A little dismayed...

  1. I don't like to complain but I'm feeling a little disillusioned with NS right now. I am finishing my first year of a two-year ADN program. I am so happy to be in nursing school and I am doing very well grade-wise...

    ...but I wonder if clinical is all it should be. I've had nearly a year of clinicals and all I feel like I do is bathe, change linens, and chart. I am not complaining about bathing my patients -- I love the way they look all buffed and shiny in a clean bed and 9 times out of 10 they thank me and say they feel so much better, plus I get a good look at them that way...

    But I have this skill down at this point! Shouldn't I, after a year of nursing school, be learning to do more, in addition to this? I pulled a catheter for the first time yesterday. I can count on two hands the number of shots I have given. I won't be learning IVs at all during my program. I've never placed an NG tube or a catheter myself. I still don't know where to look for labs when they come back. I just keep checking the Kardex and hope it gets written there. I feel like an idiot! I am one of the few in my group who has zero prior experience -- we have a Surg Tech, two aides, an RT -- I am a housewife! When an IV beeps, I have no idea why and I'm not allowed to touch it. My Surg Tech classmate helped transfer one of my pts for Xray and knew how to disconnect and reconnect her O2 -- not because she learned it in school, but because she already knew how. Things move so quickly and our CI has to be everywhere at once, plus the nurses all have 6 or 7 pts and are running constantly -- no time to teach me this stuff. You get the picture, I think.

    Classes and tests are brutal -- nearly half our class from the beginning of the year has had to withdraw. Will all of this come together at some point? I feel nearly in a panic! I dread clinicals because it is so much more of the same and I don't gain any new skills. One of my pts was d/c'd yesterday and the nurse said to me, "Shoot. I should've had you go make copies of the chart." Right. Because I am in nursing school to learn to make copies (actually, I think I am pretty good at that already...). I would've done it and not complained and she was great to me all day, but I'm afraid if I don't learn a bunch of stuff next year, I am going to be completely unprepared to be a nurse.

    Thanks for letting me vent.
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    About DroogieRN

    Joined: Sep '08; Posts: 327; Likes: 661
    Telemetry, Critical Care; from US
    Specialty: 2 year(s) of experience

    8 Comments

  3. by   Koyaanisqatsi-RN
    I hear you! I'm just finishing first semester and I have some of the same questions. However, one suggestion I can give is to bug the nurses at your clinical to let you observe and help with things. If your program is moving that slowly, you might just have to show your own initiative in learning stuff. I can't believe they aren't going to teach you IVs? That seems really weird.
  4. by   DroogieRN
    I do, when I get a chance -- several times in the past if we get a spare second, we've gone on the hunt for things like that but if the CI saw us, she might say, "Are you not busy? Then go help the aides pass trays." I don't feel like I can refuse, so I do it. Once a nurse I had found asked her if we couldn't go with her first, to see her change a post-op dressing (Oh, I've changed *2* dressings!)... But if she hadn't spoken up, I'd have been passing trays.
  5. by   J9G2008
    What you are learning, besides all the patient care stuff, is the assessment portion. I now know how to assess a patient within five minutes, and get the stuff charted within 10 minutes after that.

    If you aren't feeling challenged, you could talk to your CI about taking on another patient. I've done that a couple of times in my previous clinical, and it wasn't bad. It was nice to actually have to balance my time a little more like a nurse does.

    It also depends on the hospital and nurses you run in to. Some are great about saying, "Hey, I'm inserting a g-tube-wanna watch?" and some couldn't care less that you're there. You can also let your CI know what skills you would like more practice in. One girl last rotation needed to do injections, so the instructor sought some out for her. Me, I need to hear wonky breath sounds, but haven't had any of those on the units I've been on.

    As for IVs, I've been told that we will not be learning that in NS at all. I'm kind of bummed, but I figure they'll teach me at some point after graduation.

    Good luck.
  6. by   ♪♫ in my ♥
    I'm sorry to say that it sounds like your clinical program is not very good. Continue to look for opportunities where you find them and then try to get into a decent new-grad program.

