Today after clinical I broke down in Tears!!:(

NeoNurseTX, RN · Jun 6, 2010

as a "real nurse" you don't get to work early to research your patients. you get your assignment and go at it. every day is different and you'll always learn something new. that is why most of us like it. when you get comfortable as a nurse, that is when you make stupid mistakes and become dangerous.

netglow, ASN, RN · Jun 6, 2010

In school we never got in early to get up to speed on patients. This is good for being more real, but bad for learning as a student. I think, ideally in your first few semesters of clinical, if at all possible, it would be good to do some preliminary research as it helps cement things into your brain, and everything has a chance to be done more smoothly once you arrive as a student. Later semesters this can be changed to how I had it for experience in reality.

In my last clinical rotation, I was chatting with one of the floor nurses who was on break before I left the floor and she carefully mentioned that she hasn't seen any of us in for our preliminary research... I told her we were not allowed this. Her jaw dropped, and here, I think she was thinking we were not dedicated students!!! I am glad she spoke up so I could clarify things for her. Like I say, nursing schools want to limit you chances of being around any thing that might cause some sort of law suit. I think that this played heavily in limiting our time on the units.

carolinapooh, BSN, RN · Jun 6, 2010

In my area, I honestly don't know of any RN's OR LPN's working at doctor's offices. Here, they hire CNA's and call them nurses. My sister in law just got hired at a clinic and all of a sudden, she is a "nurse".

And who wants to attack the legality of this? Because that's so illegal I don't know where to start.

carolinapooh, BSN, RN · Jun 6, 2010

In school we never got in early to get up to speed on patients. This is good for being more real, but bad for learning as a student.

We didn't get an early go either - at any point - but I wouldn't say it's bad for learning. That depends on two things - the student and the instructor.

If you're not permitted an early go, then the instructor needs to keep that in their head. You need to be allowed to look up meds as you go and spit them back out later. We used to pull meds and look up the unfamiliar ones - very quickly - and get the gist of what was going on with them, and then the next day we turned in our list with the unfamiliar ones defined.

The student should find a way to get organized quickly - and it's possible - we did it for sixteen months. Takes you probably two days to figure out your system. You have to hit the ground running and get your system under control quickly, because in no time you'll be on your own with an RN license getting report on six patients you've never met in your life.

While I don't believe in hanging people out to dry - anyone who's having trouble should get extra help from the instructor to figure out where the problems are, especially since that's what the instructors are there for to start with - I also don't believe in handing folks everything. You shouldn't be set up to fail, but you also shouldn't be spoon-fed success either.

Just my :twocents: . Hope I don't sound like a jerk, because I really do want everyone to succeed. Get whatever resources you need to do that and don't let a jerk instructor ruin your day, your career, or your schooling. Go blow the Danskos off of her. :)

carolinapooh, BSN, RN · Jun 6, 2010

I am going out of town tomorrow and I plan to stop at a Barnes & Noble and look for a "pocket" med book (and anything else) for Believe to use to get her arsnel ready for this weeks clinicals. Do instructors let you carry and use these? Or do you think she can sneek peeks at it before the instructor starts orally quizzing her about meds, so that she is better prepared? Can you offer suggestions on a name or type of pocketbook I should look for and buy? I ask this because Believe does not have access to a large book store like Barnes & Noble...so I told her I will look for her.
In our rural midwest area LPN's actually work in hospitals and clinics. I don't think they will be phased out anytime soon. I know for most of you, especially in big cities that probably seems hard to imagine. Ohhhh, and I like the flounder idea by the way haha

Amazon.com's a great resource - cheap shipping and no sales tax. MILLIONS of resources there.

