What should we doing by last clinical?

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I'm set to graduate in 2 months and am in my final clinical rotation in oncology. I have yet to start an IV or foley, change dressing, do teaching, suction a trach, draw blood, put in an NG or any of the skills we've been tested out in other than giving meds. I have seen nurses do it but have never done it myself.

We started in our first clinical doing bed baths, emptying bedpans and giving foot rubs which I did gladly. However, 2 years later, that's still pretty much all we're doing. Since our first day on the oncology floor, we've been directed to change sheets, get coffee and clean up feces and vomit. We haven't done anything else (except vitals and the occasional meds). I don't even know why are we coming in an hour early to get patient assignments since we barely do anything with them except food trays and bedpans.

To be fair, our instructor almost gave me an opportunity to put in an NG tube yesterday but the patient said she didn't want a nursing student.

I don't mind doing these things but we're starting to feel that we're not actually learning ANYTHING in clinical. Isn't that the whole idea? Is this common?

Wow, that's sad :( I am amazed at the differences from school to school! I did my first IV, IVP, and IVPB second semester. I am in my third semester and we've already done IVs, Foleys, push meds, tons of insulin, lovenox, IMs, you name it! I think the only thing we haven't gotten to do yet is trach suctioning and care (haven't had any patients with a trach) and blood draws. I would feel cheated if I didn't get these experiences!!

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What state are you in?

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Specializes in LTC, Rural, OB.

This really surprises me at how many people aren't allowed to do much in clinical. I am in my 2nd to last quarter of an ADN program and every floor day we have a nurse and then pick two of their patients and assume complete care for them. Now we're at the point that our instructor is having us take on 3 patients. We do all of their meds, assessments, teaching, discharging, etc. Also if there is another patient who has a skill like IV start, foley, central line care, that we have not done or we want to do the nurses let us do it. This is all supervised by our instructor or the primary nurse, of course. I think why it works so well is that each instructor has 7-9 students per clinical day but half of us go to ancillary unit for half of our rotations, so she is only supervising 2-4 students at a time. If I didn't get to practice these skills or have patient involvement I would feel completely lost after graduating.

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I'm in my last semester of my ADN, and I've done plenty of IVs, done a few wound dressings, tried an NG (but ended up being unsuccessful...who knew active dysphagia and issues with post-stroke achalasia could be so challenging...) done some central line and PICC cares, plenty of med administration, pt education, charting, and lots of bed baths and oral cares!

I haven't had any caths to start, but I have made it known to the nurses on the floor that I am down for just about anything. :D I'm sure it will backfire on me spectacularly, but hey, nothing ventured nothing gained I guess.

We are taking two pts with each clinical and assuming just about all cares for them. I can't do IV cardio meds, IV hep, IV insulin. Or glucose checks, but that's a site decision, because we've tested on them just fine - it has more to do with signing into the glucometer and IT stuff I guess.

I'm sorry to hear you aren't getting the experience we all need. :( I'm nervous about having not done any cathing yet, but I review the tutorials and the site Policy/Procedures on the experiences I haven't done, so I don't forget. :)

Good luck!

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If a patient sees you come in passively and embarrassed that you are just a student, or if you appear nervous, then they will be unlikely to let you sink an NG. I wouldn't either!

Actually, they knew I was a student because my instructor came in with me giving me instructions as we entered as well as the 5 clinical students who decided to come in and watch and one said loudly she "always wanted to see one of these." So it was pretty obvious and the patient's son asked if I was a student and promptly said no thanks. I think that would make anyone nervous. I completely understand.

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Specializes in nursing education.
Actually, they knew I was a student because my instructor came in with me giving me instructions as we entered as well as the 5 clinical students who decided to come in and watch and one said loudly she "always wanted to see one of these." So it was pretty obvious and the patient's son asked if I was a student and promptly said no thanks. I think that would make anyone nervous. I completely understand.

Wow. Just, wow. Your clinical-mates, led by the instructor, completely sabotaged your learning opportunity. Maybe your fellow student should look at one on YouTube.

