I'm an ADN nursing student in a community college (of course).
I'm in my last semester.
Here is the breakdown of my education thus far:
Semester 1, geriatrics rotation. Teachers didn't know they were teaching until days before. Given wrong syllabus and then finally got syllabus 2 weeks later... still from 1 year ago.
Semester two. We're in the hospital now. We get to pass meds. We're essentially given our own patients. We have access to the pixis except for narcs. We aren't really shown how to do assessments... we review it briefly in lab and then we have our own patients. We aren't shadowed by a nurse, we don't follow a nurse. Clinical labs are a joke. We're shown something once, and then passed, even if performing the task in a mediocre or poor manner.
Semester three. We can now do IVs, IV meds, IV pumps. Oh, ya... we don't have a pharmacology course in our program. Being consistent, we're shown once how to turn on a pump in lab and then we have our own patients. IVs: we demonstrate how to do an IV on a manaquin arm that has a vein the size of a pencil bulging out with a large hole already in it from the hundreds of previous sticks... pop the iv in once and we're turned loose. Instructors are often not present on the clinical floor working on the Master's degrees homework. Instructors for labs are often disorganized because they usually don't know they are teaching them until hours before.
Semester 4. We're told we would get our clinical assignments in August. Then mid August. Then end of August, then two weeks after that. 50% of the staff had just quit. We often have deadlines that are not met. We complained about this in semester two and were told we need to deal with it, because that's what professional nurses do, is learn to adapt.
My last rotation is in ICU. I somehow lucked out and got a nurse that actually shows me what I'm supposed to be doing. I've learned more in these few days than my entire education to this point. Many other students will not get a nurse like mine and will graduate behind the curve.
Other local colleges require you to demonstrate skills a few times in lab before they pass you. Not mine. Other local colleges actually have a nurse-preceptor for clinicals. Mine technically does, but they usually have their own patients and are off doing that while we practice... um... nursing?.... The clinical instructor is usually off in random rooms, or are studying on their own. They are available should we need them. I can't help but feel that we are students and shouldn't be left to figure it out on our own.
We are NLNAC accredited... not sure how... I'm wondering what I should do. Having a nurse show me basic clinical skills I should have learned a year ago makes me think we're producing unsafe nurses. And many in my class think the same. The program is disorganized, things change on a whim of whoever is in charge. Information is often not known by all the faculty. Staff often finds out late that they are teaching and produce learning material from the previous year, and dated from the previous year. Nothing is stable or solid, we have come to expect random changes. Schizophrenia is the basis for our program.
I would approach the leadership but there is an atmosphere of fear and retaliation. One of the top instructors has outright said she hates conflict and doesn't deal well with it... and has dealt with student that do. People that have spoken up in the past get 'dropped' from the program for various reasons.
People who technically fail a semester are passed on. Students have failed two semesters and are passed on. Apparently 3 is the limit as shown by students who had to drop for failing 1st, 2nd and 3rd semesters. What is the point of having a 75-83 be a C if you're going to pass students who fail.... and why curve it up for students who are actually reading their books and not hoping to get passed on...
That actually sounds pretty typical from what I've heard and experienced in my own program. During one clinical rotation, all the staff nurses went to a meeting and left us (students) to take care of the whole floor on our own.
In my final clinical, the class time was changed from 4PM to 6AM and the location was moved 30 miles away from where it had been. This was done the day after class started and presented as a "take it or leave it" sort of thing.
I could go on and on. The whole program drove me crazy, and it was hard to transition to a real job, but I'm figuring it out :) The real learning takes place after you start working. They just teach you how to not kill anyone in school.
It sounds like you're in a poor nursing program. The true test will be sitting for your NCLEX. You truly don't know much until you get your first nursing job. You can (and will) begin to learn once you're on the job.
It's unfortunate that you all seem to be suffering in your program, but if you acknowlede what you know and what you don't, then you can learn from this and move along and supplement what you lack on your own. Why don't you make a point of what is lacking to the program director (or dean) after you graduate, or risk stopping everything for you and everyone else who might actually be learning something and making progress?
Nursing really is a foundation. Not all start with the same background or educational breeding, but just as you progress in nursing, you will learn that even though education is available to you, not all nurses will rise to the occasion or perform to the same level of ability/ethical/moral obligation as you might. As long as your eyes and ears are open, you will learn what makes a good nurse. Even with all of those things, some nurses just don't have it. We all know some nurse that makes us cringe and wonder how they got through nursing school, how they passed NCLEX, and how they snowed someone into getting a job.