Moogie · Jun 7, 2010

In school we never got in early to get up to speed on patients. This is good for being more real, but bad for learning as a student. I think, ideally in your first few semesters of clinical, if at all possible, it would be good to do some preliminary research as it helps cement things into your brain, and everything has a chance to be done more smoothly once you arrive as a student. Later semesters this can be changed to how I had it for experience in reality.
In my last clinical rotation, I was chatting with one of the floor nurses who was on break before I left the floor and she carefully mentioned that she hasn't seen any of us in for our preliminary research... I told her we were not allowed this. Her jaw dropped, and here, I think she was thinking we were not dedicated students!!! I am glad she spoke up so I could clarify things for her. Like I say, nursing schools want to limit you chances of being around any thing that might cause some sort of law suit. I think that this played heavily in limiting our time on the units.

When I was a CI, the patient turnaround was so rapid that I could go in on Sunday evening, make assignments for Monday and Tuesday only to find that the patients I'd assigned were being discharged Monday afternoon or Tuesday morning. So I had to adjust and readjust assignments. Often, if a student's patient was dismissed on Monday a new one would be admitted Monday evening, so while there would be a patient for the student to take on Tuesday, there was not much time for that student to come in early to check the chart and look up meds.

latebloomer74, LPN · Jun 7, 2010

You cannot possibly learn all there is to know about nursing in a 12-month LPN program. It's impossible. Most of your learning will take place on the job and in the real world. Today's nursing programs simply seem to be prepping the student to pass NCLEX on the first attempt.
By the time I had completed an LVN/LPN program in 2005, I had never inserted a foley into a live person. I had only given one IM injection and one SQ injection. I had changed only a couple of dressings. I had performed a moderate amount of trach care and feeding tube care. The vast majority of my clinical experience during the LVN program consisted of the p.o. medication pass.
RN school offered even worse clinical experiences, since all I did during my clinical rotations was paperwork, process recordings, and care plans. I performed no hands-on skills during the clinical portion of my RN program.
I have learned the vast majority of my skills on the job, and it looks like you are going to have to take this path, too. Find a mentor who likes being around newer nurses. Find a working environment that is supportive of new grads. Good luck to you!

I could not agree with you more about nursing programs prepping students to pass the NCLEX on the 1st attempt. "Teaching for the test" is where all real learning stops, it is really a shame. It's all about politics and looking good and not about being taught or learning, it's a sad, sad state of affairs and can leave some students feeling cheated out of a REAL nursing education. :mad:

believeallispossible · Jun 8, 2010

Well I'll let you all know how the end turns out for me. PRAY!!!!!!!!!!!!

Ginny Weasley · Jun 12, 2010

I feel your pain. My instructor is a complete witch. She's made me cry twice already, even though the staff where I'm doing clinicals at thinks I'm doing a great job. She's picky about the smallest of things. But anyway, at my school we're required to make make medication cards every week as part of our homework. I've started making them and putting them on index cards with a ring and carry them around with me during clinicals. It can be helpful. My advice to you is that next time you go to clinicals, write down all of your patient's medications from the MAR and maybe on a scrap piece of paper and then later look them up in your medication book and copy down the info to the cards. That's what I've been doing. It seems to be somewhat helpful.

cmonkey · Jul 29, 2010

Hey! We want an update!

hnvance2009 · Jul 30, 2010

I am scheduled to graduate in 4 weeks and I have done one day of med pass! I am now where you were then! How did you get through? I am not ready for anything but CNA work! I know how to give a bath and clean someone up after an accident. AND THAT'S IT! I am NOT ready for the NCLEX! I have boken down before, during and after clinicals before! I have been so discouraged lately and so stressed and depressed....and I could go on! I keep reminding myself that I am doing this to make a better life for me and my family but how do you work through that when you have NO confidence in your skills once your done? I have some medical background and even that is jumbled up in my brain somewhere..... I can't remember anything anymore. How did you get through your last 6 weeks? I will only get two days of teamleading and med pass. I have never given an injection, put in a FC, basically I have been a FREE CNA this year and I HATE IT! I don't feel like I am ready to be out in the real world (as my instructor puts it) working and having ppls lives in my hands! I know I will be a GREAT nurse and my instructors have told me that too but if all I have done is CNA work what will I do when I get out there somewhere to practice for real? I know that nursing is a hands on JOB but where does the line get drawn for being ready to be an LPN or RN and all you really know how to do is CNA work. The CNA work is hard and not what I signed up for! Anyways that is my opinion so what is your feedback?

