Advance nursing needs revamping !!

gettingbsn2msn, MSN, RN · Jan 23, 2011

Totally have to agree with you. I am very disapointed with our curriculum. Complete waste of time. We had to do a large poster on Watson. I am sticking it out but I believe the programs need revamped as well. This is an utter waste. The instructors in my curriculum are all in their 70's and haven't seen a hospital floor in 50 years except maybe to be a patient! The are clueless.

llg, PhD, RN · Jan 23, 2011

Why did you choose a school in which the faculty is so out of touch with contemporary practice? Why did you choose a school that had a curriculum you did not approve of? Did you not investigate these schools prior to enrolling?

Bad schools don't just come out of nowhere. They exist because students buy the product they are selling. We have several bad undergraduate schools in my region. I would love to see them forced to improve the quality of the education they provide. But as long as students keep paying big bucks to attend these schools, they have no incentive to change.

There are similar dynamics working at the graduate level. People tend to choose schools based on their convenience (and sometimes, price). They rarely investigate the curriculum and the quality of the faculty in depth -- and those are the things that determine the quality of the education they will get for their investment.

The pursuit of a graduate education is a major thing in life. It's worth it to invest some time, effort, and money in exploring the nature of graduate education in general and the characteristics of particular programs, etc. BEFORE embarking such a big journey. That way, you'll know what you are getting into and can make an informed decision as to whether it is the right path for you or not.

gettingbsn2msn, MSN, RN · Jan 23, 2011

llg,

how can one possibly know what the instructors are like prior to entry to a program. For example, my first choice was Vanderbilt, but I know of no one who has attended there. It was too much risk for me to spend that kind of money and receive the same education that I am receiving now. Another point to take into consideration is that many of these programs do not even provide clinical sites to their students. I am livid over this type of education. The student spends thousands of dollars at the college only to have to pound the pavement to find a preceptor. How many students have you seen that have to drop out of a program due to the fact that they cannot find a preceptor! While I attend a school that is very $$ and I find the curriculum ridiculous at least I have a preceptor. I will learn on my own. Sad, if you ask me.

llg, PhD, RN · Jan 23, 2011

I agree with you 100% about the preceptor issue, gettingbsn2msn. I think that practice is appalling and I would never attend a school that didn't provide the necessary clinical preceptors unless I had mine lined up ahead of time.

But the ages of your faculty members, their educational backgrounds, their clinical backgrounds, etc. are things that are often online and/or available through telephone interviews. Similarly, no one should be surprised at the curriculum as that is readily available information. A prospective student should be asking about those things, the courses, what is included in those courses, etc. You may not get a perfect sense of the quality of the teaching, but the actual course content should not come as a surprise.

WyndDrivenRain, BSN, RN · Jan 23, 2011

I'm really sorry about your experience so far. I'm transferring schools not because of curriculum issues but because of the slow pace of the program and they do not provide preceptors(they are a ground school by the way) and they require I remain in state for my clinicals. Which doesn't give me too many options. I like lots of options so I'm switching to an online program where I can go to any of the states I'm licensed in to get the experiences I feel will most benefit me and my future practice.

I'm happy with the curriculum and I found the theory class useful. I'm taking policy right now and once again it is fascinating. We are delving deeply into the new health care law and its impact on APN practice and its impact on the nation as a whole. We are learning the ins and outs of insurance/medicare and so on. My advanced patho and advanced pharm courses were relevant and completely current.

Our Theory and policy courses have been directly tied into the APN role. The other piece to consider is that graduate education in my view is as much about what you put into it as what your faculty or school put into it. If you don't feel you got enough out of policy or theory as it relates to the APN role (and I believe it does!) then you have the option and perhaps obligation to further explore those topics on your own. There are a wealth of resources out there on the theoretical basis of advanced practice nursing and health care delivery systems/policy issues.

The preceptor issue is going to come to a head. I have noted more and more schools moving to the model of forcing students to find their own. The schools can't find them either, probably because they do not want to compensate them which is a gross injustice and just demeans the profession that much more. Like I said above it is why I'm leaving my program. Even though I still have to find preceptors in my new one, it is a savings of $40,000 less in tuition and I have more options in finding preceptors. I'd rather take the money I'm saving and compensate my preceptors for the time and teaching than pay it in tuition to an institution that could not be bothered to do the same.

Good luck, I hope you find a program that works for you or at least can handle sticking it out in the one you are in. I know it is frustrating to be paying for something and feel like you are so not getting your money's worth out of it. Perhaps you could consider augmenting your learning on your own so you at least feel more up on current policy, direction and trends in advanced practice nursing. That might make your program more tolerable. I would focus on the end result and maybe let some of the perceived program inadequacies roll off your back. You can always work to change them once you are out and in practice.

Sue

reeya · Jan 23, 2011

llg, About the curriculum, almost every advance nursing school has theory, policy, and roles class. I did inquire many universities and found out that it was NATIONAL standard to have those classes. I dont understand why American Nurses Association thinks it is so important to do theory, community health, roles class for advance nurses who would be following medical model ultimately not nursing model. Oh ! by the way, we had 1 whole semester of "Advance practice roles" class. Are you kidding me?? 5 months to discuss different roles of APRNs. I dont get it.

