What skills are you taught/get to practice in school/clinicals?

memphispanda, RN · Feb 5, 2003

We get to do all kinds of things in clinicals--I'd hate to see a program make a habit of graduating classes who have no experience starting IVs or anything. We do have to check-off in lab before doing skills in the clinical setting. Here's what we are currently able to do:

PO/IM/SQ meds

Hang most IVPB meds, a few must be hung by RN only

Hang IV fluids

Start/discontinue IV's

Give insulin (but no accucheck)

insert/remove urinary catheters

insert/remove NG tubes

and of course there is a list of other less interesting things we do.

k123456 · Feb 6, 2003

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Jennerizer, ASN, RN · Feb 6, 2003

I'm only in first semester.....we have 6 skills to master for this semester....handwashing, vital signs, head to toe physical assessment, inserting & removing foley catheters, wet to dry dressing changes & administering meds/injections. We have to master them all before they allow us into clinicals. There are other things to learn also....but those are the actual skills to demonstrate to the instructor.

I know we deal with starting IV's next semester & by the last semester we will be fully competent with them. I don't know the exact skills they teach though.

EmeraldNYL, BSN, RN · Feb 6, 2003

We are not allowed to insert IV's or do IV push meds. I don't think it will be a problem because I have heard that most schools in my area are the same way, and when you graduate you take an IV course with your employer anyway. This is how my one prof learned to do IVs: when she got her first job, she told the ER to call her whenever a comatose patient came in needing an IV! We get to do everything else in clinical, but when we give meds our instructor has to be with us.

fab4fan · Feb 6, 2003

Back in the Paleolithic age when I was a student, pretty much everything was fair game; of course, that was a diploma program which had more clinical than BSN programs (just a statement of fact, not a comment about BSN programs).

As far as ICU, your best bet would be to find a hosp. that offers an internship for new grads. It takes a while to become proficient in skills. Another suggestion is to take as many opportuities as you can as a student to do skills...if you hear someone needs a cath, NG, IV, etc., offer to do it, even if it isn't your pt.

babynursewannab · Feb 6, 2003

We do pretty much everything except insert IV's and change Central Line dressings. Those are left to the IV teams in the hospitals.

If we go into an ICU to work, we have to become proficient on IV sticks and central dressing changes. Not otherwise, though.

deespoohbear · Feb 6, 2003

We weren't allowed to start IV's or change central line dressings. We could do IV pushes with our instructor at our side. Our school's philosophy of not teaching IV sticks is that hospitals have IV teams. Well, that isn't true. Most smaller hospitals do not have IV teams and even some of your bigger facilities have done away with them....Critical care units usually start their own IV's.....

I went to a private nursing school, ASN program...My SIL went to a state supported school ASN program. She said what I got to do in my clinical rotation was a lot more than what she was allowed to do a student....don't know if that is the difference between private schools and state supported, or just individual programs.....

Memphispanda- I wonder why students and techs are not allowed to do accuchecks but allowed to give insulin (or IM injections for that matter). Our hospital is the same way with nurse techs. No accuchecks, but they can give the insulin.....doesn't seem logical to me....I had a young child who had diabetes who was doing his own accuchecks (with his parent's watching..)

memphispanda, RN · Feb 6, 2003

Originally posted by deespoohbear

Memphispanda- I wonder why students and techs are not allowed to do accuchecks but allowed to give insulin (or IM injections for that matter). Our hospital is the same way with nurse techs. No accuchecks, but they can give the insulin.....doesn't seem logical to me....I had a young child who had diabetes who was doing his own accuchecks (with his parent's watching..)

We asked our instructor, and it has something to do with the state board. I don't understand it either, because, like you said, people do this at home all the time, even kids. *shrug*

I forgot to put on my other post that we do central line dressing changes, cap changes on central lines, wound dressing changes, IV pushes with the instructor present only, PEG tube meds and feeding...then the boring stuff like enemas. LOL

k123456 · Feb 6, 2003

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Jennerizer, ASN, RN · Feb 6, 2003

We do the accuchecks in 2nd semester.

xantha31669 · Feb 6, 2003

I go to school in MA, out of everything mentioned the only thing we do not get to do is start IVs. The hospitals around here do have IV teams, but if you work at night you are out of luck because they aren't on then. When you get hired at the two hospitals I am looking at you get an Iv class and a day or two with the IV nurse.

We don't get to do any critical care stuff either, like working with swanned patients or even just pts with reg a-lines. We do get to spend one rotation on a telemetry floor though.

Lori