A time to reform nursing education? - page 10

by nyteshade 10,921 Views | 115 Comments

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... Read More


  1. 0
    Quote from PMFB-RN
    *** That's why we need more men in nursing. More men = less skits.
    It you ever take an EMT or Paramedic course or train with FFs you will do a lot of skits for various patient situations as homework and classroom projects. These are all male dominant professions with mostly male instructors. Some call them scenarios or information projects but when the students have to come up with them and demonstrate with others in class, they are "skits".

    If anybody takes one of the defense classes that is now being offered for health care professionals across the country, you may do a lot of presentations and demonstrations over and over for different situations.
  2. 0
    Quote from PMFB-RN
    *** How many of those other health care profession must punch a time clock like most RNs and factory workers are required to do? Given the extremely high level of supervision RNs must work under compared to other health professions who seem to mostly work with very low levels of supervision. In my hospital each unit has a charge nurse, and assistant nurse manager, a nurse manager, and of course there is the house supervisor. Compare this to, say OTs who are usually the only OT in the house and expected to work unsupervised.
    I would say we are very definitely in the "skilled trade" category, just lower paid than other skilled trades like plumbers.
    If an OT, SLP or PT work in a hospital they are punching a clock and are reporting to a supervisor over many services and operating under some medical director.

    Don't home health and school nurses work unsupervised? Because of the structure of supervision, does that mean you should be less educated? Aren't RNs responsible for supervising others as well such as patients, CNAs and ER Techs?

    As far the pay, that depends on where you live. There are areas where you definitely can not say a nurse is a minimum wage earner. But then again if the industry standard only wants a 2 year college degree for entry level, what do you expect and what do you think are the expectations of policy makers when they are dealing with someone who only has two years of education. Look at the education requirements a grade school teacher must have and their pay is not that great either. Teaching kids also comes with responsibility.
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    If an OT, SLP or PT work in a hospital they are punching a clock and are reporting to a supervisor over many services and operating under some medical director.

    *** Where I work those professions bill for their services. They are not part of the room charge like nurses are.


    Don't home health and school nurses work unsupervised?


    *** Sure. I was careful to say "most".


    Because of the structure of supervision, does that mean you should be less educated?


    *** It means nurses are not seen as independent practitioners.


    As far the pay, that depends on where you live. There are areas where you definitely can not say a nurse is a minimum wage earner.

    **** I certainly never said anything about nurses being minimum wage earners. I said paid less than skilled tradesmen. Think plumber, not burger flipper.

    But then again if the industry standard only wants a 2 year college degree for entry level, what do you expect and what do you think are the expectations of policy makers when they are dealing with someone who only has two years of education.

    *** Nurses with BSNs or MSN don't get paid any more, or if they do it's some tiny, insignificant amount. If the higher levels of education where valued they would get paid more.

    Look at the education requirements a grade school teacher must have and their pay is not that great either. Teaching kids also comes with responsibility

    *** Their educations requirements are like the nurses educations requirements in that they are not actually needed to do their job.
    In my view nursing suffers from an inferiority complex. I see evidence of this in the absurd DNP requirement for NPs. Pure degree inflation.
  4. 0
    Quote from GreyGull
    It you ever take an EMT or Paramedic course or train with FFs you will do a lot of skits .
    *** I was a paramedic and never was a skit to be seen in my program. I saw my first one in nursing school.
  5. 2
    This is an interesting post...I am in week four of orientation to a busy telemetry floor. It's my first job out of nursing school. I am being repeatedly reminded on many levels that Nursing School does not equal Nursing and I'm beginning to wonder about the value of my program in preparing me for real world nursing. Like many posters my program had an extremely high pass rate on the NCLEX. I feel well prepared in theory of pathophysiological processes, medications and basic CNA skills: bathing, turning, etc. Beyond that, I still feel weak with heart and lung sounds and I realize that at no time in my education did I have the experience of listening to abnormal heart and lung sounds under the guidance of a teacher. My CI's were way too busy to do much with me other than observe my medication administration, look over my assessment on the computer, and guide me doing a few (and I mean few) random interventions. I like the idea of one-on-one preceptoring in nursing school as well as more time spent shadowing real nurses doing real world nursing.
    Another thing that is hard for me is the reality that in nursing school we are taught proscribed ways of doing things but that in the real world nurses need to cut corners in their practice in order to get the day's work done. Everyone admits they do this and my problem is in knowing the difference between safe corner cutting and what becomes corner cutting that can compromise safety. I've already had a few disturbing experiences on the floor that leave me feeling anxious and unsure about what really is "the right way."
    Not_A_Hat_Person and whodatnurse like this.
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    QUOTE PMFB RN Don't home health and school nurses work unsupervised?
    They do! And I'm an L V N, which makes me, in Grey Gull's estimation, about 2 pebbles shy of a granite block in the brainiac department.

