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 ? 

[londonflo]

6 hours ago, Wuzzie said:

I am completely aware of the challenges of finding clinical placement for students but that does not mean that the responsibility of clinical education should be abdicated to the floor staff. 

 

5 hours ago, Hoosier_RN said:

They bring the students and do a dump and run.

 

6 hours ago, Wuzzie said:

Many, if not most of us are experiencing something entirely different. Primarily, absent instructors who are available only by cell phone after depositing their students on a unit.

Such negativity. I tried to discuss with you all the challanges facing education and you fell back on broad generalizations. 

The OP was concerned about her transition to a post graduation position. Instead of offering her spirited enthusiasm for her entry into practice, you damned the whole educational process. If you have a specific complaint about an instructor -- please address your comment to that person(s) or school. When the schools ask for approval for clinical experiences at your institution, then is the appropriate moment to discuss your concerns, or on a later date follow up on who should be notified of the instructor's failings. You sound like  petulant children who expect more of the students clinical guidance but did you ever do any follow up? How would you feel if I said similar complaints about your work ethic.   Look if you do not want to be involved in assisting the next generation to learn the skills, competency and attitudes, please bow out, especially because of your attitudes.

 

4 hours ago, Hoosier_RN said:

I felt so bad for the students when they were dropped there, they were excited and just wanted to learn. But because of liability and placement agreements, I wasn't allowed to let them stay.

Hoosier, at least you acted on the problems present instead of indicting the whole clinical process.

 

4 hours ago, Hoosier_RN said:

I'm no longer in a hospital, haven't been for years.

Dated information is worse than no comment at all.

I will conclude this litany of the current state of the instructor's contribution to clinical instruction.

 

 

 

 

 

 

 

 

 

 

 

 

[Wuzzie]

18 minutes ago, londonflo said:

Such negativity. I tried to discuss with you all the challanges facing education and you fell back on broad generalizations. 

These aren’t broad generalizations these are personal experiences. We tried to discuss with you the realities of what we’re experiencing and you fall back on ad hominem attacks and name calling. 

[angel1312]

Hi everyone thank you so much for your replies. For those replies that were positive, thanks it made me feel a lot better and more optimistic. For the negative toned replies, I totally understand. I know its tough when theres a new nurse slowing the unit down because he/she has no clue as to what they are doing. My dream is to become a nurse and its finally coming true, just not how I expected it. If someone like me ends up in your unit please teach me what you know and please don't make me feel bad for asking a question because if something goes wrong you will say "why didn't you just ask me?" Well its because you seemed upset and made me feel like an idiot when I asked last time. 

I promise we won't be useless after a couple months of experience. I hope everyone can empathize with us. The sooner we learn things, the sooner we can help you out in return! Please bear with us because we didn't want this either!

[angel1312]

Does anyone have any suggestions as to where a new grad with no clinical experience should work?

I know I should definitely avoid the ICU because those patients are critical and those nurses need a lot of good skills. 

[Wuzzie]

3 minutes ago, angel1312 said:

I know I should definitely avoid the ICU because those patients are critical and those nurses need a lot of good skills. 

I don’t think that is necessarily true as long as the orientation is adequate to make up for what you lack in hands on clinical education and you’re willing to put in the extra effort to learn things on your own. 

[londonflo]

26 minutes ago, Wuzzie said:

These aren’t broad generalizations these are personal experiences

I stand by what I wrote. These were broad generalizations: absent instructor, abdication of responsiblilty, dump and run, only available by cell phone. 

[Wuzzie]

5 minutes ago, londonflo said:

I stand by what I wrote. These were broad generalizations: absent instructor, abdication of responsiblilty, dump and run, only available by cell phone. 

I stand by what I wrote. Ad hominem attacks and name calling reduce your credibility.    Pointless to continue this. Have a nice evening. 

[Hoosier_RN, MSN]

2 hours ago, londonflo said:

 

 

Such negativity. I tried to discuss with you all the challanges facing education and you fell back on broad generalizations. 

The OP was concerned about her transition to a post graduation position. Instead of offering her spirited enthusiasm for her entry into practice, you damned the whole educational process. If you have a specific complaint about an instructor -- please address your comment to that person(s) or school. When the schools ask for approval for clinical experiences at your institution, then is the appropriate moment to discuss your concerns, or on a later date follow up on who should be notified of the instructor's failings. You sound like  petulant children who expect more of the students clinical guidance but did you ever do any follow up? How would you feel if I said similar complaints about your work ethic.   Look if you do not want to be involved in assisting the next generation to learn the skills, competency and attitudes, please bow out, especially because of your attitudes.

 

Hoosier, at least you acted on the problems present instead of indicting the whole clinical process.

