Critique of Nursing School

Many nursing schools are mediocre. They are dropping the ball on teaching unifying concepts, which are so key stimulating and solidifying learning. Oftentimes, they are not teaching period. And the chance to gain clinical experience is often lacking. Nursing Students General Students Article

Having seen so many pitiable messages thrown up on this board from desperate students barely surviving nursing school, I wanted to give my two cents worth from a less immediate and frazzled perspective. Let me say that I understand that I'm generalizing. I don't believe for one second that all nursing schools are like mine was, but it seems like many are. And that is something to be concerned about.

For those who are serious about learning and who want to become nurses to apply that learning, nursing school is, by the looks, sounds, and experience of things, maybe not the best place to be at right now. Unfortunately, it is the only game in town nowadays and that's because it's all about the road to NCLEX.

Concepts are poorly explained or else, as I have experienced and seen discussed countless times on allnurses.com, incorrectly explained, or not explained at all. Conceptual understanding is the axis on which much acquired learning swings. Without identifying key concepts, teaching, and learning key concepts, knowledge is hanging by an insecure thread. And it is exactly here - teaching unifying concepts - that nursing schools gracelessly bow out of the game.

The majority of teachers now in nursing schools are not good. Is this why there is a nursing shortage?

The personal stories of weekend activity, the bragging, the pointless anecdotes and meaningless aphorisms - all students who are subject to these monotones are to be pitied for their wasted time and the fatigue of enduring them. Instead of the weekend stories, instead of the dull lazily-delivered aphorisms, why don't they teach? That is exactly the question. Is it ignorance or laziness? (Or, is the problem more structural in nature? More on that later.) More within the realm of realistic possibilities for the student, though, is the question, why don't they - the students - protest? The answer is complicated - one, it's generally a two-year program we're talking about, with a pace that is not to be believed, which leaves students with hardly any time to warm dinner, much less launch and sustain a protest. Often a faint, last hope, the evaluation system at these schools is often broken. In addition, there is the reality that often the professors are good buddies with the nursing school directors (at least the ones who want to make sure they keep their jobs are), so there's no barking up that tree. As with so much, it all comes down to leadership, and there just isn't any. The 'dons' appear to be fairly well cut off from reality.

The teachers as far as I can tell have graduated from the do as I say not as I do university, the same one that imparts a teaching style of - guess what I'm thinking right now ? For example they may throw out a question about heart failure, but inevitably it comes off as sounding like, "what am I thinking right this second is the key thing you should know about heart failure, and if you don't guess what is in my mind, I will say something to strongly imply that you all are not trying or don't know jack?" And then, that's it. There's no further discussion about why that thing the professor had in his/her mind was so important. There's no building on knowledge.

From what I can tell, there is scant teaching anywhere these days, and the cottage industry of nursing "strategy" packages is a booming one indeed, complete with the hard sell and slick language of snake oil salesmen. The fact of their existence absolves nursing schools of not teaching key concepts. Yes, nowadays, you cannot be so naive as to think you can simply enroll in a pricey nursing school, can you? No, you must also be taught separately by Hurst, or Kaplan, Simple Nursing or HESI. Our nursing schools are following and cribbing from them. What does this say about our nursing schools? Not much.

There used to be good nursing schools, ones with great reputations. But I must have missed the news: at what point did these schools decentralize and hand their knowledge, power, and organization over to Kaplan, HESI, and the others? Why in the world did anyone allow this to happen? The problem with weak nursing schools, among so many, is the application. There is very little applied learning in weak nursing schools (clinical rotations), which just makes the learning that much weaker as well. And it skimps on training.

Did my school do a good job preparing students? No. They were disorganized, detached, demoralized and chaotic. But, the staff and professors could also be sociable, personable, and nice in the very fleeting attention given to individual students. But only a tiny number of them (1 or 2) truly went out of their way to make sure they covered the material as well as they could. The others were either not up to the task but tried in their own way, or else they did have the intellectual skills but for one reason or another decided to fall back and not put in the effort. With some of the others, you could tell that they didn't know the material well enough to answer questions. In fact, asking questions was frowned on. The prevailing attitude among the staff was that it was no better than when they went to nursing school. In other words, they were fine perpetuating a mediocre system of learning. Our nursing schools have become nothing more than places where you can study on your own in order to take the NCLEX. Teachers are not needed; only monitors are needed because that's all they do anyway. You will be teaching yourself all the way through.

In addition to mediocre teachers, students must also contend with materials that are internally inconsistent and workbooks with incorrect answers, the final cruelty to the struggling student.

Now, just to show that I am not a total jerk, I will ask the question: or, is the problem structural in nature? When you consider the ratio of volume of material covered to class time, it does make you pause and wonder. What happened? Was it always like this? In whose mind is two and a half classroom hours per week covering 300 pages sufficient? What exactly is the point of those hours? Maybe at some school it was worth it, because key concepts were explained and expanded upon, but not at my school. There was also the issue of students who did not put in the time to learn the material. Obviously you cannot put that over on bad professors. But bad professors nevertheless exist. To what extent one enables another is an open question - but one for another time.

