We have several new grads in our ER. I'm starting to think that most nurses should have at least a year on a more general ward before learning a specialty.
I'm seeing some clueless mistakes, and lack of basic skill in pt care. That includes things like how to clean a pt and roll and change bedding. Basics about IV med administration, dose calculations, prioritizing, and realities of inpatient care. They have no idea how the rest of the hospital functions.
On top of that, some of them seem to harbor elitist attitudes, as if they are already big hotshots. Yet, they themselves seem to lack the above mentioned skills.
@hillaryinscrubs, I am a nursing student and I too dislike med-surg even though I am on my first rotation. I don't think I'll ever be happy working med-surg. I have always been interested in OR nursing, which is very specialized. I've met many nurses who love OR nursing and dislike med-surg nursing. I highly respect Med-surg nurses for having multi tasking skills, managing many pts at once.
I always wonder how new nurses/students get this sort of mentality. In nursing school, we didn't get a full-on OR rotations. I had a few observation days, but nowhere near enough to say, "yep, this is for me." What I observed in an intra-op environment was completely and totally different than what it was like when I was dropped into a circulating role actually taking control of a room, from timing out, to charting, etc.
When I was a student, I had a surgeon poke at and show me a parathyroid. I was engrossed in the anatomy and physiology, the music going, the polite conversation, etc. And none of that, at all, is any representation of what you actually do, when you're a circulator. So I'm wondering, do you actually get several weeks of preceptorship in the OR? Or are you just guessing that this is what you are 'meant to do'?
Edit: I reread and realized that came off a bit harsh. Did not mean it like that at all. I'm genuinely wondering if different programs do different things/what goes into making that decision. And I will not judge at all if you give me an answer like, "I dunno, it just seems cool."
Specializes in OR, Nursing Professional Development.
I always wonder how new nurses/students get this sort of mentality. In nursing school, we didn't get a full-on OR rotations. I had a few observation days, but nowhere near enough to say, "yep, this is for me." What I observed in an intra-op environment was completely and totally different than what it was like when I was dropped into a circulating role actually taking control of a room, from timing out, to charting, etc.
When I was a student, I had a surgeon poke at and show me a parathyroid. I was engrossed in the anatomy and physiology, the music going, the polite conversation, etc. And none of that, at all, is any representation of what you actually do, when you're a circulator. So I'm wondering, do you actually get several weeks of preceptorship in the OR? Or are you just guessing that this is what you are 'meant to do'?
Edit: I reread and realized that came off a bit harsh. Did not mean it like that at all. I'm genuinely wondering if different programs do different things/what goes into making that decision. And I will not judge at all if you give me an answer like, "I dunno, it just seems cool."
Thank you, thank you, thank you! This is one of my pet peeves about the surgical observation day(s) that students get. They aren't following the circulating nurse; they're watching the surgery. Even the paperwork they have to fill out doesn't really focus on the nursing duties. Maybe it's just the students at the school who does their clinicals with us, but it seems more generalized than that.
I had zero observation in the OR as a student. I did, however, spend my senior practicum/preceptorship in perioperative services. I loved it and that's how I ended up in the OR. My school used to offer an optional OR elective (stopped it just as I would have been eligible to take it), and I really wish that over the summer, students had access to electives where they could experience a closer look at some of the nursing specialties that just don't get covered in clinicals.
if you're complaining about how your nursing program didn't provide you with certain rotations, or you didn't get certain skill sets while in nursing school, look and see if your nursing school is on the top 100 list, I seriously doubt it is. all I have to say is that you only have yourself to blame for not fully researching the school you went to before going there.....should have chose your school better!
OR was one place that never seemed to appeal to me, I used to go to the OR with my burn patients and some EP patients and that was fun, but I watched the nurses standing in one spot for long periods of time, and didn't think my back would like that much, but I did enjoy going for cases I was involved with.
if you're complaining about how your nursing program didn't provide you with certain rotations, or you didn't get certain skill sets while in nursing school, look and see if your nursing school is on the top 100 list, I seriously doubt it is. all I have to say is that you only have yourself to blame for not fully researching the school you went to before going there.....should have chose your school better!
if you're complaining about how your nursing program didn't provide you with certain rotations, or you didn't get certain skill sets while in nursing school, look and see if your nursing school is on the top 100 list, I seriously doubt it is. all I have to say is that you only have yourself to blame for not fully researching the school you went to before going there.....should have chose your school better!
Perhaps your school didn't prepare you to analyze research, or a simple ranking of nursing schools.
Your list of top 100 hundred nursing programs is for master's programs.
I have never worked in a Med/Surg environment ( NICU and ED) but I felt school really covered the basics, heck a'll we did at first was give baths. I've never had a problem adapting to my specialized jobs and have always received positive feedback. ( of course there is always tons to learn!) I think each nurse is different.
Specializes in Progressive Care, Cardiology, Pulmonary, Stroke.
