RNs in Advanced Class with New Grads

Specialties Educators

Published

Looking for advice from an educator about my Professional Development BSN class that became so disrupted tonight solely due to the different levels of students in the class. By the end of the class, my head was pounding and some of the experienced nurses were expressing serious concerns about allowing different levels in the class in the first place. We are in a 300-level BSN class, but the educator had to keep stopping the discussion constantly to explain things that should have been learned in Nursing 101 - like why open-ended questions and therapeutic communication are important -- and how to do it.

Im one of the 6 experienced nurses in the class - 2 working in critical care, 2 at substance abuse programs, 1 in OR and 1 in med-surg. The seats are set up in a U-pattern and coincidentally all 6 of us, never having met before, sat on the left side from the first day. The 3 men gravitated to the center seats - 2 were PCAs, 1 an EMT, now are RNs and are at least halfway into their first year - 1 in psych, one in med-surg, 1 in home care --- so they also have some experience. Seated on the right side of the room are 5 former LPNs - now new grad RNs - 3 working in the nursing home where they were LPNs and 2 not yet working at all.

So we have the moms with teenagers on one side of the room, the guys in the middle, and the 20-something young women on the other side of the room. I point out the mix only to give you an idea of the different levels - I mean no offense to any of the group.

The most glaring thing was the critical thinking - and lack of it - between the levels. It was so obvious that there are different trains of thought between the levels. The new nurses cant be blamed since critical thinking does come with experience, but, as a student, it was very frustrating to have to constantly back-track off the topic and try to get everyone to the same level of thinking. In fact, it was impossible. We ran out of time because of it and did not finish the subject matter. Another source of great frustration tonight because the topic we were trying to get thru is what our final will be about. There were so many interruptions that we didnt even have time for a break during this 3 hour class.

We were discussing Neumans theory and applying it to case studies. The experienced nurses wheels could practically be seen turning in their heads as they applied the theory and came up with the stressors and appropriate interventions, but the new grads interrupted the discussion constantly - asking things like "why cant you just TELL the client to do it this way and move on?" And "it says this nursing theory was developed as a teaching tool for students. What kind of students? NURSING students???"

The educator had to take an extraordinary amount of time to answer questions like that and explain basic nursing, while the rest of us sat there waiting to move on to the next step. This went on for 3 hours.

At first the experienced nurses were understanding, recognizing the different levels of experience in the room, understanding that critical thinking comes with experience. They were not being judgemental of the new grads and were even trying to help them understand the subject matter and answer their questions. But after a while, the experienced nurses were getting nothing from the class, the unnecessary interruptions dominated the time. After a couple of hours of this, the experienced nurses were losing patience with the new grads and the tension was rising in the room. They stopped being helpful, and just sat there getting angrier and angrier that this class was turning into Fundamentals of Nursing and that the educator was entertaining these disruptions.

At one point, in applying Neumans theory to a case study of a breastfeeding post partum pt, a new grad kept insisting that a stressor for the pt was that her husband walked into the room while her breast was exposed. There was nothing in the case study to suggest that that was a problem for the pt or that she had any reaction at all to it. So the experienced nurses tried to explain why this was not an issue. The new grad insisted it was. The educator then spent another 10 minutes or so trying to make her understand that she is putting her own cultural ideas on the situation and got all into that. While the rest of us sat there waiting to continue the class.

One of the guys walked out a half hour early, saying he couldnt take it anymore. By the end, the left side of the room was groaning and rolling their eyes everytime the right side of the room had another question.

Maybe the educator should have not catered to the new grads interruptions that had nothing to do with the subject at hand. Maybe she should have offered to meet with them at the end of the class to go over whatever they needed. In any event, the experienced nurses left feeling very upset, drained, short-changed, frustrated, annoyed, and angry that the subject matter was not finished because of the disruptions. The new grads were oblivious to it all. I dont know how you solve this problem of teaching different levels at once but as it was, it did not make for a good class.

Any suggestions or advice would be greatly appreciated.

Specializes in Nephrology, Cardiology, ER, ICU.

This is just my $0.02 worth. I'm doing an accelerated ADN to MSN online with University of Phoenix. Have you considered doing a different program with a bridge to BSN? If this isn't possible, can you test out of this class? Good luck...I feel your frustration.

Maybe it was the group of people asking the questions that was the problem, not that they are "at a different level". I am in an ADN program getting ready to finish up and consider myself a pretty good critical thinker. I don't think it's about level of education, but about the person that is using the education. I by no means mean to start up the BSN vs. ADN debate, but your post is kind of judgemental, as I see it. I have people in my class who ask pertinent questions and people who ask irrelevent ones. That is definatly not based on "level" of education, but on the person asking the question!!! Just my two cents...

