$0.02 from an aspiring nurse

[smartassmommy]

I've read so many posts and comments here about how badly prepared so many new grad nurses are. The cost of training new grads is the main barrier to so many job searches.

One day, I stumbled upon a post about diploma trained nurses. Over and over, I saw the same theme, hospital based training produced nurses who could "hit the ground running" fresh out of school, had plenty of clinical experience time, and didn't need to be taught "how to be nurses", because they had learned that in school.

Perhaps it's time to bring the training of nurses back to the hospital. A hospital diploma could become a pre-requisite to going on for a BSN. Not to mention it would be a revenue source for hospitals crying poverty!

Any thoughts?

[RNperdiem, RN]

I would vote no.

The system existed mainly for the benefit of the hospital.

When the diploma system was started, students staffed the hospitals and they worked long hours. The only real paid nurse employees were supervisors who doubled as instructors. This was nearly free labor for the hospital and the educational needs of the students were subordinate to the staffing needs of the hospital.

[ED Nurse, RN]

Ummm my BSN program prepared me exponentially for real world nursing. I spent just as much time in the hospital as non BSN nurses do. If you're an "aspiring" nurse I would stick to what you know- which is nothing about being prepared post schooling.

[roser13, ASN, RN]

I would vote no.

The system existed mainly for the benefit of the hospital.

When the diploma system was started, students staffed the hospitals and they worked long hours. The only real paid nurse employees were supervisors who doubled as instructors. This was nearly free labor for the hospital and the educational needs of the students were subordinate to the staffing needs of the hospital.

This. And because of the nature of the diploma programs (massive bedside exposure), no one would enroll. As it is, a tremendous number of new grad RN's have no desire to ever work bedside. RN is simply a step on the road to advanced practice.

And some new grads are simply special snowflakes who don't plan to work week-ends, nights or holidays. They would simply melt in a diploma program.

[TU RN, DNP, CRNA]

I conditionally agree with the OP's proposal that nurse training should be shifted back to hospital-based diploma programs - the condition being that the individuals arent abused for their unpaid labor. I believe I once read their first time NCLEX pass rates are higher, as are their 5 year retention numbers. Even in my own personal experience the diploma nurses seem more natural in the role than my BSN counterparts (myself included). I'm sure it makes the profession look somewhat better to those in administration or academia to have more Bachelor's prepared nurses around, but what we do as bedside nurses (the majority of all nurses) does not require those extra nonsense classes. Then again the whole damn thing is a profit-generating machine, from start to finish, and we are the cogs. With how fat these patients are getting, I'd say the quintessential requirements for a nurse ideally should be more along the lines of those for the Marine Corps.

My unrequested $0.02 to you, "aspiring nurse," would be to "aspire" to be something else.

[llg, PhD, RN]

I would vote "No." For nursing to advance as a profession and discipline, nursing education needs to be grounded in educational institutions. The old model of employer-based education is not appropriate for the 21st century.

However ... that doesn't mean that a few aspects of the old diploma programs are worth saving. Many of those programs maintained high standards of professional behavior and would not be putting up with some of the lower standards that passes for flexibility and student accommodations today. However, they did not provide the academic education that today's nursing workforce needs.

There are many excellent nursing schools that prepare their students well for practice. Unfortunately, there are other schools that have lowered the standards and produce graduates that are not up to the job. The root of the problem is one of quality in individual programs and the lack of uniform standards that are high enough to meet today's needs. The root of the problem is not hospital-based vs. educational system-based.

[Nonyvole, BSN, RN]

OP, I'd suggest also looking at the role of the nurse back when it was mostly diploma programs versus now. Nursing has evolved, healthcare in general has evolved, so while the concept and goal is a sound one, it would be difficult to put into practice.

Additionally, each hospital is different. Time was, one would study where they would practice, or they would eventually go to a similar facility. But these days? Hospital X I can push Propofol. Hospital Y I can draw it up...if the doctor will let me. Different computer charting systems. Different equipment, different staff roles...the list goes on.