are they supposed to know this by now?

[labrador4122, RN]

this morning after giving report, i was walking towards the lounge and noticed a call light on. i go in there, and ask the mom "may i help you with something?" and she and the bsn nursing student answer "the iv is beeping"

so i go and look at it, and the student mentions to me "the iv bag is empty" so i said "ok no problem" and i go to the iv pump to go and put in the new bag next to it. then the student says "oh, i was gonna do it"

so i said it was ok, i would be there to watch him do it.

he took the bag, and looked at it, like as if he's never seen an empty ivf bag before...... and i said "ok, i do it like this..." showing him how to do it, and he asked me "wont the fluid come out (of the chamber)?" and i said "no, it won't it's ok".... then he did it the way i showed him.

and i think to myself that this is a bsn student, and they have already done medsurg before and he didn't even know how to spike a new iv bag.

i was spiking iv bags, priming, giving piggyback megs, flushing iv's the first semester of nursing school. and mind you, i went thru an asn program.

i don't understand why a bsn student from a state school would not know how to do this by the peds semester.

anyways, i heard their instructor telling the charge nurse "the students are doing everything but meds"

so back to the student, isn't spiking an iv a skill that they should know by the peds semester?

btw that school-bsn- has a 78% pass rate on nclex-rn exam, and my school has a 98%-asn-)

[Imafloat, BSN, RN]

Not sure what your point is. I didn't spike a bag until my second or third clinical rotation. I had done it in skills lab, but not in the actual hospital. I think that students, no matter what type of program they go through are going to be very cautious about doing things, especially in peds.

Everyone is different, some are fast learners, some aren't. I am book smart, I breezed through nursing school with straight A's without much effort. I am smart on the floor too, but I wouldn't say I am a fast learner. The way my brain works I have to understand why I am doing something and try to visualize the mechanics of it all, it may take me a minute of checking things out, but if I understand the logic behind something I know it for always. I am a little OCD about things at work too.

One thing I learned once I started working my job is that your degree doesn't matter. I am not sure of anyones nursing degree except for mine and the people I went to school with. It has no bearing on how fast you learn or how good of a nurse you are. I think being open, nonjudgemental, caring, and thorough make you a good nurse.

[nursemike, ASN, RN]

There's a pretty lively discussion of the inadequacies of nursing education and ideas to improve it on the thread entitled "Hospital orientation SUCKS" in the first year forum. I'd provide a link, but the demons who live in the box on my desk haven't been co-operative, lately. I probably need to appease them by looking up more Media.

I got my ASN through a 2+2 program. One of the requirements to complete the BSN is a basic computer course. Aaargh! I'll also have to take statistics. I'm thinking I've made too many stops at the convenience store for cigarettes and a lottery ticket to ever do well at statistics...

[llg, PhD, RN]

It doesn't matter whether the program is an ADN program or a BSN program. Not all programs teach all skills in the same semester. In some schools, a student may learn a skill in the first semester that another school teaches in the last semester -- or doesn't teach at all. Some schools have their peds rotation in the senior year, others have it in their first or second semester. You can't assume that every program is (or should be) exactly like the one you graduated from.

What is most important is that the student practices safely -- that they don't anything they haven't been taught to do without the proper supervision.

... And at the peds hospital where I work, students are never allowed to do anything with an IV, regardless of what semester they are in.

[labrador4122, RN]

I suppose so. I was just surprised someone would not know this. and I know that in that program, peds is not their first or second clinical rotation. (I wanted to go to that school!)

I know it's scary for the students, but spiking an IV is learned in the lab as well. and he mentioned to me that he was going to do it himself

well, I guess I will never be paired up with a student since I am in night shift! (too bad, cuz I love teaching!)

[BebobthefrogFNP]

I am a senior nursing BSN student and I will graduate this May. I definitely lack some basic clinical skills. My instructors say that they focus on the theory and critical thinking skills more than the clinical skills. I guess they figure that I'll learn more clinical skills on I'm working on the floor. Which is true because finished my preceptorship on Telemetry floor about 2 weeks ago. I learned a lot of skills that I hadn't learned since the first semester of nursing school such as spiking an IV bag. We are taught these skills in the very first semester in a crash course over a few weeks for about 6 to 8 hours a day. We went to the hospital a few times a week and practiced some skills but spent most of the time working on the clinical paperwork (long) that was due that day or the next. Also, how am I supposed to learn a skill if I did it once in first semester and maybe one or 2 times in 5 semesters?

