Why aren't there more nursing programs in your State !!!! - page 3

Everyone knows that there is a nursing shortage. However, there are not enough programs designed or catered to the people who really wants to go to school for nursing. To me there should be more... Read More

  1. by   llg
    Quote from ChayaN
    I"m just wondering--are hospitals indeed teeming with student nurses that they can't figure out what to do with?

    Yes -- but not everywhere. In some communities with several schools, it is a major problem.

    It's made worse by the fact that the best learning experiences (and the most popular clinical times) are limited to specific days of the week and times of the day. For example, few nursing students (or faculty members) want clinicals on Sundays ... or during the night shift. The learning experiences are not as good on those shifts (with patients asleep and few procedures happening) and people want to be home with their families during those times. So, there is a HUGE demand for clinical slots during the weekday mornings -- but no students in the hospital on Sunday evening.

    Another complication is that RN students are not the only students who want to use the facility. Every discipline (RT, PT, OT, Pharmacy, LPN, CNA, Medicine, EMT, Paramedic, Social Work, etc. ) wants to use the same facilities for their training. Prospective students want "shadowing" experiences. New employees need supervised clinical experiences for their orientations. etc. etc. etc. Each group thinks that its needs should be given priority. But they are really all important and to the people who are asked to maintain the quality of care on an ongoing, daily basis, the constant changing of student group after student group can be a nightmare. One school's group is there in the AM: another group comes after lunch. The next day, 2 more different groups come. And that's just the RN students! The other disciplines' students are also coming and going.

    The problem is particularly acute in specialty areas in which there are only a few units in a given town. For example, peds, OB, psych, OR, ED, etc. I work in a children's hospital. Every discipline wants clincal practice with peds -- and they want to do phisical things, such as give meds, change dressings, start IV's, etc. There just aren't enough "ideal learning experiences" to go around.
  2. by   llg
    Quote from sunnyjohn
    Here is some information that may go along with this arguement.
    ....
    The arguement is these community hopsitals usually provide support for an area of hundereds of miles. The patient acuity is there.They also feel that the best way to attract medical/nursing talent to these communities is to train locally.

    If doctors can be trained in these areas and new medical schools opened in small commuities, then surely the patient load is there to support new nursing schools. This way nursing students won't be tripping over each other

    If communities want talent, the community hospitals and locals will have to help pay for it.

    Thanks for the info. It's good to see that at least some other people are thinking outside the box and addressing some of the fundamental problems underlieing the problems in nursing education.
  3. by   SA2BDOCTOR
    Quote from llg
    Yes -- but not everywhere. In some communities with several schools, it is a major problem.

    It's made worse by the fact that the best learning experiences (and the most popular clinical times) are limited to specific days of the week and times of the day. For example, few nursing students (or faculty members) want clinicals on Sundays ... or during the night shift. The learning experiences are not as good on those shifts (with patients asleep and few procedures happening) and people want to be home with their families during those times. So, there is a HUGE demand for clinical slots during the weekday mornings -- but no students in the hospital on Sunday evening.

    Another complication is that RN students are not the only students who want to use the facility. Every discipline (RT, PT, OT, Pharmacy, LPN, CNA, Medicine, EMT, Paramedic, Social Work, etc. ) wants to use the same facilities for their training. Prospective students want "shadowing" experiences. New employees need supervised clinical experiences for their orientations. etc. etc. etc. Each group thinks that its needs should be given priority. But they are really all important and to the people who are asked to maintain the quality of care on an ongoing, daily basis, the constant changing of student group after student group can be a nightmare. One school's group is there in the AM: another group comes after lunch. The next day, 2 more different groups come. And that's just the RN students! The other disciplines' students are also coming and going.

    The problem is particularly acute in specialty areas in which there are only a few units in a given town. For example, peds, OB, psych, OR, ED, etc. I work in a children's hospital. Every discipline wants clincal practice with peds -- and they want to do phisical things, such as give meds, change dressings, start IV's, etc. There just aren't enough "ideal learning experiences" to go around.

    I dont mean to cast a cloud, but I disagree with your statement about few students wanting to do clinicals on a Sundays and Night shift. Before I moved to KC from TX, I was in a preceptor program, whereby, when it comes to doing your clinicals. You were matched to a preceptor i.e. a nurse who will be your teacher one-on-one in the hospital setting (Of course you worked per their shifts). You were not part of a group. My point is that 90% of the students who were in this special program, chose nights and weekends shifts to do their clinicals. It enabled us to work around our jobs, school, study and family. Thus I believe, if there are more flexibility with our current Nursing programs statewide, you will see the amazing responses.
  4. by   llg
    Quote from SA2BDOCTOR
    I dont mean to cast a cloud, but I disagree with your statement about few students wanting to do clinicals on a Sundays and Night shift. Before I moved to KC from TX, I was in a preceptor program, whereby, when it comes to doing your clinicals. You were matched to a preceptor i.e. a nurse who will be your teacher one-on-one in the hospital setting (Of course you worked per their shifts). You were not part of a group. My point is that 90% of the students who were in this special program, chose nights and weekends shifts to do their clinicals. It enabled us to work around our jobs, school, study and family. Thus I believe, if there are more flexibility with our current Nursing programs statewide, you will see the amazing responses.
    Your situation was an exception. It is not the common one. As you said, you were not in a clinical group and were in a 1-on-one preceptor program. I have also encountered many students who would like to schedule those typesof experiences that way.

