A time to reform nursing education?

Nurses General Nursing

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After reading some very interesting posts around here lately in regards to "fluff" being taught in nursing school, I wonder if it is time to reform nursing education.

I feel we could do without the nursing diagnosis. I understand they can help a student group and rank interventions for a disease process (dare I say that?), but there are better ways to help a student understand this concept. I am not against throwing out holistic nursing practices, but we really could do without the fluff. Why is it that many new grads can't "put it together" Maybe, because fluff doesn't cross over into real-world nursing practice?

I realize that nursing schools are geared towards passing the NCLEX, and that will never change. People in the nursing adovacy groups want nursing to be a profession, no problem with that, but our hands-on skills are being "outsourced" by RTs, techs, therapists, etc. We are "losing" our skills. Nursing students are graduating and have never even put in a foley. What's happening?

I'd like to know what experienced nurses, novices, instructors and new grads feel should be included, or tossed out of the nursing curriculum. Who knows, maybe reform will come?

Specializes in oncology,med/surg,psych..

I have been in Nursing RN/BSN for 34 + years and never used a Nursing Diagnosis. We in the real world use Medical Diagnosis across the board to plan treatment along with the MD. I hated the concept of nursing diagnosis and found it to be a waste of time.

Maybe your teachers did not explain the purpose of those activities or relate them to the patient care environment. These assignments should help with your creativity for conveying your messages to others. I do skits, presentations and posters everyday as part of my communication with patients and co-workers. I often will get people who speak different languages or who forgot their hearing aide but I still must find a way to communicate. For teaching, if you just give a few dry statements to a patient who is already overwhelmed with information, you may think you've done enough to check the education box but in realty the patient may have gotten nothing from your words. Just writing the instructions down may not be enough either. I use the dry erase board frequently to draw a picture. When doing a skit or presentation in class you should be instructed on how to read your audience to know your message is being received. This translates into the patient care environment. If you don't know your patient is not understanding, just checking off the "done task (education)" box is not good enough. One problem when some just focus on skills or tasks is that the job becomes just a bunch of checkboxes.

Sorry, but lose the skits. It's an insult to nursing students. Teach them to start an IV, place a foley, give meds through a G-tube, and explain why you're doing it. They will learn more than through skits.

Oldiebutgoodie

Specializes in OB-GYN, Med-Surg, Rehab.

Nursing school is hard. It is a fantastic career, but it takes a lot for one to earn their title. If anything, it seems that now 4 years is not enough to accomplish everything that is required of you to learn without pushing your sanity over the edge. For those who have made it - you should be proud of yourselves for accomplishing such a hard task.

I hated doing nursing care plans when I was in school years ago and I too wondered why we had to do this and that. Only years later did it make sense and lead me to an appreciation for what I have learned. I understand that sometimes the theory part and the need to support all your actions with evidence based research seems tedious and useless at times, but I can tell you that having lived outside of the U.S. for 3 years now and having experience first hand not only teaching nursing students in another country (where no textbooks, eletronic libraries, or equipment is available), and being a patient in the hospitals and clinics here - I truly wish you could understand how well you have it in the U.S. AND for the high quality education and endless resources you have there. Nurses in the U.S. today have such a great name to them compared to other parts of the world.

While I find nurses very kind here, I also often find that many lack the theory behind their practice or the theory they have is from what their teachers taught them rather than based on up to date evidence. They often are not encouraged to critically think or to question a doctor. When I taught students abroad, I worked very hard, despite having very limited resources (as in a 1980s photo copy of a fundamentals of nursing text to teach med/surg nursing), to teach them to critically think. It was so rewarding to see them put the theory and the practice together with evidence based data (the little we could find, in Spanish, for free online).

My BSN program has skill sheets with two columns. One for lab checkoffs (which must be done first) and the second column is for real world check offs on real patients.

We have ~800 hours of clinicals and our final 200 hours are 1:1 with a preceptor working like a nurse. I think this is a great model.

I think this is an outstanding method to cement the theory with applications. I am a huge believer in the underlying understanding though. The so called "fluff" and theory is what makes you a thinking clinician with skills rather than just a technician. That's why nurses can get decent pay.

One thing I do think there should be MORE of: NURSING RESIDENCY. There are just a few of these programs, and more growing, but it needs to be the standard.

why do people post stuff like this and never post the name of their school ?

if your school is great, don't you think others would benefit in knowing the name ?

If you really want to make a difference in nursing education, turn it into a pre-med eligible curriculum to give nurses the ability to transfer the basic science prerequisites for med school later if so desired.

YES!!!!! :yeah:

Rensoul

I'm in my first semester of an ADN program and honestly, I wish we had more clinical time. I don't feel like we have enough time in the lab (we get 4 hours a week) or in clinical (1 shift of 7 hours a week, this includes pre conference, post conference and dinner so in reality we are with patients about 4.5 hours a week). I also hate how we don't get our pts till we get there so we don't have time to look up whats going on with them, the meds they are on, or anything. Ugh.

Specializes in ICU + Infection Prevention.
why do people post stuff like this and never post the name of their school ?

if your school is great, don't you think others would benefit in knowing the name ?

Just as with employers, it is usually not wise to advertise who you are with. Saying the wrong thing in a public forum, even if you thought it was positive, can be bad for your career. I am not an official spokesperson.

If anyone does want to know, they can message me. :)

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I have been in Nursing RN/BSN for 34 + years and never used a Nursing Diagnosis. We in the real world use Medical Diagnosis across the board to plan treatment along with the MD. I hated the concept of nursing diagnosis and found it to be a waste of time.

This is one of my main problems with it. It introduces vocabulary that does not cross into other areas of the multi-disciplinary team. The medical diagnosis is adequate to make a nursing care plan.

Specializes in Med-Swing/Rehab.

I have been an RN for about four months. I graduated from nursing school in June. We had TONS of clinicals during nursing school but I feel we did nothing! All we did was change beds, give baths and VERY RARELY give medications. Luckily we have a nursing practicum (the very last class) where you actually do RN stuff ... not CNA stuff. You have 120 hours to learn how to be a good RN that you should have been learning over the course of 2 years. Clinical experiences should be changed, be more student friendly and more flexible!

Specializes in Med-Swing/Rehab.
I also hate how we don't get our pts till we get there so we don't have time to look up whats going on with them, the meds they are on, or anything. Ugh.

That's how it is in the real world. Nurses don't have all night to fumble and think about the meds that they will be giving in the morning (unless you do night shift... haha)! My school required us to go to the clinical site the night before and get ALL the information on the patient and look EVERYTHING up and write tons of plans and look up EVERY single med, all the adverse reactions, drug interactions and all that lovely stuff. I really did hate it and it was a waste of time.

I'm in my first semester of nursing coursework in a BSN program, and I have a previous degree in an unrelated field. College is usually a bit different than it is in the real world. A good program, no matter what field, will try to emulate the real world as much as possible, but some programs lack the appropriate funding and resources for staff or equipment.

All those "fluff" classes, the electives, statistics, whatever it may be may seem really useless while you are taking them. But I've found that I really appreciate my well-rounded education from my previous degree, where my curriculum was centered around humanities and journalism.

Even though they may not perfectly relate to my future career as a nurse, my education has expanded my world view. With a well-rounded education, I'm not just filled with useless knowledge. I feel like I can better contribute to society because I understand and appreciate the realms outside of my specific career. It sounds corny, but I think it's true.

This is one of my main problems with it. It introduces vocabulary that does not cross into other areas of the multi-disciplinary team. The medical diagnosis is adequate to make a nursing care plan.

Just this. Just this alone is reason enough.

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