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.
I could barely set up an IV when I started, but I also caught two strokes (one pt was tPa'd) pneumonia (because I was the only nurse who had had the patient before during his stay), and prevented a more experienced nurse from giving a med the patient was allergic to (and because I did it quietly, she thanked me) within the first 6 months.]
I worked several years as a phlebotomist, in behavioral health, and as CNA. I gained plenty of experience doing these, that I'm sure will help me when I graduate. I would like to start in specialty, and I know it will be demanding, but I'll try my best, and I will always keep humble. I don't think being a new grad is the problem. We come to the arena with fresh eyes and a lot of good intentions. Honestly, I think the problem is people's attitude from the new grads that believe that they are big hotshots to experienced nurses that don't remember when they were new grads.
Dear BlueDawnRN, ASN, RN I don't know which nursing school you went to, but my nursing school first semester we were passing meds, giving insulin, and everything an LPN does. Going to my fourth and last semester I have done several(over 100) IV's, urinary catheters, and way more. In clinicals the nurse just watch you do their job, it is awesome.
As a very new grad, my first job is in a very busy GI clinic. I feel overwhelmed sometimes but it's bc they have me training for various positions at the same time. I'm grateful to have been given this opportunity and I think that we all have to start somewhere. No one knew all they needed to know, no matter where they start. I think having patience and remembering how you felt as a new nurse helps training. I want to be the best nurse possible but I can't if I'm not given the opportunity. My thing is if you see the new nurse trying, like real trying, then give them some time to learn. I still have to study up on all the things we glossed over in nursing school and that's not even touching on administration, insurances, and paperwork! Happy nursing!
I am a new grad in the ER. I was on 3 months orientation before they would let me take patients on my own and I don't think I'm an elite hotshot but I think that I got alot out of my orientation and adapted very well to the environment and the daily demands of the ER. It is a huge learning curve without having been on a general floor with a slower pace. I feel that if you get the right training during orientation then the new grads should know how to clean and roll patients and med calcs and administration. They threw me in from day one and I loved it. They also say nurses that start out in the ER actually adapt better than if they were on a floor but I honestly think that each and every person is different and learns in different ways. I think it can be hard to learn everything you need to know if you don't have a good preceptor because it is such a fast pace. I was lucky to have an amazing preceptor whose passion was to teach everything he does. I have made some mistakes here and there but nothing major and if I'm ever unsure about anything I always ask a seasoned nurse so that I make sure I don't make a major mistake on drips and pedi LPs and things like that.
I could not have said it better myself, Crackling. I touched upon this aspect of poor schooling in my article posted in allnurses last year. Hands on experience is terrible, lacking, at least at my school. The OP was correct to complain.
"I could barely set up an IV when I started, but I also caught two strokes (one pt was tPa'd) pneumonia (because I was the only nurse who had had the patient before during his stay), and prevented a more experienced nurse from giving a med the patient was allergic to (and because I did it quietly, she thanked me) within the first 6 months."
I also as a new grad caught a baby having an absence seizure and I told the doc and she yelled at me saying that it was NOT an absence seizure because the baby cried upon hard nipple stimulation. The next shift I worked I found out that same baby got admitted for seizures. I never got an apology from the doc. I don't feel I know everything but that doc was very defiant about listening to what I had to say.
In Northern Nevada word around suggests the ADN grads are in higher demand than the BSN grads due to the fact that they spend more clinical hours doing the very skills you describe. I've heard it enough times to know there's truth behind it.
Well I have been called out for being a constant deviant, but here is my opinion. Nurses (even though I despise the pay scale) are hitting the floors with BSN and MSN degrees. It is not elitist to enter an entry level nursing job (no offense but any specialty with a basic requirement of "RN" is entry level) and act as if they know something, they are trying to show that they should be there.
The old head down victim nurses are being replaced by new nurses who are demanding respect right out of the gate, and this is not a bad thing. Regardless of your approach to nursing you will make mistakes but you will also shine. Stop giving a **** about how someone got there and be a team member and start supporting them.
FYI.... APRNs are not even required to work bedside anymore so if this bothers you wait till your CNS teaches you to change a central line drsng, and they have never actually done it themselves:)
I'm currently a float pool CNA at an acute care hospital a nursing student working on my BSN about to start my Med-Surg 2 term. I have been told by countless nurses when I graduate to do at least 1 year on med-surg or a telemetry unit to grasp the basic skills, time management, and patient care. Sure nursing school teaches us skills for the field of nursing, but we have to gain and use critical thinking as well. I have been told starting as a new grad it is a whole different beast within itself outside of nursing school. I am very fortunate I took a CNA course and work as a CNA. It has given me a foundation to build off of and hopefully make me a better nurse. Not every student or school give their students the opportunities to practice skills like NG, foleys, IVs, med pushes, passing meds, and etc, but take the opportunities if they are there, be proactive and ask. You can make the best of your schooling and clinical rotations. Yes, sometimes students are paired with nurses that do not like to work with students, but prove them wrong by doing your best. I'm sure by the end of your shift they might think differently of you. I haven't had too much opportunity to do IVs in the hospital, so I practice at home on family, friends and friends that are nurses. I hope when I graduate and find a job, that the hospital that hires me has a great new grad program. That is one of the top reasons for hospitals I will apply at. I think nursing students and new grads bring back a flame into seasoned nurses and employees. Most newbies are eager and excited to learn something new, understand, or grow that it inspires seasoned employees. As a new grad if I am given the opportunity and if there is a new grad program in the ER, I would like to do that. If you want to be an ER nurse, the best place to learn is in the ER and so on. If I have to, I will pay my dues working on the floor in med-surg or telemetry. Lastly, its not necessary the nursing schools that are failing to prepare the students, but also the new grad programs. The better and more structured the new grad program is, better the success rate and quality of nurses it will produce for their hospital. Yes, also depends on the attitude of the student as well. Never think you are above or deserving, be thankful you are given a job.
I agree. We spent 2 weeks on those basic skills and that's it. Now med calcs we do constantly. But the basic CNA type stuff we never did outside of skills lab
Would you please clarify for me what you mean by "basic CNA stuff"? outside skills lab.
I do not want to prejudge you/your post before understanding what you mean w/that statement-thanks
I think working in a floor like med surg would still require you to learn the skills you mentioned above, such as rolling and changing sheets. I think becoming better at this tasks requires time and experience. You'll have to learn all these skills in any floor. I started in ICU and I'm a new grad, and I do find myself wanting to be better at some tasks but I feel that I lacked the training in my school, and no matter where I go I will be the same. It's all about learning
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