Why not a "match day" for nurses?

cherrybreeze, ADN, RN · Mar 20, 2010

I am certainly not against the "liberal arts crap", however I do agree that clinical time is sacred, and the quality of clinical time in nursing school is what is truly important. While I was in nursing school, I certainly did not appreciate the liberal arts classes that I was forced to take (and I blame a lot of that on the fact that I was 17 and probably not really ready to go to college yet), but now I do recall a lot of the things that I learned in those classes and can apply them in my everyday practice. What saddens me, is the fact that while I am working and have senior clinical students come my way, they have never inserted or removed a foley, never inserted or removed an NG tube, never suctioned a patient, never administered medications via PEG or NG tube, etc. They are senior nursing students, and the only skills that they have are administering PO meds to 1 patient, taking a fingerstick (if they are lucky), and taking blood pressure with an automated machine. Most of them are scared to even get a manual blood pressure or an apical pulse. I don't know if it's because the clinical instructors are overworked (scratch that I'm sure that they are), but these students are being severely deprived, and many of them are then spending a great deal of time as new graduates unemployed where they are further losing the knowledge that they have worked so hard for.

I'll tell you what, I have gone round and round with my unit managers and the CI's we work with about this issue. On my unit we use automatic BP machines, but I have frequently *suggested* that the students do manual pressures, for several reasons, including: 1) we have a limited number of machines to start with. Our CNA's use them to get VS, and they get vitals on 8-12 patients a piece. When they can't find a machine to use because the students all have them (and there are more students than machines), that's not right. A student has one, maybe 2 patients, they have the time and can take it to get a manual (our rooms still also have the manual cuffs on the walls). Also, we keep machines in the rooms of post op patients, since we are doing frequent VS. This saves a lot of time for staff. Again, if we don't have machines available since the students take them, it adds a lot of time to our routine. 2) Plain and simple, they need to learn that skill. Yes, in practice, we use the machines, but you don't always have one, and you need to be proficient in taking a simple blood pressure. Any pressure I took in nursing school was manual. Using a machine is OK, only after you have mastered the skill.

Sorry, I know it's off the original topic, but this has always been a big concern of mine, so I'm glad to see it's not only me.

RNnbakes · Mar 20, 2010

Maybe new grad nurses do not have "match day" because they dont stay three years at their first job.

Fribblet · Mar 20, 2010

Harsh, much?
Not all people need a liberal arts education to produce proper sentence structure, use words correctly, and not write like "a child." I've looked at some BSN bridge program cirriculum, and didn't feel it was worth my time or money, at this point, to take an art class. I don't consider myself less "enlightened" for feeling that way.
I have the same reaction to poorly worded/structured emails and memos, but those are not limited to nurses, or nurses with less "well-rounded" educations. It seems to me that a LOT of people fail in that area...regardless of their degree (an MSN did a PowerPoint CE for staff and used the word "irregardless," so no, her extended education level didn't help one bit). In fact, you use managers, educators, and your CNO in your examples of those who send poorly written emails and memos...as a general rule, those positions require a BSN, or in the case of a CNO, and MSN. You contradict your entire argument right there.

How do I contradict my argument here? A BSN is not a liberal arts degree. In fact there is very little of the liberal arts in a BSN track education. No where in my post did I even suggest that a BSN was a liberal arts degree. If anything I suggested a BSN needs MORE liberal arts courses. Maybe a comparative lit. course would help improve your reading comprehension? :)

Some of the aspects you mention can be attibuted more to a person's ingrained intelligence and strengths rather than their degree. I think your tunnel-vision perhaps makes YOU "less enlightened."

