To me, nursing school often felt like a series of crash courses, one in each specialty area. Dozens of disease processes and conditions were covered each lecture, with no time for questions, discussion or digestion.
I can understand the motivation to try to cover so much. RNs currently are hired for nursing jobs
as varied as those in NICU, CCU, L&D, invasive procedures, OR, LTC, and more in addition to the stereotypical bedside med/surg nursing position. But is it possible that there's just currently too much material to cover to be adequately prepared for all the potential roles an RN may be asked to fill?
Why have every nursing student cover 1000 pages of L&D nursing (or ICU nursing, pediatric nursing, etc) when most of them will never work L&D (or fill-in-the-blank)? It's great to introduce the students to the broad spectrum of nursing possibilities in case they want to pursue them, but reviewing a 1000-page book of it is a bit of overkill for an "introduction."
And why not focus on symptom assessment and management as opposed structuring nursing texts around 1000 different diseases and conditions? Why have every nursing student study retinal detachment, cervical traction, laryngeal cancer, hydronephrosis....? Cover the biggies such as diabetes, CHF, stroke, etc... and leave the rest for specialty training that's perhaps post-registration. So after one gets their RN, they can take specialty coursework, such as orthopedics, neuro, oncology etc. And it wouldn't take longer because RN training would be much shorter if all students didn't have to cover all specialties as extensively as they do now. And if a nurse wanted to switch specialties, they could take a cram course in just that one area, which would be useful for both the nurse and the employer.
I understand that both nurses and hospitals have benefitted from nursese being able to float between units, but the reality is that after years working in one area, most will forget what they learned about those other areas anyway. As it is, there aren't too many formal ways for a nurse to bone up on their skills and knowledge when changing to a different area. Yes, self-study is important! But for safety reasons, is it really enough to only count on a nurse's training from years prior and their own self assessment of their preparedness to start into a new area?
It seems as if the schools (and BON that set minimum requirements) want nurses to be able to say to just about anything they come across "I studied that in school!" That's a great ideal, but to me, reading 1-2 pages out of thousands of pages of reading doesn't count for much. Having the name of this or that disease sound familiar and having some idea of what body system it affects doesn't really help me take care of a patient. I'll still have to go and look up the condition because I won't remember the details. Meanwhile, because we had to cover so much material in class, we didn't have time to ask questions or discuss things in lecture. We didn't address real world nursing situations - like how we might deal with 6 or more acute care patients or how we might deal with 20+ LTC patients.
Just thoughts! I'm sure there are those who see things differently and have had different experiences. I'm curious to hear any responses! :spin:
Sep 14, '07
Woody - I wasn't complaining about the amount of work in nursing school. It just seemed like for the amount of time I had to put into it, I came out of it knowing at little about a lot of things but not enough to really do anything with it. For all of the work it was, I didn't feel I'd mastered anything... except perhaps writing care plans
- which no one needs to write as practicing nurses. Yes, you work from them, but you don't have to come up with them from scratch as we did in school. I also learned how to pass the NCLEX.
I expect that there is much to learn on the job, that school won't teach me everything, but I also expect to learn a lot in two years of intensive study (jr/sr year BSN program). We covered a lot of ground but I really didn't feel that I *really learned* much. Maybe that's just an indication of my own strengths, weaknesses and preferences, as I felt the learned the most in my pre-reqs (microbio, chemistry) and auxiliary courses (epidemiology, statistics, psychology).
Some information was repeated again and again through the nursing courses, across the spectrum of of conditions, such as preventing and assessing for DVT and pulmonary embolism, preventing and assessing for skin breakdown, etc.... those things, very important nursing responsibilities, are what stuck. But which medications go exactly with which diseases? What are the prognoses for different diagnoses? What specific symptoms should I be expecting to see? I'd have to look it up same as if it were a disease or condition I'd never formally studied in school. So why spend all of that valuable time studying a multitude of conditions on might come across instead of spending more time in clinical, actually seeing the diseases and conditions?
Sure, I studied a little bit about traction, but if I were to work with a patient in traction, unless I happened to have previous clinical experience with that, I'm going to have to ask for help and look up the details of that specific variety of traction to know exactly what nursing care is required and to understand the specifics of whatever type of traction is being used. If I were to care for patient with AML, I'd have to look up the drugs and information on the disease in order to properly care for the patient; I couldn't just rely on what I'd studied in school.
Going on a tangent here.....
I'm just curious here... wondering what your nursing school experience was like and how it compares to nursing programs
today. I don't want to assume one way or another. Did you guys have the same two inch thick texts? Surgical nursing, maternity nursing, etc? Were you assigned hundreds of pages a reading each week in each text? Did you have the same ridiculously vague nursing exam questions? Were lectures essentially a rehash of the readings with no time for questions or elaboration? (Since the texts were essentially already summaries of disease processes and treatments, lectures couldn't really summarize it any more than that). If so, were you satisfied with that?
Some programs today do have strong clinical components but from what I've read here, it seems many do not... often due to liability concerns, I'd imagine, as well as the lack of strong clinical instructors. Students care for no more than 2 patients for much of the time and have to wait around for the instructor to do tasks. Students also often have a hard time coming across enough opportunities to practice skills for all the students. They might have only done one foley catheter and set up a chest tube set once during their entire education.
Last edit by jjjoy on Sep 14, '07