I were you, the next time I went to clinical, I would make it my business to go to any and every nurse, that if there is a med to be hung or a foley to be put in (or even taken out), you have dibs on doing it. Sometimes, you have to go for what you want and not stand by the sidelines.

I was told at the beginning of nursing school, that when the clinical instructor asked "Who wants to do...", to ALWAYS be that volunteer. Even if you're instructor never asks, leave her...find a nurse that will let you hang a med...go back to your instructor and say "Nurse So-and-so needs Vanco hung...can I do it?"

kgh31386, BSN, MSN, RN · Feb 2, 2011

I could have written this. I, too, am a bit embarrassed to say I'm in my last semester of school because of my lack of clinical skills. The instructors keep telling us, "Oh, you'll learn on the job."
What I have never done:
hung a primary IV
hung a piggyback
any type of venipuncture
placed a Foley
placed an NG tube

To be frank....that suuuuuuucks. The things you listed were check offs for us both in skills and in clinical by the 2nd semester. We were doin trach suctioning, central line things, all the fun kinds of things students would love to do. Our teachers made it their priority for us to get practice with all of those things. And if there wasn't an IV or something that day in clinical to be started, she either let us start one on her...or we would go to the ER or different floor to do some skills. And why is the OP just now having ICU stuff their LAST semester?

katebean04 · Feb 2, 2011

My cousin is a charge nurse now and told me that she only hung one IV during nursing school. My mom's chemo nurse told me that she didn't do more than one or two IVs until she got her first job and that they didn't even have plastic arms to practice on like some schools have. Bottom line, they were both book smart nurses and learned through experience. My mom's chemo nurse probably does hundreds of IV sticks on people per week that have horrible veins but had almost no experience in school. Good luck, I hope that you feel more confident after your ICU rotation.

Lovelymo79 · Feb 2, 2011

To be frank....that suuuuuuucks. The things you listed were check offs for us both in skills and in clinical by the 2nd semester. We were doin trach suctioning, central line things, all the fun kinds of things students would love to do. Our teachers made it their priority for us to get practice with all of those things. And if there wasn't an IV or something that day in clinical to be started, she either let us start one on her...or we would go to the ER or different floor to do some skills. And why is the OP just now having ICU stuff their LAST semester?

A lot of schools do ICU the last semester, which makes sense. Save the hardest and best for last. We got a firm foundation in med-surg the first year (even though we were working on vents/trachs/feeding tubes second semester) and then you're more at ease by last semester. We threw in OB/Peds/Psych in 3rd semester, so that was our "chill" semester.

ash2987 · Feb 2, 2011

I have actually hung IV/piggyback, started successful IV's, inserted catheters, etc... I had an internship in the Surgical Unit of a local hospital over the summer.. which REALLY HELPED, and I loved it!!! BUT, what I am saying is that I do not get to do enough of these skills...even though I did that from May - July last summer, I haven't done any of that since. And for me, if I don't use it I feel like I'm losing it! I think what happened with my school is they took on WAY too many students, so they have nowhere to put us all for clinical! So we go to random sites, for example, in my OB rotation we were sent to local grade schools to teach children about their heart/nutrition/etc...how that relates to OB?! no idea. I am so lucky to be in the ICU for clinical this semester, and starting February 16th I have an internship in the ER. I truly hope being on both of these units gets me to where I need to be by graduation!

kponderRN · Feb 2, 2011

I have done everything but start an IV, and put in an NG or Foley. Giving shots, D/C IVs and Foleys, hanging meds, IV pushes, drug calculations I am very comfortable with. Hoping to get to practice IV starts in the ER tomorrow:D! Not too worried about it honestly, it will come with time.

east2010 · Feb 2, 2011

I say the same thing about not being prepared to be a nurse in such a short period of time and feel my school won't prepare me enough...and the nurses I work with say that no one is prepared, that you don't learn what you really need to know in school. All of what you need to know and what you will be doing you learn while your hands on working and the confidence will come. You have to make sure you tell yourself that you can do it and you will. There are times I see the most seasoned nurses mess up or don't have a successful stick. I think it just happens to the best but you have to remain confident.

whitn23 · Feb 2, 2011

I was told (by an instructor) that you are there to learn the knowledge behind the skills. You may not always get to do those skills while you are in clinicals but they can be taught in a few times or a refresher given on the job. i understand you feel unprepared but that is something that can be taught in the "real world." :)

I'm not saying that this is MY point of view but it is something to think about. :)