I did not mention anything about specific degrees in my post. I was reacting to the LACK of the liberal arts required FOR a degree and to the person who thought we needed less of that "crap." Again, do you see how important reading comprehension is? The liberal arts are essential to nursing and the fact that there are so few of these courses required is a detriment to students both personally and professionally. But, I suppose someone who thinks this stuff is "crap" wouldn't see the value in taking an course on ethics. I mean, all that philosophy stuff is crap anyway. :)

Hell, taking an art course and examining societal and my own personal reactions to different pieces won't be of any value to me whatsoever. It won't offer me any insight on myself or society or on generational differences. Nope.

Reading literature and examining a character's relationships and actions won't help me be objective and less judgmental with the people I meet. It won't help me look at situations and people from different perspectives.

It's all a colossal waste of time. Rather than ethics, nursing students should spend more time starting IVs!

Asking students to only take courses in nursing school where they are tested based on what they have memorized is depriving them of skills and information that are necessary to nursing. Nursing isn't "memorize this and then choose the correct answer from A, B, C or D." Requiring students to take more liberal arts courses as a prerequisite to nursing school is beneficial. Asking students to write more papers (you know, that liberal arts crap) in their nursing courses rather than just taking multiple choice tests has multiple benefits. It forces them to think critically about an issue/subject. They have to formulate their own ideas, and then sift through literature and information to back up what they say. It also improves their communication skills, both written and orally.

To be advocates, critical thinkers, and to reduce the stress associated with morally distressing situations, the liberal arts are crucial to nursing education.

Pharmacists and MDs are required to hold a 4 year degree before beginning their education in their respective fields. The fact that nurses are allowed to practice after as little as two years of schooling is frightening. Although impractical given the nursing shortage, it would be ideal for nurses to be held to the same standards. Nursing is vital to the health care system, why should our educational standards be so much lower?

Edit: This will be my last reply as I just realized that I'm talking about something entirely different than the topic at hand. My sincere apologies for the derailment; totally my fault.

Although this might make for an interesting discussion elsewhere!

Otessa, BSN, RN · Mar 21, 2010

To OP-isn't this what a nurse residency is?

otessa

NeoNurseTX, RN · Mar 21, 2010

We do have new grads as nursing residents. It'd be neat to have a student follow me from beginning to end of shift though. You don't get to do that much in school so it's nice to see the WHOLE picture.

nyteshade, BSN · Mar 21, 2010

"*students don't need more liberal arts crap."
that liberal arts "crap" has a lot of benefit. if you prefer to be less educated that's your choice, and, as evidenced from your poorly written post, you made that choice.
i don't see how philosophy, art, literature, leaning how to read and think critically, and leaning how to write like an adult are "crap," but i guess the less enlightened among us will continue to think so and push for more one-track university educations.
i'm continually shocked and embarrassed by the emails and memos i receive from nurses in positions of authority (managers, charge, cno, educators, etc.) that are full of incorrectly used words, poor grammatical structure, and generally give the impression that a child wrote it.
having nurses who are well rounded, educated, and can form complete, coherent sentences only benefits our profession and helps others (doctors and the general public) to take us more seriously. i, personally, would have less confidence in a nurse taking care of me who spoke to me and others like she had never attended an english course. (this, of course, applies only to native english speakers. although i work with foreign nurses who speak english better than some native speakers i work with.)
so while you may think the liberal arts are "crap," don't advocate for the continued dumbing down of our educational system.

yes, i stated they don't need more liberal arts. the whole point of the post was to suggest that more clinical time be added. i never said i was for "dumbing down" nursing education. while nice, robert frost poetry isn't going to help land you that first nursing job.

the fact of the matter is that new grads aren't getting jobs. could it be that schools are not meeting the demands of the job market? if you have failed to see all the new grads on here with their shiny new rn credentials falling behind on their bills, then it's time you wake from your slumber like rip van winkle.