[LibraSunCNM, BSN, MSN, CNM]

I don't think it serves any purpose to constantly be sniping at different types of nursing programs. Different schools teach different things. Not all associate's programs are bad, and not all bachelor's programs are good, but to insinuate that an associate's degree is fundamentally better than a bachelor's degree because one nursing student didn't know how to spike a bag of fluids is simply ridiculous.

[DolphinRN84, MSN, RN, APRN, NP]

I agree with the other posters. Different schools may just do things differently. I was in a BSN program..and honestly I don't remember when I first learned how to spike a bag of IV fluids but I do remember learning it. I'm sure that student was just trying to be cautious, especially working in peds. There is more to being a nurse than spiking a bag of IV fluids or any other technical skill.

[GratefulHeart]

I suppose so. I was just surprised someone would not know this. and I know that in that program, peds is not their first or second clinical rotation. (I wanted to go to that school!)

I know it's scary for the students, but spiking an IV is learned in the lab as well. and he mentioned to me that he was going to do it himself

well, I guess I will never be paired up with a student since I am in night shift! (too bad, cuz I love teaching!)

In my experience, the best *teaching* nurses are the ones who are eager to show or talk me through a skill they can see that I'm clumsy with. Instead of expressing shock about what the student doesn't know (how does that attitude help the situation?), try looking for ways to come along side to help them improve. IMHO your attitude of shock that the student isn't up to your expectation is a real barrier to you being an effective teacher. If they sense you're disgusted with them (and I'm sure they do), the last person they'll want to turn to for help and instruction is you.

It really doesn't matter when their nursing program teaches a particular skill or what you learned by their stage in school. There's an old saying that goes, "No one cares how much you know until they know how much you care."

My gut response to your original question, "Are they supposed to know this by now?" is does that really matter? They're at where they're at. The next time you see a student struggling like that, you might want to try, "I can see you're having difficulty remembering how to do this. Can I help walk you through it?"

[Chloe'sinNYNow]

In my experience, the best *teaching* nurses are the ones who are eager to show or talk me through a skill they can see that I'm clumsy with. Instead of expressing shock about what the student doesn't know (how does that attitude help the situation?), try looking for ways to come along side to help them improve. IMHO your attitude of shock that the student isn't up to your expectation is a real barrier to you being an effective teacher. If they sense you're disgusted with them (and I'm sure they do), the last person they'll want to turn to for help and instruction is you.

It really doesn't matter when their nursing program teaches a particular skill or what you learned by their stage in school. There's an old saying that goes, "No one cares how much you know until they know how much you care."

My gut response to your original question, "Are they supposed to know this by now?" is does that really matter? They're at where they're at. The next time you see a student struggling like that, you might want to try, "I can see you're having difficulty remembering how to do this. Can I help walk you through it?"

Now THIS is a reply I'd love to blow up and put on every wall in my own facility. Because I have been encountering such attitudes. since I first stepped onto a clinical facility floor. And sorry O.P., don't want to get flamed, but they think they're great teachers too.

Chloe

[pebbles, BSN, RN]

I remember the HUMILATION of simply asking a question about the drug being used to sedate during a procedure and getting the "THIRD YEAR AND YOU DON"T KNOW THAT???" response from the nurses. I have never darkened the door of that facility again and I never will.

I think it's not unreasonable to expect that a student may never have spiked an IV bag in previous clinicals, depending on the type of patients he had or what the nurses did instead, etc.

[KYCNM]

I teach in a BSN program. My teaching assignment provides an opportunity to teach across the curriculum (sophomores, juniors and seniors). The growth I see as students progress through the program is enormous, however that growth is not measured in abilities such as "spiking" IV bags, but in the ability to approach patients in a variety of settings and assess their needs on all levels. Thanks to all who have provided more supportive replies that could improve nurse-nurse relations

I recall a professional colleague saying "I learned everything I needed to know in my diploma program". She said that after she had completed a BSN and MSN. As an educator, I felt sorry for her because what I heard her saying was that "I didn't get it." She saw no value in all courses she took or the experience she gained in those educational programs.

Every day I learn something new about nursing, about myself and about the world. They are all intricately intertwined. I will never tire of being a nurse on whatever level.