Are Student Nurses Prepared for "Real Life?'

oakbourne · Jul 21, 2008

I have also heard that universities and collleges don't prepare the instructors for teaching nursing students. Case in point: College instructor more interested in getting her PhD than teaching students.

Takes students to hospital to do clinicals and has to ask the nurses what to do? Instructor tells student nurses incorrect doses, skills and other important details. The school is at fault for letting an instructor teach who doesn't have the skills or motivation to teach and only cares about getting her PhD. This is WRONG and I feel sorry for the students because she failed the majority of the class and it puts the system in a turmoil.

jml444 · Jul 21, 2008

I highly doubt anyone came out of NS fully prepared to work. Although it sounds like some of the more experienced nurses here went through some magic nursing school that turned out perfect super nurses who knew everything and never struggled during their first year or two. I guess that school went out of business.

Love it!!!!! You would think that to be the case with the attitude's of some of the "seasoned" nurses. I came across so many of that type during my clinical rotations- they are a pain in the rear and should retire!!

jml444 · Jul 21, 2008

NewcdnNurse: That was very well put- you are so right, nobody is every fully "ready" for something that is brand new to them. The more experienced nurses need to remember that, think back to when they were brand new, have more patience and take new nurses under their wing to cultivate the new nurse, NOT to look for their shortcomings and criticize!!

Djuna · Jul 21, 2008

The transition from student to practitioner takes time. While I am not naive to think all experienced nurses will be supportive of new Grads, in my personal practice I always have and will continue to be a role model, an encourager and an advocate for these new nurses.

satie · Jul 21, 2008

I just graduated last yr and it is scary to be on your own. When u r on the floor and new to everything, no one supports, old nurse make fun of me (since I am the new kid there), they yell, they gossip and even lie to other nurses.... well what do u expect, other nurses dont' know anythign about me either...The sad part is, the older nurses do not realize how scare to be new on the floor, doing your own things, trying to fit in and hold our head up high (or trying to). Its HELL. I find only few remember whats like to be NEW. Its not like we do not know or remember our skills, it just the nurses do a GOOD JOB in making us doubt our selves. I feel sorry for everyone who goes through this hell with these unappreciated, selfish nurses and managers...

Pookababy · Jul 21, 2008

What I want to know is what insulin syringe holds 5cc's of medication? Standard U-100 insulin syringes are 1ml. Why would anyone use a 5ml syringe to draw up insulin? That's more than you would give to someone in an IM injection into a large muscle mass.

At least use realistic values of measurement!

But I do agree that nursing students are completely unprepared for the real world, as I am a nursing student with only one more year to go in my ADN program. However, I don't think that there is a way to truly prepare someone for what it is really like to be a nurse in today's world. Nursing is a science and an art. First you have to know the science, then you can worry about the art of nursing.

I truly believe that there need to be more bridge programs and a much longer training/mentoring period than is currently offered at most hospitals. Also, instead of throwing new nurses into a situation of having too many patients, which they are no where near ready to handle, they need a longer amount of time to cope with only a few patients a day until they get the hang of it, then you can add more patients on.

When I was a new waitress, which in comparison to nursing, is a breeze, I would get quite frazzled when there were too many tables for me to serve because I didn't have the experience to be able to "think on my feet" and multitask. Nursing, which is nothing but multitasking, is the same. You cannot expect a new grad to just jump right in and behave as a 15 year vet would. Its just never gonna happen that way.

-Kelly

MB37 · Jul 21, 2008

I think I'm pretty prepared for "Real Life," having lived in it for 29 years. Am I prepared to function independently as an RN? Not at all. I won't technically be a GN for 2 more weeks, but that's only because the ceremony isn't right after classes finish. I do, however, feel prepared to begin working, as a GN, at a hospital that offers me a good thorough orientation/preceptorship.

I went to an ABSN program. We were not allowed to push IV meds (except saline flushes) or really do anything with blood products, but we learned most of the rest of the typical skills way back in Fundamentals or early MS 1. I had NG tube insertion in lab last September, and finally got to try to put in a couple of Dobbhoffs over this past summer - I'd never even seen a pt with one until I'd been in the units for awhile. I've put in I think 4 Foleys, and started one IV successfully. That's a little sad, but I made a significant effort throughout the program to take every available opportunity. I had bad luck on some of my rotations - my MS 1 floor had mostly patients with central lines/PICCs, for example, which meant they didn't generally need IVs. I've never given an enema either, and not because I'm afraid of a little poop - they were rarely ordered for anyone as even a PRN, and it was never the first choice if we could try a PO first. I've put in a rectal tube...

I feel that my program definitely taught me to critically think, and I know the whys behind most of what we do, not just the steps to a skill. I wish we had more hands-on experience, but it's tough when we don't pick our patients. It still sounds like my experience was better than that of many - at least I got to try a few IVs, and I've drawn labs successfully a few times too. I haven't had only one patient since early Fundamentals or my first couple of ICU days, I've taken both ICU patients all summer. People with med-surg preceptorships took a full load by the end as well. I think I know when to ask questions, which is one of the most important things, and I always verified insulin with my nurse before giving it. Is it possible that your student also hadn't drawn up insulin before? The hospital I did clinicals at used the pens in most places, so I've only drawn up fake insulin in lab at school. I'm very aware that units are not the same as ccs, and of course she should have been as well, but have you never seen an experienced nurse do something blatantly unsafe? We just all hope it gets caught before it gets to the patient.

