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I just started my med/surg 2 rotation, I'm a senior in my BSN program (next semester will be precepting! Yay!) I am interested to hear what other people's experiences have been with this rotation because ours is going to be quite limited, it seems. We can NOT do glucose checks (we were able to do this in med/surg 1), it looks like we won't really be giving ANY meds either. Our instructor basically told us that our focus is on patient care, helping with AM care, vitals, etc. To this list I added doing shift assessments, and perhaps hourly rounding for the RN's we are assigned to, and trying to do total care for more than one patient per shift.

I am curious about others because I get the feeling that it is the hospital that is dictating this, and the instructor is trying to make lemonade from lemons by telling us that skills are the easiest thing to learn, it's the patient interactions and bedside manner/care that is most important to get. I can certainly see her point, and I did have a chance to do many skills in my med/surg 1 rotation (the only route I didn't give meds was IV push), I've put in a catheter, d/c'ed IV's and so on, so it's not like I haven't done anything. Others in my clinical group are extremely frustrated, however... and my only major concern is whether I'll be adequately prepared for precepting when the time comes.

What say you oh wise nursing students?

Comments

( 7 comments — Leave a comment )
lissalynn
Feb. 21st, 2012 11:52 pm (UTC)

You will learn the skills you need for the job you get, when you orient (and over time after that) to the job. Which could be anywhere in any setting, especially in this economy. It's more likely that you'll get a job a) through a placement, b) through someone you know, or c) if you're working somewhere as a PCA/CNA now than that anyone will look at your specific skills experience and decide whether or not to hire you that way.

Enjoy your clinicals and learn the things you can learn from it- don't worry about what you can't learn in this rotation, think about all the things you CAN work on and learn. For instance, don't worry about med administration. Worry about med safety, what needs to be considered before giving a med, how to do med education for the patient, etc.

Nursing care today is much more focused on critical thinking, evidence-based practice, health education, wellness care, prevention, etc. Not the manual skills. If you made it into nursing school, trust me, you can learn the manual skills.

(I'm a Pedi NP student currently and also work as a Pedi RN).
fivepoints
Feb. 21st, 2012 11:52 pm (UTC)
I would be upset. I'm a senior in a BSN program too, and the only rotation we couldn't give meds in was psych. I can't imagine a whole rotation just about daily care and vitals (seriously not even FSBS or PO meds?!). But I also have 4 years experience as a CNA, so I don't feel like i need any more practice with that sort of thing. I'm all about the nursing skills! How long does this rotation last for you? Yikes.
daisyfleur70
Feb. 22nd, 2012 01:06 am (UTC)
It's a 6 week rotation. :-/
tachy
Feb. 22nd, 2012 12:20 am (UTC)
I completely agree with the first comment. My academic advisor gave me some wise words when I had a similar frustration. She said, "It isn't about putting in the foley. Anyone can learn in an hour how to do that. It's about knowing when the foley goes in, how to monitor what's coming out, and how to critically assess your output." I think that can be extrapolated into every aspect of nursing care. Physical skills can be picked up easily; the biggest skill you can take with you into your preceptorship & first job is that critical thinking mindset.

I just started my preceptorship on a pedi step-down (cardiology). Many of the skills done commonly there are ones I never had seen or done before, but I feel confident that I will pick them up, and my focus is more on independent management/critical thinking/organization. That's not to say I'm not going to be getting my hands involved in every skill I can. I think it's unfortunate that the hospital you're doing your rotation at is being so strict, but it isn't the end of the world. There is definitely knowledge to gain!

Edited at 2012-02-22 12:22 am (UTC)
daisyfleur70
Feb. 22nd, 2012 01:09 am (UTC)
I am trying to make the best if it. My gials I have set are to do as many shift assessments, pre and post meds assessments (pain/anxiety, etc.), hourly rounding, and whatever else comes at me. I&O's, catheters, or anything else. Care of multiple patients, too.
laura
Feb. 22nd, 2012 01:05 am (UTC)
I was also told by an instructor that skills aren't important. "I could teach a monkey the skills - it's the critical thinking that's important." And I agree. But without having to perform those skills, I'd really, really wonder how you're going to learn what was, for ME, the most important part of med/surg 2 - time management. It's hugely different experience to be a nursing student with half a patient assignment than to be a precepting student with a full load, or a new grad nurse with a full patient load, especially if you're also trying to master those skills you never even got to practice in school.

I guess make the best of it, but be sure you try to figure out just how your buddy nurse gets everything done, because it can be crazy-making to juggle all your patients, their meds, their basic care, their dressing changes, and actually getting your own breaks, and nothing teaches you that but experience, IMO.
starzysky
Feb. 22nd, 2012 05:12 pm (UTC)
Yeah... time management is the key thing to learn. Balancing a full patient load...knowing skills is one thing, but being able to juggle everything is the hard part. Doing morning care and nurse assistant skills is NOT what you are in nursing school for. We were told by that point in nursing school that we needed to learn to delegate those tasks to the NAs, NOT do them ourselves.

FWIW, I felt completely unprepared to enter nursing until I was about midway through my preceptorship. Hopefully you'll learn what you need to know then -- and really, on the job training is where you'll learn everything you don't learn in nursing school. Don't worry. Try to find a job where you'll have 10-12 weeks of training as a new-grad nurse and that'll help.

Nursing education really is terrible, in my experience... both undergrad and graduate.
( 7 comments — Leave a comment )

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