Offically a second year student... is this a normal feeling?

[Fitzy819]

Hi all,

Well, after passing Mother/Baby I am officially a second year nursing student. Even though I should be happy, I guess, I am terrified. I still feel like I know nothing. I have done well in all my classes (mostly As, 2 Bs) and I know I have come a long way from when I started but it seems like there is so much to learn still and no way to learn it all in a year. I'm a champ at taking vitals and giving bed baths and we have passed meds, given a few injections, done some basic wound care, and a few other various things, but that doesn't even seem to make a dent in everything I know I will be expected to do and know after I graduate. We have already been told that we will not be starting IVs and that will be something we will learn "on the job" after we graduate. I hear about other hospital based RN programs in the area (my schooling is through a college) whose first semester students are already putting in foleys and starting IVs and this and that... I have only put a foley in plastic people. This just makes me so nervous.

Is this a normal feeling in nursing school? I hear a lot of people say not to worry, because the majority of nursing knowledge is gained after graduation but... AAAHHHH!!! I'm doing everything I can to gain more experience and knowledge but just seems like it will never be enough. I work as a pharmacy tech, volunteer at a local hospital, and have started applying to summer externship programs so I'm hoping that will all help some.

For the RNs out there, did you feel this way during school? Did you hear about other students getting more hands on experience and wonder how you would ever catch up? Any suggestions on things to do gain more experience?

Thanks for the input!!!

(Sorry if there are already a million other threads like this out there. I tried searching for some in the student forums but didn't have much success.)

[decembergrad2011, BSN, RN]

I am a fourth semester student about to finish up and move on to the next semester.

I think it is a little hands-off that your school doesn't do IVs or blood draws. Even some of our techs can do blood draws, so it's a skill that you should be able to do as a student under the supervision of a licensed nurse.

Overall, even with all of the time I've clocked in the hospital now in clinicals, I still feel fairly under prepared for many of the skills I need to learn. I do think that there will be a lot of learning on the job. I also think that a lot of what we are learning is going to be re-learned depending on what the facility, supplies, and policy dictate.

I would ask for more opportunities in clinicals to perform skills. Make yourself available to all the nurses on the floor - if someone needs a Foley, tell them that you'd like to try it. You also can observe nurses doing IVs and ask them to run you through the process as they do it. Watching up close isn't the same as practice, but it's good to see nonetheless. I would try to get away from doing just the tech things (bed baths, ADLs, vitals) if you can and ask to have patients who have more pressing issues, lots of medications, possibly a procedure like PICC line insertion, or chest tubes from a motor vehicle accident. All good learning patients.

[AKsummers]

I am also about to embark on my second year! However next semester for us is Pediatrics and OB, interesting. I have a lot of the same emotions as you, I study all the time and have managed to maintain a 4.0 but as far as my clinical skills and confidence go, they are diminished. I know how to put in a Foley, but was never present with a chance to put one in a patient. I have taken blood sugars, given insulin, given 2 tb tests, administered IV push meds as well as PO, assessments, hemaculted stools, and put in an NG tube. I feel like I have not had the oppertunity to practive and perfect my skills which also makes me nervous. I have been told by many people they didnt learn hardly anything until their first year working as a nurse, which sounds terrifying. Just know you are not the only one feeling like this.

[Fitzy819]

I am a fourth semester student about to finish up and move on to the next semester.

I think it is a little hands-off that your school doesn't do IVs or blood draws. Even some of our techs can do blood draws, so it's a skill that you should be able to do as a student under the supervision of a licensed nurse.

Overall, even with all of the time I've clocked in the hospital now in clinicals, I still feel fairly under prepared for many of the skills I need to learn. I do think that there will be a lot of learning on the job. I also think that a lot of what we are learning is going to be re-learned depending on what the facility, supplies, and policy dictate.

I would ask for more opportunities in clinicals to perform skills. Make yourself available to all the nurses on the floor - if someone needs a Foley, tell them that you'd like to try it. You also can observe nurses doing IVs and ask them to run you through the process as they do it. Watching up close isn't the same as practice, but it's good to see nonetheless. I would try to get away from doing just the tech things (bed baths, ADLs, vitals) if you can and ask to have patients who have more pressing issues, lots of medications, possibly a procedure like PICC line insertion, or chest tubes from a motor vehicle accident. All good learning patients.

