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Can nursing programs graduate practice ready nurses?

Nurses   (16,685 Views 90 Comments)
by dnsonthego dnsonthego (New Member) New Member

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DoGoodThenGo works as a Entrepreneur - Business Owner.

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IMHO the problem stems from an old debate within the nursing profession; to what extent is the practice of professional nursing a "practical' or "technical" one.

It is really a scary thing when you speak with current nursing students who have no idea where their hands will go as a RN and or that the job does actually involve *gasp* being up close and touching patients. There seems to be no small number that think aides and other UAPs will do the "grunt" work.

Pity of it all is that hospitals are now in the healthcare "business" and have started to follow that model. Much like elsewhere in the economy the ideal nurse/employee is one that has done exactly what a position requires before, or close enough to it that minimal training is required. You see this in many areas with the current bias towards seasoned nurses even if they are travelers over hiring new grads.

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Intention of the second post with link was not to offend, but to demonstrate what a typical diploma program was; am very sorry you are upset.

However still stand by the fact there is no free lunch when it comes to producing nursing school graduates with the clinical competence skills hospitals increasing are demanding. If they are not acquired in school they have to be gotten somewhere. It is quite clear many places no longer consider it their duty or job to do so; they will do what is required obviously but there are limits and it won't be on any large scale. Well not at least whilst everyone expects hospitals to pick up the tab for this post graduation "education" out of their own purses.

DGTG...thank you for that post. It was a trip down Memory Lane for me. It sounded so much like my own nursing school experience. The stories I could tell. I remember it as one of the most stressful times, and one of the happiest times in my life. We worked hard, but oh, did we have fun.

 

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2 Likes; 53,572 Visitors; 5,978 Posts

IMHO the problem stems from an old debate within the nursing profession; to what extent is the practice of professional nursing a "practical' or "technical" one.

It is really a scary thing when you speak with current nursing students who have no idea where their hands will go as a RN and or that the job does actually involve *gasp* being up close and touching patients. There seems to be no small number that think aides and other UAPs will do the "grunt" work.

Pity of it all is that hospitals are now in the healthcare "business" and have started to follow that model. Much like elsewhere in the economy the ideal nurse/employee is one that has done exactly what a position requires before, or close enough to it that minimal training is required. You see this in many areas with the current bias towards seasoned nurses even if they are travelers over hiring new grads.

I can't think of anyone in my graduating class who would have thought to ask about getting a "poo-free" job. My class was not just people right out of school: we had middle-aged mothers; a woman who was a VietNam vet and a cop; musicians; an artist...all sorts. We didn't live in a dorm, but we may as well have. Bunches of us would sleep over at another's house and have a big study group where we did some studying and a good more deal of foolishness.

 

What I remember most is that we all pulled for each other. We wanted to graduate, and we wanted everyone else to graduate, too. If someone was struggling, we'd help; this was true for classroom and clinical.

 

Sometimes I wish I had a time machine, just to go back there for a little bit.

 

 

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BuckyBadgerRN has 4 years experience and works as a Registered Nurse.

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Only 4 responses until this tired old arguement came into play. Is that some kind of AN record?

Or when nurse bullying comes in...making it hard for new nurses to thrive in fear of going to learn and being berated.

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Esme12 works as a emergency ,critical care,cath lab,open heart,traum.

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Or when nurse bullying comes in...making it hard for new nurses to thrive in fear of going to learn and being berated.
I have a quote that addresses this....

"Let me never fall into the vulgar mistake of dreaming that I am persecuted whenever I am contradicted".......Ralph Waldo Emerson

I think nursing needs to stop worrying about the cash cow and concentrate on graduating quality grads. I think hospitals need to look at student nurses as free help and an investment in the future. I think the three year diploma clinical model needs to be merged with the academic model and graduate competent new grads that have clinical experience and book smarts.

Unfortunately....so far it's a pipe dream.

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SaoirseRN has 8+ years experience and works as a Registered Nurse.

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I have a BSN, and while there was certainly much class room education, we also had lots of clinical time. The whole final semester was clinical practice. While I obviously didn't know everything when I graduated, I felt ready to practice. Of course I needed guidance and had questions, but I felt prepared.

The same program I attended (while it has been redesigned since I graduated) has continued to turn out some awesome graduates who are ready to practice.

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Only 4 responses until this tired old arguement came into play. Is that some kind of AN record?

When all else fails, pitch the rallying cry, "NETY!"

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Not_A_Hat_Person has 10 years experience as a RN.

