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.
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.Last edit by Joe V on Nov 4, '16Jun 18, '14Wow, I'm glad to know I'm not alone in the feelings I often have about my nursing program. There are a handful (a small handful) of great teachers, great classroom experiences, great classes but so often, it's just a list of hoops to jump through so you can get a piece of paper that lets you go to a hospital where you can really learn. Which scares me, because I don't want to learn things for the first time with my license and a patient's life on the line. But I am glad to know it's not just my program that has these problems.Jun 18, '14I'm glad you wrote what many think and have experienced. Change can't happen unless those who can make the changes know they're needed. Keep advocating for improvement!
As an instructor with experience at 3 different nursing schools, and as someone who attended 2 different nursing schools, I think you're overstating the negatives. I know many excellent instructors and administrators who bend over backwards to make their schools the best they can be. Both schools I attended were excellent in many more ways than they were deficient. In fact, I can't remember many deficiencies at all! I feel I absolutely got my money's-worth from both schools.
It saddens me to know so many have had a mostly-negative experience with their nursing schools. That's not how it should be...Jun 18, '14When you search for what you are looking for, you tend to neglect the truth. These are forums that are available for nursing students in order to ask questions and seek some answers from others. Yes, you're going to see a lot of "pitiable messages thrown up on this board from desperate students barely surviving nursing school". They need help, thus they post here.
You will not see threads concerning every "win" that comes from a complete understanding of material. If you want a better overall idea of student understanding, then look at the replies to those threads that ask for help. While the moderators and RN's will assist, many times students also post help on a topic.
I am a nursing student, and my class load and study time is doable. Nursing school may be time consuming, stressful, and at times difficult. I assume the same is to be said about the profession of nursing.Jun 18, '14I think you hve it reversed. Yes, there are a good amount of poor programs and cruddy instructors. But I believe that the sat majority are good and the problem is the student. An instructor can provide a good learning environment but it is up to the student to actually learn. Using this forum as an example is not good. The people who post have a question, concern, or rant. This is ecause people are a lot more likely to post negative then positive. It's the same as customer service. For most people, you expect a good experience, so when you get it you don't most likely won't put a complimentary review on yelp or whatever. But if your experience is horrible, most likely you will want the world to know about it. Same applies here.
For example, there have been a few posts about t current school that are negative and people will sometimes post about rumors they have heard about my school. By my own perspective, as well as that of a good majority of my class, my school is great with a good teaching style and enough support to pass the course, NCLEX pass rate was 100% for last graduating class and is consistently above 95% and usualy above 97%, nationally and regionally accredited. Basically, it is a great school. If I went by what people have posted here, I would think it is a terrible school. All because a handful of students with a bad experience had to post or gossip about it.Jun 18, '14I think part of the problem with nursing education is that those that are qualified to teach nursing school often have to take a pay cut to pursue teaching. As a result, many stay working in the hospitals or other facilities. I am very lucky to have some great instructors, but they told me themselves that they could be making much more out in the field but are teaching because it is their passion and/or because it gave them a flexible schedule to be with their kids more. It's unfortunate that nursing educators aren't valued enough to be payed as such. I think we are all suffering because of it, educators and students alike.
As for the "nursing-prep industry?" I think its crazy, we were given a long list of expensive textbooks to buy, then when students were having difficulty in my class, some profs looked at them aghast and said "Well no wonder?!?! how could you possibly think that you could get by without purchasing extra books by so and so even though we don't cover it in class, mention it at all, etc. ATI is a total joke in my opinion, and I get so confused when professors I respect and have learned from stand by it, or say, " Sorry we cannot see the ATI tests because their content would be compromised so we cannot answer your questions about them." Or worse, tell me behind closed doors they too dislike ATI but can't do anything about it because their hands are tied. I have been doing fairly well so far with one more year to go, but I can't help but feel sorry for my fellow classmates who have been struggling. Then when our dean tried to use me and the few others who passed our tests first try as examples of why ATI works....well lets just say I had to bite my lip.