    However, most nursing school clinicals are not 1-on-1 preceptored experiences. Most clinicals are done in a group with an instructor. It is less common for people to prefer night clinicals and Sundays in that situation -- though Saturdays are a more popular. Imagine 10 students on a unit where 75% of all the patients are asleep. They just don't get as much experience in that circumstance. It's also more expensive as the school has to pay premium pay for the instructor to work the "off shift." Also, schools worry about the safety of their students coming and going to and from clinicals in the dark. Plus, it is harder for many mothers with small children to find child care over-night. I've never encountered any school that regularly offered large amounts of clinical experience on night shifts -- only a few ocassional experiences.
  5. by   JeanettePNP
    The only time I"ve ever encountered a student nurse in the hospital was when I was giving birth to my first. She was a great help. But I can imagine how crazy it can be with dozens of students milling around needing direction when nurses just want to get their work done.
  6. by   SA2BDOCTOR
    Thanks for sharing. All that I am saying, is that there need to be more options for prospective nursing students. Unfortunately there are not enough programs. More day and evening classes should be developed in different states. This will help eliminate the long waiting list.

    As the others have shared, in order for this to happen we need more instructors etc. I am just saying that something has to be done. Or maybe schools can change their current programs to accept more students, rather than 20 - 100 per semester.
  7. by   SA2BDOCTOR
    Quote from llg
    Your situation was an exception. It is not the common one. As you said, you were not in a clinical group and were in a 1-on-one preceptor program. I have also encountered many students who would like to schedule those typesof experiences that way.

    However, most nursing school clinicals are not 1-on-1 preceptored experiences. Most clinicals are done in a group with an instructor. It is less common for people to prefer night clinicals and Sundays in that situation -- though Saturdays are a more popular. Imagine 10 students on a unit where 75% of all the patients are asleep. They just don't get as much experience in that circumstance. It's also more expensive as the school has to pay premium pay for the instructor to work the "off shift." Also, schools worry about the safety of their students coming and going to and from clinicals in the dark. Plus, it is harder for many mothers with small children to find child care over-night. I've never encountered any school that regularly offered large amounts of clinical experience on night shifts -- only a few ocassional experiences.
    Thanks for sharing. All that I am saying, is that there need to be more options for prospective nursing students. Unfortunately there are not enough programs. More day and evening classes should be developed in different states. This will help eliminate the long waiting list.

    As the others have shared, in order for this to happen we need more instructors etc. I am just saying that something has to be done. Or maybe schools can change their current programs to accept more students, rather than 20 - 100 per semester.
  8. by   SA2BDOCTOR
    Quote from ChayaN
    The only time I"ve ever encountered a student nurse in the hospital was when I was giving birth to my first. She was a great help. But I can imagine how crazy it can be with dozens of students milling around needing direction when nurses just want to get their work done.
    I wouldnt think that. Schools have relationship with hospitals and nurses I am sure have not forgotten where they came from.
  9. by   Freedom42
    Interesting thread. Here are my two cents:

    I agree that there's no shortage of nurses, only a shortage of attractive nursing jobs. Government reports state that the shortage is caused in part by people leaving the profession due to unacceptable working conditions. I wouldn't worry about a glut caused by nursing schools, either: There are reports by various nursing organizations that suggest that even if the capacity of nursing schools were doubled immediately, the shortage expected by 2020 would still not be met. We've got an entire generation of nurses about to reach retirement age.

    I disagree that there's a shortage of instructors with master's and Ph.Ds, but there is a shortage of the political will to come up with the money to pay them competitive salaries. It also costs about three times more to educate a nurse than it does to educate an engineer. (Consider the 1:8 instructor-to-student ratio in nursing programs versus a typical class size of 24 in other academic areas.) Yet the per-student allocation by most legislatures is no different for nursing than it is for any other program. Lawmakers do not consider these ratios, so schools must -- and faculty salaries are not raised as a result.

    One poster questioned why a nursing professor earns 47K and a law professor 100k. Since that's exactly the situation at the public university I attended, I did some digging. What I found was that the law school has an extremely well-organized alumni association that raises at least $350,000 a year in private contributions and that has established an endowment in excess of $2.2 million. The interest from that endowment allows the law school to offer competitive salaries. When I go back to school in January, I intend to find out if this has been considered at the nursing school and what it would take to get a similar campaign established, either by alumni, students or their supporters.