Court

Here's my suggestion. Go to your instructor (alone or with your other like minded classmates) and explain that you are very interested in learning all the class material. Explain further that with so many students asking questions the class is not covering all the required material. Then suggest that the instructor ask the class to hold all questions until todays' class material has been covered. When the class has covered the material- there could be an open discussion session. If there is not enough time- the students can e-mail her/him with their questions.

Constantly interuptting class is rude and unprofessional. The students who are constantly asking questions should read the required material before class- and learn to save their questions for later. Your instructor needs to gain better control of the class IMHO. I do not think the problem is with the students. They can be required to behave differently so that ALL of the students get the benefit of the class that they have paid for. Your instructor needs to set some limits.

Interesting, thoughtful post, I feel your pain at the situation, but actually think you are going to have to grin and bear it or partially lose your sanity in the process.

I do not believe you are going to get this to change in the time available for your course. Representations to the prof. will just end in further 'talk' -s/he does not sound able to manage this sort of class.

The best you could do is to suggest that the group splits for discussion - along the lines that Neuman is a model for experienced practitioners (- it also does not translate well for acute, short term care) and suggest that the prof. works with the inexperienced. You sound more than competent enough to handle your own discussion group.

Another suggestion you could make is that some very small, basic text on group discussion, or something similar is made a prerequisite to the class. This won't help you now, but might make subsequent classes more bearable. Something to try and get over to some participants that 'this is not about you.'

The major issue is that your educator does not sound experienced enough to deal with this sort of learning environment. First by setting the ground rules for the discussion and then by firmly handling the class. Difficult, but doable.

If you cannot provide an environment in which students may learn then you have failed as an educator.

As an aside: Neuman is a moderately hard model to use and requires experience. (I actually used Neuman in ?1986 in a community setting and had my account of it published. Neuman later referenced my neophyte efforts in her later work.) And I am wondering at a professional program that is devoting so much time to one nursing model.

Most schools of nursing have moved on from using a model as a curriculum base because they were 80s nursing. If you're looking at history, that's another issue.

Another aside: This taps into one of my pet peeves with our profession in the USA - so much nursing is taught by people who have no education qualifications or experience. Most of Europe requires a year long teaching course, with supervised practice before we are let out to torment students in the way you describe.

Try asking your Uni what sort of teaching credentials profs. have. It may alert them to the issues without naming names.

To recap: Get thru it as best you can; I do not believe you can salvage this situation.

Thanks for all the feedback. I really appreciate your taking the time to help me out. So Id like to respond to each

Juji Fruit, youre right. Some of it was the person asking the questions. One of the new grads acted as though she was the only one in the room and it was all about her. She made the most interruptions with irrelevant questions and she was practically getting private instruction on the basics of nursing right there in the class. Part of it was some immaturity, for lack of a better word. Part of it was also that the instructor felt the need to answer every one of those basic nursing questions completely, instead of telling her to see her after class because thats not what this is class is about. But a big part of it was that the new grads, as a group, could not grasp the concepts - for whatever reason they were having difficulty understanding every paragraph - as a group. The educator had to spend about 10 minutes trying to make them understand that a "client-client system" means one or more people NOT INCLUDING the nurse. As a group, they just couldn't understand why the nurse was not part of the client. The rest of us just had to sit there and wait for the discussion about that to be done. Theyre brand new nurses. A couple never even worked yet. I think there has to be a difference in the way of thinking depending on your level of experience. Its only natural. I dont think Im being judgemental of them. Just of the fact that more than half the class was completely disregarded in order to start from scratch in baby steps trying to bring the others up to speed --- for 3 hrs. Ive been an ADN for 21 yrs and still am. I didnt intend to make it sound like its about ADN vs BSN. Its not the degree. Except for the one who kept stopping the discussion to ask inapproriate questions, it was the level of experience that was causing the problem. The less experienced group had to be spoon fed sentence by sentence while the more experienced group spent the evening sitting there waiting for them to "get it". How do you teach an advanced topic to someone who has no experience in the field or in patient care at all & at the same time give the rest of the class what they are supposed to be getting out of it? It must be very difficult for educators to have such opposite levels of experience in one class.

