recently graduated w/Accel. BSN, and worried/disappointed about not enough practice

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    I recently completed an Accelerated 2nd degree BSN program, and studying for NCLEX. I was in a conversation with some nurses/students who said that diploma or ADN nurses have the most clinical experience when they graduate, and are better prepared to work in the hospital.

    I think this may be true, unfortunately, after having talked to alot of people experienced with this, and doing some reading.
    Although I think I got a very good education and did have very good clinical experiences, I feel kind of discouraged that maybe I was sort of 'jipped' by doing this accelerated program, in terms of enough clinical hrs. We did have plenty but a friend who completed a diploma program used to spend 10-12 hrs on the floor during her clinicals, and my program didn't have as many hrs.

    I know that maybe I have more theory knowledge than she does, but did most of the clinical skills required, but I still think that the More practice, the BETTER when it comes to nursing. I mean, I did a few foleys, but was nervous in most of them, and feel like I needed to do ALOT more to get more practice. I also suctioned, but not enough, to be completely comfortable. I still feel like I will be too nervous when I do it on my own for the first time, w/o my instructor.

    I wonder if it's easy to start a job when a person didn't get as much clinical time as some other programs. I know there are preceptors, but you can't rely that they will be that good or very supportive of new hires.

    Is it possible to do an externship after graduating from nursing, before getting a job? I just feel like I need to have much more clinical practice, and I think some school programs may be better than others in this aspect.
    I actually think diploma nursing programs, although diminishing in the U.S., tend to be the best in terms of providing actual clinical practice.
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    Interesting, because there should be a minimum standard of hours. NLN approved programs have the same minimum number of clinical hours that are the same for accellerated programs as they are for traditional programs. However, some of those "clinical hours" might be the community health, mental health hours, so it feels like less hospital hours.

    The accelerated students here do 10 to 24 hours (beginning they do 10-12 shifts and spend the other day in the lab, later on it's two 12-hour shifts). The ADN and traditional students do 4-16 hours. So in the end it adds up the same.

    Nonetheless don't pine fore what you didn't get because you can't rewrite the past. I've precepted many ADN and BSN traditional students after graduation and they all feel green and unprepared for the real world.

    If you get into a good hospital with a good new grad program, you'll get plenty of experience on the job. Good luck, you'll do fine!
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    Even though the clinical part should have a minimum, I did notice when I looked on my state board, that the Community Colleges and Diploma programs and a higher pass rate on the NCLEX than the 4-year BSN programs. The three lowest schools in the state, were 4-year institutions.

    I'm all for a BSN, and plan to get one myself, but it does make you wonder what the difference is as far as clinicals.
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    Quote from Hopefull2009
    Even though the clinical part should have a minimum, I did notice when I looked on my state board, that the Community Colleges and Diploma programs and a higher pass rate on the NCLEX than the 4-year BSN programs. The three lowest schools in the state, were 4-year institutions.

    I'm all for a BSN, and plan to get one myself, but it does make you wonder what the difference is as far as clinicals.
    Looking at the NCLEX pass rates alone often gives the wrong impression. The reality (and range of possibilities) is actually much more complicated than can be shown by one simple statistic. Consider the examples below:

    1. School #1 accepts 100 students into their program. During their program, 25 students fail and don't complete the courses. 25 other students are not allowed to graduate until they pass an exam (such as the HESI) that predicts NCLEX success. Therefore, only 50 of those original 100 students are allowed to take the NCLEX. 45 pass, giving the school an NCLEX pass rate of 90%. But in reality, only 45% of those original 100% actually became RN's.

    2. School #2 also accepts 100 students into their program. They nurture their students growth and offer remedial help to those who need it. Only 10students fail their courses and are dropped from their program. The 90 students who graduate all take the NCLEX and 72 of them pass on the first try. That gives the school an official NCLEX pass rate of 80%. The 18 graduates who failed NCEX the first time all pass on the 2nd try. So, in the end 90% out of the original 100 students became RN's even though the official NCLEX pass rate is only 80%.

    If you looked at only the NCEX pass rates, you would see that school #1 had a rate of 90% and school #2 had a pass rate of 80%. But few people would conclude that school #1 was the better once they looked a little deeper. To make a final determination as to which school is actually "better," one would need a lot more information.
    blkgurlwithwings likes this.
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    Quote from MiaNJ
    I recently completed an Accelerated 2nd degree BSN program, and studying for NCLEX. I was in a conversation with some nurses/students who said that diploma or ADN nurses have the most clinical experience when they graduate, and are better prepared to work in the hospital.
    Each school has its strengths and weaknesses. One school might be really strong in giving its students lots of clinical practice that helps them feel comfortable at the beginning of their first job. Other schools might be weak in that area, but be much stronger in another area -- such as leadership skills, teaching skills, research skills, analytical and evaluation skills, understanding of pathopysiology, etc. The important thing is to have a good understanding of your own strengths and weaknesses and then seek a first job that will give you a chance to further develop as you would like.

    Most good hospitals are prepared to give new graduates a thorough education that includes plenty of opportunities to practice the technical skills you will need to succeed in your job. Don't work for any hospital that won't provide that.

    If you continue to work on your development as a nurse throughout your career, you will do just fine regardless of what type of program you attended to begin with. It isn't where you start that counts, it's where you finish. The people who acquired lots of technical skills probably need to work on the theoretical foundations of practice and the academic aspects of nursing if they want to grow and advance in their career -- and you need to work on your technical skills to move to the next level. There is nothing wrong with that.
    Last edit by llg on Apr 21, '07
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    I'm in the ABSN program at Duke University. Sometimes I worry about this too, even though we have over 1000 clinical hours over 16 months.

    Here's my take on it, and this is what I use to keep my fears in check: if the method your school is using didn't work, the BON would no longer let them use it. Apparently they're doing something right. From everything I've heard, EVERYONE feels that way. Our last class (actually, every class - we've only existed as an ABSN since 2004) is doing very well (many of them have remained at Duke). They're no better than I.

    You and I will both be fine. I know it. :spin:


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