    For comparison, first semester we were passing meds, giving injections, starting Foleys, and discontinuing Foleys and IVs. By the end of second semester we were starting IVs, doing IV push meds, etc. We were hanging piggybacks and clearing pump errors. Some things I've done more than others simply because of exposure... I figure those opportunities will present themselves once I'm out in the world.

    Be assertive in looking for oppotunities but don't **** off your clinical instructor... they can ruin your life if they want to.
  7. by   Violet08
    I can relate to you! I hated clinical because I felt like I didn't learn anything. I spent a lot of time waiting around for the instructor to check my meds with me or answer a question. We did assessments and AM care or PM care and then waited around for something to happen. We had 10 students in each clinical group. When we were on smaller floors it was really difficult for us all to have something to do. 3rd semester I had a great instructor who really made sure we all got to chance to do all the skills on her list.

    Some ideas to help:

    1) Injections-one of our teachers asked students to volunteer at a flu-shot event. The students that went spend hours just giving injections. See if something like that would be available.

    2) Externships (I think this may not work out for this summer but sometimes externships are offered over winter break as well).

    3) Get a job at a hospital. It will help you feel more comfortable in clinical and you will pick up those little things that help you.

    Part of getting a good experience in clinical is pushing for experience. I am not good at that, I am not very forward and it was difficult for me to jump in and offer to do things or go see something.

    Keep a list of things you have done and things you want to do in clinical and bring them up to your instructor or the nurses on your floor in clinical.
    Last edit by Violet08 on Apr 17, '09
  8. by   Violet08
    Quote from ♪♫ in my ♥
    I'm sorry to say that it sounds like your clinical program is not very good. Continue to look for opportunities where you find them and then try to get into a decent new-grad program.

    For comparison, first semester we were passing meds, giving injections, starting Foleys, and discontinuing Foleys and IVs. By the end of second semester we were starting IVs, doing IV push meds, etc. We were hanging piggybacks and clearing pump errors. Some things I've done more than others simply because of exposure... I figure those opportunities will present themselves once I'm out in the world.

    Be assertive in looking for oppotunities but don't **** off your clinical instructor... they can ruin your life if they want to.

    I just want to point out that different states, hospitals, and schools have different rules about what nursing students can do. We were NOT allowed to start IVs or give IV push meds ever in clinical.

    Follow your clinical guidelines and look at what the school has outlined for your clinical experience. You should have some sort of sheet that explains what you should be able to do each semester.

    I really agree about staying on your clinical instructor's good side. They make the patient assignments, evaluate your performance, write letters of recommendation, are references for employment and work in the hospitals you may work in or want to work it.
    Last edit by Violet08 on Apr 17, '09
  9. by   matilda123
    I am in my first semester and in clinicals. I have gotten alot of experience, I did a NG tube yesterday (well, mine didn't go, the instructors did) but I learned a great deal and can't wait to do my next. We also do assessments and a.m. cares, pass meds, do blood sugars and insulin injects, change dressings and go with patients for tests and such. My advice is to get your stuff done quickly and then offer you help, to other students, the aids, the nurses, the doctors, anyone doing patient care because you never know where a chance to learn will come from. Offer yourself and jump to help, nurses and aids will put out more effort if you can lighten their load a bit. good luck!
  10. by   mama_d
    "I'm afraid if I don't learn a bunch of stuff next year, I am going to be completely unprepared to be a nurse."

    See the many many threads regarding how poorly nursing school prepares you for actual nursing...you're not alone. Actual tasks often don't come until you're employed with a license in hand. Even then, some of them don't come along very often...I can count on one hand the number of times I've thrown a NG into an adult, for example, and I've been a nurse for over nine years. Heck, I don't even give IM injections that often. Stuff like IV's you'll get plenty of experience with eventually, I promise!

    I think most of us who have our licenses would agree that we were pretty scared to begin with. If not, it was through ignorance of how much wasn't known. I still get a little jittery when I have to go to an area I'm not familiar with, despite doing agency nursing for a couple of years.

    Would it be possible to go around to the nurses on the floor and let them know "Hey, I'd love to observe as much as possible, if you're doing a procedure, even a simple one, would you mind if I tagged along?" I work nights, so I rarely see nursing students, but when I do I enjoy having them come in the room with me when I do stuff. It's nice to have someone in the room who has that fresh appreciation for a complicated dressing change sometimes

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