Are new grads prepared for the bedside?

[Robert.CFRN]

In doing some research, I've found very little in regards to how well prepared new grads are by their nursing programs for actual bedside care. Stereotype says that ADNs are better prepared than BSNs because of concentration on clinical vs theory. Of course, I'm sure it varies widely by program?

How are the new grads in your facility and area? Do they seem fairly well prepared, or do they take a lot of time and effort orienting? What are nursing programs missing?

I'm also doing a couple of surveys that take about 3 minutes to complete, just to gather data. (I'm not a nurse academic. I actually take care of sick people). One is for new nurses, and the other is for experienced nurses who are working with today's new grads.

Survey of new nurse graduates (1 year or less experience as an RN) (New nurses, less than one year)

Survey of experienced nurses (2+ years) on the preparedness of new nurse graduates. (Experienced nurses, over 2 years)

[Ruby Vee, BSN]

New grads are not well-prepared for the bedside. I've worked with ADNs, BSNs and MSNs, and MSNs are the worst. Or maybe it's just the local MSN program. It takes approximately 6 months to train a new grad RN to work in our ICU, and we have to start with the bare bones basics. Schools have abdicated their responsibility to teach actual nursing skills; it is now expected that they will learn these things in their first jobs.

One thing I really wish the schools would teach is how to receive negative feedback constructively.

[ruby_jane, BSN, RN]

I wasn't. We didn't get enough clinical time (although I'm not sure what amount of clinical time would be "enough.") I went through a BS to BSN conversion program and what should have happened (in hindsight) is that I should have done med-surg for a year to firm all that up. I didn't. It's not until I look back (and have these kinds of conversations) that I realize how much I still had to learn. The beloved is also a nurse and went through an ADN program. He was much better prepared to start IVs and that sort of thing.

[mmc51264, BSN, MSN, RN]

I had 650+ hours of clinical time as an ADN student. From what I have heard, 4 year BSN students do not have anywhere near that many hours. Need to ask some of the ABSN students. I know that ADN students seem to be, in general, better at time management. Have no idea why.

[ItsThatJenGirl, CNA]

I think you're missing a really important question - how many clinical hours the program requires. Mine is over 1,000 (BSN - 1,080 to be exact). I think that factors heavily into success as well. But I'm not a nurse yet. So.

[pixierose, BSN, RN]

New grads are not well-prepared for the bedside. I've worked with ADNs, BSNs and MSNs, and MSNs are the worst. Or maybe it's just the local MSN program. It takes approximately 6 months to train a new grad RN to work in our ICU, and we have to start with the bare bones basics. Schools have abdicated their responsibility to teach actual nursing skills; it is now expected that they will learn these things in their first jobs.

One thing I really wish the schools would teach is how to receive negative feedback constructively.

^^^ So much of this. When I was in school, it was common to hear, "well you'll get this experience in your first year of nursing." It was more theory and teaching to the NCLEX during instruction time ...

... and while I had 1450 hours of clinical time ...some hospitals had policies that didn't want students to do xyz, and our school also established policies in place. Students and their clinical instructors were often navigating through a clinical mine field of "can do's" versus "can do not's." So no, I didn't feel prepared.

I think an entire skill check off should be done with receiving negative feedback constructively ... it can be done on those skill days each semester lol ("great job with setting up that Alaris pump ..." "... Now, I noticed how ...").

[guest52816]

No, new graduates aren't prepared to work at the bedside. And I can honestly say that because I graduated May, 2016, with an ADN.

We actually did very little hands-on care during our clinical time. Pitifully little. So little, that I now realize I came out of nursing school with little idea of what most nursing shifts actually consist of.

Our clinical instructor spent a lot of time yelling and berating and belittling students. So much so, that many were afraid of her. But since I was an older student, with life experience, I never let her intimidate me. You simply can't learn if you are terrified all the time. And she terrified many students.

I do remember her saying: No hospital is going to want to teach you how to do your job.

Unfortunately, hospitals must do that very thing as nursing school doesn't.

If I had had proper exposure to actual nursing, I probably would have dropped out of the program, and gotten a graduate degree in Social Work.

Just my thoughts!

[NuGuyNurse2b]

I can honestly say that my clinical experience was a joke. I would read on here how people would advise student nurses to seek out opportunities and make opportunities for themselves, etc. There was simply too many students for one instructor and our scope of practice was very limited.

For example, if we wanted to do a foley there weren't any opportunities since the hospital shied away from them for fear of CAUTI's and resisted it, let alone allow a student nurse to perform it. I got really good at listening to lung sounds, though...cause all we did was assess...and assess...and assess.

[Castiela]

I was pretty comfortable going from school to bedside. We had ~1250 clinical hours, but by the time I graduated, I was caring for a full nursing assignment +meds+charting, ordering etc. And started immediately after I graduated, so I felt it was an easier transition

[That Guy, BSN, RN, EMT-B]

Not well prepared at all. Thats the problem of teaching to take the NCLEX.

[umbdude, MSN, APRN]

I went to a BSN program and felt prepared as a new grad. My program has a senior clinical preceptorship, which is 170 hours 1-on-1 with a preceptor. We were expected to take full patient load towards the end of the semester. It made a huge difference. I was able to hit the ground running on my first job after 2-3 weeks. From what I've heard, most of my classmates did quite well as new grads too. I'm sure there are individual differences, but overall my program did a good job preparing us.

[oceangirl1234]

I graduated with a four year BSN degree. 1, 670 clinical hours later and I felt prepared to start on the floor. We had numerous clinical rotations: general medicine, oncology, palliative, community, general surgery, ortho, seniors, mental, pediatric, and community. My final preceptorship was 370 hours and by the end of it I was managing a full five patient assignment by myself.

While I learned the basics in nursing school, I was given four orientation shifts on my floor when I started out and have gotten great feedback since then.