I know I need a ton more practice with my skills, and I'll have to get it while I'm working. I would love to take an IV course, or even spend a few more days in the ER just getting experience. I went to an accelerated program, but we get the same number of hours as the traditional students. It's all based on our credit hours - the program is only allotted a certain number by the state, and has to pay instructors from the tuition they charge based on credits. Without increasing funding, or having 20:1::student:instructor ratios at the hospital, we can't increase clinical hours. Sorry this got so long - just please realize that most of us students/new grads desperately want to learn and made the most out of school. We just didn't always have a hundred opportunities to try a procedure, and were lucky to get one or two in many cases. As long as hospitals realize this, and provide us with decent training from nurses who are willing to teach us, I hope most of us will have learned enough in school to make it.

harleyridingirl · Jul 21, 2008

I'm in an AD program and just finished Med Surg 1 and let me tell you, I gave baths to every patient I had whether it was a bedbath or a shower. I also made beds, got coffee, extra juice, etc. I too gave meds with my teacher watching over me and kept one pt from getting an extra dose of antihypertensive because the nurse wouldn't listen to my pt when she was trying to tell her she had taken her medicine from home that morning. I also caught a drug order mistake made by two doctors. My pt was getting over 200 mg of Potassium in one day and I realized one doctor didn't realize the other doctor had repeated the same order an hour earlier. I brought it to the nurses' attention but she just kinda blew me off so I brought it up to my instructor and she blew me off until I wouldn't back down. Then when she realized I was right I got a "good job". Isn't it amazing that it seems like the "good" nurses get the hardest patients and the so-so nurses get to skate? And PCA's..... there are great ones and then ones I wouldn't want taking care of anyone I know. What happened to treating pt's with respect and keeping them COVERED while bathing them, not just whipping the sheets off.... that is if they get bathed at all. Don't get me wrong. I'm 50 years old and have been out in the real world so I know how things work. I just think so many people in the medical field think of pt's like cattle to be run through the shoot. I know there are a lot of good nurses out there and I am not trying to offend anyone. I'm just telling you what I saw in 8 DAYS in clinicals. Sad for sure and GLAD I could make a difference to the 8 pts I had. :nurse:

DoBB · Jul 21, 2008

As an old diploma school grad (1970's OUCH!) who later went on to get my BS and MS (not in nursing!), I would like to add a little insight to this conversation.

When I graduated from school, I was VERY prepared for my job. My first week out of school, I was charge nurse on 3-11 on a med/surg unit with 1 other RN, 1 LPN and an aide for 40 patients. Of course that was pre-care plan days so we actually had time to care for our patients rather than plan it.

During my 24 months of training, I learned the skills in a lab and then had to actually perform each one at least twice on an actual patient before graduation. We were not sugar coated with 1-2 patients on our clinical days which started at month 2. Things were so ancient back then that we had to mix our own IV bottles and count drops to be sure that the correct amount was being infused. No pumps for us! Yes as freshman, the experienced nurses rolled their eyes etc but by the time we reached our senior level they knew that we were skilled and worked side by side with us. Of course, our nursing instructors were always present and very involved. They also made us shake in our boots or should I say perfectly laced white shoes :saint: but the end result was that we were very clinically prepared nurses.

I stayed in clinical nursing for 12 years moving from med/surg to ICU to head nurse etc and then moved out of the clinical arena to work in other areas of nursing which I continue to do today.

I will say that having nurses learn critical thinking, standards of care and other knowledge at an advanced level is very important but instead of decreasing the amount of time in those programs, the time should be increased to allow for additional clinical practice. Let students see and experience what the "real life" of a nurse is all about. Maybe then, fewer would be lost after a year due to frustration. I could never understand how the answer to the nursing "shortage" was to burden the already overloaded system with nurses ill prepared for the work at least at the clinical level! :banghead:

cuddlesrose · Jul 22, 2008

As a nursing student myself, I would have to say that no, student nurses for the most part are not ready for "Real Life" in my state it is not required for student nurses to be a CNA or tech before joining school. It use to be, now these men and women are told to go and "volunteer". I have been a CNA since 2000, I know some of what the job entails, so help me though if I hear another student say, "I am getting my RN so that I don't have to wipe butts" I will scream. Thanks for letting me vent:banghead:

azguyrn · Jul 22, 2008

There's a big difference from the late 80's/early 90's. I can see the difference of the shift away from diploma RN's. Those 3 year programs were basically all clinical. I don't think the ADN or BSN programs are providing enough 'realistic' clinical time, depending too much on labs. I think the biggest challenge I see with new grads is time management now.

PEBBLES1 · Jul 22, 2008

I am a student nurse and I have 5 months left before I am finished. As a student nurse, I don't feel prepared. I have had some bad clinical experiences. I am a Medical Assistant and I do have some patient experience, however and unfortunately, some nurses tend to forget they used to be a student and they weren't born a nurse. 1 example of a bad clinical experience was I had a nurse tell me on my 1st day with her, that if I wanted to learn, that I would be up her behind (she really used the A word) and that she wasn't going to come looking for me. Now granted we do have students who try to be slick but, I felt that she prejudged me before I had a chance to start. So I fixed her, every time she turned around I was on her back and heels. One time she turned around and almost kissed me. After awhile, she asked me to back up, I told her no because I wanted to learn. To make a long story short, when you have students on clinicals help us don't hinder. You as a nurse can tell the students who want to learn and who don't. When you encounter the slick ones then simply ask them Why are you here?