Published Jun 20, 2005
I'm about six months into my program and I am really starting to get worried. We are starting to do some pretty serious procedures in lab which require lots and lots of practice just to check off on the mannequins. We will be expected to do some of these procedures in clinicals, but obviously we are not going to be able to do all of them and even the ones we do will be under supervision and I do not feel confident going into a job with that level of experience. My question is, when you start working as a nurse, how much guidance do you get when you have to do these procedures? I worked as a CNA in a LTC and I saw LPNs fresh out of school come onto the job, get three days orientation and then it's sink or swim. Can you tell me about your experiences?
I'm about six months into my program and I am really starting to get worried. We are starting to do some pretty serious procedures in lab which require lots and lots of practice just to check off on the mannequins. We will be expected to do some of these procedures in clinicals, but obviously we are not going to be able to do all of them and even the ones we do will be under supervision and I do not feel confident going into a job with that level of experience. My question is, when you start working as a nurse, how much guidance do you get when you have to do these procedures? I worked as a CNA in a LTC and I saw LPNs fresh out of school come onto the job, get three days orientation and then it's sink or swim. Can you tell me about your experiences>>>>>>>>>>> Im my experience I was left to sink or swim in LTC-however my orientations in acute care were much longer and more thorough.Bottom line-you are responsible for your own actions.If you are called upon to do something you have never done or are uncomfortable with then you need to ask your supervisor for assistance.This goes for RN's,LPN's and CNA's.....No one can ever hope to perform every possible procedure during their clinicals and orientation....Like they say-the only stupid question is the question that is not asked.....
i have been an lpn for 11 months and it was scary at the first and sometimes it still is. if i was worried about doing a procedure or only had done it on a mannequins i would get another lpn that knew how or get my rn to help me. if u are uncomfortable always get another nurse. u will do fine, it gets easier
Its true, it is sink or swim.
Having said that knowing how to ask for assistance is part of knowing how to swim. The best preceptor I ever had was an LPN with 40 years experience and she admitted she hadn't done something in ages and said lets do it together, got the facility guidelines, gathered the supplies with me and walked me through it with the procedures manual.
She also told me its time to get out of nursing when you don't enjoy going in every morning. She's 64 this week and still enjoys going in...
I worked as a CNA in a LTC and I saw LPNs fresh out of school come onto the job, get three days orientation and then it's sink or swim. Can you tell me about your experiences?
#1 rule of nursing.........CYA (cover your ass) (If it isn't charted, it wasn't done)
#2 rule of nursing.........IF YOU AREN'T COMFORTABLE DOING IT.....DON'T UNLESS YOU HAVE ASSISTANCE.
It is scary to do new things, but you have to do EVERYTHING for the first time at some point, but ONLY when YOU are Comfortable with it!!!! :uhoh21:
Always CYA. If you're not sure how to do something, ask a coworker if he/she can find the time to show you how to do something because you're not experienced in doing it. I'm sure they will gladly help you. Then the next time, ask if they can watch and guide you while you do it. Since she helped you, ask if you can do something for them as a trade off like her finger sticks or a straight cath or something you're familiar with. Most of the time they'll say, "Oh, that's ok, don't worry about it." But at least offer. Team work goes a long way. :wink2:
By the way, I've been an LPN for 30 years and I've never straight cathed or placed a foley in a female pt. and I hope to God I never have to. :uhoh21:
mandykal, ADN, RN
As you continue the program and start clinical, your confident will grow. I have about 12 days left, and during my past rotations, the scariest for me as a guy, is the first time I had to do the procedure. But after that it wasn't bad, but you have to have that attitude to "want to learn." Don't be afraid to get your hands on. My first clinical, first day I was assign to a patient with a trach. As I entered the room, I met his wife who was an RN, that made it worse as I thought at the time. As I was doing my first assessment, he started to gag, and the alarm was going off. The wife told that he needed to be suctioned, my eyes was bulging, I quickly went to the next room called my clinical instructor (because I couldn't do anything without her), I told her I was going to get the nurse to suction my pts, she said "YOU ARE THE NURSE"...we proceeded to check my client, and he indeed needed to be suctioned, I grabbed my sterile glove because this was an open-suction...and just did what I was taught. Can you imagine my adrenaline...
So, when you do your labs, apply yourself, don't mess around because the real time might or will come, and knowledge of the procedures goes a long way. And you should over-come your fear after the first time. Good luck.
I love that acronym; CYA Cover your anatomy!
Lucky you not having to do that.......its not as easy as it looks all the time, and doing it on female peds is even harder!!
When I started on my job, I had 6 weeks orientation. I could have had more if I felt I wasn't. Most procedures I had to watch, then do it while being watched. Even after orientation, there were a few things that I didn't get to do that came up. My fellow nurses are good about showing me things if I don't know them. Even my nurse manager will show me how to do procedures. When you interview for a job, make sure you find out what type of orientation they have and if you can get longer if needed. It is YOUR license that you are putting on the line.
There is no way you can get all the practice you need in clinicals. My instructors told me I would really learn to be a nurse when I got a job...and it was true. There are showing you a little bit of everything. You will zero in on your job depending on where you end up working. On the job training..that's what it is. But you will have a good background from school to help that training. Watch and learn from each nurse that you get to train under. They all have different styles. I picked up a little from each and have my own style now.
I'm going to cross post this to the LPN/LVN Corner...
I agree with many of the above posters... if you dont feel comfortable doing something, you find someone who's comfortable with the procedure, and you have them do it with you...
I've found that a quick and effecient confidence boost, is to fake it in front of the patient... Instead of saying 'I'm gonna try and attempt to insert this foley'.... say... 'hi, my name is Cashew(insert your own name here) and, I am going to insert this foley'
Not a major difference, but more often than not, even with someone with you supervising and helping, Showing confidence in front of your patient will make them confident in you.... gods gotta love psychology.
Review what you gotta do before hand.... if necessary, do it step by step in your head, take a deep breath, walk in, introduce yourself and the procedure, take another deep breath... then do it...
I rely on the faked uber confidence more often than most people that know me would think... 'Hi, my name is Cashew, and I'm going to start an IV on you now. Do you have any questions?' works much better than saying 'hi, um I"m gonna try and attempt to kinda hopefully start an IV on you.'(that was actually said by a newbie nurse I was precepting. needless to say, the patient was not exactly confident in his nurse.)
I hope this helps...
I'm gonna cross post it now...
"I've found that a quick and effecient confidence boost, is to fake it in front of the patient..."
Thinking about that I did that on my first injection of insulin. My pt had many family members in the room, and I was feeling nervous. So, I thought I'm going to go in there and do it like I've done it a million times. It works because if you show your nervousness, it questions your competency to the client. I wonder what kind of mechanism was that I used...
Never be afraid to ask for help. I had to do a procedure I had never done before. My RN supervisor hadn't either, so we looked for the P&P whoops none existed...Called our nursing educator, she didn't know either. Called our UM, our DON...everyone without exception didn't know. Called the patient's Dr. explained the situation and he said "I don't have a clue, feel free to reschedule the procedure for when we have everything in place." Valuable lesson. No one was nasty because I said "I don't know and I won't do this if I can't insure the patient's safety." Everyone was very supportive. My motto is my patient's safety insures my license's safety.
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