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I graduated from an ADN program in 2008. Clinicals left a lot to be desired. Unless you were in very aggressive about doing procedures, at a facility that allowed students to do procedures, you spent the shift doing bed baths, vital signs, toileting, and ambulation. Basic nursing care is important, but that's not all nurses do, and it shouldn't be all that nurses learn. I managed to graduate without starting an IV, and doing 1 straight cath.

My med-surg rotation was at a rehab hospital where students would get the patient's vital signs, then get them up, dressed, and washed. Patients went to rehab after breakfast, leaving literally nothing for students to do until Glucose Smackdown at 11:00 am. One of my classmates had a complex med-surg rotation where students were only allowed to give PO meds.

I really wish more schools used the 1-to-1 preceptor model for clincals. It's really not the staff nurses' job to train students, and some nurses are not good teachers. My school had clinical groups of 7, which meant the instructor was often unavailable. In my last rotation, I was one of 7 students on 2 units, and my instructor was impossible to find.

When all else fails, pitch the rallying cry, "NETY!"

When I was a student, the nurses at 2 clinical placements were downright hostile to students. At the first, we were one of 3 groups that was there over 3 days. Our third week on the floor, the charge nurse looked right at us and said "Thank God you're here! We had the Weekend people here Sunday, and they didn't know crap!" (though she didn't say "crap") "They asked so many stupid questions! I don't have time for that!" She said it very loudly, in the middle of the unit. It didn't exactly make us feel welcome. That was the day our instructor told us to come to her, not the nurses on the unit, with questions.

My peds rotation was in a pediatric SNF. The nurses were LPNs and mostly younger than me and my classmates (not to put down young LPNs). Our first day, they spent the entire shift discussing whether or not one nurse should get back together with her cheating boyfriend, and whether another should rent her sister's house. I only know this because they literally spent the entire shift debating it. If I or any of my classmates asked any questions, we were greeted with sighs and eye-rolling, as if we were interrupting something important.

As much as people deny it, nurses do eat their young, especially students. I don't expect roses, but simple courtesy would be nice. Open hostility doesn't produce competent nurses. If that makes me entitled, so be it.

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Esme12 works as a emergency ,critical care,cath lab,open heart,traum.

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Moderator note:

This post is about graduating practice ready nurses.

 

Let's stick to topic.

 

If you wish to discuss how some nurses treat other nurses ans students please start another thread.

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Asystole RN works as a Vascular Access Specialist.

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As much as people deny it, nurses do eat their young, especially students. I don't expect roses, but simple courtesy would be nice. Open hostility doesn't produce competent nurses. If that makes me entitled, so be it.

I am sorry for your troubles.

This has its roots in the nonexistence of a formal, standard, residency program. Not every doctor teaches medical residents because it takes a certain amount of experience, professionalism, education, and personality to teach effectively so why do we expect every nurse to teach new nurses?

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Not_A_Hat_Person has 10 years experience as a RN.

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Many BSN programs in my area had nursing practicums, usually in the last semester. My school didn't offer one. I volunteered at a hospital while I was a student, and applied for a summer nursing internship, but didn't get in. I also tried to find a CNA job, but no one would hire me without a CNA certificate, and not even my advisor would tell me how to challenge my state's CNA exam. My options were the school's $1,500 1-year CNA program, or a $700 Red Cross course. I was already working and going to school full-time.

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kmclark has 22 years experience.

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Well, I must disagree with nurses not being ready to practice. I work in a teaching hospital that has an ADN and BSN college in the same community. I have heard many doctors say that the ADNs were better at bedside than the BSNs because the ADNs get more clinical practice. The push is definitely to get your BSN and Masters for sure. I don't understand this. If you take the same exam to be a RN and most places pay you the same money to start, why pay for 4 yrs. Most high schools in this area let the kids take some college courses which saves a lot of money for the parents. Go to a community college and get your ADN, then go on line and get ADN to Masters. You will be able to do and have a lot more opportunities. Plus, your education will be much more affordable. If you have been in any branch of the armed service it is 200-300 dollars cheaper per class on line. My daughter is an ADN, my son is an ADN, married a BSN. I told him he would have to stay home and take care of the children or go back to school. I have encouraged them both to go back. It is still true in our profession that the men advance faster than women too. When I got out of school and was hired I got a week of following my preceptor. Then I was given 3 pts, then 4, then 5, then six. By the end of 5 1/2 weeks they were ready for me to take my own assignment. Now, we have a 16 week orientation with numerous classes to prepare the new nurse. I would say at least 1/4 of nurses have no real desire to nurse they think it is good, easy money. Once they start a lot don't nurse long. Nursing is very long hours and hard work physically and mentally. Who started the rumor that the pay is so good is just not true.

Edited by kmclark
I didn't really want my name posted.

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