What to do now?

To the majority of nursing students outside the age range of 18-20, honestly I don't know what to say. So I'll address the moms and dads out there because it's the young students that I feel have the best chance and the most hope of getting the most from nursing education. If you happen to be a mom of a teen who really wants to be a nurse, I recommend scouting out the best BSN (not RN) programs in the country and start preparing her or him now. Find good nursing schools, more than one, more than four, and start planning. Now. Unfortunately many well-known and good schools of nursing have shut down. Inadvisably. Maybe the administrations at their universities wanted to play up the 'sexier' programs, and failed to realize the power of a good solid nursing program, much to the chagrin of the longtime nurses and doctors who taught there, no doubt.

But getting back...How can I nutshell this at its most fundamental? (This goes for young learners and adult learners alike.): Find the programs with the best teachers. If you find good teachers, and you are willing to work very hard, you are all but there.

But your MSN instructors sure can write a mean paper in APA format. Nursing education (both ADN-BSN and MSN) needs to be revamped to EXCLUDE mindless paper writing.

But your MSN instructors sure can write a mean paper in APA format. Nursing education (both ADN-BSN and MSN) needs to be revamped to EXCLUDE mindless paper writing.

Well if the papers are "mindless" then they do need to be eliminated. Of course, some of use used our brain to write our papers when we were in school.

Specializes in orthopedic/trauma, Informatics, diabetes.

One of the issues I had with my nursing (ADN) program was that they were trying to "upgrade" the instructors and got rid of the BSN-MAT instructor that was the most fabulous teacher-patho especially, for the MSN-PhD candidate that ended up walking out of his job halfway through a semester. Why fix something if it isn't broken? The text book was horrible. The best thing was that we had 600+ clinical hours.

It was just a horrible experience. I am a lifelong learner-a "schoolaholic" and I have never had test anxiety. Not only do I have that now, but I swear I have some lingering PTSD from the experience.

The Instructors at my school were very knowledgeable and I can only give them high marks and compliments. Nursing is hard and carries a lot of responsibility. The Director of the Nursing Program let you know on the first day the commitment required to get thru the program. If you were struggling with a particular class or clinical they offered help but expected you to put the time and work in learning to be the best Nurse you could be. The Instructors were determined that when you graduated you would be knowledgeable in Nursing Theory and Practice as well as having hands on practice for what is required to take care of your patients.

Many of the young Nurses I have met, feel they are above getting their hands dirty after graduating from Nursing School. As a Nurse you appreciate your Nursing Assistants, Medical Assistants and anyone who lends a hand to make your job easier and helps take care of patients you are responsible for.

Once you graduate, you still do baths, change diapers, change beds, empty bedpans and foley bags if needed. You work together with your staff to make sure the patient is taken care of. As I tell my patients when they apologize for coming back to the clinic so often. I say to them "If you did not come to see the doctor I would not have a job". Meaning no company, hospital or doctors office is hiring a Nurse to just sit around.

Specializes in Hospitalist Medicine.
I graduated from an ADN program in Minnesota last year, at the age of 48, so I am not looking at college as a young, fresh adult. It took me two years to get through the pre-reqs for my ADN program because I could only go half-time. I don't have to tell any of you how crazy things got when I started the actual nursing program portion. First, my practical nursing program, and the next year, the registered nurse program. (At the school I went to, you have to successfully complete practical nursing and pass the NCLEX for LPN before you can move into the RN program, which meant that not everyone moved forward).

I might going against the flow here, but I had a positive experience at my nursing school. Other than the craziness and insane amount of studying and work expected, I really liked my nursing school. I thought I must have the best instructors in the world. They not only encouraged questions, but tried to answer all of them (and if they couldn't, they worked to try to find the answers). They gave many examples through lectures to try to help us apply what we were learning to real-life situations. We were encouraged to email or call with further questions. We not only met before, but also after each clinical so we could go over our experiences to learn as much as possible from each other. My instructors truly seemed to care about each of us, and wanted us to succeed to become the best nurses we could be. They were uplifting and positive in their attitudes toward us. They also had student representatives join their meetings regularly, and we were encouraged to voice our concerns to our student representatives so that they could be addressed. I know that instructors come and go, so I hope that it continues to be the positive place it was.

Your program sounds very similar to mine, except we have the option to take NCLEX-PN, not required. We have wonderful instructors. We are encouraged to ask questions, our instructors support & encourage us.

I agree with previous postings about there being more negative posts than positive ones. Of course. Who is going to come on the boards and go on & on about how great their program is? Or what a wonderful teacher you have?

Unfortunately, negativity draws people in. It's just like television news. 99% of the stories reported are negative. They throw in a feel-good piece once in a while. Bad news "sells". Sunshine & rainbows doesn't.