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I'm set to graduate in 2 months and am in my final clinical rotation in oncology. I have yet to start an IV or foley change dressing, do teaching, suction a trach, draw blood, put in an NG or any of the skills we've been tested out in other than giving meds. I have seen nurses do it but have never done it myself. We started in our first clinical doing bed baths, emptying bedpans and giving foot rubs which I did gladly. However, 2 years later, that's still pretty much all we're doing. Since our first day on the oncology floor, we've been directed to change sheets, get coffee and clean up feces and vomit. We haven't done anything else (except vitals and the occasional meds). I don't even know why are we coming in an hour early to get patient assignments since we barely do anything with them except food trays and bedpans. To be fair, our instructor almost gave me an opportunity to put in an NG tube yesterday but the patient said she didn't want a nursing student. I don't mind doing these things but we're starting to feel that we're not actually learning ANYTHING in clinical. Isn't that the whole idea? Is this common?[/quote'] I really think it depends on your clinical instructor and the site. For my LTC and rehab rotations, my instructor had been teaching clinicals at those sites for years so she knew the staff and they sought out the students to do whatever needed to be done. It was the same thing for medsurg except better because my instructor actually worked at the hospital in addition to teaching clinical there for many years. Those experiences were great because I was able to do plenty of IV's, NG tube insertions, dressing changes, d/c IV's and foleys, pass meds, give injections and observe plenty of procedures with the doctors. Now in my OB rotation, my instructor seems to have some issues with the staff and subsequently, we aren't able to do much besides observe. There are also only 12 beds on the unit compared to 30+ at other sites since this is a small community hospital so opportunities are more limited with a group of 8 students. The only good thing about my OB rotation thus far is that there are 5 males in my group of 8 so the pregnant women aren't very willing to let them do much so us ladies are able to see more! We'll see what happens in peds..that starts next month.
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As an Old Diploma RN, we finished nursing school having performed (on patients) virtually every nursing activity you mentioned. The old "See one. Do one. Teach one." method of learning had its shortcomings. Nevertheless, we graduated with the necessary hands on experience that enabled us to "hit the floor running", literally. I had a 2 week general hospital orientation and was on my own thereafter. Had I requested a nursing internship, it is very likely that I would have been escorted to the door of the hospital and told that I was not adequately prepared to meet the needs of patients.

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Wow I'm surprised you didn't get to do much other than changing beds and cleaning up bodily fluids. I agree some nurses don't want to teach you but that is where your instructor should come in. I'm in the second nursing class out of 4 and have already ran a flu shot clinic, passed many meds, plenty of SC/IM injections, have hung IV antibiotics, suctioned a trach, inserted a catheter, and more. I feel like you will learn it all easily when you find a job. I also think it depends on where your clinical rotations are. Good luck!!

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While foleys and other task aren't such a big deal... I'm really surprised that you only do adls and vitals? What about assessments? Patient teaching? Neuro checks?

That is what you should be practicing... Foleys are easy and none of my patients ever needed a ng placed.

Do you assess wounds, check on patients incisions?

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Specializes in L&D, infusion, urology.

That's kind of sad, and definitely a disservice to you, your first employer, and your first patients as an RN. I graduate in two months, and I'm taking 3 patients (couplets, actually, so 6 patients) 100% right now. My preceptor unlocks the Pyxis for me, and I pull them under her supervision, and she observes anything she hasn't yet seen me do, but otherwise, it's all me. I was doing the same thing in med/surg last semester, delegating a few things here and there to the RN. That said, I had earned those nurses' trust that I would come to them when I needed to, and they were comfortable with my skill level. I think most students were taking care of 2 patients last semester. By the end of this semester, my goal is to be taking the full patient load. As it is, my preceptor gets bored most days! LOL

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Specializes in psych/dementia.

Ditto to a lot of the above. I know we can't do blood draws or start IV's but am pretty sure we can do anything else. Granted, the opportunities haven't been there for a lot of things, but that's just the luck of the draw in what patients are on the unit.

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