What didnt you do in school?

Nurses General Nursing

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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?

Specializes in Pediatric Critical Care.
Wow. I feel really lucky to be at the school I am after reading this! I'm in level two of a a 5 semester BSN program. Level one we were taught to do assessments, give oral meds and injections. I was able to do an assessment with each patient and multiple lovenox, insulin, and flu shots. This semester we were able to do (with our instructor present) IV push and IVPB meds, foleys, IV insertion, hang fluids, NG tubes, etc. I think the only thing we aren't allowed to do is BGs but that's hospital policy- weird but true. I have done 3 IVs, multiple blood draws, 2 foleys and one straight cath, so many injections I don't remember how many, no NG, (that doesn't seem too common to even have a patient with one though.) Each clinical we took at least one patient as our own and passed all meds, did assessments and other care for them. Great learning experiences!

Wow! I'm so curious what school this is...sounds nothing like mine

Specializes in Legal, Ortho, Rehab.

Wow, what an interesting thread! I started nursing school 10 years ago, and remember "trach duty" which was essentially a couple of days following a RT around suctioning, changing collars, and cannulas while the RT stood outside the room drinking their coffee! We did several injections, assessments, post-op care, drain care, pin care, wound care, ostomy care, tube feeds, and foleys.

Specializes in Emergency/Cath Lab.

So this begs the question, what do you actually do at clinicals?

I went to a four year BSN program and did very little in clinical. For us clinical was assessing our patient, bathing, and if you're lucky passing meds. We spent a large amount of time researching the pathophys of our patients and doing evidence based research projects on our units. I resented it at the time, but I learned my skills as I went at my first nursing job. Once you start working at a hospital I like to think you start at the beginning anyway!

twinmom, before you do another cath, check with your hospital policy or nurse manager to confirm aides are allowed to do this. If someone finds out that you are operating outside of the scope of practice, your nursing career could be over before it started. "what happens behind the curtain stays behind the curtain"?? that attitude scares me, honestly.

I think I understand now why so many hospitals no longer want to hire new grads. They have no clinical skills? I am sure some schools are better than others but sheesh it should be a requirement to do the basic skills. I have my phlebotomy license and my school required 100 venipuntures (successful ones) before finishing our clinicals. The state only requires 50 and I had 110 at the end of my clinical. That is 110 live patients of varying health condition, weight and age. Why is there not a checklist of skills to be done before finishing the clinical aspect of nursing? I am shocked. BTW, none of the nurses do ABG's at the hospital I am at and the only Phlebotomists that can do them have to have a higher level license and 5 years experience. The RT's do them all the time and most commonly.

Specializes in ICU + Infection Prevention.

Different perspective: I've seen a lot of post talking about lack of clinical opportunity... I'm absolutely certain, and evidence abounds: one can be a great nurse without rich clinical opportunities. However, I'm certain that, all other things being equal, transition to practice is eased by excellent clinical practice opportunities. If you can think about disease processes, patients, and planning instead of stressing about psychomotor issues, it makes things better. I think all nursing programs should ensure great clinical opportunities in addition to offering excellent theoretical preparation. Anything less is a disservice to the students.

I'm a recent grad. By the end of my first year of my RN program I'd done a ton! This included (obviously under supervision) given IV push meds including centrally, several foleys, many IVs, many blood draws (fresh sticks, central lines, art lines), many SQ and IM injections, dropped a few NG tubes and a dobhoff tube, changed dressings, performed full and focused assessments, captured many 12 lead EKGs, d/c'd an artline and a PICC, trach care, deep suction, inline ETT suction, performed CPR twice, delivered O2 a dozen different ways including BVM, assisted with central line insertion, assisted with art line insertion, observed bronchs, endoscopy, observed several IR procedures, observed PICC placement, observed 3 surgeries, and much more. The next year of the program had even more opportunities. I'm grateful for the clinical practice opportunities I was afforded and the wonderful scholars and preceptors I had. It made my transition to practice much easier.

This was a BSN program...

Specializes in Peds, Float, Ambulatory, Telemetry (new).

There were a few things I didn't get to practice on a "live patient" with. Sometimes its all about the types of patient and time you have in clinical that would allow you the opportunity to do something. I think once you go over it in class and maybe practice it in skills class is what matters most. But it is what it is if you don't get the opportunity in clinical.

twinmom, before you do another cath, check with your hospital policy or nurse manager to confirm aides are allowed to do this. If someone finds out that you are operating outside of the scope of practice, your nursing career could be over before it started. "what happens behind the curtain stays behind the curtain"?? that attitude scares me, honestly.

since I'm a student nurse aide I'm allowed to do it - the RN is generally in the room doing something else...as far as the attitude of what happens behind the curtain stays behind the curtain? My clinical instructor is a 30 year ICU nurse and did clinicals on the unit she currently works on - she is there with us when anything is done (and/or our co-assigned nurse) - what it means is that if there is an opportunity to say - draw labs with a butterfly needle on a sedated, ventilated patient we got talked through it - we weren't allowed willy nilly to just whip around drugs and stick patients at whim...please give me a little credit...I'm graduating in 10 days and start GN residency on 6/17 - I'm not a noob with no knowledge whatsoever...and before you start accusing me of being a "know it all" - I'm not, I know my scope of practice and the nurses I work with at my regular job are more than willing to pull me into a room to do easy stuff like caths while they're hanging drugs, giving IV pushes or just observing me...

Specializes in Acute Care Cardiac, Education, Prof Practice.
since I'm a student nurse aide I'm allowed to do it - the RN is generally in the room doing something else...as far as the attitude of what happens behind the curtain stays behind the curtain? My clinical instructor is a 30 year ICU nurse and did clinicals on the unit she currently works on - she is there with us when anything is done (and/or our co-assigned nurse) - what it means is that if there is an opportunity to say - draw labs with a butterfly needle on a sedated, ventilated patient we got talked through it - we weren't allowed willy nilly to just whip around drugs and stick patients at whim...please give me a little credit...I'm graduating in 10 days and start GN residency on 6/17 - I'm not a noob with no knowledge whatsoever...and before you start accusing me of being a "know it all" - I'm not, I know my scope of practice and the nurses I work with at my regular job are more than willing to pull me into a room to do easy stuff like caths while they're hanging drugs, giving IV pushes or just observing me...

I think the concern is more with your senior nurses possibly bending the rules around your scope rather than anything directed at you. I give you lots of credit for getting in there and getting the experience you need, as well as knowing what you can and can not do.

I wonder if under the old hospital based diploma programs there were fewer new grads complaining after graduation that nursing isn't what they thought it was?

Specializes in Med/Surg/Tele/Onc.

With evidence and best practices always changing, equipment being updated and new things being invented, skills are constantly being re-addressed throughout your nursing career. It's great to have skills opportunities in school, but in some places, the opportunities don't present themselves.

You will have to learn how to use the latest and greatest XYZ equipment (foley, IV cath, etc) at the next hospital in-service. Learning disease process, the basics of pharmacology, good assessment skills, and most importantly, critical thinking are much more difficult to learn outside of school.

A good nurse doesn't just practice a check-list of skills. A good nurse sees the whole patient and helps guide them through the healing process to help them regain the best level of function they can. Sometimes this means starting an IV, but often it means helping the patient and family understand how to incorporate new medications and new limitations into their daily lives.

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