I''ve been slowly noticing, though, that to some people when us "newbies" point out flaws we see or issues, other more veteran nurses take on the defensive and think we are attacking them. If they could do it why shouldn't you be able to? I don't disagree there, and I do believe I will be able to do it. I will graduate and hopefully with honors too through my schools honors program. However, that doesn't mean I don't think the system is flawed, or that things could and should be changed. One thing that I love about nursing is the creativity and adaptability that the profession yields, but even as I write this I felt like I had to "defend" myself by throwing in that I am doing well in school because I feel like other people in these forums will assume I am doing poorly because I think there are problems in nursing education. That fear that I have and acted on is the problem. If changes are going to be made to better nursing education's future its going to take the new graduates and the educators already out there to do it. Meanwhile though, any of the students out there with a decent head on their shoulder like me are just learning to keep your head down and get your degree, which really saddens me. I'm not dense though, so, that is what I am going to do.Jun 18, '14Let me just add, that yes I know there are "newbies" out there who are rude or disrespectful and yes sometimes when they say something, I cringe. I am not talking about that. I was more referring to when people try to talk about policy change and others say well I got through it so its fine. When in reality, yes you got through it, but that doesn't mean we can't try and make it better. (and no better doesn't mean easier) I apoloigize if that all came out wrong.Jun 18, '14I too feel like it's more a student issue as opposed to an issue with the nursing schools. Of course there are terrible faculty members and terrible schools out there. However, there's also a lot of terrible students. I see many students that have difficulty with content and automatically it's because the content is flawed, or the instructor is terrible, or the entire school is incompetent but never is it the student's fault for failing to master an area of content.
At the end of the day you have to take active responsibility for your education, you can't expect instructors to hold your hand or to pour the information into your brain. If you fail a test, before you blame the person that administered or created the test, take a long hard look at yourself.Jun 18, '14I agree with the poster who noted that you tend to find what you're looking for. I've gone through a hospital-based diploma program, a state uni B&M BSN completion program, a graduate program, and have since taught in ADN and BSN programs, and I can count on the fingers of one hand (with some fingers left over) the number of poor quality instructors I've encountered. Most of the faculty in the programs I've attended have been excellent. There are a fair number of poor quality programs "out there," we're all aware of that. Maybe students need to be more careful "shoppers" when it comes to choosing.Jun 18, '14I am a student with a 4.0 grade point average, one semester away from graduation. This is my second degree. I had the same kind of high academic achievement my first time around. I'm generally a hard working student, who does well on tests and in my classes. That does not mean I think all is well. However, in nursing school, I've learned it's not worth addressing even serious problems or utter incompetence when it comes to teachers, whether it is theory or clinical. It's always the student's fault. And that's pretty much the end of the story. Sadly, nothing will change with this mentality. There are some great teachers out there and I feel grateful when I get lucky enough to be placed with them. Then there are those who have no business teaching or being clinical instructors—and in some cases, it's actually scary. Sometimes students have legitimate concerns and complaints.Jun 18, '14My spouse and several friends/former co-workers are diploma RNs. Best nurses I know. Their education was based on clinical experience.
I went to a LPN program with a high NCLEX pass rate. However, the school would literally cancel clinicals so we could focus on the ATI practice tests as the ATI tests were our key to passing the NCLEX. I have to say I passed the NCLEX first try and didn't find it to be that difficult primarily because I'd done so many ATI questions which are so similar to NCLEX.
I was taught to pass the NCLEX. Clinical experience was a second priority.
I had one good instructor. Some mediocre instructors and one instructor who had a nervous breakdown at a clinical site. I can deal with that as I believe that getting the information was my responsibility. What I begrudge the school is not giving me the clinical experience that I should have received. From what I'd heard from others and witnessed on this board it is the clinical experience that is lacking in many programs.Jun 19, '14several months of my time were wasted with three attempts at the ATI, then they made me take HESI until I finally cleared my exit exam, did they prepare us, heck no, then ATI was leaked and made history, and HESI became the official exam for all nursing student at my school, and to think we were prepared for Ati in all my later courses in school, then they made us take HESI if we couldn't pass ATI, what an ordeal of frustration for me and my family, then finally I passed HESI then they sent the letter to the state to clear me to register for the NCLEX, I walked in May, but wasn't allowed to take board until following January, I could have gained so much more than I did. I am just glad to be an rn now. I realized then and now as I pursue grad school a lot depends on the students' abilites to self-teach and learn.Jun 19, '14Just curious why parents should search for the best BSN program while completely ignoring the ADN programs out there. Especially since you seem to be disappointed with poor clinical training. It really depends on the school, both programs can offer vastly different clinical experiences.
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