    In the meantime, I've written a letter to the governor pointing out the salary disparity and the problem it poses for students who can't get into nursing programs. I hope my classmates will do the same. The time spent is an investment in our futures.

    I agree with posters who suggest that the situation will change when the public feels the pain.
  10. by   NaomieRN
    My school would love to offer more nursing classes, but who is going to teach? The nurses can make more money working as a staff nursing in a hospital, why would they want to teach?
  11. by   llg
    Quote from SA2BDOCTOR
    Thanks for sharing. All that I am saying, is that there need to be more options for prospective nursing students. Unfortunately there are not enough programs. More day and evening classes should be developed in different states. This will help eliminate the long waiting list.

    As the others have shared, in order for this to happen we need more instructors etc. I am just saying that something has to be done. Or maybe schools can change their current programs to accept more students, rather than 20 - 100 per semester.
    Actually, I agree with you whole-heartedly. Schools need to change the way the way they do things in order to accommodate more students. For example ... not all students need the same amount of clinical time in each area. Why not give very brief experiences in all of the areas early in the program and then let the students go back only to those areas that interest them most. Not everyone is interested in OB or Peds or Psych, etc. Let everyone spend 2 or 3 weeks to be exposed to the basics -- then those that are interested can chose 2 or 3 places to return to in their last semester to get more depth. That would cut down on the demand for the limited, specialty clinical sites such as OB and Peds.

    Outpatient settings can also be used more for some specialties, such as OB and Peds. You don't need a hospitalized patient to study growth and development, pregnancy, etc. But that makes it more complicated for the school to provide faculty supervision -- so, it doesn't happen as much as it could.

    Also, as I said in an earlier post, clinical facilities farther away from the schools could be used. Some students wouldn't like that, but incentives could be offered to facilitate it. For example, a tuition discount could be given to those willing to commute greater distance. For some clinicals, overnight housing could also be arranged for those students willing to go to a distant clinical site 2 or 3 consecutive days per week. That was done in my undergraduate program many years ago and it worked just fine. It's not for everyone, but some students would choose to do that if there were some incentives to do so.

    etc. etc. etc. I could go on and on ... but schools are not able to make such changes in their curricula without university approval and some additional funding -- and that is almost impossible to get from university administrators who are part of a general public that does not understand the problems. Until they feel the pain, they will be unlikely to do anything to help.
  12. by   JBudd
    In our local ADN program, a BSN can teach clinicals, titled "instructor". The community college won't pay nursing instructors any more than any other instructor at the CC (math tutors etc. ).

    I am working on my master's, and would take a pay cut of at least half to work there, as opposed to my ER job with my BSN.

    There have been times we had more students in the ER than staff nurses, 3 from the Airforce, 4 from CC, at least 2 from a different school. Makes it hard to give everyone one nurse to follow!
  13. by   SA2BDOCTOR
    Quote from Freedom42
    Interesting thread. Here are my two cents:

    I agree that there's no shortage of nurses, only a shortage of attractive nursing jobs. Government reports state that the shortage is caused in part by people leaving the profession due to unacceptable working conditions. I wouldn't worry about a glut caused by nursing schools, either: There are reports by various nursing organizations that suggest that even if the capacity of nursing schools were doubled immediately, the shortage expected by 2020 would still not be met. We've got an entire generation of nurses about to reach retirement age.

    I disagree that there's a shortage of instructors with master's and Ph.Ds, but there is a shortage of the political will to come up with the money to pay them competitive salaries. It also costs about three times more to educate a nurse than it does to educate an engineer. (Consider the 1:8 instructor-to-student ratio in nursing programs versus a typical class size of 24 in other academic areas.) Yet the per-student allocation by most legislatures is no different for nursing than it is for any other program. Lawmakers do not consider these ratios, so schools must -- and faculty salaries are not raised as a result.

    One poster questioned why a nursing professor earns 47K and a law professor 100k. Since that's exactly the situation at the public university I attended, I did some digging. What I found was that the law school has an extremely well-organized alumni association that raises at least $350,000 a year in private contributions and that has established an endowment in excess of $2.2 million. The interest from that endowment allows the law school to offer competitive salaries. When I go back to school in January, I intend to find out if this has been considered at the nursing school and what it would take to get a similar campaign established, either by alumni, students or their supporters.

    In the meantime, I've written a letter to the governor pointing out the salary disparity and the problem it poses for students who can't get into nursing programs. I hope my classmates will do the same. The time spent is an investment in our futures.

    I agree with posters who suggest that the situation will change when the public feels the pain.

    Interesting post! I will join in with you regards tp writing a letter to the governor. However, if all nurses see the importance of uniting together for better salaries, better programs, better working condition, it will make our letters have a stronger impact. After all we are just the students. We are not the nursing generation becoming extinct. (retirement age)

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