Are Student Nurses Prepared for "Real Life?'

RedhairedNurse, BSN, RN · Jul 7, 2008

Exactly what my BSN program does -- it focuses very very heavily on critical thinking and gives us the knowledge to think our way through a situation.
There are many hospitals around the country that have done away with hiring ADN nurses for this reason (I have nothing against ADN nurses) but it is a known fact that ADN programs focus very heavily on skills and less on the theory and critical thinking.

Very wrong, IMO!! We didn't focus heavily on skills. I wish we would have though. Our focus in my ADN program was critical thinking and lots of critical thinking exams! Pathopysiology was a really big think in our program. Knowing lab values....just lots of critical thinking. We were trained to see the "BIG PICTURE!" LVNs are taught to focus on task oriented skills, not critical thinking. I have a friend that just bridged to her RN and that's what she said the difference was between an LVN and RN

RedhairedNurse, BSN, RN · Jul 7, 2008

I disagree...although I am still in school (and I am in an accelerated program BSN) we are in skills lab EVERYDAY I have already had mastery check offs on SQ, IM, PO, topical, TPR BP, NG tube, Ted hose, IV starts, priming and hanging and IV bag, and we do Foley's this week.
One of my classmates started an IV on our 3rd day in the hospital. on his first try. And we've only been in school a month.
PLEASE, PLEASE, PLEASE don't start the battle of ADN vs. BSN.....

Just a healthy discussion, I think. I'm not trying to battle with anyone,although I see where you're coming from. Some people just need to be educated on the truth. From what I hear, the BSNs don't get any more pay where I work.....just more opportunity to go into management positions.

I would actually like to go for my BSN. I think it's great! I just chose this career in a mid life change and wanted to start with ADN. I really just started learning though....because actual nursing is NOTHING like nursing school. Much more hands on in real life, but just like anything else, takes practice to get good and really learn the art of nursing.

BradleyRN · Jul 7, 2008

In my state, only 7 classes and more clinicals separate an ASN from a BSN.

1.Health Assessment (online) Lab-Classroom

2.Professional Community-Based Nursing (online)

3.Pathophysiology (online)

4.Pharmacology (online)5.Nursing Theory & Research (online)

6.Population-based Nursing Care II (online)

7.Transition to Professional Practice (online)

From: East Tn State University

3 semesters, all from home.

citygrl646 · Jul 7, 2008

well, I can only speak for myself, and while I had a decent amnt. of clinical practice and direct pt. care my school did not allow us to draw bood, do an IV start, etc so that's giving me anxiety. I am not sure if the hospital I will be at has phlebotomy teams doing that.there was such ad nauseum emphasis on "evidence based" medicine and lots of papers.....

but knowing pathophys well helps with critical thinking- (i.e. I noticed way too many c diff outbreaks on a floor I was on as a student and saw that most pts were on proton pump inhibitors as a prophylactic for "stress ulcers" i asked a nurse why they did that since it seemd to me that it was contributing to the c diff outbreaks-she gave me a look like i was an idiot/out of line and said "evidence base"-I looked it up and recent research shows proton pump inhibitors can contribute to causing c diff).

so, while I can make an observation like that, I still get tegaderm stuck on my glove tips and have never inserted a foley, and worry i'll screw up Iv med settings or deluge my pt with deadly air bubbles

Tweety, BSN, RN · Jul 7, 2008

I don't think just because one student made a med error it's necessary to worry about the quality of education students are receiving these days.

I agree that nursing school's job is not designed to prepare a nurse that's independent. I've yet to meet a student ADN or BSN that can handle themselves well without guidance and orientation.

It think whether or not hospitals prefer ADNs over BSN is more of a regional thing and the amount of nurses in the labor pool. There's a huge ADN school here that graduates 300 to 500 nurses a year (for some reason I can't remember exactly) so consequently more ADNs are hired by hospitals around here.

I think too there are regional differences as to which schools graduate the better nurses. I work with both ADN and BSN nurses and they both require the exact number of clinical hours, and I'm equally impressed with their skills and knowledge....which is basic and entry level. I understand in other areas BSN students have less clinical hours and visa versa.

Lots of good ADN vs. BSN discussions here: https://allnurses.com/forums/f283/

SillyStudent, ASN, RN · Jul 7, 2008

There are a lot of downfalls of some ADN programs focusing so much on clinicals and very little on the theory.

Oh, it isn't that the ADN programs focus very little on the theory....

