Seeking Advice/Encouragement for nursing school and beyond

[hopefulstudent223]

Hey there! 

I wanted to reach out on this forum in hopes of obtaining some advice/feedback/encouragement. I am in semester 3 and getting ready to enter semester 4 of nursing school in January. Last semester (semester 2) we had to complete the second half of our clinical experience online due to COVID and this year we have shorter hours on the floor than normal for the same reason.  I have spent A LOT of time talking with my other classmates about skills that they've had the opportunity to perform and what they feel comfortable with. At this point, I have only be assigned to up to 2 patient and this was only for 2 clinical days. I have not inserted an and IV, started a foley, placed an NG tube. I HAVE initiated one continuous tube feeding and hung IV medications twice however I don't feel that I would be able to fly solo on this if I had to do it again. Meaning, I still feel like I would need some prompting or small reminders. The pump itself I feel may take some time to get comfortable operating. I've been advised to seek out a PCT or CNA position but due to taking care of my family and ill mother, I cannot add that to my plate. I know my capacity for stress and I still need time for self-care as I deal with my own mental health issues. I am continually told that this experience will come when I am on the floor and not to worry about it. HOWEVER, yesterday on the floor I asked a nurse if she needed help with anything and she offered to let me flush a dophoff ngt. I was excited to help as I am eager to learn. I went to flush with the large syringe and I was meeting resistance so I looked at the nurse and she simply stated: "it's okay". I proceeded to try to flush and the water sprayed everywhere. All over me, the nurse, and the patient's bed. I was mortified and apologized profusely and even though she said it was okay, I could tell by her face that it was not. The nurse left me at the bedside and sent another nurse in to help me troubleshoot the issue. Meanwhile, I felt like I was unraveling or like I had done something terribly wrong. I came home and searched videos on ngt flushing and did see that it could be done either by gravity or the way that we had tried it but it did not make me feel any better. At the same time, I am faced with questions on basic procedures. If a patient has a continuous tube feeding, how often and I flushing? How often and am I replenishing? Do these protocols become second nature with time? Just looking to know that how I am feeling is normal. I want to be the best nurse that I can be and I want to take care of these patients the best that I can (and I would like to stop feeling so incompetent). Everyone keeps telling me to worry about passing the boards and the other stuff will come later but that just doesn't feel right. Anyways, I know this post was long-winded but hearing from people who understand where I am coming from would help me the most. 

If you are inclined to be passive-aggressive (or plainly aggressive) or discouraging I would kindly ask you to refrain from commenting. I promise you, I beat myself up enough for the both of us. 

Signed, 

Disheartened but hopeful

[KWheaton]

Hello! I'm sorry to hear about your experience during clinicals, I probably would have reacted the same way. I just got accepted into a BSN program that starts on January 11, online. I'm pretty sure that labs will also be online and I'm not even sure if there will be clinicals during my first year. I'm afraid that this batch of nursing students will graduate being wildly unprepared. I know that everyone is having a difficult time, so you are definitely not alone. This is a tough time and it sounds like you are doing well for yourself during this time! Don't forget to look back and see how far you've come and be proud of yourself! Take time for yourself and take care of yourself. ?

[Kangoshi, BSN, RN]

As a fellow 3rd semester who had their entire 2nd semester online with cut-backs in clinical hours this semester, believe me when I say I completely understand where you are coming from and that it can and will get better. Not being confident about flying solo I think is a good thing, since you won't be reckless or overconfident. That being said, your experience with the flush sounds very familiar to my last clinical where I accidentally broke a vial of a narcotic all over a patient's bed. I was mortified, but my nurse was much more accepting and told a similar story she did when she was a new grad. Accidents do happen, and imo your nurse should have felt the resistance you were feeling instead of blindly telling you to continue. Take every clinical as a new learning experience and really try to put yourself out there. I was able to experience the emergency department and ICU earlier than most in my cohort because I took the initiative to ask the charge nurse and my clinical instructor if I could shadow and assist. I still haven't gotten to place a foley or NG tube, but just remember that our supervision doesn't stop once we get licenses. New grad programs I think should and have been understanding given the current circumstances of the pandemic and what that means for us as soon to be nurses. Keep your head up and keep practicing, we got this. ?

[kubelkabondy, ADN, RN]

I am also finishing up my third quarter of nursing school and I resonate with much of what you wrote. My "clinicals" were all virtual last quarter, and this quarter fortunately they were in-person but were somewhat restricted due to COVID regulations - for example we could only go into the rooms of the patients we were caring for. Even if there was an interesting procedure happening in another room on our floor, we wouldn't be allowed in. 

I also did not place an NG tube or insert an IV. I had the chance to insert one foley with the nurse standing beside me telling me what to do each step of the way. It was a good experience, but I'm certain that I won't remember all the steps next time I need to perform it anyways.

I understand and to some extent relate to your worries and anxiety about not being adequately prepared before becoming an RN. However, I think you have to remember that what you are experiencing now is what ALL current nursing students are experiencing and that employers are going to be aware of this. The hospital where I did clinicals this quarter said they are taking this into consideration and letting new grad RNs orient for longer and essentially transition at a pace that feels comfortable for them. 

When we become RNs, there will be skills that we are not familiar with, or that we only had a chance to perform once in clinicals and don't remember well. That's okay. We can always ask an experienced nurse to show us, and once we have done it a couple times we should be comfortable doing it on our own.

Regarding the mistake you made with flushing the NG tube, I wouldn't feel that bad about it. Of course it's embarrassing, but I think most student nurses and even brand new nurses have made similar mistakes. What's important is what you learn from it. You mentioned that after you made that mistake, you went home and watched videos on NG tube flushing to fill in the gaps in your knowledge. So you already learned something from it. And the good thing about making an embarrassing mistake is that you know you'll never do it again. On my first day of clinical I dropped a pill on the floor and felt so stupid. The nurse was a little annoyed, but now I'm really good at getting those pills out of their packages as a result, and you can bet I'll never do that again!

Be able to ask questions when you need to and know how to find the answers, but other than that fake it till you make it! One day we'll look down and realize we're not faking it anymore and wonder when we became competent nurses.