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...
In my supposedly inferior BSN program, I started IVs, inserted a foley, had a decent amount of experience with NG tubes, tube feeds and I even had the opportunity to work with vented patients, arterial lines, etc. I had a one on one preceptorship my last semester on a med-surg unit where I got to deal with trachs and other skills. It also helped that I worked as a tech and had experience with blood draws and foleys and ostomy care.
There are still skills I don't feel comfortable with, but I am a brand new nurse. That is to be expected. I just know to ask questions and keep patient safety as my top priority.
In my supposedly inferior BSN program, I started IVs, inserted a foley, had a decent amount of experience with NG tubes, tube feeds and I even had the opportunity to work with vented patients, arterial lines, etc. I had a one on one preceptorship my last semester on a med-surg unit where I got to deal with trachs and other skills. It also helped that I worked as a tech and had experience with blood draws and foleys and ostomy care.
There are still skills I don't feel comfortable with, but I am a brand new nurse. That is to be expected. I just know to ask questions and keep patient safety as my top priority.
Then I must not have worked with you. The BSNs I have worked with are very knowledgeable, but not practiced. No one said the BSN was inferior, just that the grads tend to be light on skills practice. But if you want to be offended, go right ahead. I'll enjoy the show.
Then I must not have worked with you. The BSNs I have worked with are very knowledgeable, but not practiced. No one said the BSN was inferior, just that the grads tend to be light on skills practice. But if you want to be offended, go right ahead. I'll enjoy the show.
Those who are comfortable and secure in themselves do not need to tear others down to build themselves up.
It's just that it's not even TRUE. It varies by the school/hospital for clinicals more than by the program. The amount of clinical time needed is set by the state board of nursing and isn't different for different kinds of programs. I haven't looked at every state but I knew from talking to other students in my area when I was a student that the ADN students weren't getting more clinical time than we were. They all THOUGHT they were. I'm not even sure they believed me. They had been told over and over by nurses, teachers, and each other that ADN programs were superior in clinical skills. Some people may find this to be true when new grads come to the hospital, but it's likely to be more dependent on the individual school... not to mention confirmation bias. Also, at least in some places, ADN programs may have a larger percentage of older students than BSN. Life experience does help in many cases.
Any nurse who didn't get to start IVs (or whatever) in school, finding him/herself in a clinical setting that requires IVs (or whatever), will probably do more of them in the first month than s/he was able to do in nursing school, no matter how the clinical experience was. After a month everyone will be about the same (barring things like natural aptitude and common sense).
I work now in a setting where almost all of the students are in a diploma program and even those that aren't do almost diploma-level amounts of clinical practice. I'm definitely not knocking the oldschool diploma programs, I know they produced great nurses, but I definitely see the value of academic programs, those that spend more time on pathophysiology/disease process, pharmacology, etc. These students only do "tasks" and may or may not develop critical thinking later. The pathophysiology they'll probably never learn. Those with strong academics at their school at least "get" that nursing is more than tasks, even if they don't have the opportunity to do much more than that in clinical. (Again, NOT comparing this to the traditional diploma programs in the US... though it's worth remembering that in those cases, also, some programs were very good and some were very bad.)
So true. I think it is ridiculous for one to make such generalizations when there are so many different diploma, adn and bsn programs of varying quality. The adn program a few miles from my bsn program did not have anywhere near as much clinical time and their preceptor/capstone programs required less hours. Plus my bsn program is affiliated with a teaching medical center, so we had first dibs on all the resources and learning experiences at the institution.
Some programs are better than others regardless of the degree conferred. I just notice on allnurses it seems okay to bash the bsn new grads. But if a diploma or adn new grad was accused of being less competent , a storm of feces would ensue. Why the double standard?
Oh, for Christ's sake. This thread is NOT saying that they are less competent. Just that the direct BSN students have less skills practice. The OP stated straight out that she felt she didn't get much practice. I swear, if I told you the sky was blue you would say that I meant it was bluer over me.
