A time to reform nursing education?

Nurses General Nursing

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After reading some very interesting posts around here lately in regards to "fluff" being taught in nursing school, I wonder if it is time to reform nursing education.

I feel we could do without the nursing diagnosis. I understand they can help a student group and rank interventions for a disease process (dare I say that?), but there are better ways to help a student understand this concept. I am not against throwing out holistic nursing practices, but we really could do without the fluff. Why is it that many new grads can't "put it together" Maybe, because fluff doesn't cross over into real-world nursing practice?

I realize that nursing schools are geared towards passing the NCLEX, and that will never change. People in the nursing adovacy groups want nursing to be a profession, no problem with that, but our hands-on skills are being "outsourced" by RTs, techs, therapists, etc. We are "losing" our skills. Nursing students are graduating and have never even put in a foley. What's happening?

I'd like to know what experienced nurses, novices, instructors and new grads feel should be included, or tossed out of the nursing curriculum. Who knows, maybe reform will come?

*** Oh I am not saying we aren't good at them. And those where college students, not nurses.

LOL! So, as soon as they pass their NCLEX, they'll no longer be good at skits...I see, right.

We've been talking about nursing education for this thread.....so the complaint about using skits for nursing education is going to be directed at students, who for the most part, aren't yet nurses.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
LOL! So, as soon as they pass their NCLEX, they'll no longer be good at skits...I see, right.

*** Oh no, they will still be good at them. I never said men are not good at whatever they need to be good at. Just that by the time they have the experience to be instructors and are responsible for learning of students they will realize how demeaning, absurd and silly they are and won't do them. That's not the same as saying that if they need to be good at something to get the job done (graduate from nursing school) they can't be good at it.

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*** Oh no, they will still be good at them. I never said men are not good at whatever they need to be good at. Just that by the time they have the experience to be instructors and are responsible for learning of students they will realize how demeaning, absurd and silly they are and won't do them. That's not the same as saying that if they need to be good at something to get the job done (graduate from nursing school) they can't be good at it.

and your assertion is that only men will automatically come to this enlightened perspective?

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Specializes in Legal, Ortho, Rehab.
I haven't read this whole thread but it seems like a lot of folks would like to see less theory classes and more hands on clinical work.

I think this attitude is why so many people treat nurses like technical workers and not professionals. Personally, I don't just want to know HOW, I also want to know WHY.

No, no, no. Hands on is important yes, but one needs the how and why's. They cannot be separated. Many are reading this thread with the same notion. That was not the intention.

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I agree.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
No, no, no. Hands on is important yes, but one needs the how and why's. They cannot be separated.

*** yes we should be learning more about the how and why. Exactly what we do not learn now and why nursing education, particularly at the BSN level needs reform. Instead of wasting our time studying Jean Watson and other nursing theorists, we should be studying more basic sciences, patho, pharm, physiology and similar. Instead we spend countless hours writing papers on abstract subjects.

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Specializes in LTC Family Practice.
things i would love to see change in nursing education and nursing, from the perspective of a nurse educator:

1. fund programs adequately, including scholarships for students that have the intelligence, but not the means to become nurses. just as nursing in general is understaffed, so is nursing education. many of us carry the workload of two people, but more educators are not hired. also, supplies are often begged/borrowed from local hospitals. when programs are not adequately funded, you begin to find yourself saying things like "well, we don't actually use 'equipment x' at my facility, but..." and are stuck with outdated equipment. and yes, i do write grants, in addition to all my other responsibilities, with little support.

since i graduated in '72 it's hard for me to relate that you don't have adaquate equipment to teach with, we did and it is imperative that appropriate equipment is available.

2. raise salaries: many of my new graduates make more than i do when you consider the hours i put into my work. i do laugh when people ask if i like holidays/weekends/evenings off. i wouldn't know. i am too busy grading, preparing lectures and activities to benefit my students while also caring for my family, pursuing my doctorate, and working in the clinical setting. oh, and don't forget research and grant writing!

i've got no problem with this one.

3. consider alternate ways for clinical practice: for example, partnerships between hospitals and schools in which the hospital provides a staff member that knows the floor well and enjoys teaching. several agencies have done this successfully where a nurse educator pairs with a staff member to ensure that the students know the "ins and outs" of that floor while still maintaining consistency with the overall program goals. also, precepted and simulation hours are strictly limited in some states.

yup, and that's how it used to be done - the diploma rn programs and my lpn school (as most lpn schools at the time) had not only our clinical instructor but we were assigned patients with certain floor nurses that were also assigned the same patients as a reference and co-teacher. i think this thread points out that it's not just the lack of clinical hours but quality of the clinical hours that make a difference.

4. educators should teach essential content. there are millions of "nice to know" things we could teach, but what will keep the patients safe?

too true, even in our lpn program we had plenty of "nice to know" but it was integrated into our clinicals and labs as a oh btw you will want to consider this and that.

