Are new grads receiving adequate preparation? - page 2

:confused: I see more and more new grads who are totally underprepaired for the realities of the clinical floor. Many have never had more than 2 patients at a time and many have never performed... Read More

  1. by   fergus51
    New grads are never adequately prepared. My aunt became a nurse in the 60s, graduated from a hospital based program and the nurses at the time thought her generation of students were unprepared. In 20 years all you new nurses will be talking about how your program prepared you better than the current newbies. By the end of my program we were doing the RN role alone, but we still were not "adequately" prepared. We were minimally competent. If you ask me, nurses really become nurses in that first year out of school.
  2. by   tatianamik
    I have clinicals 1 day per week (Saturdays) for 3 years. It's a part time RN program for people who have to work to survive. I've actually had 6 patients at a time. I had an excellent preceptor who would try her best to answer any question I asked. And she wasn't a regular preceptor just a weekender who never usually saw students.

    I have worked critical care/ER while in school. Honestly I do feel mostly prepared to enter one of these specialties when I get out of school.
  3. by   JohnnyGage
    I am of the belief that the entire nursing education system is obsolete. Never mind the whole diploma-AD-BSN debate that has raged on without end, but threads like this also seem to emphasize the point.

    Nursing and patient acuity have come a long, long way since good ol' Flo. We shouldn't change what nursing is, mind you, just how we learn it. Frankly, I think the medical model is an idea: Four years of university for the bachelor's degree, then two years of nurse residency. The first year would be pure clinical time in a med-surg environment; the second year would be the first year in your chosen specialty (and yes, I believe that med-surg is a specialty of its own -- it also offers the best training environment).

    This no doubt will never happen, and the very idea will enrage millions of nurses and nurses-to-be. Oh well.
  4. by   Dr. Kate
    Nursing school cannot prepare you for everything you will see and do as a working professional. The real purpose of nursing school is to teach you basic principles that guide your actions, how to think in an organized cohernet manner, what resources are avaiable to you and how to use them. Nursing school also gives you an overview of disease processes, treatment modalities, nursing actions and theory, and pharmacology. Hopefully, enough of these to be safe, but nothing close to what you need to be proficient as a nurse. Being safe meaning that you have enough sense to know when you don't know something and to get help.
    New grads focus on skills because those are easy to identify and quantify. Virtually any reasonably intelligent person can be taught the skills in 6 weeks. It takes years to learn how to think and apply the body of medical and nursing knowledge you acquire in nursing school and afterward.

    First and foremost nurses, bless us all, judge everyone on whether or not they can perform the skills. After you prove yourself able to do things, then they judge on what you know. It's the Yoda approach: there is no try only do or not. After that we can discuss it.

    Sorry if I sound cranky, but I am tired of new grads focusing solely on skills when what they need to do is learn to think and do.
  5. by   leeca
    l trained in Australia as a div 2 nurse, l feel terrified about starting work as l feel l didn't get enough hands on experience. When l did do some work experience the nurses were fantastic, l'm hoping they still will be when l'm actually working. l'm hoping to go on to do div 1 and that the training will be better, will more hands on.
  6. by   emily_mom
    Originally posted by Dr. Kate
    Nursing school cannot prepare you for everything you will see and do as a working professional. The real purpose of nursing school is to teach you basic principles that guide your actions, how to think in an organized cohernet manner, what resources are avaiable to you and how to use them. Nursing school also gives you an overview of disease processes, treatment modalities, nursing actions and theory, and pharmacology. Hopefully, enough of these to be safe, but nothing close to what you need to be proficient as a nurse. Being safe meaning that you have enough sense to know when you don't know something and to get help.
    New grads focus on skills because those are easy to identify and quantify. Virtually any reasonably intelligent person can be taught the skills in 6 weeks. It takes years to learn how to think and apply the body of medical and nursing knowledge you acquire in nursing school and afterward.

    First and foremost nurses, bless us all, judge everyone on whether or not they can perform the skills. After you prove yourself able to do things, then they judge on what you know. It's the Yoda approach: there is no try only do or not. After that we can discuss it.

