New RN who may lose her Med Surg job

[Epona]

Hi all. My preceptor has told me that I am weak in hands-on skills. I graduated with my BSN and was in the top of my class. I had no previous nursing skills before I got my RN. I was not able to do my externship because of an emergency that came up the summer before I graduated.

They have told me on my crazy busy med surg unit that I am very smart and have a great theory base, BUT, my clinical hands-on skills are lacking. They have suggested I practice on the "dumbies" in the hospital lab and "play" with the machines. They have told me that if my skills are not up to par in two weeks (when orientation is over), there is a chance they could let me go. This is very discouraging. :uhoh21: I have worked REALLY HARD for this.

What do you suggest?? Is there a book I can use as a quick reference?? I am employed there, full time, passed the drug test and all, been working fine, etc.... do you think they will just let me go?? My RN manager likes me and has told me I am smart. My preceptor thinks the same, but has noticed my frustration when I try to do the hands on. I am just lacking here. What do you think?? Can they just boot me out?? I asked if it came to that if could put me on another unit where it is not as busy, but I am not sure if they would do that OR just let me go. Oh my..... what do you suggest to help me?? I was a top student and now I may lose my job. HELP!!!!

[AZO49008]

I think the advice others have given you is sound. Now for my two cents: I would approach your preceptor or director and THANK them for bringing these things to your attention. They could have let you go two more weeks and say "so sorry, see ya." Look at the positive side - they must see potential in you or they likely wouldn't have given you a heads up.

Next, take their advice to heart. Go to the lab, ask other nurses about "best practices" and go back and review your clinical skills textbook. Even if you don't make a lot of progress in two weeks (you made it through nursing school, so I would be surprised if you couldn't pull this off - give yourself some credit!) the fact that you were willing to make a concerted effort and improved somewhat might show them you are serious about imrproving and that could save your hide.

In addition, I would sit down after you speak with your preceptor and gotten specific feedback and draft your own improvement plan. It doesn't have to be elaborate. But you should document that a) you understood their concerns, and b) you are taking action to correct any deficiencies. Then share it with your preceptor and/or director. And just like writing a care plan in nursing school, make sure it is measurable, lol (i.e. I will spend 5 additional hours each week in the SimLab practicing XYZ). It will again show them that you are professional, motivated and worth keeping around.

Good luck!

[Blackheartednurse]

I have to disagree. As a new nurse, I think it's important to take what they say to heart and work on improving those skills. Some places may always look down on her, but that doesn't mean all will. She doesn't say how long of an orientation she has had. Is she at the end of a 6 month orientation, and is stil struggling? They could have very valid concerns, and without knowing the whole story, it is a bit premature to automatically jump to "you should find a new place and quit"

If after doing the work they ask, improving her skills, and she they have unrealistic expectations, then yes she should look for a new job. But how is one to ever learn and improve if they just get a new job everytime the one they have says they are somehow lacking? That won't solve the problem, only delay it for a while.

All I'm saying that she should start looking for another job,just in case.

[llg, PhD, RN]

Epona: How many jobs have you had since graduation?

Perhaps I am confusing you with someone else on this board, but it seems to me this is not your first job since graduation. If that's the case, you may need to get some serious career counseling to help you find something that will fit your particular personality and skill set.

I encourage you to take full advantage of that skills lab and get as much practice as you need. You've been told what you need to do. Now you need to put in the necessary time and do the work.

[heartbrokenRN]

Hi Epona! I'm glad you were able to find this site so that you can vent and get some feedback from others. I've been in your shoes and I can't say that I was successful in getting around the situation. If you look at some of my other posts, you will get to know my own situation. I also was a top student, had prior work experience, however, I did not have the benefit of having specific areas of needed improvement pointed out to me. I was simply let go the day before my probationary period was up. I would definitely go look things up in your med-surg book. Book knowledge cannot replace hands-on skills, but it will help pull the pieces together. Make it known that you are putting in the effort, ask for advice from other experienced nurses (not the ones who will go and advertise your "ignorance"). It's hard knowing that jobs do not come a dime a dozen these days so hang onto what you have... Try to change the impression that people have already formulated about you- you are a new grad and will not know everything, but you are trying. Just know that you are not alone! Please keep us updated on your situation!

[Batman25]

I do think many nursing schools are so heavy on the classroom and woefully light on the clinical aspect. The truth is you need to be able to do these things again and again to get good at it and become comfortable with the tasks. That comes with time and experience.

Get a list of the skills you are most lacking and get in that lab. Practice practice practice. If you are having tons of trouble with foleys ask the other nurses if you can insert theirs. If someone is great at IVs ask if you can watch them do a few. I think with some practice you can do this.

[Calixan]

Well, like I said I am a nurse extern so I have done ekg, foleys and assessments when patients arrive on the floor BUT have never done it as apart of school clinicals so I'm not really "checked off" on it. I just feel bad for those in the program who don't have medical experience but then again I don't. If all the students in my class would stop asking to leave early or would put there foot down and say they wanted to stay, we would probably learn a little more. The school is always going to be accredited because "on paper" it shows us staying the full time. We really don't though.

[jjjoy, LPN]

The truth is you need to be able to do these things again and again to get good at it and become comfortable with the tasks. That comes with time and experience.

If one has the combined bad luck of graduating from a program light on clinical and ends up not "getting up to speed" quickly enough for employers, there often is no recourse for the nurse to get the hands-on practice they need.

[ShannonRN2010, BSN, RN]

I would ask your preceptor what areas you really need to focus in, then go practice it in the lab!

[ShannonRN2010, BSN, RN]

It also surprises me that you don't have a skills check off. At the end of our first week of orientation to the facility, we have a skills check off.

Maybe your preceptor would be willing to go to the lab with you and go over a few things with you?

[Hopeful3]

>> my clinical hands-on skills are lacking. They have suggested I practice on the "dumbies" in the hospital lab and "play" with the machines. They have told me that if my skills are not up to par in two weeks (when orientation is over), there is a chance they could let me go

Get busy girl! If you want this, fight for it! You have the job, now show them you can do it.

Find someone to follow around that you respect and that will be honest and kick your a** some! You need to toughen up and get with it. I would be there 24-7 showing you have what it takes, and let us know what happens in two weeks.

YOU CAN DO IT!