Confidence in Nursing School

My biggest fear while I have been in nursing school has been starting my first IV on a real live patient. I have had plenty of time and practice on mannequins with plastic arms and red water, but even I knew that a plastic vein was a lot different than a human one.

While I have been doing my externship in the labor/delivery department of my local hospital I have had numerous opportunities to start IVs on admitting women. My first several attempts were complete disasters and I was absolutely horrified and embarrassed. One attempt was on a woman who had a gigantic pulsating vein on her hand that would seem to be impossible to miss - hit a valve. My second attempt on a patient I must have completely blown through the vein because her hand swelled up to the size of a softball. I felt sick. After many uncomfortable and embarrassing moments following these events, I think that I have finally gotten the hang of starting an IV. What a confidence boost!

I never thought that being only one month into my externship that I would have learned so much and gained so many basic nursing skills. I now think that I could insert a foley catheter into a women while blindfolded, prime and hang IV tubing and program a pump in complete darkness (and have had to on several occasions) and even gain a fairly good handle on doing a cervical check. I am so much farther than I would have expected at this time.

I guess this means that the goals that I had for this externship have been met. I wanted to do it this summer because I didn't want to spend my entire orientation as a new nurse trying to learn basic nursing skills while I should be focusing more on overall patient care and policies/procedures, etc. If anyone is having doubts or questions over whether they want to do an internship/externship—I would highly encourage you to do it. It is never a waste of time to have more practice! The confidence alone is invaluable.

Nursing Journals, Do You Keep One?

Recently I've been seeing fliers around town inviting nurses to join a weekly meeting where their journal entries are shared and discussed. I found this idea of sitting around with other nurses discussing work-related journal entries very exciting. As a nursing student I think it would be a wonderful idea to get other nursing students together and do the same thing.

Along with all of the joys of being a nursing student there also comes a lot of fear, anxiety and stress. While we have all discussed the many negative coping mechanisms that nursing students often turn to, we rarely discuss positive ways to release some of this tension. Writing a journal about being a nursing student can be a great way to cope with the abundance of emotions and also help to solidify the many things we are learning on a daily basis.

Although I unfortunately do not journal regularly, I have written several entries during some of the more monumental days of nursing school. Looking back I can see how I grew from being a nervous wreck the night before my first clinical to finally being comfortable with patient care. I also think that by sharing journal entries with other members of the profession it might be encouraging to see some of the same fears or worries and perhaps get tips on how to deal with problems or situations in a positive manner. It could also be educational to have seasoned members of the profession and student nurses in the same group to remind older nurses where they came from and to let younger nurses see what to look forward to.

If any of you are members of a group like this, please share your experience with us! I am very interested to see how a group like this supports one another in a profession that needs a lot of peer support.

Are You Marketable?

In nursing school we are taught ways to become a well-rounded nurse and we learn a wide facet of skills to cover every dynamic field within nursing. But how are we outside of the classroom? As I sneak closer to my graduation date every day, I have come to ask myself the question, "Am I marketable?" Sure, I get good grades in class but is that all that it takes anymore?

In the current state of our country, where more and more hospitals are placing hiring freezes and more nurses are staying put, I have found that the job market is not near as friendly as we were hoping it would be by the time we graduate. This means that is so important to not just be a student nurse with great grades and an okay resume, it is now the time to be an incredible student nurse that can't be turned away.

So how do we do this? By speaking with several recent graduates from my school and several recruiters from my area, I have come up with several great ways to add to your repertoire and make you stand out.

The first thing that I would recommend is to be active in your school. This means becoming a class representative, joining the Student Nurses Association or maybe starting a new club that might serve your school well. This will show initiative and enable you to show concrete ways that you are a facilitator.

The second thing that I would recommend is to become active in your community. This could mean either joining the American Red Cross, working with a local food bank, organizing blood drives, etc. There is no end to the multiple ways that you can help your local community. Not only will this give you great memories and make you feel great, but it will also add to your skills of becoming a compassionate nurse and giving member of society.

The third thing on my list is doing an internship or externship at a hospital. Usually these take place over the summer before you graduate and can be a great way to add to your skills as a nurse and help prepare you for the NCLEX. If you plan on working at the hospital you accept an internship with this can also help get your name and face out there and you may even become friendly with the people that may someday interview you for a job. Some hospitals are now offering internships after you graduate. This may also provide many of the same benefits and give you a foot in the door at a specific hospital or field you may have your eyes set on.

The last thing is to be excellent at your job. If you are one of the many unfortunate ones that have to work during nursing school make sure that you are doing it as well as you would if you were finally a nurse. This shows great work ethic and time management. I was fortunate enough to become the employee of the quarter. Not only did this make me feel great, but it told me that even though it is very hard to juggle school and work, it is not impossible to succeed and do well at both. I believe that my future employer will also take this into consideration.

If you do not work, make whatever you do a success. If this means being an excellent parent, getting straight As, writing a blog, or enjoying your hobbies - do it with the intention of being great.

I know there are many other things that I could add to this list that would make you a more marketable graduate, but these are just a few ideas to get you started. Of course not everyone can do all of these and be successful, but pick and choose among them to become a well-rounded student and someone an employer would be honored to hire.

Concerns About the Nursing Job Market for New Grad Nurses

When I first started nursing school two years ago, the local hospital had pages and pages full of positions for registered nurses. Now that list of jobs has shrunk to less than a page with only part-time or PRN positions available. The hospital has also done away with loan repayment for new hires and has also temporarily frozen personal paid leave. This had scared most of us who are graduating in December and were anticipating working locally.

