What didnt you do in school?

[aachavez]

I'm getting close to graduation, and theres SO many things I've never done on a live patient! Stuff like, foley, IV's, injections, (all I really have done is some minor wound care and hygiene stuff) It makes me nervous, but hopefully I'll be blessed with a great orientation....SO.... What types of things had you never done on a live person til after you were licensed and working?

Have you precepted a new grad and been surprised at the skills they hadn't had much practice with?

[cassie77775]

I have not:

-hung blood(not allowed for a student nurse) but have observed the nurse and did the vitals with the nurse beside me

-Put in an Ng/OG tube(most our patients already have one if it is needed) but have taken them out

-haven't taken out a catheter(no opportunity)

-IO infusion-I've never even seen ont

I think I have done all of our other skills. I have suctioned a trach, I have done feedings through feeding tubes, I have started IVs, tons of IVPB, IV meds, injections, removed NG tubes, done several catheters. We are trained to do them but between 6 students and 1 instructor, the opportunity doesn't come up often. Most of our patients on the floor already have IVs started and catheters in, especially if they came in through the ER.

[PnutButterJelly]

I have done a lot of skills. I have done IV'S, foleys, labs, NG's, tube meds/feeds, etc. by third semester we are allowed to do any skill we have checked off on without our instructors. By fourth semester we are allowed to do anything under the RN scope of practice (except blood) regardless of if we have checked off on it. This is assuming our preceptor is willing to teach us the skill. I always feel like I don't get to do enough at clinicals, but when I read some things in here I realize how much I have gotten to do.

[citylights89, BSN, RN]

Never started an IV, inserted an NG tube, or did anything trach related. Probably never will since I'm in the OR now. However, I get to put in Foley's everyday!

[jchilds]

I'm in my 4th semester of 5 and I've never put in an NG or done trach suction. I haven't put in an IV since 1st, and I only did my 1st (and only) Foley on a real patient in 3rd. Im more concerned with getting better at my assessment, giving report, and my time management. My suggestion is to try and find an externship for the summer. Lots of more chances for skills than regular clinical.

[dirtyhippiegirl, BSN, RN]

I didn't do much during clinical rotations but I did put in 520 hours my senior year in a capstone/practicum where I was expected to orient as essentially a new nurse. That experience was invaluable.

[calivianya, BSN, RN]

Wow, this was interesting. I did a lot of skills in my regular rotations. Haven't graduated yet, and I've probably done ten million subQs (is it just me or is everyone in the hospital a diabetic needing lovenox or heparin?), IMs, started many IVs (but I'm still not great at them yet), a couple of NG tubes, put in foleys, irrigated foleys, lots of straight caths, hanging blood, lots of wound care, trach care, etc. Since I'm doing my practicum in the ICU I've now gotten to do a ton of skills not seen quite as often on the floor like drawing blood from central lines/arterial lines for labs, checking central venous pressure, changing central line dressings, suctioning ET tubes, helping my preceptor with CRRT, etc. I honestly can't think of anything off the top of my head that I haven't gotten to do multiple times over. I am surprised that you all aren't getting to do more skills in school. My program is a BSN program; I don't know if that makes a difference...

[eukaryote]

I have done a lot...trach care, trach auctioning, IV insertion, IVPB, wound care, burn care, NG insertion. Pretty much most general nursing skills. The only thing I haven't done is hang blood, simply because I haven't had the opportunity yet. In my program the only things I can think of that we are not allowed to do is administer TPN and change the dressing on a PICC.

[AJJKRN]

Wow, this was interesting. I did a lot of skills in my regular rotations. Haven't graduated yet, and I've probably done ten million subQs (is it just me or is everyone in the hospital a diabetic needing lovenox or heparin?), IMs, started many IVs (but I'm still not great at them yet), a couple of NG tubes, put in foleys, irrigated foleys, lots of straight caths, hanging blood, lots of wound care, trach care, etc. Since I'm doing my practicum in the ICU I've now gotten to do a ton of skills not seen quite as often on the floor like drawing blood from central lines/arterial lines for labs, checking central venous pressure, changing central line dressings, suctioning ET tubes, helping my preceptor with CRRT, etc. I honestly can't think of anything off the top of my head that I haven't gotten to do multiple times over. I am surprised that you all aren't getting to do more skills in school. My program is a BSN program; I don't know if that makes a difference...

I really don't think it matters if the program is BSN or ADN, I thinks its more about the program itself and the clinical sites available. I started my nursing journey in an ADN school that was fast and furious with skills and theory with a teaching hospital as the main clinical site. Did alot of skills which helped time management vastly upon starting as a new nurse.

To all students that aren't heavy on skills...you will eventually get there. Please please please remember infection control though. Do not forget to alcohol swab every IV cap and don't touch the tubing spikes when priming IV tubing!!! I have oriented a fair share new nurses now and the trend seems to be that if they weren't familiar with skills they forget the basics of infection control because they are more focused on completing the task at hand (and make sure the IV you're about to place is going to go the right way in the vein!!!). Understandable but preventable.

[BeenThereDoneThat74, MSN, RN]

I really don't think it matters if the program is BSN or ADN, I thinks its more about the program itself and the clinical sites available.

Back in the day, the AD and diploma programs were the ones where skills seemed to be more plentiful. All diplomas (and some AD programs, like the one I graduated from) were hospital-based (run by the hospital, and all clinicals were done within that institution). Clinicals were run more like internships; the students basically ran the floor. There was this belief that those nurses were better prepared than their BSN counterparts (that was before my time, but it's what I hear from my elders).

[NicuGal, MSN, RN]

Diploma grad here :) we worked in the hospital 3-5 days a week. We were in a certain area for 6 weeks at a time. We spent several days in the OR holding room placing IV's, we did every skill possible with not only our instructors but with the floor nurses, majority of which all graduated from our school. We have Meds on all our patients from the get go. We spent 6 weeks in ICU and CCU....scariest 6 weeks!! Lol. We also did our last semester in Leadership....basically we were the team leader and had up to 16 patients under us with an LPN and an aide on our team. When we graduated we hit the floor running. I wish the programs were heavy on skills again.

That being said, I have worked my way up thru degrees and can see how having more theory is good. But when I orient, sometimes I just feel that I am moving the person slow because they do lack skills. I wish their could be a good compromise. We do have residency and they do learn these skills, but it takes away from

Their time on the floor. Sigh.

[edmia, BSN, RN]

Interesting!

My school was closely related to the hospital and we were in clinicals from week 2 of the first semester. We did all the care for the patients with the instructor there for back up and the RN precepting.

When I got to my first job I started with other new grads who had never even hung an IV med! They had a rough start.

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[Julius Seizure]

I agree. You tube is great, but can you imagine approaching a patient and saying "I've never done this but I saw it on You Tube"

Probably shouldn't actually say that