BSN program only requires 10 clinical hours per week. Thoughts?

Editorial Team / Admin · Feb 11, 2017

The state BON sets the criteria for how many clinical hours are required. As long as your school is at least meeting that, the program isn't going to have any issues.

However, facilities have figured out that they do indeed have to teach new nurses how to be nurses once they start working- it's one of the reasons new grad programs exist. It's not unique to your program.

Hailie54 · Feb 11, 2017

Thank you for the response! It makes me feel better knowing that it isn't just my program. I enjoy my program and have great instructors that really care and want their students to succeed. Just wanted to get opinions on how nurses would weigh the value of clinical vs. theory hours when preparing to be an RN.

Sweetheart2005, ASN · Feb 17, 2017

There's a group of students that come to my work from the local community college. (Associates degree) They have one clinical day and most of them will give meds to one patient do an assessment and then just do their clinical paperwork throughout the day. I have no

clue how they are going to make it on the units. The instructors are even concerned and talking to their administration to try to have them do more of the paperwork a at home so they can be active on the floors to at least observe more.

As long as you are being well

exposed and making the most of your clinical day, it will prepare you for the expectations an employer would have for a new grad. I had two clinical days a week during school. I was out of school about two years. Did the associates route. I never placed a foley and I only did one or two straight caths. Never attempted a feeding tube during school or had it in my orientations my first one I grabbed my charge nurse and told her I never did one before and asked to be walked through. There are absolutely things you won't be ready for but employers expect the limited experience for new grads.

umbdude, MSN, APRN · Feb 18, 2017

My program had about total of 820 clinical hours (some students had more). We had a final-semester practicum where we spent at least 170 hours 1-on-1 with a preceptor, 10-15 hours in discussions, and that was over 10-12 weeks (at least 2-3 shifts per week). I think most students found it enormously valuable. Towards the end of that semester I was practically doing most of the RN's work. Both clinical and theory are important. But PPs are correct that employers know they need to train new grads.

MountaineerFan57, BSN · Feb 18, 2017

My BSN program, which also has very high NCLEX passing rates, is also set up this way. Junior year we only have clinical ~9 hours, once a week. During our senior year, our clinicals are one 12 hour shift a week working with a preceptor. Some of my classmates and I are also feeling the same way you do, like we are not practicing skills enough. However, we have been reassured by seniors that you get much more experience with the preceptor senior year and as someone above me said, new grad orientation is prepared for us to have very limited experience.

Best of luck to you through the rest of your program!

applesxoranges, BSN, RN · Feb 18, 2017

It's pretty common. Unless you are in an ER or an OR, how often do you insert foleys or IVs? Not very often. Some places no longer routinely swap out IVs so they may have a single IV placed the entire time they were in the hospital. Foleys I do maybe once every two weeks in our ER since the hospitals are moving away from foley insertion unless really needed. NG/OG? Rarely unless they are intubated. Oh, and except for last year when this one nurse inserted about 8 NGs and I did two for him because he complained in his 30 years of nursing he never inserted so many NGs.

Heck, we had an ICU nurse orienting in the ER who said she was horrible at IVs since most people they access ports or had IVs placed by the ER.

My sister called me almost daily when she first started. She cried one day because she pushed zofran from the top port instead of the one closest to the hand. I had to tell her that the med would still reach them, would take a little bit longer (fluids were running at 125 ml/hr so probably like 15 or 20 minutes).

AliNajaCat · Feb 18, 2017

.... I am beginning to worry that we will graduate without even attempting yet being somewhat competent in basic skills that we will need to perform as a new nurse. I hear people graduating the program without ever inserting foleys, feeding tubes, etc. Is this lack of clinical preparation a common thing? I feel like the program is so concerned with NCLEX pass rates that they ignore the clinical portion. In all honesty, I believe that this intense focus on theory and testing will be detrimental to both to us as new nurses, and the patients that have to take their chances with someone who has barely gotten their feet wet in Nursing. I would love to hear others' opinions on the matter, perhaps this is normal or I am not seeing the full picture?

This is normal and you are not seeing the whole picture, LOL.

This feeling is common because of the ubiquitous student focus on what they call "skills," which are in reality tasks. The lab check-off way of looking at what nursing is, is not reflective of reality. We teach tasks to lay people-- when there's a mother of a child on a home ventilator who knows how to suction her kiddo's trach, is she a nurse? Is the guy who does his own peritoneal dialysis a dialysis nurse? Is the spinal cord injured person who self-catheterizes q4-6 hours a nurse? No, of course not.

Yes, it's good they expose you to these things in lab; the commonalities of sterile procedure, nursing assessment, and what's expected when a piece of gear is needed will carry over into a lot of situations. This is that "theory" that it's so fashionable to mock, when in reality there can be no knowledge without theoretical backup.

However you feel, the fact is that when you are new graduates you will have barely gotten your feet wet. You won't be competent providers for every, or even most, patients you lay eyes on in your first weeks and months. You will have ample opportunity to say to your preceptor or another colleague, "I was great in sterile technique in lab, but I've never done X. Can I describe the procedure to you and ask you to come watch me to be sure I do it OK?"

Never fear, both the Board of Nursing that sets acceptable number of clinical hours and the facilities that employ new grads are well-aware of your limitations. It will be in their best interests to be sure you get oriented, precepted, and evaluated on an ongoing basis to be sure you will become safe practitioners of the art and science of nursing-- and keep the patients safe.

Graduation and NCLEX is just the first step over the threshold. Remember that. Just the first step of a journey of many thousands of miles.

Hailie54 · Feb 22, 2017

Thanks for the reply! One thing I am good at doing is knowing my limitations and asking for help, so hopefully that'll keep me out of some trouble as a new nurse, lol.

Hailie54 · Feb 22, 2017

Sweetheart2005,

(For some reason it's not letting my reply to your post, so sorry if this ends up in the wrong spot)

You hit the nail right on the head with the emphasis on paperwork during clinicals. Last semester, (which was my first semester with clinicals) there was a HEAVY emphasis on paperwork. We had to complete a 12 page long care-plan on each patient and had a multitude of other assignments to complete throughout the semester. This left us little time to shadow a willing nurse or see each other's patients to learn about the different disease processes up close and personal. Mind you we weren't on the most student friendly unit, never received report from the nurses, and pretty much had to bully our way into assuming any kind of responsibility for our patient's (nursing) care, which may have also factored in to the heavy reliance on getting spots at the few computers available to students.

This semester is the opposite, I get report from the nurse and aunt spend about 20 mins fishing around in my patients chart to get acquainted with their history, meds, and labs and then I am off caring for patients the rest of the day. The paperwork load has been reduced by a good 70% and I have learned SO much more this semester and feel such a relief to be able to fully engage in the clinical experience without having mounds of written assignments looming over my shoulder. I don't think care plans are a waste of time like some others do, but it's a major waste of time to spend half of the day getting kicked in and off of computers during valuable clinical time trying to get the info needed to complete them. Thanks for your input!