Ugh, I just had something typed up and then I accidentally closed the tab

Thank you so much for the advice!!!

I try, as do all my clinical group classmates, to do as many procedures as possible. The problem is there just hasn't been very much to do yet. Maybe that is just normal for first year type of clinicals; I'm not sure.

We have been to:

-Nursing Lab: We learned all of the basic skills here. I really wish we still went there because I still feel like there are so many more skills that I would like to practice first, even if it is just on a plastic dummy.

-Nursing home: Only therapeutic communication and AM care

-Med-surg floor: More therapeutic communication and a few procedures, very few

-Psychiatric hospital: Even more therapeutic communication... but that was fine, it was a whole new world with therapeutic communication there

-L&D/Postpartum/Nursery floor: Mostly observation. There isn't much to do there and when there is, the nurses typically won't let us do it

I think we go to more critical care floors next year so maybe that will help. When we talk about stuff in class our instructors always say, "Oh, you will learn that later. Don't worry about it now." With only one year left, I'm just really getting worried that there is way too much to "learn later".

I will also try to speak up a little more in clinicals when I would like to do something. I have no problem speaking up when my instructor is asking if I would like to do something, but if I see a nurse about to do a procedure I would like to try I just feel like I would be in the way if I asked them. I guess the worst they could say is no, I just need to keep that in mind. Do you struggle with that too?

[decembergrad2011, BSN, RN]

I ask nurses if I can do certain things, if they are things that I have learned in school. For example, I took all of the newborn vital signs when I was in deliveries and on post-partum for my OB clinical, because I could do that. However I could not check a cervix, that was beyond what I had learned and was allowed to do in clinical. I could start IV's, do blood draws, massage funduses, etc though. If I have done the skill before, I ask if I can do it, unless it is a combative patient or an emergency situation. If the nurse offers to teach you, it's probably okay to move along with her and do the skill simultaneously, but you should have a general idea of your clinical expectations. For example, we were not allowed to hang blood products regardless of if a nurse was watching or not - nobody was allowed to do it in clinicals and it could be expulsion from the program if you did.

I think you should rely on your clinical instructor to be with you for certain opportunities which are more invasive, but overall I think that being confident and looking for opportunities to practice is important. Most people are willing to give you one go at a skill before they want an experienced nurse to just "get it over with" I believe. I don't really get met with a lot of resistance being a nursing student except from a small portion of the patients I have.

[joanna73, BSN, RN]

Don't worry :) we were all terrified at the start of second year. But everything will come together in time. I am a new RN BSN as of 3 weeks ago, so I remember how it felt. Try to sleep, stay organized, and have some fun. There will be a light at the end of the tunnel. I found it wasn't until my fourth year that things started to gel. Now, as a new nurse, the learning continues, which is a good thing. Happy holidays everyone.

[kbm318]

we don't learn how to do IV's either because they said something about a JCAHO thing I'm not sure what it was. But they said not to worry because the hospitals in my city all have IV teams that do it for you. I'm worried though because I'm moving out of state when I graduate and I don't know if it will make it hard for me to get a job because I have no idea how to start an IV

[jjjoy, LPN]

I hear ya, Fitzy. Your program sounds a lot like mine. First year we heard "oh you'll learn that later, plenty of time!" and as we neared graduation at the end of the second year we heard "what? you don't know that? that was already covered!" ... yeah, it was covered in one page of 3000 pages of text. And in lecture? Sure, it was covered when the instructor said "we don't have time to go into that now; there'll be plenty of time later." I do wish there were more options out there for nursing students whose programs were light on clinical and/or returning nurses who felt too rusty to build on their clinical experience without having to jump right into a full-fledged RN staff position. It feels as dangerous as trying to merge from a short on-ramp into fast-moving traffic from a full stop in a small engined car; if I could just have a bit more time to get up to speed, I'd feel a lot safer.