Are Nursing Programs Adequately Training New Graduates?

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    I am a nurse educator and I am currently working on my doctorate. As a nurse educator (and as a previous nurse manager), I am concerned about the knowledge and skills of our graduate nurses. I feel that nursing education has turned into a type of "assembly line" to get nurses into the field as quickly as possible. I have witnessed some actions by nurses that I know they were not taught in nursing school. Nurse managers...do you think that the new nurses being hired need better preparation and training? What do you think are the most important skills or knowledge that new nurses should have when they graduate and start working on your units?
    hope3456 likes this.
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  3. 10 Comments so far...

  4. 0
    Absolutely! They need to be able to manage minimally 5 patients. I know that is difficult when one clinical instructor has a class of 8-10.
    These novice nurses haven't a clue about time management or prioritization and there is no one to blame because they weren't exposed to it.
    I interview new grads and all they want is to go to a critical care area. Forget about learning the basics and getting a good solid med-surg foundation, they want what they want and want it NOW.
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    In my never to be humble opinion... I think it is a shame that the diploma based hospital nursing programs were ended. I graduated being able to team lead an entire surgical floor because I had done it for 3 months in a Team Leading rotation. I also transitioned to Critical Care without any problem because of the many clinical hours I spent on the unit. I had more sense after working as a HHA for a year before I started nursing school then a lot of the student nurses I worked with. They were in a 4 yr BS degree program and who were just starting clinicals their Junior year.
    (guess this comment shows my age!)

    Kyasi
    RN In FL likes this.
  6. 3
    Quote from Kyasi
    In my never to be humble opinion... I think it is a shame that the diploma based hospital nursing programs were ended. I graduated being able to team lead an entire surgical floor because I had done it for 3 months in a Team Leading rotation. I also transitioned to Critical Care without any problem because of the many clinical hours I spent on the unit. I had more sense after working as a HHA for a year before I started nursing school then a lot of the student nurses I worked with. They were in a 4 yr BS degree program and who were just starting clinicals their Junior year.
    (guess this comment shows my age!)

    Kyasi
    ITA. That was my thought, also, upon reading the OP. I graduated from a hospital-based diploma program many moons ago and graduated well-prepared to start practicing nursing with a minimum of orientation. Since then (and since returning to school more than once ), I've taught in ADN and BSN programs -- and I'm truly shocked at how little nursing students learn about actual nursing in school now. No wonder employers are reluctant to hire them! And I want to be clear that I'm not blaming the students for this -- I blame the schools and the larger nursing establishment, for "throwing the baby out with the bathwater" in nursing education.
    RN In FL, hope3456, and Kyasi like this.
  7. 0
    I've wondered alot about this. Pretty much it is the reason that so many hospital jobs are only wanting 'experienced' nurses. there is so much nursing school does not teach - skills that can only be learned on the job and with practice.
  8. 3
    Quote from hope3456
    there is so much nursing school does not teach - skills that can only be learned on the job and with practice.
    But the skills that you say "can only be learned on the job and with practice" used to be learned in nursing school. It isn't that they can't be taught in nursing school -- nursing schools have just quit teaching them.
    Last edit by elkpark on Jul 10, '11
    RN In FL, Kyasi, and llg like this.
  9. 0
    Quote from elkpark
    But the skills that you say "can only be learned on the job and with practice" used to be learned in nursing school. It isn't that they can't be taught in nursing school -- nursing schools have just quit teaching them.
    I agree. But the answer isn't going back to diploma programs. We need to upgrade the BSN programs to include more/better quality clinical experiences and eliminate that "quickie" programs that pop out a new nurse in less than 2 years.

    We need to combine the best of what the university-based programs have added to the profession and combine it with the best of what the diploma schools offered.
  10. 0
    There was nothing quick about my diploma program. I went to school for the equivalent of 4 years in 3. It was gruesome! But I had an amazing education!

    Kyasi
  11. 1
    Quote from Kyasi
    There was nothing quick about my diploma program. I went to school for the equivalent of 4 years in 3. It was gruesome! But I had an amazing education!

    Kyasi
    Ditto.

    llg, I wasn't specifically advocating a return to diploma programs, just challenging the common belief that skills can only be learned "on the job" and can't be taught in school. I agree that we need to identify the best that each model of nursing education has to offer and consolidate those elements to ensure that we are producing well-educated, competent graduates who are well-prepared to enter practice.
    Kyasi likes this.
  12. 0
    llg,

    "We need to combine the best of what the university-based programs have added to the profession and combine it with the best of what the diploma schools offered."

    I could not agree more with these comments. I attended a recent conference where the concept of 'Dedicated Education Units' was discussed, and I'm now in the process of replicating this model at my organization.

    Essentially, it involves cross-training of the experienced staff RNs (who are interested) to be adjunct clinical instructors, with a 1:1 student/RN ratio. The clinical faculty are present on the unit and function as faculty oversight for the rotation. They provide weekly objectives to be covered during a given week's rotation.

    Expected outcomes are that everyone wins: better student clinical education means higher quality new graduate RNs=better patient care outcomes. Schools of Nursing make the best use of their faculty resources, and the staff who choose to participate gain 'points' on the clinical ladder program at this organization, gain CE's for the training, etc.

    Thanks,
    Sunflower3


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