New grad from online RN program with ZERO CLINICAL EXPERIENCE

[angel1312]

Hello everyone so after covid hit, everything transitioned online, including clinicals. I am going to graduate this December but I have a huge problem.

I HAVE NO HOSPITAL EXPERIENCE!!

The only clinical I went to was at nursing home where we didn't do much besides feeding the residents and taking vital signs. We did not get to pass any medication, look at documentation, etc. I have never done or observed any basic nursing skills such as administering IV, documenting, passing a med, IV push, foley, assessments, etc.

I feel like I know nothing and will be fired from my first job because I am completely clueless. What do I do ? 

[Hoosier_RN, MSN]

6 hours ago, Words Matter said:

LOVE IT!! Talk about perspective ?

That was the Civil War. There wasn't much in the way of formal nursing education and registration/oversight by state. Just a thought

[The Seasoned Nurse, BSN, RN]

On 11/17/2020 at 6:17 PM, CalicoKitty said:

Honestly, schools get so uptight about how pretty your "nursing care plans" look. They grief nurses about having stripes on their shoes. Have a tattoo, maybe you don't even get into a program. I found a lot of it was petty, to be honest. I hated peds, and really got almost nothing out of maternity (except seeing 3 lady partsl births) because I had no interest in working in either population, and those were some of the most stressful clinicals. I got on the job training thru a new grad program.

Yes! All of this! When I watch students in clinicals, I see them stressing over paperwork. I notice they spend hours in the break room working on their care plans instead of actually learning to take care of patients. Then they go off and take a leisurely one hour lunch. This experience is nothing like the real world. I would not stress about missing out on clinicals, you will be fine. I would encourage you to be upfront with your preceptor about your lack of hospital experience so they know to take it a little slower with you early on. Good luck to you!

[Hoosier_RN, MSN]

4 minutes ago, The Seasoned Nurse said:

I notice they spend hours in the break room working on their care plans instead of actually learning to take care of patients. Then they go off and take a leisurely one hour lunch. This experience is nothing like the real world

Exactly, then they get culture shock when they get into the real world of nursing. 

Hospitals know that these new grads haven't had much direct care lately, but still want to spend minimal time with residencies and orientation, if they even hire new grads at all

[CalicoKitty, BSN, MSN, RN]

I did see that some people graduated from programs with "capstones". Where, basically they spend a period of time (semester, x # of hours) working with a staff nurse, on that nurse's schedule. Basically like an orientation program. My program didn't offer that.  Mine was like 7am-1pm (including the last hour as lunch/discussion)... Maybe get a vital signs or blood sugar.. pass meds once or twice per semester..... Often did not even have access to the EMR...

[BSN-to-MSN, ADN, BSN, RN]

On 11/17/2020 at 3:13 PM, angel1312 said:

Hello everyone so after covid hit, everything transitioned online, including clinicals. I am going to graduate this December but I have a huge problem. I HAVE NO HOSPITAL EXPERIENCE!! The only clinical I went to was at nursing home where we didn't do much besides feeding the residents and taking vital signs. We did not get to pass any medication, look at documentation, etc. I have never done or observed any basic nursing skills such as administering IV, documenting, passing a med, IV push, foley, assessments, etc. I feel like I know nothing and will be fired from my first job because I am completely clueless. What do I do ? 

Apply to the hospitals, do not let yourself think you are worse off than others. There will be more and more new nurses with no clinical experience. Every 6 months, many more. An extended orientation may be an option for you. 

[ThePrincessBride, MSN, RN, NP]

I am precepting a new grad whose education was affected by the pandemic and it shows. She can't do some of the most basic stuff that it terrifies me. 

[ThePrincessBride, MSN, RN, NP]

On 11/20/2020 at 9:33 PM, murseman24 said:

How can one have the capacity for this when they are focused on how to prime the IV tubing they never got to touch in school?

No, you have to be able to go through the basic motions before you can "ascend" to the level of critical thinking.  

Yup. It really is quite shocking. In my program, we had a capstone where we were one on one with a staff nurse for an entire semester (four months) and by the end, we were taking an entire team and doing everything we were legally allowed to do. This was done at the end of the program to ensure that we could hit the floor running. 

Now? They are letting nurses out having had little to no clinical experience. It isn't right, nor is it safe.

[NurseNelly24, BSN]

On 11/19/2020 at 5:34 AM, RNperdiem said:

Seems like hospitals are the real nursing schools now.

Absolutely. It seems like hospitals—hospital management of course—are determining our scope of practice too. To think that hospitals have to make up for what most nursing schools are not doing is sad. We are truly not taking hold of our own profession, and it’s pretty evident in comparison to other health profession (MD, PT, Phamarcy etc.)

