Multiple IV's for one student, none for the rest... Is this usual during clinical?

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Hey guys,

I'm just wondering about your clinical experience in terms of gaining real-world experience with skills such as IV insertion, foley's, etc... The trend seems to be that certain people get multiple IV's (4 in two days for two students as an example) but none for any of the other students (there are 12 of us on this rotation). We kind of hoped this was a first-semester thing but now we are midway through the second semester and here we go again. Anyone else experience this and if so, how did you handle it?

Thanks in advance!

Specializes in Pedi.
Actually, that's worth a lot so thank you for sharing. I'm stressing out, obviously, and fearful that I won't have the skills that I think I need to be employable and a great RN in a year from now but it's nice to know that this isn't uncommon for multiple reasons.

You don't need IV insertion skills to be hired as a new grad RN. FWIW, some seasoned RNs don't know how to and have no desire to place IVs. Many hospitals have an IV team for that purpose.

Even if you are trained on peripheral IVs in school, wherever you're hired will likely have their own competency in it. I took a peripheral IV insertion work-shop when I was a senior in nursing school because it was required. The instructor who taught it wanted every senior nursing student to make peripheral IV insertion a goal for their preceptorship. The hospital I did my preceptorship at (and was later employed at) didn't allow students to insert IVs because you had to take their course and do supervised insertions with an IV nurse.

Student experiences are highly variable in school. I, for example, got a ton of feeding tube and central line experiences in my pediatric clinic and preceptorship but none of either in med/surg. The only Foley I ever inserted was on a laboring woman. And in 11 years of being a nurse I've only inserted a handful of them- the only one I remember doing was on a baby with spina bifida whose existing Foley fell out. Most of the patients who needed them when I worked in the hospital had them inserted in the OR. We occasionally had chronically cathed patients with spina bifida who straight cathed during the day and inserted Foleys for overnight but they usually did it themselves if they were old enough or their parents did it since they did it every day.

One of my clinical instructors used to always say that these kinds of things are just tasks and not all that nursing is about. I agree with MotoMonkey, focus on your knowledge and critical thinking skills. The tasks you need to perform for each specific job can be taught then. It's not necessary, for example, to become proficient at accessing a port in nursing school. If you get a job in oncology, you can perfect that skill then. Many other environments you work in won't require that skill.

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Neither really. We are assigned a patient and then we are given the name of the nurse who is officially assigned to that patient and told to let the nurse know that we will be taking care of said patient for the day and what meds if any, we will be doing.

I like to make a list of skills I really want to do, and ask around to see if any nurse has a patient that needs that skill performed. If so, I ask if I can be pulled when they are ready.

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Specializes in Pharmacy, Mathematics, Physics, and Educator.

Too bad you can't practice on each other.

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Specializes in Emergency.

Over all, and maybe this is just a function of my program, I am not very worried about being a master of skills. I am much more concerned about developing my depth of knowledge and critical thinking ability. As a student I feel like it is easy to focus on physical skills because it is something I can use to "show" someone else my proficiency. Like if I place a foley or hit an IV the first time it will show the nurse im working with just how "good" I am. Where as it is much harder to impress someone with my critical thinking or clinical judgment, which is far more important.

^^^^This exactly! I know earlier in the program it feels like you need to learn the skills, but those can be learned in an afternoon. Understanding why you do them, when to do them, and what they impact -- that's what were in nursing school to learn.

All the best!

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Specializes in Psych.
It wasn't a matter of letting an instructor know. It had a lot to do with relationship-building. People who seemed to find more opportunities coincidentally were the ones who put themselves out there - to help staff with linen changes, answering call lights, toileting, personal care, refilling waters...basically anything to show that we were making the most of our time there. I worked hard on trying to build a few relationships with the staff nurses, or stuck close to one or two with whom I happened to "click." I'm pretty sure they went out of their way to help me with opportunities. I personally don't think any benefit I may have received as a direct result of rapport-building is transferrable upon demand.

I'm sure you're not sitting around waiting for someone to "give" you an opportunity. Just the same, things have changed and there are a lot of students who sit (even looking at their phones sometimes) or stand around chatting with whomever when they come to the ED (where I now work); it's slightly mind-boggling. I tell you this to point out that if you are pleasant, observant and interested, and ready to learn and help, and if you reach out to the nurses and get involved in what they're doing, you will likely stand out amongst your peers, and you will get opportunities.