Raphael, I agree the instructor could have set better limits. I think she let the class be monopolized by the irrelevant questions and irrelevant interruptions. I dont know what she could have done about the new grad group not understanding the material, though. I guess she had no choice but to spend a lot of time on breaking it down. But if she had taken better control of the other interruptions and didnt start teaching basic nursing too, we might have had time to finish our course work. Thanks for the suggestions. If the next class turns out the same (Watsons Theory is next), I may just do as you suggest.

Indie, all very good ideas. Thanks. Believe it or not, the educator is extremely experienced, doctorate, & teaching for decades. Its a Seminar in Professional Development. We're doing the history of nursing - Chitty, Lunney, Pender's health promotion and we're getting an overview of the different theories. Just reading one article on one theory each week & applying to a few cases to see how they work. Not really spending alot of time on each theory at all. Which is a good thing cause we'd never get it done at this rate. Congrats on your publishing and recognition! What an achievement!

Trauma, I just got a U of Phoenix postcard in the mail for that degree yesterday --- and threw it out. Hows the course working out for you? Are you satisfied with it? I was considering Excelsior last summer but was afraid to try an online program.

Thanks.

What a professional you are! Such thoughtful replies.

Doctorate or no, teaching 'experience' or no, I do not believe she knows much about education if she lets a class run away like this with nothing being learned and one student walking out.

Remember, for some, ten years' experience is just one inexperienced/novice year repeated'!

Just a little light hearted comment to lighten this thread. Keep on keeping on.

-jt, you have very valid points. I guess I just was initially kind of offended because I happen to be young, but do not consider myself immature. I am however, lacking in experience, so I will admit to that:0) I also agree the instructor should have kept things on track.

Court

"One of the guys walked out a half hour early, saying he couldnt take it anymore."

Coudn't take the questions from the "inexperienced" right side of the room, or Neuman's "Systems" model???

There's a reason why I call my degree "BS"...

I had a class like this when I was getting my BSN. The mix was LPNs and I was the only RN. The class met for 3 hrs also. I dreaded it, but it is just one of those things you have to put up with to get your BS degree.

Just grin and bear it and be thankful the semester is almost over!

Good luck!

---- Coudn't take the questions from the "inexperienced" right side of the room -----

Yes. Thats right. That and the constant disruption. Look at the "questions" they were asking.

Questions about the coursework are understandable. Thats what we're there for. And some time was spent on that too. But there werent many of those because we never got to do much of the coursework.

What we got to were:

- delays & inappropriate interruptions from the new grads every couple of minutes. One one of them stopped the discussion to ask "what do you mean 'therapeutic communication'? What is that?"

-the educator then actually taking class time to explain it in detail and teach basic nursing

-another one stopping the instructor while she was talking about health promotion activity --- to ask"how long should you make a pt wait before you answer his call"

-another new grad asking "what kind of students are nursing concepts developed for? NURSING students????"

-and the educator spending way too much time answering questions like this in detail.

-the 8 to 10 times another new grad interrupted the class to make completely unrelated, irrelevant, & lengthy comments about a million OTHER things in nursing and her family. Almost every comment received an almost-equally lengthy reply from the educator. In the meantime, the coursework we were supposed to be doing was not being covered.

-more than half the class was sitting there spending the entire time waiting to be instructed on the course topic while all this was going on from the right side of the room.

And the icing on the cake:

-One of the new grads stopped the educator Mid Sentence at one point when she was teaching the actual course content. She interrupted the instructors train of thought, and disrupted the class ---- all to announce that she had found a paragraph in the textbook that gave her a better answer than the instructor did to a question she had asked in the previous hour. Nobody knew what she was talking about. It had nothing to do with what we were doing at that moment. But she interrupted the class, stopped the instructor from speaking, stopped the coursework we were in the middle of & proceeded to read us the entire irrelevant paragraph that she was interested in. And the educator did not stop her.

-at that point, the other student closed his books, said "I cant take anymore of this". And walked out. And he wasnt the only one on the left side of the room who felt that way.

I suppose theres different levels of experience in every class. They all have different learning needs. But now I can see how the instructor contributed to the problem here. There do have to be some limits and the educator has to stay on track with those limits. Those new grads need to do some homework, get their extra attention and basic nursing review after class, and learn some classroom etiquette besides. But that wont happen until the instructor sets some limits.

Thank you everyone for your replies and suggestions.

I posted before that the problem is the with the educator and the system that allows someone this poor to teach, as much as with the students.

If you cannot produce an environment in which students may learn, then you are not an educator. Sounds like a 'sage on the stage' type, not 'a guide on the side' either.

There are many ways to handle these sorts of interruptions without putting the students down publicly.

+ Add a Comment