[NurseNelly24, BSN]

I know COVID hit an all, but I’m just curious if you’re in an ADN or BSN program. Either way, I’m quite shocked you went through an ENTIRE program with no hospital clinicals.

I mean if you’re in a 2 year program, the goal is to start clinicals the first semester isn’t it? Even if it was initially at a a nursing home, you’re telling me each and every clinical semester consisted of work in an SNF (especially last year pre-COVID?) If this was a BSN program, like wow: Huge Disservice to the students. 

As some mentioned, your best bet is to get into a NURSE RESIDENCY program. Residency programs tend to have better resources for new nurses to excel on their respective units.

If you get into one, you need to make it very clear to the educators and management what your program didn’t prepare you for; so they must understand what you have and haven’t been exposed to. I hope you also get a STRONG and PATIENT preceptor because most nurses precept new grads with the intention that they’ve had SOME sort of exposure. 

The other option is working in an SNF or LTC/Rehab and getting some experience before you reach a hospital setting. 

Most importantly, be a sponge to all you have to learn despite the information overload. The goal is to be a critical thinker, but take those practical skills just as seriously because the one thing that affects is TIME MANAGEMENT. If you spend 25 minutes trying to put in a Foley, or spend 30 minutes trying to put in an IV it can alter your ability to critically think in a time-sensitive matter. Good luck. 

 

[Hoosier_RN, MSN]

1 hour ago, NurseNelly24 said:

I know COVID hit an all, but I’m just curious if you’re in an ADN or BSN program. Either way, I’m quite shocked you went through an ENTIRE program with no hospital clinicals.

I mean if you’re in a 2 year program, the goal is to start clinicals the first semester isn’t it? Even if it was initially at a a nursing home, you’re telling me each and every clinical semester consisted of work in an SNF (especially last year pre-COVID?) If this was a BSN program, like wow: Huge Disservice to the students. 

As some mentioned, your best bet is to get into a NURSE RESIDENCY program. Residency programs tend to have better resources for new nurses to excel on their respective units.

If you get into one, you need to make it very clear to the educators and management what your program didn’t prepare you for; so they must understand what you have and haven’t been exposed to. I hope you also get a STRONG and PATIENT preceptor because most nurses precept new grads with the intention that they’ve had SOME sort of exposure. 

The other option is working in an SNF or LTC/Rehab and getting some experience before you reach a hospital setting. 

Most importantly, be a sponge to all you have to learn despite the information overload. The goal is to be a critical thinker, but take those practical skills just as seriously because the one thing that affects is TIME MANAGEMENT. If you spend 25 minutes trying to put in a Foley, or spend 30 minutes trying to put in an IV it can alter your ability to critically think in a time-sensitive matter. Good luck. 

 

Considering that Covid has only caused issues for not quite a year, I do find it interesting that some in 2 to 4 year programs claim no patient interactions. Covid only accounts for a year. Longer than that suggests program deficiency. Many students definitely got the shaft. Scary proposition 

[NurseNelly24, BSN]

2 hours ago, Hoosier_RN said:

Considering that Covid has only caused issues for not quite a year, I do find it interesting that some in 2 to 4 year programs claim no patient interactions. Covid only accounts for a year. Longer than that suggests program deficiency. Many students definitely got the shaft. Scary proposition 

Exactly, COVID has only been prevalent for approximately one year. It wasn’t until March, that we started seriously wearing masks and taking precautions. So my question is what were they doing before then? Definitely scary. 

[9kidsmomRN]

On 11/22/2020 at 3:43 PM, CalicoKitty said:

I did see that some people graduated from programs with "capstones". Where, basically they spend a period of time (semester, x # of hours) working with a staff nurse, on that nurse's schedule. Basically like an orientation program.

The ADN program in my area requires a preceptorship program. It is 72 hours in 4 weeks. The student nurse works with a nurse(unpaid) to gain experience. I think it can be excellent for the students IF they put effort into learning. 
You (OP) will get out of your orientation what you put into it. Newbies who think they will learn everything about being a nurse while in orientation/on the job are mistaken. Try to look up 2-3 things you had questions about during the shift each night when you get home. Ask your preceptor or educator for resources to enhance your learning. 
Maybe clinicals have changed. I never had time to work on my care plans during clinicals and neither do the students who come to my unit. We were expected to be there before 7am and stayed until 3:30 or 4:00pm for recap discussion. We did assessments, all med passing and total cares for our patients as well as the charting, though we didn’t take a full patient load until 4th semester. 
I hope that you are honest in your interviews. I would rather work with someone who admits that their education was less than optimal (not blaming) and understanding that this, though difficult, can be done!  I wish you the best.