This too shall pass...? We hope?

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Specializes in Home Health, Nursing Education.

After reading this: Data indicate schools may be overproducing nurses - Nursing for Nurses

I feel sick. I have just 1 last semester...just 16 weeks- a total of 65 school/ clinical days until I graduate from an ADN program. Now I know, I know, its not a BSN.. but I have 2 great kids... so the BSN is meant to come after getting an actual JOB. :)

Ok- so I got a job- as a PCA. In this hospital the PCAs can insert foleys, D/C saline locks, change dry dressings, drain wound vacs, assist-not verify- with blood transfusion reactions, and something else that has escaped my mind at the moment.

All of the above things-in my very new , virginal, humble experience- require some type of assessment.(?) Yes I know an RN should delegate data-gathering as permitted by the facility and an unlicensed person's scope- but WoW! I have been trained in all of these things by some fantastic teachers...

Fast forward-- this week is our orientation week- specific PCA training, too. Half the hires are totally inexperienced. The saline lock "test out" lasted 2 minutes, the foley insertion was a JOKE, with a seasoned nurse new to teaching who kept having to back-track and re start or restate what she was doing.

Bottom line- after a total of 4 hours (maybe) of total training time for all the skills mentioned above plus the logistics behind every vital sign, I know that these people arent ready. These poor kids... they we literally barraged with info... MRSA, VRE, CDiff, etc... I mean- the preceptor had to explain what I/O stood for for some of them! They do not even have an A&P or microbiology class to rationalize this info from... I would have passed out if I was new. Back- forever ago- when I was new, we were never allowed to do any of those things.

I BARELY feel ready, but at least a few other "can see the light at end of tunnel" students are dumbfounded as well. Maybe I am not giving enough credit, or maybe I have become sensitive and selfish, maybe I dont know what the heck I am talking about!

I am perfectly OK with having it in my job description- I expected it- as an RN-when I graduated/got licensed, though.

I don't know what I am getting at. But nursing is changing... right before my eyes... different than 3 years ago when I got accepted into the program.

I am rattled, and grateful all at once. Grateful for the job I have right now- but when I get my license, I will still be praying not to have to wait to long as a PCA for an RN spot when I have an RN behind my name. I love assessment, the science, the thought process.. I will wait for a spot- but since lower paid workers are doing some of the RN tasks- WILL THEY EVER NEED ME?

This could be a real possibility- as one of our newly graduated/newly hired PCAs is in this boat. They told her to continue with her new hiring training as a PCA- and to go online to their website and apply for an RN spot- I mean- HR AND her hiring nurse manager.... she takes her NCLEX in 2 weeks...

I am sorry I rambled. Long day, and I am rattled. :)

Love all of you on here- you brighten my day by reading you all. I do not post often... but I had to say this out loud to someone who may understand me better than myself

Thanks, guys :)

:eek::nuke::dzed:

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I think that most everyone experiences pre graduation "jitters". However, what you are describing as training for pca's makes me VERY uncomfortable. This just not sound like a sage situation///

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Specializes in Home Health, Nursing Education.
I think that most everyone experiences pre graduation "jitters". However, what you are describing as training for pca's makes me VERY uncomfortable. This just not sound like a sage situation///

thanks for your comment....

Although it benefits my situation at the moment- skills gained while in school- If I was already an RN, I would not agree to this level of staff performing some of these skills. Not like I would have a say in the matter, though...

Knowing what I know now about nursing and patient care... this gives me the heebeegeebees. :confused:

Or like I said before- maybe I am naive to the changes...

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Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

Our PCA's can remove iv cath's, foley cath's and write down I&O's but all of these are done with delegation by the RN. I decide what I let the PCA do, so make your self available to your RN's. Be willing to learn, say yes to opportunities. It will take you far in school and even further in the eyes of your co-workers and manager.

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Specializes in Home Health, Nursing Education.
Our PCA's can remove iv cath's, foley cath's and write down I&O's but all of these are done with delegation by the RN. I decide what I let the PCA do, so make your self available to your RN's. Be willing to learn, say yes to opportunities. It will take you far in school and even further in the eyes of your co-workers and manager.

Can they insert foley's, too? I guess that really got me. It's invasive, has great potential for infection, it can be traumatic...

Also, thank you for that advice. I do intend on being as available as possible for my nurses. I am not one to hide, I want to be out there learning and helping. I am very interested in establishing a relationship with the nurses and management. I crave a close floor team, one day!!

The benefit of starting at this level is that I will know what to realistically expect from my Pca's (assuming I get carried over into an RN spot once I (crosses fingers) get my license). And I will get to know them, and work within their scope of knowledge, as you have advised based on what you do.

