bring back diploma they can function on graduation

[Susan Boff]

I graduated from 3yr diploma school 2weeks off in 3years We did everything charge nurse nights supervisor You name it double shifts no weekends off We didnt have an instructor with us At times we had the whole ward. Gave meds did dr orders called drs wrote notes gave report After graduation worked in ICU very confident..I had major experience.But the Rns with associates & BSN had no clue all book work & charting never did IV Foley hung blood or ran a code...big difference letters after RN mean nothing...experience.Wow Nurses in ER professionalism is gone...bring back diploma they can function on graduation

[Nurse Carol]

I think we may have to move to a somewhat hybrid model in nursing education. I don't think the BSN new grads are completely prepared but by the same token part of that is due to the lack of clinical space in hospitals. We want everyone to be using EHRs but don't give nursing students access to the chart in many situations. How can they fully participate in patient care if they can't review the chart very easily. The floor nurses are tired of dealing with students because they have them nearly every day from one school or another. I think the whole system need to be revamped to include more preceptorship or residency but at the same time going deep into the psychopathology and assessment and critical thinking skills that we focus on at the university level. The profession is evolving and patients are sicker, we have to change as a result.

[labordude, BSN, RN]

3 hours ago, Nurse Carol said:

I think we may have to move to a somewhat hybrid model in nursing education. I don't think the BSN new grads are completely prepared but by the same token part of that is due to the lack of clinical space in hospitals. We want everyone to be using EHRs but don't give nursing students access to the chart in many situations. How can they fully participate in patient care if they can't review the chart very easily. The floor nurses are tired of dealing with students because they have them nearly every day from one school or another. I think the whole system need to be revamped to include more preceptorship or residency but at the same time going deep into the psychopathology and assessment and critical thinking skills that we focus on at the university level. The profession is evolving and patients are sicker, we have to change as a result.

No one from any health profession is prepared to fly right out the door, doctors have residency, we are getting more and more of them for new grads and specialty changers.

If the floor nurses are tired of dealing with students, they can work at a non-teaching hospital.

You are absolutely correct that there needs to be more pathophys and other pathobiology, A&P, micro, etc but the decreasing assessment skill I've seen in students is a big concern. I'm a little less worried about critical thinking because some of that comes with experience but the decreasing amount of hands on patient care is absolutely an issue.

[Wuzzie]

15 hours ago, Nurse Carol said:

I think the whole system need to be revamped to include more preceptorship or residency but at the same time going deep into the psychopathology and assessment and critical thinking skills that we focus on at the university level.

Uh no. All nursing programs have this as a focus regardless of the degree obtained certainly not just "at the university level". ?

[Wuzzie]

12 hours ago, labordude said:

If the floor nurses are tired of dealing with students, they can work at a non-teaching hospital.

The use of "teaching" hospitals has nothing to do with nursing education. It is in reference to medical students/residents. I'm sure you are aware of this but nursing students do their clinicals at all sorts of facilities including hospitals that don't participate in medical education. I don't blame the bedside nurses for being tired of doing the work, for free I might add, that the nursing school staff should be doing.

[labordude, BSN, RN]

56 minutes ago, Wuzzie said:

The use of "teaching" hospitals has nothing to do with nursing education. It is in reference to medical students/residents. I'm sure you are aware of this but nursing students do their clinicals at all sorts of facilities including hospitals that don't participate in medical education. I don't blame the bedside nurses for being tired of doing the work, for free I might add, that the nursing school staff should be doing.

Forgive my overly generous use of the term, but the point still remains. There's a whole host of things wrong with nursing education that aren't going to be fixed by the school faculty alone doing more.

1 hour ago, Wuzzie said:

Uh no. All nursing programs have this as a focus regardless of the degree obtained certainly not just "at the university level". ?

The rigor and information presented in classes for nurses is often (and I just looked at 4 different random BSN program curriculums at big schools across the country) different than those in other pre-health professions. They are often designated as "for nursing majors only" and they are definitely easier than the full-on courses. Someone is going to comment saying "well at my school we take the same classes as the pre-medical, pre-dental" hence why I put often and qualified my statements. Programs can have it as their focus all they want, doesn't mean they are doing a good job of it.

