A time to reform nursing education?

Nurses General Nursing

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Specializes in Legal, Ortho, Rehab.

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 ER, ICU.

You pose some good questions. Nursing practice is constantly changing and nursing education will probably never be able to truly keep up. It seems that the nurse is becoming manager of a care team more and more. It is disheartening to struggle to understand nursing diagnosis's when every nurse tells you that you won't need that knowledge once you graduate. Perhaps it is time to put that to bed. Hmmm...

Specializes in LTC, Disease Management, smoking Cessati.

Nursing school needs to be more realistic about what to expect after graduation. It's a big slap on the head when you finally get there and it's not the way you learned about. That would help new grads cope with what they feel is failure when it's not failure but not knowing it would "be this way." Teach organizational skills... how do I organize my daily work. What is a priority and what could wait a while.... those are the things that would mean something along with why you do things etc. More Reality.

Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.

There is a new book that addresses everything you've brought up and more: Educating Nurses; a Call for Radical Transformation by Patricia Benner. Unfortunately, the ANA is the most powerful force in Nursing curriculum, not Benner.

Specializes in School Nursing.
Nursing school needs to be more realistic about what to expect after graduation. It's a big slap on the head when you finally get there and it's not the way you learned about. That would help new grads cope with what they feel is failure when it's not failure but not knowing it would "be this way." Teach organizational skills... how do I organize my daily work. What is a priority and what could wait a while.... those are the things that would mean something along with why you do things etc. More Reality.

Educational degrees don't exactly prepare people for their JOBS. Medical majors definitely seem to get that more than others (with clinicals and such) but when you enter any work world after graduating you have the base of knowledge.. the education necessary. Learning what your job is and how it is expected that you do it is up to your employer.. figuring out how to organize a priorities your JOB is up to you after learning what your employer expects of you.

Specializes in LTC Family Practice.

I would agree, I'm a '72 grad and I had tons of clinical hours and was well prepaired when I graduated, I passed the national exam on my first try and my first job I had 2 weeks orientation to learn where stuff was, policies etc. and was off and running, now grant it they didn't give me the real sickies right off the bat, but I was pulling my weight with a full pt assignment and they added higher acuity patients PDQ as I demonstrated my skills.

I look at the old diploma programs and boy those nurses hit the ground running right out of the box. They were hospital based and really worked the floor and I loved working with them.

I see the need for a good theory base but not at the expense of good clinical hours.

We had a skills check list that you HAD to complete before graduation and it wasn't just run in and insert a foley, we were assigned a patient who needed one and cared for them.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I wish there were more opportunities for externships for students. That was BY FAR the best preparation for real-world nursing and being on my own as an RN. I was ready to go out on my own 2 months after graduation, in a specialty unit that usually requires 3-6 months of training (even for experienced nurses). I credit my year of externship as a student, as well as an exemplary preceptor.

Specializes in Legal, Ortho, Rehab.
Educational degrees don't exactly prepare people for their JOBS. Medical majors definitely seem to get that more than others (with clinicals and such) but when you enter any work world after graduating you have the base of knowledge.. the education necessary. Learning what your job is and how it is expected that you do it is up to your employer.. figuring out how to organize a priorities your JOB is up to you after learning what your employer expects of you.

I think you are misunderstanding what Ruthiegal was trying to say. Nursing school is supposed to teach you how to prioritize patient care that is standard, however, many are not doing the job. That is part of graduating a safe, prudent nurse.

Specializes in Legal, Ortho, Rehab.
You pose some good questions. Nursing practice is constantly changing and nursing education will probably never be able to truly keep up. It seems that the nurse is becoming manager of a care team more and more. It is disheartening to struggle to understand nursing diagnosis's when every nurse tells you that you won't need that knowledge once you graduate. Perhaps it is time to put that to bed. Hmmm...

I've noticed that nursing is shifting to care team manager in a lot of ways too...

Specializes in Legal, Ortho, Rehab.

DogWmn bring up very good points. I was taught by nurses who started off as hospital diploma grads that later earned their degrees. They were the best instructors I've ever had.

Specializes in CVICU.

Yea I am a second semester nursing student now working on my ADN and this will come as no surprise, but the clinical experience is the most important, most influential part of my learning.

You know all week we learn about disease processes and the only time I really grasp them is when I see them come up in clinical. I really wish that instead of reading 6 hrs a week about respiratory alterations that we could spend 3 hrs a day briefly going over them and practicing at school the interventions and expectations of us.

For example, my first learning moment where I "put it together" as a first semester student was in the nursing home when I got my patient info, I had a lady with anemia. It wasn't until the next day where I cared for my patient, I understood anemia. Reading about it was all good in understanding, but to be at the nursing home, providing care for this disease really did it for me.

I'm going to get my BSN right away, but I don't see much point in my having to take statistics and other fluff classes that truly don't affect how I'm going to provide care to my patients.

Bottom line, I would support much more hands on skills in the school setting, and less fluff that ultimately doesn't matter, just costs me more money.

Nursing has an identity crisis. Are we a trade or a profession?

The old diploma programs taught nursing as a skilled trade.

When my aunts went to nursing school in the 60's. Nursing was taught using the hands on method similar to an appprentice. On the first day, students were in the hospital doing the minor chores and working their way to more responsible tasks.

Nursing as a profession is going to include what some people consider fluff. There is no way around it.

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