Inexperienced with assignment

[nurse.j., ASN, BSN, MSN]

Recently my caseload has become more difficult and they're sending me out in the field to do procedures and care I have never done before. My training was very limited and there was no checklist of skills to complete with my preceptor before I was allowed to go out in the field alone. Recently was sent out to change a wound vac....never done that before and literally had to wing it...like run out to my car and watch a quick youtube...I felt so uncomfortable and ended up having to have another nurse come out because I couldn't get the seal correct. I told my DON I would not go back to see that pt until I had proper training. Another pt they want me to manage is a trach patient which I have no experience with. I'm starting to feel more and more like my license is at risk and they just tell me to ask other people or look up videos but that is not the same as an in service or class on ways to complete procedures and then being checked off. Not sure what to do :/

[JustBeachyNurse, LPN]

Without proper inservice and hands on training just.say.no. You (and your coworkers) are doing your clients a huge disservice by self-educating and self-training via you tube. The ludicrous part is the DME vendors will do hands on training (often with CEUs) for no charge to educate on their products and proper use from the latest wound vacs to ventilators (the trach/vent training is product specific and presumes a working competency & familiarity of trach/vent). The agency only has to ask the vendor.

We had a patient go out of state for surgery ultimately requiring a wound vac, but a brand not commonly used by local practitioners. As part of discharge planning the hospital put the agency clinical educator in touch with a local rep. Nurses to be working with the patient once returned home were given a hands on inservice on use, trouble shooting as well as tech support contacts if issues arose. No cost to the agency but part of the vendor services.

[Farawyn]

NO NO NO.

I am an experienced nurse and really haven't done a wound vac in about 5 years. I will not take one on without going over it first- with a real live nurse.

This is not fair to you, nor your patient.

[Libby1987]

We have a dummy with wounds, just did a training refresher with a newer nurse who has had minimal experience. Demonstrated a dressing change and explained some rationale and protocols then had her practice. She said she felt much better about afterwards.

We can't go out on every type of complex wound that will come up but there is no reason for you not to be able to see a live demo with back up practice in the office.

BUT it's going to be up to you to stay firm about receiving basic reasonable training opportunity.

[gibsongirl]

I had that problem. I did a few things incorrectly, even though I watched YouTube because I had no experience. Self educating is not adequate training. The learner doesn't know what she doesn't know. It is risking your license. I had a hard time saying no until I realized nobody is going to take the blame if I do something wrong on my own. I have no trouble saying no now. Like the other poster said, reps are available. It is the managers responsibility to provide proper and timely education.