But, hey, if you want to feel inferior, go for it. Not my job to make you feel better.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
For some reason, this shocked me. You are so wise and benevolent, I just figured you'd been there and done it all.
I'm not yet wise, but I think I might be getting there sooner rather than later.
However, I am far from benevolent. My real-life demeanor is a 180 degree turn from my online persona. I'm less helpful, more insulated, more reserved, and far more self-focused in real life. 'Dry' and 'aloof' would be appropriate words to describe my off-screen personality.
Oh, for Christ's sake. This thread is NOT saying that they are less competent. Just that the direct BSN students have less skills practice. The OP stated straight out that she felt she didn't get much practice. I swear, if I told you the sky was blue you would say that I meant it was bluer over me.
But, hey, if you want to feel inferior, go for it. Not my job to make you feel better.
Why so hostile?
I honestly don't care what you think about BSN-prepared nurses, but realize that stories do not constitute facts. Please link your sources before making unsubstantiated claims. Otherwise, it just comes off as a snarky attempt to bash those with different degrees from yourself.
I swear. If someone started a thread stating that ADN nurses were less prepared or skilled than their BSN counterparts, allnurses would be in an uproar.
I honestly don't care what you think about BSN-prepared nurses, but realize that stories do not constitute facts. Please link your sources before making unsubstantiated claims. Otherwise, it just comes off as a snarky attempt to bash those with different degrees from yourself.
What are you talking about? It's like you're having a conversation with someone else and you think it's me. I personally spoke to my experience with new grad BSNs. If you want facts and figures, look them up or ask one of the other posters who generalized. I'm not that interested.
Why are you trying so hard to get someone to say that BSNs are inferior? Just feel like picking a fight? Sorry, I don't feel that way so I'm not going to say it.
I also did not have much opportunity for these things in nursing school. I only started one IV and never cared for a foley, trach or chest tube. I just developed these skills as I began working. You will get the hang of things once you actually do them, and experienced nurses will be willing to help. Good luck!
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.
Me also. I started in LTC as a CNA and loved working with this pt population so much that I've never had even a little desire to work in hospital. 20 years later I'm still there. As long as you are fortunate enough to be hired in one of the good facilities orientation can be flexible. We offer a minimum of 9 shifts if the new nurse is already experienced in LTC nursing and 12-16 shifts for a new nurse. This can easily be lengthened if the new nurse requests additional time.
Just be prepared to make less money as a LTC nurse, though there are a few parts of the country where this specialty actually pays more. Too bad I don't live in one of them!
As far as the skills you mention being performed in a LTC setting, well it probably won't even come up for some of them. IV starts are very occasional, most of our IV residents have them inserted during a hospital stay and while we do have IV site maintenance it's pretty rare to start a line in house. We can't insert NG tubes as we don't have the equipment to perform a scan to confirm proper placement. Same for replacing PEG tubes, this is always done as an outpatient procedure at a clinic or hospital. One skill you can be sure to get a lot of practice in is foley placement and straight cathing. This we do..a LOT! You will probably also see quite a bit of wound care, some of it pretty complicated.
The trickiest part of LTC nursing is learning stellar time management skills. You will have a lot of people under your care, no way around that.
ThePrincessBride, MSN, RN, NP
1 Article; 2,594 Posts
Here we go...bash the BSN new grads post...
Ugh.
In my supposedly inferior BSN program, I started IVs, inserted a foley, had a decent amount of experience with NG tubes, tube feeds and I even had the opportunity to work with vented patients, arterial lines, etc. I had a one on one preceptorship my last semester on a med-surg unit where I got to deal with trachs and other skills. It also helped that I worked as a tech and had experience with blood draws and foleys and ostomy care.
There are still skills I don't feel comfortable with, but I am a brand new nurse. That is to be expected. I just know to ask questions and keep patient safety as my top priority.