What didnt you do in school?

Nurses General Nursing

Published

I'm getting close to graduation, and theres SO many things I've never done on a live patient! Stuff like, foley, IV's, injections, (all I really have done is some minor wound care and hygiene stuff) It makes me nervous, but hopefully I'll be blessed with a great orientation....SO.... What types of things had you never done on a live person til after you were licensed and working?

Have you precepted a new grad and been surprised at the skills they hadn't had much practice with?

This entire thread is SHOCKING to me. We did foleys 1st semester. We did IVs, injections, push-meds, NG tubes, etc... All starting 2nd semester. We could access PICC and central lines in 4th. We graduate in a couple of weeks and by now I've done these things a countless number of times. Hopefully, you'll have a very patient person orienting you.

Up Vote Up Vote ×
With evidence and best practices always changing, equipment being updated and new things being invented, skills are constantly being re-addressed throughout your nursing career. It's great to have skills opportunities in school, but in some places, the opportunities don't present themselves.

You will have to learn how to use the latest and greatest XYZ equipment (foley, IV cath, etc) at the next hospital in-service. Learning disease process, the basics of pharmacology, good assessment skills, and most importantly, critical thinking are much more difficult to learn outside of school.

A good nurse doesn't just practice a check-list of skills. A good nurse sees the whole patient and helps guide them through the healing process to help them regain the best level of function they can. Sometimes this means starting an IV, but often it means helping the patient and family understand how to incorporate new medications and new limitations into their daily lives.

Perfectly worded.

Up Vote Up Vote ×

Wow!

I'm in an LPN program and we've done Foley's, injections, administered meds through g-tubes, wound care... we haven't done any NG tube insertions, or IVs because we have to go to a special class for that after we graduate (a Florida thing?). My boyfriend's sister in law went to LPN school in NY and they did their clinicals in a nursing home. We've had clinicals at an acute critical care hospital where I learned SO much (and would like to go back there to work) and are now doing clinicals at a community hospital. Sister in law can't believe all of the stuff we're doing!

I'm truly grateful that I found this program! I agree with the person who told you to get your money back!

Up Vote Up Vote ×

Your school sounds like my school, I gave Heprin shots in my first semester. Tried a NG tube a couple of weeks ago (three other RN's, including my instructor tried too) but was not able to get it in. The guy who started this string should be asking some really hard questions to his school about why he wasnt trained better. Geeze

Up Vote Up Vote ×

I'm an LPN, 10 yrs in the field. I followed my instructors around like a puppy dog during clinicals and hounded to do every and any procedure I could get in on! I would even ask the staff nurses at the hospitals/facilities we were at, if I could watch them, help them and eventually DO it on my own, with my instructor present of course. Certain classmates were mad but you know what? I didn't care, it was MY education and I was RESPONSIBLE for learning!!!

Get out there and do it while you have supervision! Good Luck!

Up Vote Up Vote ×

What the Commuter said.

Up Vote Up Vote ×

I am an LPN of 30+ years. At our school, we had a check-list of skills we had to complete prior to graduation and I am still grateful for that specific training. Interestingly, during the last two weeks of class and clinical, I had to administer an enema to an elderly gentleman, something my classmates had already done - and done and done - at the LTC facility where we trained.

Short of getting your money back, as others have said, find someone who will help/guide you as you get the real-life experiences. You may need to get a couple of people, but don't give up. It will all be worthwhile in time. (And remember the birthdays of these folks who help you!!)

Good luck - be patient with yourself.

Up Vote Up Vote ×

I think a new nurse coming out of school without having performed some basic tasks is more common than people think. I also think the clinical experience is what one makes of it. When I did my med/surg clinical I did many catheter insertions and dressing changes because I actively sought them out. If the staff nurse is willing to watch you (the student) do it, then the clinical instructor doesn't need to be there. Too many students just hang out in the conference room looking up stuff.

What's more, I think people are exaggerating the importance of the nursing school clinical experience. Most (like 99%) of how we practice is learned on the job. One learns way, way more on the first week or two of orientation than they did during their entire clinical experience.

Up Vote Up Vote ×
I agree. You tube is great, but can you imagine approaching a patient and saying "I've never done this but I saw it on You Tube"

No, because I'm not dumb enough to announce stuff like that to patients. Even with a few years of experience and all my frequently used skills down pat, things come up that I've never or rarely done. I review the procedure, ask for tips if I'm feeling uncomfortable, and then go and do it with confidence like I've done it before.

I inserted 1 foley in nursing school- none of my other patients had foleys and it was really rare to see them used at all on the floors we were on (med surg and tele) because there's a big push here to reduce their use unless absolutely necessary. Got a ton of patients on and off bedpans and to bedside commodes though. The patient I did a foley on was an ICU patient during an observation day in the ICU- it wasn't part of my main clinical.

One of my clinical sites only allowed students to administer PO meds to patients (we weren't even allowed to take rectal temperatures at this hospital if the situation warranted, had to have the CNA or primary nurse do it).

None of my clinical sites allowed students to initiate IVs. You can't not allow students to practice a technique but then expect new grads to be skilled in said technique, so learning IV skills as a new grad was no big deal here.

First NGT I inserted was on an 8 month old ex-23 weeker during my orientation as a new grad. Again, at all my clinical sites, I had the opportunity to watch a classmate insert one on her patient.

I would have loved to have had the opportunity to do more skills in clinical. We were all pretty proactive about looking for things to do even if it wasn't our patient and our instructors always asked us for skills we needed to do, but if there weren't any patients requiring XYZ that day.....not much anyone could do about it.

I've talked to a lot of students from area schools and it seems like this is pretty much par for the course in my area. A few local programs offer preceptorships and those students get more clinical exposure, certainly. But despite our limited clinical skills, graduates from my program are well regarded in the area anyway and are told that we tend to transition well as new grads. If the local hospitals are satisfied with us, I can't complain too much about it.

And I have fantastic IV skills now, btw.

Up Vote Up Vote ×

OMG!!! The nursing school you are attending is a sad excuse to have you ready for pt care. In Ky you have to be a certified NA to get in the school and that helps but my Lord, when we had clinicals the instructors kept up with what we hadnt got to do and tried to get us pt so we could jave some experience. Inj and Iv...your class should have practiced on one another. If you know a nurse at a Nursing home or hospital, see if you can work with them a shift or 2 just to be more familiar, you wont be able to do the proceedures but if you watch, you will learn some.These are things you are expected to know how and be able to do when you graduate and sit for boards...Good Luck!

Up Vote Up Vote ×

So are you saying you dont have nursing skills so you became a RN and now you will be a DNP???? I hope this isnt the case. My nursing skills are THE BEST, I am a LPN, but I am going to start an RN bridge in the fall.If a nurse doesnt have skills, she's not a REAL NURSE!!!!

Up Vote Up Vote ×
So are you saying you dont have nursing skills so you became a RN and now you will be a DNP???? I hope this isnt the case. My nursing skills are THE BEST, I am a LPN, but I am going to start an RN bridge in the fall.If a nurse doesnt have skills, she's not a REAL NURSE!!!!

Well there are other skills besides stuff like inserting foleys or giving an injection.

There's a MDS nurse on my floor who never worked as a floor nurse. I'm sure I could work circles around her when it comes to administering meds or changing a dressing. But, then she knows far more than me about Medicare reimbursement and required charting.

Those are skills, too. And, frankly, they seem to be more lucrative skills than my basic floor nursing skills.....

Up Vote Up Vote ×
+ Add a Comment