Fribblet · Mar 22, 2010

yes, i stated they don't need more liberal arts. the whole point of the post was to suggest that more clinical time be added. i never said i was for “dumbing down” nursing education. while nice, robert frost poetry isn’t going to help land you that first nursing job.
the fact of the matter is that new grads aren’t getting jobs. could it be that schools are not meeting the demands of the job market? if you have failed to see all the new grads on here with their shiny new rn credentials falling behind on their bills, then it's time you wake from your slumber like rip van winkle.

edit: anyone who thinks that philosophy, art, literature and history are "crap" isn't worth a response. you can only get so far with people who don't value a well rounded education.

also, new grads aren't getting jobs because there is too much "liberal arts crap" in nursing school.

VegetasGRL03RN · Mar 22, 2010

We have a preceptorship program incorporated into our ADN nursing school curriculum as the final 1/3 of our semester. We, in essence, get "matched" to a preceptor at a hospital in a specialty after we provide the school with a list of our preferences. You can either provide a RN you have come in contact with or the school will set you up with one. During this period, we are meeting weekly at our school to prepare us for "transitional shock" (nursing student to practicing professional) along with reviews of delegation, management, legal, and other issues while keep a journal throughout the process geared towards specific topics. The goal is to handle some of our nurse's patients in the beginning and hopefully be able to take her whole load by the end of preceptorship with the nurse as a guide. We have to complete 120 hours for preceptorship in a 1.5 month period. We get to start the registration process for preceptorship during the 2/3 of our last semester, however you cannot go into preceptorship until you have successfully passed the clinical and lecture portion of the semester. Final exams are the day before preceptorship orientation.

I mentioned this to say that some schools offer "match" programs as well as hospitals/facilities. It all seems to depend on a school's belief/curriculum and the facilities availability. Every final class is always abuzz and excited during this time of their semester.

~Mi Vida Loca~RN, ASN, RN · Mar 22, 2010

yes, i stated they don't need more liberal arts. the whole point of the post was to suggest that more clinical time be added. i never said i was for "dumbing down" nursing education. while nice, robert frost poetry isn't going to help land you that first nursing job.
the fact of the matter is that new grads aren't getting jobs. could it be that schools are not meeting the demands of the job market? if you have failed to see all the new grads on here with their shiny new rn credentials falling behind on their bills, then it's time you wake from your slumber like rip van winkle.

i think you make some really valid points. as a student myself, i don't feel we are getting enough clinical time. first semester clinicals were a joke as far as learning skills. i still found ways to make the best of it and take something from it, but overall i think it did little to prepare us for hospital nursing. second semester the first half was better but i still feel like we could have done more clinicals and for this second half, for peds and ob we are only doing 3 days of peds and 3 days of ob 1 day of respite care. i know if their was a program set up got it, i would work for a few months after school of "free" work, just to gain more experience.

caroladybelle, BSN, RN · Mar 22, 2010

This would lend the hospital another reason you pay you even less your first year. "You're just a new grad in your residency"

I agree.

Interns get paid a pittance compared to full MDs, do most of the "scut" work, and work 80 hours a week, not including extra classes, study, presentations, assisting with research, publishing,etc. They also work 30 hr shifts a couple of times per week.

They cannot easily transfer, without a major blackmark on there records, and have to continue to "prove" themselves for many more years, outside of school.

I really wonder if new grad nurses would be willing to take all the less than pleasant issues that come along with the match system.

cherrybreeze, ADN, RN · Mar 22, 2010

Fribblet,

MD's and pharmacists may be required to have a 4 year degree before starting med school, but it isn't required that it be in liberal arts...in fact, may go with biology. That negates that point.

The courses for nursing advanced degrees feature courses in literature, ect, so while they may not be a degree IN liberal arts, there are classes with similar focus.

You can't compare the length of time nurses go to school with that of physicians. It's totally different, and not "frightening." If I wanted to go to school that long, I'd BE a physician or pharmacist. We're nurses, not doctors. And the educations doesn't have to be comparable to make us good nurses.

I comprehend just fine, thank you. See how far your liberal arts focus really gets you. You'll be able to use proper grammar when saying "would you like fries with that?"