[Wuzzie]

20 minutes ago, labordude said:

Programs can have it as their focus all they want, doesn't mean they are doing a good job of it.

That may be true but stating that BSN (University level was the term she used) programs are the only ones who teach things like pathology, assessment and critical thinking is utter BS.

[Wuzzie]

21 minutes ago, labordude said:

Forgive my overly generous use of the term, but the point still remains. There's a whole host of things wrong with nursing education that aren't going to be fixed by the school faculty alone doing more.

True but to tell nurses who are tired of the constant flow of students for whom they are defacto unpaid clinical instructors to find a different place of employment is a bit harsh.

[labordude, BSN, RN]

4 minutes ago, Wuzzie said:

That may be true but stating that BSN (University level was the term she used) programs are the only ones who teach things like pathology, assessment and critical thinking is utter BS.

You're reading into unnecessary details or small grammatical errors. It's about the bigger picture and these things not being taught well enough or deep enough at any level of pre-licensure education. If the goal is nurses with a better foundation in certain areas (patho, A&P, micro, etc), then the rigor in the beginning classes has to increase.

3 minutes ago, Wuzzie said:

True but to tell nurses who are tired of the constant flow of students for whom they are defacto unpaid clinical instructors to find a different place of employment is a bit harsh.

I will tell anyone in any profession to find another place of employment if they don't like the working conditions, it is not limited to nurses. They can absolutely try to change their current working situation and it may work or it may not, but the choice is available to seek employment elsewhere.

[Wuzzie]

Just now, labordude said:

You're reading into unnecessary details or small grammatical errors. It's about the bigger picture and these things not being taught well enough or deep enough at any level of pre-licensure education. If the goal is nurses with a better foundation in certain areas (patho, A&P, micro, etc), then the rigor in the beginning classes has to increase.

I'm not reading into anything when it is clearly stated word for word but I do agree that the rigor needs to be increased.

2 minutes ago, labordude said:

I will tell anyone in any profession to find another place of employment if they don't like the working conditions, it is not limited to nurses. They can absolutely try to change their current working situation and it may work or it may not, but the choice is available to seek employment elsewhere.

The working conditions for nursing are bad enough on their own without having to do another person's work on top of it.

[labordude, BSN, RN]

4 minutes ago, Wuzzie said:

The working conditions for nursing are bad enough on their own without having to do another person's work on top of it.

I'm legitimately curious when I hear this from people. What conditions that you are facing are so bad? In 13 years across multiple states, different specialties, shifts, hospital, etc I have had bad shifts, but never thought I had continually bad working conditions. This all being said, bad is pretty subjective.

[Wuzzie]

Yes, it is but nurses are being stretched to the breaking point with higher patient loads, higher acuity and higher demands. Top that off with being entirely responsible for the clinical education of nursing student after nursing student (I'm not talking about senior preceptorships) and it can be overwhelming. It's easy to spout off "find another job" but for many it isn't that simple.

[JKL33]

Quote

In 13 years across multiple states, different specialties, shifts, hospital, etc I have had bad shifts, but never thought I had continually bad working conditions.

Serious question: How might that relate to your preference for moving around?

I ask because I do think nursing might not be as overall difficult if there were never any external pressure to stay anywhere very long and become significantly involved in a facility or community--but, regardless of profession, that is not probably the most common way that people go through life long-term.

I can't speak for Wuzzie, but my view is that nurses seem to experience frequent demands that are out of proportion to resources and they are declared to have multiple far-reaching duties and responsibilities without the autonomy and decision-making authority that makes these duties/responsibilities legit. As a group we are regarded quite poorly by corporate employers despite the services that we strive to provide and the nature of those services. I think that's kind of the gist of it.

I will give you the benefit of the doubt, but it's becoming very difficult to take people seriously when they imply what you are implying. For instance, where shall people "get a new job" a large corporation may control this work sector across very large regions? It sounds like you're saying that if people don't want to live a rather geographically-wide nomadic lifestyle, well, that's their problem.