    Sorry if I sound cranky, but I am tired of new grads focusing solely on skills when what they need to do is learn to think and do.
    I couldn't agree with you more!! Even a monkey can be taught to put in a catheter, but what about understanding the patho of disease? I mean, really understanding what your patient is going through and working with that info to make informed choices. It's not just saying, "Well, he has HTN and I see the doc has scripts for A, B, and C meds. I'll just give them." It's knowing.....and that can only come with experience.

    Kristy
  7. by   Rock
    INTERNSHIPS is the way to go ! ! !

    School only gives you basic information, on which
    to build a life of experience. State Boards of Nursing
    only certify that you have met BASIC requirements
    to practice nursing.

    After graduating from a nursing program, you should
    receive your diploma, but not be licenced, until internships
    are completed.



    :kiss :chuckle
  8. by   IRISHBREAD
    the hospital that i work at hire student nurse through the summer and weekends. when we have a student nurse on the floor we make sure she(we haven't had a he yet) gets to see what we're doing and let her get some hands on experience. canada's program sounds so much like the diploma program that i went through. i really knew what i was getting into. if you plan on getting an adn plan on going back for your bsn later--it opens more doors. my choice is the diploma program then going back for my bsn while working. it took longer but i felt more confident.
  9. by   Lol
    I am in my last year at uni in Australia and it's interesting to read that other courses in the States have similar problems to ours, which is lack of real time on the wards. Our final year is also called our "consolidation year" which is scary given the fact that I have only spent eight weeks on the wards in three years (I'm taking four years to complate my course) (excluding two in Mental health). I too have been treated poorly by RN's who seem to get a kick out of showing you up in front of patients or other RN's. I have worked very hard at Uni and can't do anything to add to my actual experience given the limited time we are given to learn the practical aspects of the profession.
  10. by   nrs-jlm
    I know exactly what you are talking about! I, myself am the perfect example. I am in my 7th week of clinical training in a small 25 bed renal unit. I am not a dialysis nurse but 95% of the patients I care for are in end stage renal failure or acute renal failure. I didn't know what I was getting into. It has been very challenging transitioning from the sheltered environment of a student nurse to the one of a graduate nurse. The BSN program I attended didn't have much clinical rotations. It was mostly presentations, papers,speeches and shadowing nurses...things which are not helping me right now. I feel overwhelmed and lost. I feel like my preceptor has reached the end of her rope and wants to let go!I really do want to stick it out, but I only have 4 more weeks of orientation and I don't know if I'll be ready to be on my own and be able to give effective care. I have seriously considered leaving the field of nursing and trying something else!
  11. by   JohnnyGage
    Originally posted by nrs-jlm
    I have seriously considered leaving the field of nursing and trying something else!
    I know you've been having a hard time, but after all of the work you put it, it seems very silly to think about making such an all-or-nothing decision. How about simply changing nursing jobs? Rumor has it that it's done all the time...
  12. by   Disablednurse
    What I am seeing and this is from my own personal point of view is the BSN nurses are not getting enough clinical experience and ADN nurses are not getting enough management training and experience. I have worked with new grads from BSN programs that did not have a clue to some clinical things and I know when I graduated from the ADN program, I did now know how to supervise anyone working under me. Both programs come out of school depending on the experienced nurses that give us orientation to help train us in areas that we are lacking. I know in ADN we had 4 classes in management. The first one talked about the history of nursing and the other three about the levels of management. Nothing that was any real help.
  13. by   Rock
    There is no way that you can become proficient with four (4) semesters of nursing. What is needed is an internship after graduation. Nurses should not be licensed until internship is completed.
    BSN programs do not fare any better. Passing rate on State Boards is not better in the BSN. Internships are needed in the BSN programs as well. I have worked with new BSN graduates, not any better than ADN graduates when it comes to clinical experience.


    :kiss
    Last edit by Rock on Mar 15, '03

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