Are new nurses adequately prepared?

Nurses General Nursing

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:confused: As a nurse, I see more and more new grads who have little clinical experience and who are overwhelmed, more than I was and that was a lot. Many have had no more than 1 or 2 patients during clinicals. Many have told me that their nursing programs included role playing, seminars, and such events as teaching kindergarteners how to wash their hands as manditory clinical days. Is this a trend? Shouldn't there be more practical experience and teaching of critical skills, especially since patients are more acute? Many of the new nurses have never suctioned or used any of the complicated equipment common on the clinical floor. Would appreciate feedback.

Also, I see experienced nurses who are less than helpful with new grads, taking the position that 'if I had to learn the hard way, so can you.' We all had to learn the hard way but we need to remember the acuity level of today's patients, the additional skills new grads must possess, and the increased stress levels. Have any of you observed any of the above?

I think there is some recognition in the health care field that nursing schools are inadequate. What is expected of a nurse is what physicians used to do many years ago, my mother retired from nursing in 1994, attended a hospital ADN program in 1950.

She said back then only physicians were allowed to take blood pressures! Now techs take them routinely. There is so much more knowledge and responsibility a nursing school cannot possibly teach it. The most they can do is prepare the students for the gawdawful shock one goes through in becoming a decent nurse. Many hospitals have recognized this and the nursing interships and externships are a godsend. I would advise any fresh graduate to solidify their knowledge and confidence in one of these, the commitment time you give up is well worth it, and seems to eliminate a lot of burnout on new nurses.

Not so long ago prior to doing my Nursing Degree, I was working as an Anaesthetic Tech. We had male orderlies back then who had the nysterious title of "Dressers". Their job was to da all the male catheterisations. Their training consisted of a cardboard box with a hole punched in it which was meant to represent the urethra! If you got the Foley in the hole, you passed. My thoughts on Nusring Education today, and there has been some discussion here in Australia, is that students in their final year should basically be employed in the hospital setting, under supervision so that they get a whole year of hands on experience

Patrick

After Hours Nurse Manager

Originally posted by darius000

We had male orderlies back then who had the nysterious title of "Dressers". Their job was to da all the male catheterisations. Their training consisted of a cardboard box with a hole punched in it which was meant to represent the urethra! If you got the Foley in the hole, you passed. Patrick

After Hours Nurse Manager

Ouch again! I know that this is one area that I'll have to tend to, mainly because I don't want to cause pain to the patient, but just this description hurts.

Kris:eek:

I'm ex faculty in UK and USA. Left my faculty position two years ago to return to full time clinical nursing - where I can really teach new grads. The ADN program in which I taught replaced the acute care pediatric experience at an excellent hospital with loads of real nursing situations and helpful staff (many of the staff acted as part time clinical teachers for the college) with a community based pediatric course because the ADON did not rate pediatrics as a good experience. I think it is real med/surg with attitude - but who am I? A career nurse (peds and adults).

The real problem in the above situation is that many of the students (who admitted they did not want to continue to work pediatrics) stated it was the best acute care experience they had got in the whole of their training. Also some colleges are being squeezed out of the best acute care clinical placements based on how the college is perceived in the community.

I think we experienced RNs have to accept the reality of illprepared students, insist on high quality orientation/new grad programs/mentor relationships and do our bit to teach as we work. The newbies learn from something as simple as good examples right up to assisting them step by step with a complex procedure. But good teaching does take time, so real preceptors/mentors should have a slightly lower caseload, although I'm not sure how I feel yet about actual $ reimbursement. We should, however, get some recognition for quality teaching.

It appals me that students nurses can be taught in the USA by anyone with RN and a little experience (clinical teaching assistants). Even fully fledged instructors are not required to have a background or qualifications in education. Compare this with the UK where nurse teachers take a minimum of a one year full time course, plus supervised practice in education theory and practice. Food for thought.

I've worked peds and adult med-surg type settings. If you can do peds, you can do anything.

Again, hi-tech skills are cool. Monkeys can learn skills. Nurses are supposed to learn how to think. Too many schools graduate nurses who have not learned how to think. That is our problem. Now, schools teach students to pass tests, not how to be nurses. That, too, is our problem.

Though I find many such "nurses" on this board, I trully believe it is never too late to learn how to think, or how to be a true professional nurse.

I hope I am not wrong. It's discouraging sometimes.

Watch the movie, "The Right Stuff". It's about astronauts. The same thing, though, can be applied to nursing.

Not that many with "the right stuff". Chuck Yaegar had the right stuff. He was one of the only ones who realized that most of the astronauts had the right stuff too.

Nursing school has much in common with Medical school. They both prepare you for general entry into your field. The difference comes after graduation. Md's thenhave to complete a residency in order to become proficent in their choosen area.Nurses are thrown into their work enviorment and maybe have OTJ trainning but that depends on the facility. Nurses like physcians only improve with experience. How the experience is obtained will control what type of a nurse you become. I am a true believer in Nurse Interns programs. Any new nurse is not ready to function by themselves and should have a clinical working experience that includes education and strong resources until they have received adequate hands on experience.

As far as experience nurses lack of willingness to help educate new nurses, their are some reasons. Hospitals refusal to pay nurses appropriately for their experience,or even their efforts to chase these high price nurses out of their facility, has caused a rif in nursing. For years, I have watched new grads be hired , get one to two years experience with the benifit of the experienced nurse, then leave to another hospital to receive a pay ratemprable to those expeirenced nurses. This leaves those nurses who train the new grads to do it all over again with another group. Physicians who work at a residiency facilty are given facility privilages and wages to train residence, nurses are told to do this without extra benifits,most of the time, or minimal befits($1.00/Hr). I have found several facilities that have hired new graduates at a higher pay rate then nurses that have worked at their facility for several years. The hospital is able to do this because they prohibit their employees from discussing their payrate with each other. Can we really blame these nurses for their lack of enthusiasm to educate after being treated in such a way? How many of use have watched new grads be hired into positions such as dayshift with the hospitals telling their their exesting night shift staff they cannot have the dayshift slot because they cannot afford to lose their experience on night shift. As long as hospitals treat their nurse as such, you will find the lack of willingness to teach new people.

I graduated from an ADN program 3.5 years ago. The skills I learned were very basic that is what the school is for. You were expected to find learning opportunities anytime you could. i was lucky I worked in a very high acuity Stepdown ICU as a tech for the last year of school and was able to do many things other students had never seen or done. Iwas able to help doctors with bedside procedures like chest tubes, arterial lines, central lines etc. I was given opportunities to do CPR, put in foleys and NGT with the guidence of the nurses I worked with. I am sure this is not the norm. But I sought out these oppotunities but I am the exception to the rule.

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