    Grey Gull, I think you've created an artificial gap between ADN nurses and BSN and up nurses by ascribing to them negative characteristics that go beyond the issue of formal education. I think it's insulting to imply that without at least a BSN would see the nurse flipping the patient back and forth and jamming a catheter up his unsuspecting penis . Can a penis suspect something not-so-good is afoot? Sorry. Ahem, anyway, I honestly think you're underestimating them by a large degree.

    The other issues I picked up from your posts is that you feel that a nurse coming out of a 2 year program would be less open to change and less flexible about changing established practices and resistant to innovation. That describes a characteristic of personality, and intellectual curiosity is not dependent on years in school. In the olden days, continuing education was assumed to be what a nurse or doctor does as a matter of course, and nurses happily learned and avoided killing people for decades before mandatory CEUs.

    You mentioned that all the RNs at your workplace have their BSNs and are therefore wonderful mentors and communicators. There are reams of complaints here about preceptors, and I'm pretty sure it hasn't been connected to their highest level of education in nursing. Same for the patient education issue. When I mentioned posters and skits, I was talking about the assignments nursing school students are given, not patient education.

    Last point- I agree that OT, PT and SLP are growing in professionalism by leaps and bounds. My daughter is in a PT program that requires 6 years of study. She's specializing in kinesthesiology with emphasis in sports injuries.
    DogWmn, netglow, and whodatnurse like this.
  7. 1
    Quote from PMFB-RN
    *** I was a paramedic and never was a skit to be seen in my program. I saw my first one in nursing school.
    You mean you never had to do one patient scenario or pretend to be in a patient care situation as a Paramedic student? I seriously would have thought you would get a chance to simulate some patient care situations with an instructor given you the scenario or having you come up with one for the class. They even have national EMS competitions based on scenarios and these teams practice by having others role play for them. They also have people trying to come up with other situations to role play. This is also done for community disaster team training.

    Where I work those professions bill for their services. They are not part of the room charge like nurses are.
    Respiratory Therapists, Radiology and Lab also bill and are not part of the room charge. If a nurse does a respiratory treatment it is placed as a general nursing or room charge because you probably will not be in the room solely with that patient for 15 - 30 minutes to meet the guidelines for a therapy.

    Of course all of these professions also had to increase their education level to maintain compliance for reimbursement status.

    Quote from nursel56
    They do! And I'm an L V N, which makes me, in Grey Gull's estimation, about 2 pebbles shy of a granite block in the brainiac department.

    Grey Gull, I think you've created an artificial gap between ADN nurses and BSN and up nurses by ascribing to them negative characteristics that go beyond the issue of formal education. I think it's insulting to imply that without at least a BSN would see the nurse flipping the patient back and forth and jamming a catheter up his unsuspecting penis . Can a penis suspect something not-so-good is afoot? Sorry. Ahem, anyway, I honestly think you're underestimating them by a large degree.

    The other issues I picked up from your posts is that you feel that a nurse coming out of a 2 year program would be less open to change and less flexible about changing established practices and resistant to innovation. That describes a characteristic of personality, and intellectual curiosity is not dependent on years in school. In the olden days, continuing education was assumed to be what a nurse or doctor does as a matter of course, and nurses happily learned and avoided killing people for decades before mandatory CEUs.

    You mentioned that all the RNs at your workplace have their BSNs and are therefore wonderful mentors and communicators. There are reams of complaints here about preceptors, and I'm pretty sure it hasn't been connected to their highest level of education in nursing. Same for the patient education issue. When I mentioned posters and skits, I was talking about the assignments nursing school students are given, not patient education.