Many of us are willing to move away once we graduate, but is the situation that much different around the country? It seems as though hospitals are now being hit by the economic crisis and are being forced to impose hiring freezes, decrease salaries and to reduce the overall benefits offered to newly graduated nurses.

Does this mean that the need has subsided? I don’t believe so. I think that there is still a nursing shortage throughout the country, but my concern is that the ratio of patients to nurses may change in some areas, as well as the overall expectations put on current registered nurses.

Throughout nursing school we were told that the older nurses will soon be retiring and that will leave a big hole in the nursing workforce across the country. But, with the current economic situation, are more nurses postponing their retirement? Are more nurses coming out of the woodwork to start working again? Are stay-at-home moms returning to the field to make some extra income for the family?

As a new nurse who will be entering the job market shortly, my concern is that I will not be able to enter the field that I am most interested in. I am also concerned that I will have to accept a part-time position first before a full-time spot opens up and that the pay and benefits will be half of what was being offered in the past.

These are just a few of the worries that current nursing students are facing. What was once a field of opportunity has now given way to a fear of what the status of the profession will be during this recession.

Perhaps this is not a time to be picky about positions available, but rather to be safe and take what is available. This is a time for nurses to stick together and help one another through this period in our country.

Do any of you have any thoughts on this? Any positive takes on the situation?

Career Fairs Helps Ease Post-Graduation Concerns

A career fair is a great way to see what health care institutions are available in your area and what opportunities you will have when you graduate. It expands the possibilities outside of the scope of just the hospital setting—which is often the focus during school. Some participants may include local prison facilities, schools, companies, government agencies, etc.

Recently my school held a career fair and I was amazed to see the many options that were available to me. Not only were there multiple local hospitals present, but each one of them offered something different. Some hospitals offered internships during the summer, while others expanded on their new facilities and benefits.

A career fair is a great way to “shop” for your future job. Instead of looking for jobs online or in the newspaper when you graduate, you can see firsthand what is available and even ask questions to the representatives while they are there. Some facilities even have nursing recruiters who will assist you in completing the application process and ensure that the transition from being a student nurse to a nurse at their facility goes as smoothly as possible.

Even if staying in your local area is not what you plan on doing, career fairs are still great learning opportunities. It can help to narrow the focus by discovering what some health care employers are offering. Once you see what is available and being offered you can start to fine tune what you are looking for in an employer and narrow it down to a place that suits your needs (perhaps one that offers relocation expenses, a sign-on bonus, tuition reimbursement or a newly remodeled department in your area of focus, etc.).

The career fairs that I have attended have helped ease my post-graduation concerns and I have found them all to be worth my time. I hope that you will discover the same.

Balancing What We Learn With What We See

In nursing school we are taught textbook nursing and how we should practice our evidence-based nursing skills. Unfortunately our clinical experience doesn’t always back up and support this information. But that’s where “do as I say and not as I do” comes into play, right?

When nurses do something in our clinical experience that is not “by the book” it is, for the most part, very obvious. Such as a nurse poking a hole in her sterile glove so she can palpate a vein for a PICC insertion—definitely not by the book. But, other things are a little less vague. One such thing happened during clinical where a nurse removed an arterial line and advised us to hold pressure for 3-5 minutes. Then that very week we had a test question involving removal of an arterial line and the answer was at least 5-10 minutes (depending on if the patient is on anticoagulants or not). This and other similar occurrences can make test time and preparing for the NCLEX more complicated than we’d like it to be. We are constantly told to “go with what the books say” instead of what we see in the real world but sometimes this can be a hard juggle.

As we prepare for the NCLEX, I think the most important thing we can do is to remember what we read and what we were taught in lecture first and foremost. This is not to say that some questions may be answered from our clinical experiences, but that our primary focus should be coming from the theory part of our education.

Has anyone else had similar experiences? Or any tips on how to balance what we learn with what we see?

Resisting the Technology Temptation in Class

Today while I was sitting in my very comfortable spot in the back row of class, I counted roughly seven out of 10 students on the Internet and chatting with friends on their laptops, instead of paying attention in class. Although I am a very avid technology fan (and would probably melt away at the thought of going without the Internet for a whole day), I am appalled at the passive learning that is done within our classrooms due to the introduction of technology.

Since starting nursing school, I have not had a single teacher give a lecture without using a PowerPoint presentation. This means that the majority of the students will either sit and read off of a PowerPoint or occupy their time on the internet pretending to pay attention. This is not to stay that I have never once checked my e-mail during class or had the temptation to check the news or otherwise distract myself from a boring lecture. It is way too tempting for us technology junkies. But how do we solve this problem? How do we get back to the basics of learning?

One thing that I think all schools should look into is blocking certain Web sites and programs. Most classes need to have access to the Internet for research and for accessing the school’s Web site and class sites, so it is not realistic to have the Internet completely blocked in the classroom, but blocking the major social networking sites like Myspace and Facebook, as well as MSN Messenger would probably greatly improve students’ attention.

Another thing that I think all students must do is to take their education into their own hands. One thing that I have had to do to prevent temptation is to simply close my laptop. Although I write much more slowly than I type, I have discovered that my grades have increased and my studying has gone much more smoothly with handwritten notes. It is such a powerful moment to make eye contact with a teacher and actually comprehend the words that are coming out of his/her mouth, instead of being buried behind a computer screen.

I would also suggest to all of the teachers out there to greatly cut back on the amount of PowerPoint presentations you give in your class. It increases passivity in the classroom and cuts back on good old fashioned learning.

So let’s all try to do our part and use technology when it is needed and use our brains for the rest.