I think today wore me out. And then those stats in that article... and I gotta be honest, I just want this so bad that I can taste it. I respect nursing, I enjoy studying it.... So maybe it hit me below the belt that my schooling will be for nothing.

I would hate to see the art of nursing- the care and knowledge and skill wrapped into one- be lost among various under qualified workers.

Thanks for your ear, DSCRN and RedHead :)

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Specializes in ICU, ER, EP,.

YOu want qualified competent staff, and you don't want them to go through a rough time to get there...:yeah:

Woot, thats how us nurses think! You're worried and CARE about the quality of care. All in time, everyone starts out as a novice, encourage your new buddies to seek guidance from the RN's/ LPN's and offer helpful hints as you find them.

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Specializes in Acute Care Cardiac, Education, Prof Practice.

We recently rescinded a PCT's right to insert or d/c a foley cath because of the high incidence of FRUTI's and urethral damage from, yes an inflated balloon being removed from a patient.

I am not afraid that my job will be taken away by someone with less training than I do, when the demands on RN's for increasing education become greater each day.

Let this worry rest quietly, it doesn't need to be a stress right now.

:)

Best of luck,

Tait

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Specializes in NICU, Infection Control.

I disagree. I am really not trying to scare you, but that situation sounds dangerous, IMO. Let me count the ways:

inadequate staffing as evidenced by:

hiring unqualified staff (and it doesn't sound like YOU are unqualified, but you seem to be an exception);

an almost non-existent orientation;

and an apparently high turnover.

I think you will do a good job--@ least you have a clue, but the others you describe don't seem to. And any young (not age, experience, I have no idea how old you are) nurse needs some mentoring and back-up initially! In this situation you could find yourself "in charge" of a whole lot of pts, unreliable assistants, and no one to help you figure it out. And probably in the middle of the night.

If something sad, scary, dangerous, etc., happened, would you blame yourself? Because we all do that kind of self-questioning even in the best of circumstances. But you don't have the experience or the "big sister nurse" to help you analyze what went wrong and how to avoid that in the future.

If we treat new nurses like this, they don't stay nurses for long.

Best suggestion I have is to ask for on unit orientation for a shift of 2, if it is really as hair-raising as I read it (I could be wrong, don't tell on me ;) ), rethink your employment. Please. :eek:

In any case, I wish you the best.

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Specializes in Home Health, Nursing Education.

Yes- ZooKeeper- I do want qualified competent staff! :yeah: Quality in care-Not only for the patient's sake, but for my experience/other nurses experience at the facility as well! Thanks for wording that for me! lol

Tait- you make a great point about the education expectations rising for RNs. Also, rescinding a PCT's ability to insert Foley's is GREAT. Causing UTIs and urethral damage is serious- something that I do not believe is looked at as a possible reality among certain untrained staff personnel. When you know only how to do something; not the rationals of WHY or WHY NOT, I think people tend to take more shortcuts. Sounds like that PCT didn't take sterile field seriously, among other things. Happy to hear they aren't inserting any longer... or d/c, either!:up:

PRMENRS- It is scary- I have to depend on these people to help me- and it makes me question who is on the floor as it is... you worded my fears well.... I know that I will try and help the floor staff as best I can, within my current scope of practice. But you are right- I am on nights- and that leaves lots of times to be feeling a little alone. This is going to be a learning experience in a multitude of things, that's for sure.

I am 32 years old- started as an STNA at the age of 19 in a NH that didn't give me any orientation after my training d/t the fact that they were so short staffed that they couldn't. I was on days, with 15 patients... some totals, many assists, nearly all incontinent or at least dependent on me to help them to the toilet. I remember feeling so lost back then! I was way out of my league- and I managed to learn and time manage and all that, eventually. But I remember how I felt... no one to help, the LPNs wouldn't either. One of them even told me that I wasn't "cut out" for that type of work. On my 2nd day. :uhoh3: But- I made it, and after a while was able to go to agency for extra hours, and confidently take any assignment at any time without knowing the patients.

However- I did feel TERRIBLE at first! I remember driving home crying, thinking that I could have done better for those patients. But I knew that in reality, I was doing the very best I possibly could. AND I was being safe and respectful to those residents.

I took a break away from nursing to slowly attend school and raise my little ones. I missed nursing- but this new period- the unknown of the future with this degree(finally).. I do want qualified workers working with me.

I hope these new people get support from their floors- and I will help them as best as I can. :)

I busted my butt to do the best I could- and I will now a PCA, and eventually as an RN, too.

Thanks everyone! :redbeathe:redbeathe:redbeathe:redbeathe:redbeathe

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