Out of 20 credits core class before we could start clinicals, only 3 classes (9 credits) were applicable to advance nursing like adv assessment, adv patho, adv pharm...rest (11 credits) were like nursing theory, adv. roles, comm health & policy)...all were just a complete waste of time !! Instead I would have loved to learn adv. pathology, diagnostics, radiology 101 ??

Now, clinicals start from this semester and we are expected to know what tests to order...interpreting radiology without any education...simple suturing class would have been helpful. Like we did in BSN : putting cath, NG tube, wound care, trach care, feeding tubes etc in sim lab before we did the procedures on real person during our clinicals. When clinical started we had at least some idea of what to do and what not to do in real patients. Why cant adv nursing focus teaching basic radiology, suturing, adv diagnostics etc., instead we learn nursing theory & roles class for what???????????? I am asking why does NATIONAL standard set by ANA is so out of touch of practical advance nursing education in real world ??

Le-Lee_FNP, MSN, RN, NP · Jan 23, 2011

reeya i have to agree with you. i think this is why many PAs feel that their education is superior to NPs... not as much "fluff". I think the issue is that the goal of the ANA is to keep APRNs true to their "roots" of nursing theory and the nursing model, separating them/us (I am a FNP student) from medicine theory.

gettingbsn2msn, MSN, RN · Jan 23, 2011

I actually like the idea of paying preceptors as Wynd above stated. What a novel idea. I just do not like the idea of students going out and begging for a preceptor. Colleges are charging too much in tuition and fees for this situation. Thankfully, my program finds the preceptor for us but I believe we should have classes in radiology interpretation, suturing, and ect. This would certainly enrich the educational experience.

reeya · Jan 23, 2011

I think its about time that nurse educators re-evaluate the outcome & planning of advance nurse practice education based on current APRN job demands. I am in FNP program too...I went to talk with my chair of graduate nursing program and all she said, "it was a national standard and they have to follow the curriculum". I was so disappointed. Who ever made that national curriculum standard probably did in late 60s, 70s, 80s...They need to re-evaluate the national standard.

Jasil · Jan 24, 2011

I'mgonna get my wife to chime in as she would agree!! The medical model seems so superior, to me as a outsider, and to her as a student. Maybe it's because my wife's closest friends in the medical profession at doctors but she is very disappointed. Almost enough to pull the plug now and go to PA school. Well see!!

elkpark · Jan 24, 2011

I am completely in agreement with llg and Wyndy. My graduate program had almost no nursing theory content -- only what related directly to our clinical specialty/practice, and the one "issues & trends" course was v. relevant and useful. Almost my entire curriculum was focused on learning my clinical specialty/practice (plus statistics and research methods, of course). Our clinical placements were in facilities with which the school had a formal, ongoing relationship and all our clinical preceptors were faculty members of the school.

I would never consider attending a school that expected me to go out and find my own preceptors/instructors. Totally apart from the issue of the school expecting me to do its job (while still paying full tuition), when each student arranges her/his own preceptor(s), how does the school know whether that preceptor is a good instructor, or, for that matter, a good clinician? Where is the oversight and "quality control"? The student might be learning all kinds of bad habits, dangerous short cuts, etc., or simply getting a poor quality clinical education, and how does the school know? There have been threads here about the difficulties NP students are having with finding preceptors, and sympathetic new grads, who had just been through the same ordeal themselves (of struggling to find preceptors) have commented that they'd be happy to serve as preceptors. That's v. nice of them, of course, but I certainly would not want a new grad as a clinical preceptor -- I would want a seasoned and experienced expert.

When I was "shopping" for a grad program, I used the interviews as much to find out about the schools, faculty, etc., as the schools did to find out about me. You have to consider the process a two way street and be willing to ask tough questions and ferret out the information you need to make a good decision. It's also helpful to talk to current students in the program, and schools will often put applicants in touch with graduates, if you request it, so that you can find out how graduates of the program are feeling about their experience at the school now that they are out and practicing. That is a perfectly reasonable request to make of any school, and, if the school is reluctant to do so, that's a big red flag right there, IMO. There are lots of ways to find out good information about a prospective school, if one just makes the effort to do so.

Unfortunately, there is a wide range of quality (and lack of ...) among nursing graduate programs "out there," and it's up to the potential students to put the time and effort, up front, into making sure that they are making a good choice for themselves. I see far too many potential students just assuming that they're going to attend whichever school is the cheapest or most convenient for them, and that there isn't any significant difference among schools (or that the difference doesn't matter), and that's just not true. You're going to put a huge amount of time, effort, and $$$ into getting any graduate degree in nursing; you might as well make sure you're getting into a program that is going to meet your needs and that you're going to feel good about.

I don't know what "national standard" curriculum requirements these other schools are talking about (or whether that's just a convenient excuse), but, if there is such a thing that requires a lot of extraneous content, it's certainly a newer requirement, not a leftover from the old days. I attended grad school quite a number of years ago, and there was no mention or evidence of any such thing in my well-known and well-respected program, which was clearly focused on turning out well-prepared clinicians. (For the sake of this conversation, I just checked the website of my school to check on the current curriculum, and it's basically the same as when I attended -- almost nothing in the way of so-called "fluff" classes.)