5. stricter admission standards in some cases. i don't believe it is fair to accept an academically unprepared student. it will only cause heartbreak for the student and take time away from those students who are prepared. also, i would love to see all schools implement a program for students who need extra help. i wish i could tutor each struggling student one on one, but i can't be every place at all times.

i can't agree more, before admittance to my program we had to take a reading and comprehension course. that course was the one huge factor that helped me through school and with my life in general. 1. it diagnosed my mild dyslexia and i was given the tools to resolve it and became a book lover and life long reader, prior to that i struggled and still do with spelling, but at least i know. 2. it taught me how to really read, find key sentences and really comprehend what the writer is trying to convey. 3. it upped my speed dramatically and to this day almost 40 years later i still have the edge to read something quickly and "get it". 4. this course opened so many doors for me through out my years of work both in the nursing field and non-nursing field. it might sound like some little funky course but in fact it was not, having one on one instruction to identify and resolve learning issues was invaluable.

students without the basic skills to slog through mountains of very technical information need help prior to admitance to a nursing program.

6. in a few rare cases, students feel that they are entitled and buying the "right" to a degree. as i said, this is rare, but it is also scary. i don't think this is "fixable" per se, but there is nothing like having a student write "i don't think i should have to read for class. you should just tell me everything i need to know" on an evaluation.

sigh, i see this in every day life too now. i'm glad i went to school during a time where this entitlement 'tude was unthinkable.

7. we need some standardization so that a student who chooses to transfer can attend another school without starting from scratch.

i agree, i attempted to return for my rn several times and because of spousal transfers i started over twice and post divorce moved again and was not willing to take pre-req's again.

8. a climate that is respectful of all nurses would be fantastic. i know we all feel frustrations at some point, and i've made the mistake of becoming angry at the bureaucracy myself, but i am so tired of reading bashing on this board. it seems anyone in management, education, or with a doctorate is seen as an easy target for ridicule, and we seem to find it acceptable. last i checked, this board was called allnurses.com, which means that all nurses, whether in management, education, or any other specialty, and future nurses such as students, should be welcomed here. we will all disagree, and i don't mind a joke at my expense, but i am tired of seeing my chosen specialty being characterized as "not real nursing" or for "those who can't do." i have the letters rn behind my name also.

i agree and i hope you do mean lpn's too we also have nurse behind our name. one of the big issues from my stand point is there are now generations of rn's who have never worked with us, have no clue about who we are, our knowledge, scope of practice etc. from what i gather lpn's are vilified in some rn programs by instructors. in my state experienced lpn's are clinical instructors for cna and lpn programs! i can't tell you how many times i've taught noobie rn's how to do skills that they didn't learn in school...gasp an lpn teaching an rn:rolleyes:. the in fighting between nurses needs to stop be they lpn/lvn or rn.

9. i hope those that gripe are politically active and active in the community. otherwise, it's just whining. we need people who are politically active and willing to serve on school's community advisory. i find it interesting that many people have an opinion, but few are willing to really dig in to find an implement potential solutions. to those with some of these wonderful ideas, please find yourself a local nursing school and offer to serve on the community advising board.

it goes both ways, i've found the entities who dictate policies and requirements tend to live in the ivory tower too much and don't reach out to the "nurse on the street or bedside" they need to open their hearts, minds and ears and have an avenue for the nurse on the street to provide input.

10. be willing to participate in research. what parts of the curriculum actually contribute to success and which parts are extraneous?

hmmm, we had an exit document to fill out before we graduated, however, i would have liked to have seen additional follow ups 6 months and 1 year post graduation, only after working in the real world will a former student know what they missed or feel they missed in school.

11. be a willing teacher. i have two clinical groups. one facility has the most wonderful nurses; we have a fantastic relationship, and they are welcoming to our students and to me as an instructor. our students fight to work at that facility. the other facility has 1 wonderful floor and 1 floor where the nurses are rude to students and to each other. nobody wants to work on the floor where the majority of the nurses are hateful. in this economy, i recognize things are tough, but we all have a responsibility to help the next generation of nurses for the safety of our patients.

i agree, and floor nurses who have a student attached to their hip for the shift should be getting extra pay to go along with the teaching. on the other hand some people are just not good teachers and shouldn't be burdened with it. there should be an evaluation program to identify and utilize those floor nurses who are not only willing but able to be the additional "teachers on the floor" to help support the clinical instructor.

12. address those nurses (whether nurse educators or staff nurses) who are cruel and angry and get them out! nursing has no place for this type of nurse. this type of nastiness seems to be accepted in our profession. it shouldn't be. these people should be counseled on their behavior, and if it does not change, document it and follow facility protocol for firing them.

yup and you'll notice bullying has become a national issue not just in the work place but in schools. where did they learn to be like this? when i did hospital nursing it was a team effort and we all worked together for the benefit of the patient to reach best outcome possible.

livetolearn, thanks for some really positive input to this problem and i hope you don't mind my comments back attcha;).

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*** yes we should be learning more about the how and why. Exactly what we do not learn now and why nursing education, particularly at the BSN level needs reform. Instead of wasting our time studying Jean Watson and other nursing theorists, we should be studying more basic sciences, patho, pharm, physiology and similar. Instead we spend countless hours writing papers on abstract subjects.

I still maintain that this is based far more on individual programs and not on what kind of degree it is. Jean Watson, or her brethren, weren't mentioned in my BS program, but we spent a lot of time on patho, pharm and then integrating those into our nursing practice.

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