New RN who may lose her Med Surg job

Hi all. My preceptor has told me that I am weak in hands-on skills. I graduated with my BSN and was in the top of my class. I had no previous nursing skills before I got my RN. I was not able to do my externship because of an emergency that came up the summer before I graduated.

They have told me on my crazy busy med surg unit that I am very smart and have a great theory base, BUT, my clinical hands-on skills are lacking. They have suggested I practice on the "dumbies" in the hospital lab and "play" with the machines. They have told me that if my skills are not up to par in two weeks (when orientation is over), there is a chance they could let me go. This is very discouraging. :uhoh21: I have worked REALLY HARD for this.

What do you suggest?? Is there a book I can use as a quick reference?? I am employed there, full time, passed the drug test and all, been working fine, etc.... do you think they will just let me go?? My RN manager likes me and has told me I am smart. My preceptor thinks the same, but has noticed my frustration when I try to do the hands on. I am just lacking here. What do you think?? Can they just boot me out?? I asked if it came to that if could put me on another unit where it is not as busy, but I am not sure if they would do that OR just let me go. Oh my..... what do you suggest to help me?? I was a top student and now I may lose my job. HELP!!!!
Unfortunately being a "top student" doesn't mean immediate success in nursing. Some of the best nurses I know barely had 3.0 in nursing school. When in school, its very broad based and theoretical, and covers such a wide range of topics. I hope they keep you on...if not keep your head up, another opportunity will knock.

They already told you what to do. Go to the lab and practice on those skills that you need to work on. What are you waiting for?

Great hands on skills comes with experience! Your preceptor should have some more faith in you and understand that you're a new RN. Perhaps whenever you get the chance, volunteer to help other nurses on the unit with hands-on tasks I'm a new nurse too and I see myself getting better at it everyday just by repetition

Quote from AnneSThey already told you what to do. Go to the lab and practice on those skills that you need to work on. What are you waiting for?

Hands-on skills are very important on a med-surg floor.....I would do as they say and practice, practice, practice also ask a lot of questions, 2 weeks isnt that much time but its enought time to show growth. Stay strong and good luck.

A book will not help you. You need hands on training. Go to the lab and work with the dummies. Did your BSN program only have one clincal rotation? You have the book knowledge the hands on skills will come. How long is your orientation? I have always heard that skills can be taught on the jobs, it is the education you need.

Has your preceptor provided any specifics as to what hands on skills you are "weak" in? Have you precepted with anyone else? If I were a manager, I would want more than one opinion. As a preceptor, there are many aspects to being a nurse. Some skills take time to develop. Are your patients in danger because of your "weak" skills? Are you able to provide safe care and piece two and two together as the information comes in to you i.e. assessment findings, labs, side effects of medications, appropriate diets, etc? If so, then you are on the right track but just need time to develop your "skill". If not, you need to take the time to reflect on what is happening with your patients and how the pieces of the puzzle fit together. Look things up if you are not sure. Ask if you are not sure. A preceptors job is to assess where you are in your career. If you are new, you need more guidance and opportunity to "get your hands dirty". If you have experience but are new to a certain specialty, there is no need to rehash universal skills, but focus on unit specific skills. Maybe you need a new preceptor and can ask to have your orientation extended by a couple of weeks.

First of all, your preceptor has to define what she means by hands on skills. is she refering to your bedside manner i.e how you relate with the patients as a nurse or is she talking about assesment skills. for eg can you give IM injection but cannot take a manual bp, can you do a finger stick but not wound care? Hands-on-skills is very broad, you have to go back and ask what exactly am I not getting. Just focus on the SPECIFIC things they need because doing that would keep you from losing your job.

I would start looking for another job and resign.I'm sorry to tell you but in their eyes you always be the black sheep.Do yourself a favor and find a better learning envinronment.Skills take time...The more you do it the more it becomes easier.I'm a home health nurse,I just started my job and I never did finger sticks during my nursing school days and I have been practicing on myself,my boyfriend,the first couple of times I couldnt figure it out how to correctly drop a sample of blood on a strip and and I used to get an error message on my machine.It was driving me insane since soon I was to start my work and was expected to check pt's blood sugar,but eventually I learned how to correctly apply the blood to the strip and when the time came to finger stick my first patient I did it the first time.But even though I learned the correct method I still sometimes make mistakes and cant get a blood sugar check on a pt,it happens to everyone one.So please find yourself a more tolerant envinronment.

Quote from BlackheartednurseI would start looking for another job and resign.I'm sorry to tell you but in their eyes you always be a black sheep.

Ok, stop for a minute and think about what you just said. They are telling you that you are lacking in "HANDS ON" clinical skills. Then you ask if there is a book you can read to learn. Hands on skill is only obtained by hands on experience. How are you going to improve with a book?Are they giving you any specific skill you are lacking in? Do you need practice in IV, dressing changes, etc? How long of an orientation did they give you?

I would also like to know what specifically you're lacking in? IVs, foleys? Do you ask for help a lot when performing these skills or do you try yourself first? When I first started, I would always do these things myself with very little assistance, that is, if I was confident in doing so.