Take Care and Thanks

hnvance2009

pagandeva2000, LPN · Jul 31, 2010

I just don't know if I can do this. I am graduating in 6 weeks in the LPN program and I have 5 days of rotation on a Pediatric Floor in a major hospital. This was my 2nd day of clinical for it. I just honestly feel completely lost. I don't know if it's my program or what, but all we did today was pass medication.....that's it. I have never once put in a foley before, I have changed a dressing maybe 2 times, I have maybe given a shot 1 time...... that's it. I don't know nursing at all. Today I was giving meds and my instructor asked me about 3-4 medications that this patient was scheduled to take, and I had no idea, all i knew was that one was for pain and the others were laxatives. She drilled me with more questions and I just didn't know it. Also I'm SO nervous during clinical I am AFRAID. Maybe partly because i'm shy but mainly because i don't feel confident at all! During pre conference in clincal she drills me with more questions and I have no idea. I feel dumb and I don't know if maybe it's because I'm not real strong in science or what, but I can't seem to do this. During clinical she pulled me to the side and said that I should know what these medications were and also how all the labs and everything tie into the patient. I just didn't know nursing is so much science. If I would have known that I wouldn't have gone into it. I would have became an accountant or something because i love math.
I want your honest opinion here, I don't want people to just say "oh you can do it!" when honestly, maybe I should know everything a nurse does by now since I'm practically graduating in 6 weeks. I'm just thinking about quitting I am soooooooooo down right now. What do you think? I'm one inch away from quitting.

Your story is not new...and I am not saying this out of cruelty, I am saying it because I lived it. We had plenty of clinical cancellations because the clinical instructor we had was employed fulltime elsewhere and if her job, or even the weather interfered with our training, we were placed on the back burner. And in spite of what anyone says, no new grad walks out of their program knowing everything. It also takes time to correlate the book knowledge to real life. We walked in with the fantasy that clinicals would prepare us, but it didn't. I might have done two injections, no dressings, no foley care or insertion, no real notes, nothing. This was in 2005/06.

Since graduating, I think that it got stranger...I had a horrible orientation, no real guidance and had to forage support on my own. But, somehow, common sense kicked in, because it was either do or die by then. No longer did I have the poor clinicals as an excuse not to function. People did see that I was smart and the nice ones helped me. I also had to learn personalities...who was approachable and about what. Keep in mind, also, that you will never stop learning. When you walk into that first job, start learning where your resources are...is there a manual or computer somewhere? Bring your drug book. Keep your textbook at the bedside, write notes during the course of your day and refer to the text at the end of the day. I also strongly utilized my companion books to the texts I had. I purchased one for med-surg, another for OB/GYN. I work in a clinic, so, I kept them in my desk drawer to refer as needed. I also wrote a list of websites to review labs tests so I can teach the patients how to prepare, signs and symptoms of diseases, assessments, etc... When I see medications I don't recognize, I look them up before I administer, look at the reportable parameters, etc...

Trust in the name you gave yourself here... Believe All Is Possible! There is nothing wrong with a bit of meditation or prayer, mantra, etc before you walk in the door to ask for guidance and discernment to steer you through your day. I still walk around saying to myself that I can be better, that I am unhappy with myself as a nurse at times, but when I hear from SO many others how much faith they have in my judgement, practice and work ethic, I can see just how far I came from that first day in July, 2006 when I walked in the door as a new nurse.

For now, at least give it your all to graduate from this program. You have 6 weeks! Give it one step at a time! Then, concentrate on NCLEX-PN, because until you pass, you can't even test the waters. And, then, concentrate on the real deal. And, sure, if you don't like it, you can go to school for something else. But, take one step at a time...they will be giant steps at this point, but you can only do one at a time. Good luck and keep us posted.