Quote from elkpark
It's not just a matter of the employer expecting you to function according to the "payscale" -- the employer is paying for your level of licensure. The fact that you hold a nursing license is supposed to mean, legally, that you are competent to function at that professional level. Long, long ago, new nursing graduates came out of school much better prepared to start functioning in clinical settings. Now, most new grads need (and expect to receive) extensive "orientation" (I put it in quotes because what we're talking about is really much more an extension of formal nursing education than it is an orientation to a new job) which is very expensive for employers to provide -- that's not the fault of the new graduates, but a lot of employers are getting fed up with having to pay to teach new grads stuff that the employers feel, rightly or wrongly, that the individuals should have learned in nursing school.
The nurses of yesteryear got a lot
more clinical training than more recent grads. Back in the days of hospital-based training, students staffed the second shift. They could hit the floor running after graduation because they'd been nurses in all but license for a while.
When I graduated in 2008, not only were clinical sites very hard to find, they put extensive restrictions on students. My program had 2 med-surg rotations. My first was at a rehab hospital; once AM vital signs and breakfast were done, there wasn't much for students to do until Glucose Smackdown at 11 am. One of my classmates had a complex med-surg rotation at a facility that didn't allow students to give non-oral meds. Another had a peds rotation at a hospital that got so few peds patients that the unit sometimes shut down. With one exception, we never had a Pyxis/Omnicel access, so we had to go to the nurses for everything, including tissues. If you weren't very aggressive about doing procedures, at a facility that allowed students to do procedures, you gave bed baths all day. Yes, bathing, feeding, and ambulating are basic nursing care, but that's not all nurses do, and it shouldn't be all they learn. A student RN needs to be able to function as an RN, not a CNA who occasionally gives meds.
I wish more schools used the one-on-one preceptor model for clinicals; it's really not the floor nurse's job to train students, and some are very bad teachers. Clinical groups at my school were 7 or 8 students per instructor; for complex med-surg it was 7 students on 2 units per instructor. It's hard to ask you instructor for help when you can't find them. I also would like to see more semester-long practicums (practica?), to make up for the lack of clinical training in school.
New grads don't know much about hands-on care because they don't have much clinical time, and they aren't allowed to do much in clinical. Hospitals brought the problem of poorly-trained new grads on themselves.