Accelerated Nursing Programs

ruby red slippers · Sep 15, 2008

i am in a 15 month program too. i just began my 3rd semester out of 4. we had a nursing fundamentals course in the beginning, so it's odd that your program doesn't have one (honestly though, it's basically med surg I), but anyways i know how you feel. i worry about practicing safely and competently when i graduate too.

when i get report in the morning at clinical, i do try and sneak a look at the patient's chart to see their code status before i go in to do the initial assessment. usually if they're DNR or DNI, it's noted in the front of the chart, really noticeably. but you can always ask your clinical instructor or primary RN about where to find the info. also, depending on the unit, there may be a code button, but totally ask your clinical instructor/primary RN about what to do. also, usually you do an assessment as soon after report as possible, starting with the sickest patient first. try to go in with your primary RN and watch her do an assessment on another one of her patients. you can also carry a little cheat sheet that goes by body system if you're worried about forgetting something.

it seems to me that no matter what, when we graduate we will not know enough, but the hospital where you get your first job will orient you pretty thoroughly. also, other RNs on your unit can be really good sources of information - i know so many RNs are unapproachable, or don't want to be bothered, but it's better to ask a question than to jeopardize your patient. also, something i wish i had thought of sooner was doing an externship at a hospital. my classmates who are doing externships love it and are a lot more confident in their practice. also, check out hospitals in your area to see which ones have new grad programs.

anyway, i know it's not advice from a nurse, but i hope it was somewhat helpful. try to hang in there - it's just part of being a nursing student! :)

amjowens · Sep 15, 2008

It's nice to hear your honesty about what you feel you don't know. That shows your intelligence and desire to be a competent nurse. I'm sure-with your style-you'll find a way to learn what you need to in order to succeed as a nurse!

I've read about newly graduated nurse practitioners (without nursing experience) having a very tough time when out in practice. Respect is really important in nursing-physicians, other nurses, patients-have very high expectations, and rightly so if you ask me.

It should be interesting to see how these programs affect the profession. Hopefully we won't set ourselves back by trying to churn out a bunch of nurses asap. I'm trying to think of any other profession that is so in flux with educational requirements/what certain degrees actually mean..can't really think of any.

Good luck to you! There are many routes of learning, much more than the classroom setting. I'd try to be proactive, find mentors, read about procedures, etc.

missjennmb · Sep 15, 2008

I am trying so hard to wrap my mind around a 15 month RN program but it eludes me. Thats what you're referring to right? RN not LPN? I'm in a 12 month/3 semester LPN program, and I've gotta say I am struggling to keep up with the info that I'm given. Maybe if I did all my prereqs seperately first, and THEN had another 15 months of nothing but full time nursing... I'm just very curious how your course load is layed out that you are able to cover the material necessary.

I have AP1, Nursing Fundamentals (for 9wks then med/surg1 for 9 wks), and Nursing Lab, and its all I can do to get the material read and the homework done every week, let alone study on top of that.

I'm sorry that you are struggling. There is a hospital in my area that offers, as one of it's perks, a very long and very thorough new grad program that is a combo extended learning/job opportunity. Perhaps you could find something like that?

Hisown · Sep 15, 2008

Courtenia, I understand your anxiety but let me assure you..it has been done many times before and with the right attitude and amount of determination, you can do it! I'm in an accelerated program myself and it's not easy...we've all known from the beginning that it isn't easy.

Its interesting that your program did not offer a fundamentals class...you can still get by. Many hospitals have volunteer departments. I don't know what your time schedule is like but you can consider putting in a few hours at a local hospital every week. You can also volunteer with a private practice in your area.

The accelerated program is only accelerated because we already have our general education courses and prerequisites covered from another program. Technically, you have already had a good 4 or 5 semesters worth of coursework already covered..you've probably completed a degree in another area and are a competent hard-working student. You would not have been accepted into an accelerated program if your history didn't show that you can handle the rigours of it. The fact that its accelerated doesnt mean that we're missing anything.

All the best and just keep a positive attitude. You will be very well trained as a new nurse and even though it would be a difficult road, you will be smiling about ( and grateful for) this experience in a couple years to come!

courtenia · Sep 15, 2008

Our program is only 15 mo. because all students are required to have a prior Bachelor's degree and were also required to complete all of our pre-reqs beforehand...(A&P 1 and 2, Chemistry, 2 semesters of psych, microbiology, statistics, etc) So in additon to my previous degree, I was taking classes for a year, completing pre-reqs, before the BSN program even started.

Yes, there is alot to learn, in all health-care professions!

Thank you, all, for your encouragement and positive ideas! I really appreciate it!

missjennmb · Sep 15, 2008

ah ok, I was thinking it was actually 15 months, not 15 months plus a year of pre-reqs. That makes more sense. Thanks for clearing that up for me. :)

Good luck! As the pp said, others have done it, so can you!

TUN925 · Sep 16, 2008

Hi

I'm also in an accelerated program about 16 months for RN BSN and currently in my first semester. It is going by fast, we have finals coming up in a few weeks and its hard trying to review everything. But in your situation I don't understand why the program does not provide a Foundations class. I can see why you would feel that way, most people would. Good luck to you and hope for your success. It's good that your taking charge by getting information that you need to succeed. Keep up the hard work.