I'm thankful my program is wonderful and my instructors are excellent. I guess we need an "I love my program" thread...LOL :)

Specializes in Pediatrics, Emergency, Trauma.

Unfortunately, negativity draws people in. It's just like television news. 99% of the stories reported are negative. They throw in a feel-good piece once in a while. Bad news "sells". Sunshine & rainbows doesn't.

I'm thankful my program is wonderful and my instructors are excellent. I guess we need an "I love my program" thread...LOL :)

That's why there is a Nurses' Rock forum where one can post the positives of nursing...even though anyone can post the positives of nursing anywhere...it's just the right plan for kudos. ;)

Your program sounds very similar to mine, except we have the option to take NCLEX-PN, not required. We have wonderful instructors. We are encouraged to ask questions, our instructors support & encourage us.

I agree with previous postings about there being more negative posts than positive ones. Of course. Who is going to come on the boards and go on & on about how great their program is? Or what a wonderful teacher you have?

Unfortunately, negativity draws people in. It's just like television news. 99% of the stories reported are negative. They throw in a feel-good piece once in a while. Bad news "sells". Sunshine & rainbows doesn't.

I'm thankful my program is wonderful and my instructors are excellent. I guess we need an "I love my program" thread...LOL :)

It's good you had a positive experience. It doesn't mean there isn't a need for some schools to improve. Reasonable, mindful evaluation of nursing education in general requires objectivism, not optimism or pessimism.

Nursing education should be subject to evidence-based evaluation just like nursing practice.

Sounds like you went to my school. Lol. All I know is my school experience has changed my mind about my career path and now I want to move towards Nursing Education because it just has to be done better. I have over 12 years experience in education and decided to study nursing when my school closed for financial reasons. I love everything that I am learning but a LOT of it I am teaching myself. I've had one or two decent classroom instructors so far and only 2 clinical instructors out of 4 that actually wanted to instruct. It's disheartening but it's also my motivation to work hard and learn as much as I can. I know I will never stop learning. I don't want to. That's what the schools should be instilling in their students.

Specializes in Pediatrics, Emergency, Trauma.
It's good you had a positive experience. It doesn't mean there isn't a need for some schools to improve. Reasonable, mindful evaluation of nursing education in general requires objectivism, not optimism or pessimism.

Nursing education should be subject to evidence-based evaluation just like nursing practice.

It's interesting that you brought that up; my program that I graduated from (should be on year 3) is utilizing EBP by measuring their BSN programs over a 5-year span; they measure the outcomes each year as well as collect data in order to evaluate their program.

I recently graduated with honors from nursing school and had good and bad teachers. But the main problem at my school was the administration. It got to the point I also kept my head down and mouth shut and got my piece of paper (there were other students who felt the same)! Now I'm learning clinical skills on the job that I should have been taught in school (I did pay them to learn these things). And that's a sad situation all the way around...

Many of the young Nurses I have met, feel they are above getting their hands dirty after graduating from Nursing School. As a Nurse you appreciate your Nursing Assistants, Medical Assistants and anyone who lends a hand to make your job easier and helps take care of patients you are responsible for.

Once you graduate, you still do baths, change diapers, change beds, empty bedpans and foley bags if needed. You work together with your staff to make sure the patient is taken care of. As I tell my patients when they apologize for coming back to the clinic so often. I say to them "If you did not come to see the doctor I would not have a job". Meaning no company, hospital or doctors office is hiring a Nurse to just sit around.

For the nurse aid/direct care skills at the beginning of our PN program, we had clinicals in an ALF where 90% of the residents needed little or no ADL assistance. We complained that we were getting no hands on experience from this clinical: no bed baths to give or occupied beds to change. We were told not to worry about it because as LPNs we'd be going into LTC and have nurse aides to do the direct care.

The remainder of the program was equally inept. However, the school has something like a 95% NCLEX-PN pass rate. I never did a single bed bath in nursing school. But I passed the NCLEX on the first try. And that is really all that mattered to them.

Specializes in Pediatric Hematology/Oncology.

One thing that jumped out to me the most from this article that did not occur to me until now is the 2.5 hour lectures that are given weekly and must cover an obscene amount of material. While our program theory lectures are 4 hours, this does little to actually allow anything to be accomplished. I am just now thinking, however, that the CCNE (I think....I doubt it's the actual BON) requires us to have these 4 hours/week. So, they think that must somehow be enough to cover all that information. Of course, it isn't and the schools are definitely not going to have the instructors give longer lectures. This is a strange problem and I don't know how we can really fix it without having either longer lectures or more frequent class meetings -- which our school likely is not going to be willing to allow for that kind of change. It's definitely something to ponder...Make the lectures actually appropriate to the amount of material covered and our instructors will actually be able to give meaningful lectures and actually address questions -- instead of the harried, "drive by"-style lectures where we whiz through the slides without any actual teaching being provided.