Good luck ~

Thank you for your reply. Everything you shared really hit home because my clinical instructor asked me if I am in the hallway and available in case there is an IV or a procedure and I told her no, I am not standing in the hallway. If my patient is stable and taken care of for the moment, I'm helping the CNA's. I'm giving bathes, refilling water, answering call-lights and offering to help other nurses'... I was slightly confused by her question to be honest. Like you, i don't feel like it's the right to do in any situation, to be standing around in the hallway while patient's go uncared for, call-lights go unanswered and hospital staff are understaffed.

Again, thank you.

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Specializes in Psych.
I like to make a list of skills I really want to do, and ask around to see if any nurse has a patient that needs that skill performed. If so, I ask if I can be pulled when they are ready.

That is a great idea!! I'm going to do that. Thank you!!

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Specializes in Psych.
^^^^This exactly! I know earlier in the program it feels like you need to learn the skills, but those can be learned in an afternoon. Understanding why you do them, when to do them, and what they impact -- that's what were in nursing school to learn.

All the best!

I'm so glad that HarleyGrandma wrote that; I wasn't looking at the situation quite like that but she's right and now I have a different perspective to consider. So grateful!! Thank you!!

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Specializes in Psych.
Too bad you can't practice on each other.

Agree 100%

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how are you in IV's. My teacher would give the people who she believed needed more practice (myself for sure) a pt with an IV every clinical. Now I am very strong and confident in doing them. Also if your teacher asks for your assistance then take it. She is making you a stronger nurse. One day you will have 6-8 pts. and you will be well prepared.

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Specializes in Oncology, OCN.

We won't even be doing IVs in my program. As for some people getting more skills opportunities than others that absolutely happens. It's factor of who their clinical instructor is, what clinical site they are at, and simply what's happening on the unit that day and the nurses willingness to give us students educational experiences. I've been pretty fortunate to get a decent number of opportunities so far and feel pretty good about it.

Start my peds rotation next week and hear mixed things from my classmates who have already done their peds rotation about how much we actually get to do. Thankfully I think I've got one of the better clinical instructors for peds so I'm excited. Will be a nice change from the psych rotation I just finished where as student nurses we weren't allowed to do anything except talk to some patients.

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Specializes in Psych.
how are you in IV's. My teacher would give the people who she believed needed more practice (myself for sure) a pt with an IV every clinical. Now I am very strong and confident in doing them. Also if your teacher asks for your assistance then take it. She is making you a stronger nurse. One day you will have 6-8 pts. and you will be well prepared.

Actually, I have no idea how I am in IV's.... I've only done about 5 of them, on fake arms, and those fake arms were the perfect arms with the perfect veins. I do take every possible opportunity to help but unfortunately, there aren't many. It may be that our clinical instructor is brand new, new to our school, new to the clinical site and unsure herself just like us so maybe I just need to not think so much about it and focus on what's really important, patient care.

After reading all of this great advice from you guys who have taken this path before me, I definitely see the bigger picture.

Thank you so much!

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Specializes in Psych.
We won't even be doing IVs in my program. As for some people getting more skills opportunities than others that absolutely happens. It's factor of who their clinical instructor is, what clinical site they are at, and simply what's happening on the unit that day and the nurses willingness to give us students educational experiences. I've been pretty fortunate to get a decent number of opportunities so far and feel pretty good about it.

Start my peds rotation next week and hear mixed things from my classmates who have already done their peds rotation about how much we actually get to do. Thankfully I think I've got one of the better clinical instructors for peds so I'm excited. Will be a nice change from the psych rotation I just finished where as student nurses we weren't allowed to do anything except talk to some patients.

Oh my gosh, I know! Before getting accepted into this RN program, I worked charge on inpatient psych units for close to 20 years and had my share of RN students over the years. Felt so bad for them because it's like you say, they basically could talk to the patient's and sometimes, do vitals but that was the extent of their rotation. Occasionally they witnessed something that led to a teachable moment but most often, it was just a quiet milieu.

I had my peds rotation the first 4 weeks of this semester and only 2 of the days were spent in an actue care facility where really, didn't get to do much at all. I did however, get to play with and cuddle a couple little ones so that was nice :). I think the best part of the rotation was 2 days in a clinic. I definitely got the most experience there and had the best Doctor and LVN to follow.

Hey, good luck with the rest of your program!

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