My nursing education was the most difficult thing I have ever done, to include having children and being in the Army. This includes basic training and Air Assault school. It was rigorous work. I consider myself lucky to have gotten through nursing school, and it wasn't the academic portion, it was more the testing of your mental fitness above all else. Perhaps this was more a testament to the program that I was in, but nursing school should be the most challenging thing you have ever done.
you're hanging IVs on living people as a student? That's SO illegal. refuse to do it!! Well, I think it is anyway, and if you don't know what you're doing, you shouldn't be doing it, even if it's allowed!
no, you DO place iv's as a nursing student. It's not illegal. ???? WHERE are you getting your information from...???
You carry insurance for a reason. A patient could refuse if they didn't want a nursing student performing invasive procedures, just as they could refuse a medical student performing a procedure.
Sounds like you had a problem from the beginning, I would have went to the administration with other nursing students to evaluate their instructors; it is NOT the responsibility of the hospital staff nurses to be your clinical instructors. The clinical nursing instructor is to supervise the students as they are practicing under his/her license.
a nursing student is assigned to a clinical nurse and then utilizes them, while also under the (less direct) supervision of the clinical instructor.
Try to graduate as soon as you can, take advantage of the blessings of having the ICU nurse precept you and thank God for that extra blessing so that you'll be ahead of the curve when you are a new RN.
I don't think these issues are that uncommon in nursing school truthfully. I think many just get a very rudimentary experience and then thrown to the wolves when they graduate as they realize they lack the finesse for technical hands on skills that takes practice!
I always encourage people to get into the healthcare setting before they graduate, even as a CNA in a hospital system and soak up all the learning experiences they can before graduation. Ideally getting a internship/externship that allows them to learn and practice and perfect nursing skills!
If you can do this it will give you an edge in the hiring dept and it will make your first year so much easier and maybe you won't cry yourself to sleep at night when you are faced with the realities of the job and the honeymoon is over!
Students need to take the iniative themselves to work outside of school and get the practical experiences they'll need to help them succeed and decrease the stress of real world nursing! Nursing schools typically don't provide real life residency programs, like medical schools due so its not uncommon for a majority of new grads to be clumsy and clueless!
Once you graduate than if you decide you want to go on for a BSN or NP you can do a more thorough evaluation of colleges to find one more suited for you, but in the meantime make the best of the program you're in now, especially if your close to graduation! Transferring to another school would no doubt cost you in time and money so if you can finish there you're probably better off.
Again you can take the initiative to get the practice you need as you are already doing and also you can study beyond the classes you are taking. Back when I was in school I used Nyclex RN board nursing exam review books to prepare for my school work and always did well on my exams and passed boards without any problems!
Great posts. I have several years experience as a CNA and as a BEC provider... while helpful, it is not nursing.
I like the post that suggests I send a letter to the director suggesting improvements. I might do that, but based on previous years nurses' experiences I'm not sure that individual will get past the first paragraph before it hits the trash.
I'm just flabbergasted at the responsibility we've been given (in hindsight). Should a 2nd sem nursing student have complete care of a pt.? IMO, no. We can't recognize the things an experienced RN can. I've been lucky enough not to have a pt. die on me.
Should a 4th sem rn student know how to start ivs, run an iv pump, flush lines, etc? Yes. Should every nursing program have a pharmacology program? Yes. Should I have been taught clinical skills? Yes. Why? Because it is in the best interest of the patient. That's what we're so big on is 'nursing care' and 'caring'. It really is a farce of an idea if programs produce students like mine. From the posts on here, its commonplace in many programs.
We should be ashamed of ourselves to allow this to happen. Yes, I will 'deal with it'. I am now learning the clinical skills I should have been learning all 4 sems. Not all of my peers will be so lucky. Yes, I will have to resolve to learn on my own and teach myself. It has been the name of the game in this program. Perhaps it is the advocate in me that fears what we are producing...
As a LPN I "teach" new Rn's how to be a nurse all the time. Schools teach you the bookwork. On the job is how you become a Nurse! Become a Nurse. Take on the job education from each and every person you work with. Remember, even the CNA might know more than you. I work with a CNA that has been one for more than 20 years. She can spot problems before many others. She doesn't have the schooling behind her, but she has knowledge. Soak up the knowledge.
you're hanging IVs on living people as a student? That's SO illegal. refuse to do it!! Well, I think it is anyway, and if you don't know what you're doing, you shouldn't be doing it, even if it's allowed!
A student nurse can hang an IV, she cannot hand blood in any way shape or form.
The only thing I don't get is complaining about the curriculum being a year old. I don't know of anyone that expects instructors to write up new teaching plans every semester, or even every year.
I can see how the hospital and clinical rotations are disheartening. I would hope there is some sort of lab, or instructor available to practice skills outside of class time.
luvazsun, RN
61 Posts
I would suggest a very good state board review class.