    Last point- I agree that OT, PT and SLP are growing in professionalism by leaps and bounds. My daughter is in a PT program that requires 6 years of study. She's specializing in kinesthesiology with emphasis in sports injuries.
    If you had read my posts, you would have noticed I differentiated between those who are open to education and those who become task fixated which can also due to their mentoring situation and work environment. There are some places that will never advance regardless of education because "this is the way we've always done it" keeps getting passed down. And as the sentiment with some on the forum, the ADN has been good enough for the past 4 decades and should still be good enough. Times are changing.

    As far as education, if the nursing program has a long list of prequisites which are heavy in the sciences, maths and English, the student may spend at least one year taking those classes. Why not just take a couple more classes and get the BSN? Wouldn't that be more effective for the long run?

    The problems some BSN programs have encountered is placing their students with nurses who have an attitude toward education and believe all BSN students are stupid. How well do you think those clinicals go for the nursing students? Just the few comments on here I would not want a BSN student placed with that person. The inflated education comments from PFMB-RN would probably not make any BSN student comfortable. Regardless of how good you are, your emotions and attitude will eventually show. If you read through some of the different threads on this forum you will see a variety of opinions about advanced education and nurses. Many believe the person automatically becomes less a nurse if they get an education and the statements about those who have MSNs or Ph.D.s are not a good reflection of a profession that wants respect.

    Your statement about "all BSNs at my workplace", I refer you back to my post and notice I said the RNs in most of our units (critical care, transplant, ECMO etc) are BSNs.

    When I mentioned posters and skits, I was talking about the assignments nursing school students are given, not patient education.
    Those assignments later become patient and staff education. You might think this is stupid also but to maintain our unit ladder status, each of us must give a little educational inservice to our co-workers, including doctors (Residents and attendings) which can be a visual of some type. Generally we resort to a poster rather than trying to set up a lot of electronic equipment. So some of those "silly things" you did in school never go away and you will find they can be educational with practical uses. As far as skits, we go out to the med-surg floors to practice Rapid Response and Code scenarios all the time to keep everyone up to date on equipment and skills. I can play a dead patient now even better than I could in college...provided I can lay on the bed and not the floor. We also have drills for missing babies where someone sticks a doll in their backpack or we have a staff member play a confused person wondering the halls.
    Last edit by GreyGull on Oct 9, '10
    flyingchange likes this.
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    I cannot speak for the poster who originally mentioned "skits". I would make a distinction between role-playing scenarios which teach patient care such as Grey Gull describes, and assignments that some students are required to complete including songs and other cutesy/campy arts & crafts projects that certainly do nothing the elevate the image of professional nursing.

    I am tired of nursing educational activities which refer to "jewels" or "pearls" of knowledge and include accompanying graphics which would be more appropriate for an elementary school audience. I am also tired of nursing educational activities which include drawings for prizes such as a spa day, a designer handbag, or other feminine, non-professionally associated items.

    In my fantasy world, students would utilize group work experiences to prepare professionally-oriented presentations such as they will be required to do in their future professional lives, and "prizes" would at least be professionally oriented such as memberships in local chapters of nursing organizations, or subscriptions to journals.
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    You learn something new every day...I was also unaware that a penis alone could feel or exhibit suspicion.

    I think I've got this concept map thing DOWN though...

    Last edit by metal_m0nk on Oct 9, '10 : Reason: Beat me to it, nursel56...great minds and all that :)
    DogWmn likes this.
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    Quote from Altra
    I cannot speak for the poster who originally mentioned "skits". I would make a distinction between role-playing scenarios which teach patient care such as Grey Gull describes, and assignments that some students are required to complete including songs and other cutesy/campy arts & crafts projects that certainly do nothing the elevate the image of professional nursing.

    I am tired of nursing educational activities which refer to "jewels" or "pearls" of knowledge and include accompanying graphics which would be more appropriate for an elementary school audience. I am also tired of nursing educational activities which include drawings for prizes such as a spa day, a designer handbag, or other feminine, non-professionally associated items.

    In my fantasy world, students would utilize group work experiences to prepare professionally-oriented presentations such as they will be required to do in their future professional lives, and "prizes" would at least be professionally oriented such as memberships in local chapters of nursing organizations, or subscriptions to journals.
    We definitely went to different colleges. We sing cutesy songs or have spa days. Designer handbags? My advisor never told me about those perks when I was choosing a college. I went to a state university which was no nonsense.


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