Today, it seems as though many nursing students are barely trained to provide hands on nursing care any more. I have read numerous accounts of the lack of clinical training students have received, but I have never really read good explanations for the reasons why nursing training has changed so much. I remember when nurses who were hired into the ER/ICU were mostly experienced nurses. I don't really understand why facilities hire new nurses into specialties such as the ER, when the nurses can't even function at a basic level.
Lawsuits, unfortunately Seems like most clinical instructors are terrified of losing their license... wont let any students perform skills without them present... Ive had some like that and others fine with me doing skills with a staff nurse. Even in peds as long as the nurse was ok with it.
Lawsuits, unfortunately Seems like most clinical instructors are terrified of losing their license... wont let any students perform skills without them present... Ive had some like that and others fine with me doing skills with a staff nurse. Even in peds as long as the nurse was ok with it.
I don't know how many times and in how many places I have to remind everybody that students are NOT "working under the instructor's license." No. Not.
Every student has a scope of practice-- student. S/he is operating under limits delineated by the agreement between the program and the hospital, is an adult, and is responsible for not exceeding the scope of practice outlined in that agreement. The licensure of the CI or the preceptor has exactly nothing to do with it. I know that sometimes even CIs don't understand this, or if they do, sometimes they intend to scare their students by threatening them with "you're operating under my license" to keep them in line. Still not true.
If the agreement says students may not do X at all, that's that, and even if your preceptor or your CI offers to let you do X under her supervision, you dast not. Your preceptor or CI would be liable for anything that goes wrong if you do, but that's because they let you, not because you're operating under their licenses. You would be screwed too, because you exceeded your scope. NOBODY, ever, even when you're an RN can tell you it's ok to exceed your scope of practice because they'll cover you. What will cover you is the bus they threw you under.
If the agreement says you may do Y under supervision from your CI or preceptor, you'd better not do it without one of them watching you. If you do, it's on you and nobody else, and you are screwed if anything bad happens, and maybe even if nothing bad happens at all, because you have exceeded your scope of practice.
If it says only students at last semester level may do Z independently, then no other student had better do it independently.
Every student has a scope of practice-- student. S/he is operating under limits delineated by the agreement between the program and the hospital, is an adult, and is responsible for not exceeding the scope of practice outlined in that agreement. The licensure of the CI or the preceptor has exactly nothing to do with it. I know that sometimes even CIs don't understand this, or if they do, sometimes they intend to scare their students by threatening them with "you're operating under my license" to keep them in line. Still not true.
If the agreement says students may not do X at all, that's that, and even if your preceptor or your CI offers to let you do X under her supervision, you dast not. Your preceptor or CI would be liable for anything that goes wrong if you do, but that's because they let you, not because you're operating under their licenses. You would be screwed too, because you exceeded your scope. NOBODY, ever, even when you're an RN can tell you it's ok to exceed your scope of practice because they'll cover you. What will cover you is the bus they threw you under.
If the agreement says you may do Y under supervision from your CI or preceptor, you'd better not do it without one of them watching you. If you do, it's on you and nobody else, and you are screwed if anything bad happens, and maybe even if nothing bad happens at all, because you have exceeded your scope of practice.
If it says only students at last semester level may do Z independently, then no other student had better do it independently.
Hope that clears that up. AGAIN.
Thank you! On every unit, we have a list of tasks that nursing students can perform, and underneath it it says, "Remember, a nursing student can do anything YOU can do, as long as you are present for it!" That being said, when I have students shadowing me for one day, of course I'm not going to let them sedate or time-out, but I'll let them have a go at an IV, if they can talk to me through the technique. Not going to let someone I've just met start jabbing my patients. And for the ones that follow preceptors around for 12 weeks, and their preceptors get to know them, of course they let them do even more.
I don't know where that misconception came from about students being on their clinical instructors' licenses. During my capstone rotation, my clinical instructor wasn't even always at the facility when I was there. I wouldn't have been able to do anything!
Seems like most clinical instructors are terrified of losing their license... wont let any students perform skills without them present... Ive had some like that and others fine with me doing skills with a staff nurse. Even in peds as long as the nurse was ok with it.
Awesomocity0
100 Posts
I always wonder how new nurses/students get this sort of mentality. In nursing school, we didn't get a full-on OR rotations. I had a few observation days, but nowhere near enough to say, "yep, this is for me." What I observed in an intra-op environment was completely and totally different than what it was like when I was dropped into a circulating role actually taking control of a room, from timing out, to charting, etc.
When I was a student, I had a surgeon poke at and show me a parathyroid. I was engrossed in the anatomy and physiology, the music going, the polite conversation, etc. And none of that, at all, is any representation of what you actually do, when you're a circulator. So I'm wondering, do you actually get several weeks of preceptorship in the OR? Or are you just guessing that this is what you are 'meant to do'?
Edit: I reread and realized that came off a bit harsh. Did not mean it like that at all. I'm genuinely wondering if different programs do different things/what goes into making that decision. And I will not judge at all if you give me an answer like, "I dunno, it just seems cool."