I just recently graduated from nursing school and am sitting for state boards.
During nursing school, I had the opportunity to start 2 IV's. Both of them were failed attempts. I never had a patient during clinical with a NG tube, trach, chest tube, or really any type of tube. I also never had the opportunity to draw blood. I feel unprepared in the real world due to lack of experience. I have had a lot experience with wound care, medication administration (IV, IM, SQ, PO, etc), catheters, complete physical assessments.
Is this a typical thing for new grad nurses? I don't want to feel stupid asking for help starting my first IV on the job, or suctioning a trach...
I've done many things but there are many, many things I HAVEN'T done. Always ask for help. Always. If you think you can function 100% without anyone ever then you are a danger to yourself and others. Great question but don't be concerned...there is always help available and nursing is an ever-changing, ever learning world. You'll get experience anywhere and everywhere you are...sometimes you won't even realize this until after the fact :) . For every skill/procedure you learn, there are five more you know nothing about. This, I think, is true of all nurses. You'll be a-ok. Good luck with your boards!
This is probably the norm since the hospital based diploma programs with LOTS of bedside experience became less common. I went to nursing school years ago and never placed an IV since all our clinical sites had an IV team and students weren't allowed to do them. I've never placed an NG tube, in school or since!
Any new grad is expected to learn the vast majority of needed skills on the job. For that matter any nurse is expected to learn skills that are specific to that floor/specialty on the job. So don't worry too much about being unprepared due to lack of experiences, as long as you have the nursing knowledge the skills will come with training and practice.
I find that to be so sad. I graduated as an ADN, we had a CRAP TON of hands on experience. I probably got to start at least 75 IV's, a handful of urinary catheters, got to hang blood twice and lots more skills. If we weren't doing it in clinicals, we were poking poor Sim Simpson until he was speechless (our name for the Sim manniken)
Specializes in Med nurse in med-surg., float, HH, and PDN.
Do hospitals even require you, upon being hired, to fill out a skills checklist anymore?
Used to have to do that, and begin working on goals to be "passed off on" and get skills under your belt. Most crucial would be the things you need for your floor/specialty. Something outside of what you're dealing with day-to-day can be put on hold indefinitely.
I suppose that now each nurse is responsible for doing this on his/her own? I can't imagine, with budget and staffing cuts the way they are now, that a hospital would 'waste' any time, money , or personnel for keeping track of and reviewing competencies of their nursing employees. CPR seems to be the one thing required and kept track of now.
eta: I'm one of those Hospital Programs grads and we also got sometimes an un-nerving amount of hands-on experiences. To have the clinical instructor come to your classroom, point at you, and gesture to 'come with me'.....scary!
But then, going out into the real world wasn't scary after you'd been through those trial-by-fire moments!
I attended a community college, 2 year program and have found that most associates programs do a lot more hands on than the BSN programs. I have a lot of experience with all the skills you mentioned with the exception of chest tubes. Unfortunately, a lot of hospitals do not allow students to practice. So new nurses are unprepared. You catch up fast though.
We haven't had an ADN grad come to us with much hands on experience. We have a community college merit based program that feeds the area and they all need skills training if they didn't come thru acute care. And the ones with LTC experience haven't done complex wound care.
I just recently graduated from nursing school and am sitting for state boards.
During nursing school, I had the opportunity to start 2 IV's. Both of them were failed attempts. I never had a patient during clinical with a NG tube, trach, chest tube, or really any type of tube. I also never had the opportunity to draw blood. I feel unprepared in the real world due to lack of experience. I have had a lot experience with wound care, medication administration (IV, IM, SQ, PO, etc), catheters, complete physical assessments.
Is this a typical thing for new grad nurses? I don't want to feel stupid asking for help starting my first IV on the job, or suctioning a trach...
From what I've seen this is extremely common.
Diploma nurses are very prepared
ADN nurses moderately prepared
BSN nurses mildly prepared
when it comes to clinical competencies.
The best advice I can give you is ask, ask, ask! Don't fear your limitations, you're not the only one, and it is 100% okay to ask for help. It's okay that you don't know how do things. You're new, nobody expects you to know everything. Even the most seasoned nurses, don't know everything and still ask for help on things-daily!
Sure it might feel scary, but in time you will feel much more confident. Just ask for help, and put on your fake confidence face when preforming the procedure!
I recommend doing a lot of research when deciding where to work. A new grad program, new-grad internship, or entry level program, will be your best bet.
Make sure to ask how long orientation will be. Most hospitals with a new-grad transition program work in one or two ways; one- you have a set amount of time you're on orientation (ex 6 months), or two- you have a range of time in which you complete a competency checklist with a preceptor.
Most programs will pay less during orientation. If the program is like option 2 -don't overwhelm yourself to try to complete orientation early, it's great to have a one-on-one preceptor to ask questions to. Take your time and make sure you're comfortable. Once you complete your orientation, you have a bunch of co-workers there for second opinions!
Thanks all for the wonderful advice! I don't feel as inadequate as I did knowing that this is somewhat normal.
I want to add that I have absolutely zero desire to ever work in a hospital... It just doesn't interest me in the slightest. I became a nurse so that I could work with the elderly in a LTC facility. I have always loved the idea of having the same patients for long term. Getting to know the patients and being able to pick up on the slightest change is something that I've always been highly interested in.
With that being said, LTC facilities don't typically offer very long orientations- even to new grads. I've heard of many LTC facilities orient new grads for 3-6 shifts, which in my opinion isn't near enough. I'm hoping to find a facility that will train and orient me for at least 12 shifts...but it seems as if that may be asking too much by some facilities standards.
It is normal...you will never get to experience all of the procedures you learn or performed in skills lab. You may also never get to perform those procedures in your everyday job. It just depends on the extent of the skills required and the acuity of the position/patients you will have. That's why their is orientation/training on the job to help you get that practice. :)
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Is this a typical thing for new grad nurses?
I've had two nursing school experiences (LVN in '05 and ASN in '10). By the time I graduated I had never started an IV line, or irrigated a Foley, or maintained chest tubes, or drawn blood.
I've been a nurse for nine years and still have not inserted an NG tube or performed many other procedural skills. I think your experience is becoming the norm, not the exception.
I've had two nursing school experiences (LVN in '05 and ASN in '10). By the time I graduated I had never started an IV line, or irrigated a Foley, or maintained chest tubes, or drawn blood.
I've been a nurse for nine years and still have not inserted an NG tube or performed many other procedural skills. I think your experience is becoming the norm, not the exception.
For some reason, this shocked me. You are so wise and benevolent, I just figured you'd been there and done it all.
Call me if you need an NG dropped or a foley diddled with. I am the tube queen. As long as you start my IV for me. I'm about 5/100.
OP, don't worry about the skills. I haven't worked with a new grad BSN yet who could do much, at first. It doesn't take long to pick it up. Although there was one BSN who was a prodigal IV starter. She had magic fingers.
AllieSparksRN
118 Posts
I've done many things but there are many, many things I HAVEN'T done. Always ask for help. Always. If you think you can function 100% without anyone ever then you are a danger to yourself and others. Great question but don't be concerned...there is always help available and nursing is an ever-changing, ever learning world. You'll get experience anywhere and everywhere you are...sometimes you won't even realize this until after the fact :) . For every skill/procedure you learn, there are five more you know nothing about. This, I think, is true of all nurses. You'll be a-ok. Good luck with your boards!
Allie