 

Dated information is worse than no comment at all.

I will conclude this litany of the current state of the instructor's contribution to clinical instruction.

I'm sorry that you feel that my personal experience is too old for what you're discussing. It doesn't make it any less relevant, as others have mentioned that this is still going on. When I was teaching, even more recently, multiple clinical instructors, both from my school and from another area school, were dismissed for doing the same thing. Luckily, different state, different schools from my original comment. So maybe now my timing is now better for you?

As far as complaining about my work ethic, if you can give specifics as I did, then have at it. Petulant children? No. Nurses who are frustrated at what is being pumped out-students who are mostly not prepared, and need their hands held for basic things. They apply to various settings all of the time with the expectation of a thorough residency program. Facilities continue to cut back on those programs, expecting schools to teach. You say we should bow out if we don't want to teach? We are there to guide and add to the teaching, not carry out the whole teaching process. 

It seems as if you are taking this as a personal attack on you and your career. If you did as you say you did, then kudos, you are in the minority. Reading comments on here, not many of that caliber anymore. And before you get into the same argument about number of clinical sites, remember, the school knows exactly what is available when they accept x number of students. In the end, the student suffers, and here we are

[Hoosier_RN, MSN]

2 hours ago, angel1312 said:

Does anyone have any suggestions as to where a new grad with no clinical experience should work?

I know I should definitely avoid the ICU because those patients are critical and those nurses need a lot of good skills. 

Begin in an LTACH if you don't land a residency. Good experience, will build time management skills plus help you to learn basic hands on skills. Also will teach many meds. Good luck!

[JKL33]

@londonflo,

I often enjoy your comments because they remind me of the way clinicals were not very long ago.

But things are going down the tubes, fast. You think Wuzzie has taken your comments too personally but you are kind of doing the same. We know there are excellent nursing instructors. We know that you have to do the best with what you're given and/or allowed to do. Understand that this line of discussion continues on because people feel that the good things we experienced (such as some of the very same things you are proud of having facilitated) are just increasingly being deemed unimportant. I'm pretty sure that if you walked back into the important instructional roles that you have performed in the past....you may be a least a little appalled.

Nursing schools and hospitals seem to be constantly scheming both with and against each other in such a way that they are driving everything into the ground. Nurses, student nurses, and of course patients are the casualties.

 

10 hours ago, londonflo said:

Some of my best clinical days were where staff were totally involved creating a good learning environment

One major change has been the factor of time itself.  The staff nurses whom you want to help provide the education that someone else is being paid to provide (educational institution) are working against timers now, you know that, right? I used to LOVE having students; even now I still love the idea of being able to help student nurses get great experiences. But these days every single medication that is ordered on one of my patients pops up on my screen with a red "overdue" timer the second the order is active. Managers sit in their offices and look at their dashboards monitoring real time stats on how fast I am doing x, y, z. When we go to staff meetings they might pull some dumb stunt like passing around a list of all staff nurses' names noting our average times for collecting lab samples from patients once the order is active. (To encourage people, not to shame or blame anyone, of course. ?) And so much more.

You give the example of showing up on a floor/unit 1.5 hrs early to make connections and prepare for the clinical day. This would be neither entertained nor tolerated in the Magnet facility with which I'm most familiar. It would probably be a HIPAA, TJC or OSHA violation and also no one would have time to stand around chatting and hearing about what kinds of experiences your students need.

It kind of seems like none of this is the fault of the instructors or the staff nurses, but rather their two (respective) greedy employers.

 

1 hour ago, Hoosier_RN said:

And before you get into the same argument about number of clinical sites, remember, the school knows exactly what is available when they accept x number of students.

Had this exact thought earlier. I'm also not sure how a given region, X, can need so many nurses to be pumped out (or can support so many schools) but yet not have places to put the students for clinicals. Who's going to hire all these new nurses who were produced in a region where there supposedly aren't enough sites or patients for the students to have had decent clinical experiences?

 

3 hours ago, angel1312 said:

For the negative toned replies

 

3 hours ago, angel1312 said:

if something goes wrong you will say "why didn't you just ask me?" Well its because you seemed upset and made me feel like an idiot when I asked last time. 

Best of luck.

[Quota, BSN, RN]

I’m currently precepting a new grad who missed out on a lot of clinical experience, no capstone either.  She went through the same ABSN program I did a few years ago.  It was a bit of a rough start as I realized just how lacking in hands on skills she was but with a little patience she has caught on quickly to most things.  Her orientation has been extended slightly because of this but I think she will do well on the unit in the end.  Things certainly would have been easier if she had that clinical time and hands on experience but she is hard working and knows when to ask questions.