PMFB-RN, RN · Sep 16, 2008

Our program is only 15 mo. because all students are required to have a prior Bachelor's degree and were also required to complete all of our pre-reqs beforehand...(A&P 1 and 2, Chemistry, 2 semesters of psych, microbiology, statistics, etc) So in additon to my previous degree, I was taking classes for a year, completing pre-reqs, before the BSN program even started.
Yes, there is alot to learn, in all health-care professions!
Thank you, all, for your encouragement and positive ideas! I really appreciate it!

*** I suggest that after you graduate you go to work in a hospital with a nurse residency program, but I recomend that for all new grads.

Now what do you mean you are in an "accelerated" nursing program if it is 15 months long? The regular nursing prorgam at a BSN school or at a community college is 4, four month semesters for a total of 18 months after pre-reqs. Shaving 3 months off a program makes it "accelerated"?

wannabe07 · Sep 16, 2008

Courtenia,

Hi! I'm in a 14-month accelerated program as well. I feel your pain! I'm in my second semester, we had a fundamentals class (basically med surg I) but we are learning the majority of our skills (IVs, catheters, etc) this semester. It is a ton of information in a very limited time frame but it will be worth it when we get another bachelor, right?! :wink2: I have heard from every single RN that I have talked to that you will finish nursing school and feel like you don't know anything once you get into the real nursing world. That is a common trend I guess. I guess this is why it is so important to find a preceptor/new grad program that is reputable and will teach you what you need to know. I plan on going to a hospital here that has an 11-week orientation for new grads, I am counting on that being plenty of time to figure out what I am supposed to know. I have a friend who just graduated from a traditional 2 year ADN program and she feels the same way...she has the skills but its the organization of everything that experience will bring.

With regards to the code status of your patients, I think it is a good idea to always know what the status is. At my clinical it is clearly labeled on the front of the chart and I think its on the assignment board too. It is just a good idea to get in the habit of checking that when you get your patient assignment because the consequence of performing a code on someone when they are a DNR is huge!! If you can't find it ask the RN...no question is a stupid question especially when it comes to a pt's code. Well there can be stupid question but that is for another thread. :saint:

Good luck...just think...this time next year we will be :nurse: s. Yay!

MB37 · Sep 16, 2008

In my 15 month program it was four semesters, but we started in May and graduated in August - hence 15 actual months from start to finish. That's 15 mo. including breaks between semesters, holidays, etc. We had 12 mo. of actual classes. However, we took every single class the traditional students took, we just took more at a time and didn't take summers off.

Rabid Response · Sep 16, 2008

I know exactly how you feel. I graduated from an ABSN program in May of 07. I also felt like "a fish out of water" in my first couple of clinical rotations, although I did have a nursing fundamentals class and a very good nursing assessment class. Nobody did anything to prepare us for the general environment/atmosphere of the hospital, though, and for students like me who had little or no experience in healthcare, it was daunting to be thrown right into the mix. I had a million stupid (to me) questions that I was way too embarassed to ask anyone. Everyone used acronyms and initials for everything, and I didn't know any of them. I didn't know what a kardex was for or how to read it. I didn't understand the process of how orders were written and followed. To top it off, the nurses on my first med-surg rotation were for the most part unhappy to have to work with students, and several of them were downright rude. I actually preferred the ones who flat out refused to work with me to the ones who stonily accepted my assignment to them and then ditched me the first chance they got. I know I spent at least 30 minutes total the first week crying secretly in a supply room.

A patient's code status should be covered in report, preferably at the very beginning: "John Smith is a 72-year old male, full code, no known drug allergies, who is here s/p cardiac cath on 9/14, etc..." If the patient is assigned to you, you must know the code status. It should be written in a prominent place on the kardex and will also be in the patient's chart. If, however, a nurse just asks you to get vitals on one of his/her patients, you don't need to go looking up the code status just for that quick trip into the room. If you are in a room with a patient, and the patient stops breathing or something else very serious occurs, I would first of all YELL for help--"I need some HELP in here!!!!" which will get the necessary aid to the patient, and one of the nurses can call the code if it is necessary. If no one is around or responds to your cry for help (god forbid) there is nearly always a code button in the room that you can hit. Familiarize yourself with the locations of these buttons in the patients' rooms where you are working. No one expects a student to run a code or even to participate.

As for the structure of a workday, you are right that every day is different. However, you will always get report first, and you will always assess your patients shortly afterwards. The rest of your shift is structured around the workload.

I'm sorry that you are feeling so overwhelmed. I felt the same way. If I were designing an ABSN curriculum, I would incorporate a class called "The Hospital Environment" in order to prevent the sort of culture shock you are now experiencing.

I've worked with a number of new grads over the last year, and in my experience ABSN grads don't do any better or worse on the job than regular BSN or ADN grads. Don't psych yourself out!

Good luck to you and don't be too hard on yourself. Also, feel free to shoot me an email if you have any questions.