In my clinical experiences, I’ve found that it’s really hard to get the opportunity to perform a new skill.
New patient admitted to the floor, assigned to the nurse you are following, and needs an IV started.
You (the student nurse): Can I start the IV?
Nurse: Have you done it before?
You: I’ve performed it several times in our skills lab (the response you’ve been taught to say when the only time you’ve done it was on a plastic arm)
Nurse: (looks at you funny) Have you done it on a person?
You: Um… not exactly (OK! So he was plastic –big deal!)
Nurse: No, you can’t start the IV unless you’ve done it before, our patients aren’t pin cushions.
I get it. I really do. I have a family full of hard to find veins (not that I tried to find them myself!). But what I don’t understand is that if we can’t perform a skill without experience, but can’t get experience until we’re allowed to perform a skill – when are we supposed to do it?
Our skills lab really trains us well, but it is plastic. And at our school, we aren’t allowed to practice on each other (at least not with anyone knowing). It just seems odd to me that if we aren’t trusted to perform a skill in person while being talked through it with a nurse (on a willing patient of course!), then why would our future employers want to trust us to perform these skills post-graduation?
Today I got the chance to draw blood – a new skill for me. I was walked through it by the nurse and with her explaining it to me step by step, I felt comfortable. It felt like I had done it several times before. I feel fortunate that I got the opportunity, and that I can now say “yes, I’ve done this before,” but I still feel like we’re held to this goal that remains unreachable until some very rare opportune moment.
What are the policies for new skills at your schools or workplaces? Have you experienced this Catch-22 as well?