They just generally focus on the theory that is required for practice. Stuff like nursing research and community health went out the window in my program in favor of more pathophysiology. They also did not teach a critical care unit, because they were preparing us for entry level nursing. (So, erm, I bought lots of books)

I would really have liked a community health unit, but you get what you pay for. :)

mpccrn, BSN, RN · Jul 7, 2008

students today don't get nearly the clinical they need to be functional as grads even in the broadest of terms. the students i've worked with don't even spend a full day on the floor! i LOVE the "shadowing" they do......talk about a complete WASTE OF TIME! how do schools expect to turn out grads when they don't give them the opportunity to take care of patients for an entire shift??? give me a diploma grad ANYDAY! :banghead:

flightnurse2b, LPN · Jul 7, 2008

i think alot of the reality of nursing is not portrayed well in school. i am a senior in nursing school and i dont think it prepares you for real life nursing at all. the students in my class whine and cry if they dont get a lunch break after 2 hours at clinicals and regardless of whether they are done or not, pack up their things and go exactly at the specified end time. they refuse to do certain treatments that make them lightheaded or gag. they leave the grunt work to the CNA's, and when they come upon a poopie patient hit the call light and leave the room.

not one of my instructors has said "hey, once you graduate you might not get a dinner or potty break for 12 hours. you might not clock out on time and you may be charting for 2 hours after your shift. you might get a patient covered head to toe in poo and have to clean it. you might get slapped by a patient. you might not have a CNA to help you. you might have more patients than you are supposed to. and doctors might yell at you and hang up on you."

as a nursing student, i truly think those are things that need to be said to nursing students. not to scare them but to show them what they are getting into and that nursing is definately not easy money. maybe that is a reason why so many brand new nurses get burned out so quickly is because they arent prepared for what they are actually getting into.

RN1982 · Jul 7, 2008

I do have to agree with you. Sometimes it is a complete waste of time. When I was in school, I just felt like the I was in the nurse's way. They seemed really annoyed with the nursing students there which really bothers me because they were students themselves. Why are nursing students looked down upon but not medical students? It's rather irritating. I never had one nurse in all of my clinicals say anything encouraging or nice. Some of the nurses were downright rude, saying "Hey you" instead of my name which was made clear by the badge on my uniform. Or I would get "It's my license". Ok, fine.

Jo Dirt · Jul 7, 2008

Many of the student nurses I have encountered lately appear to be ill-prepared for the real world.What is going on? What are these students being taught and prepared for? Ex: Student drawing up 5 cc of insulin thinking it's 5 units. What are they doing????

Mon dieu.

Mein gott...

This is so disturbing. I will say I believe a lot of nursing schools have greatly lowered their standards.

Passing the NCLEX means NOTHING, BTW.

I see some nurses who may as well be walking down the hall with a cigarette hanging out of their mouths. And when the employer has to hold off on their drug screens to let whatever get out of their systems (yes, they do this!) I think something is wrong.

flightnurse2b, LPN · Jul 7, 2008

I do have to agree with you. Sometimes it is a complete waste of time. When I was in school, I just felt like the I was in the nurse's way. They seemed really annoyed with the nursing students there which really bothers me because they were students themselves. Why are nursing students looked down upon but not medical students? It's rather irritating. I never had one nurse in all of my clinicals say anything encouraging or nice. Some of the nurses were downright rude, saying "Hey you" instead of my name which was made clear by the badge on my uniform. Or I would get "It's my license". Ok, fine.

i have been so far very fortunate with the nurses i have precepted with except for a select few. they have been very helpful and grateful for my help. but there have been some who act annoyed that you want to listen to report, or ask them about hospital protocol, etc.

but the thing is that many of the preceptors i have had are new nurses themselves and have fresh in their mind what its like to be the lowly student no one wants to talk to.

my preceptor graduated in january of this year from a BSN program. i am doing my acute care rotation on a spinal-neuro floor. the other night one of our patients had a violent seizure and i ran in, got the patient on his side, slapped in an IV, called the rapid response team, over rode the meds in the pyxis and handed them to the RN to push. the nurse i was precepting with was like "thanks for that, i kind of went into a panic and i have never started an IV".

so we went IV hunting and i helped her successfully start two IV's. then we sat down and reviewed the RRT protocols together and kind of had a two way pep talk. she told me she could write me a hell of a paper but when a rapid response is called she wants to crawl under a rock.

chowlover · Jul 7, 2008

Woah!!! Was the professor notified?