Critique of Nursing School

Many nursing schools are mediocre. They are dropping the ball on teaching unifying concepts, which are so key stimulating and solidifying learning. Oftentimes, they are not teaching period. And the chance to gain clinical experience is often lacking. Nursing Students General Students Article

Having seen so many pitiable messages thrown up on this board from desperate students barely surviving nursing school, I wanted to give my two cents worth from a less immediate and frazzled perspective. Let me say that I understand that I'm generalizing. I don't believe for one second that all nursing schools are like mine was, but it seems like many are. And that is something to be concerned about.

For those who are serious about learning and who want to become nurses to apply that learning, nursing school is, by the looks, sounds, and experience of things, maybe not the best place to be at right now. Unfortunately, it is the only game in town nowadays and that's because it's all about the road to NCLEX.

Concepts are poorly explained or else, as I have experienced and seen discussed countless times on allnurses.com, incorrectly explained, or not explained at all. Conceptual understanding is the axis on which much acquired learning swings. Without identifying key concepts, teaching, and learning key concepts, knowledge is hanging by an insecure thread. And it is exactly here - teaching unifying concepts - that nursing schools gracelessly bow out of the game.

The majority of teachers now in nursing schools are not good. Is this why there is a nursing shortage?

The personal stories of weekend activity, the bragging, the pointless anecdotes and meaningless aphorisms - all students who are subject to these monotones are to be pitied for their wasted time and the fatigue of enduring them. Instead of the weekend stories, instead of the dull lazily-delivered aphorisms, why don't they teach? That is exactly the question. Is it ignorance or laziness? (Or, is the problem more structural in nature? More on that later.) More within the realm of realistic possibilities for the student, though, is the question, why don't they - the students - protest? The answer is complicated - one, it's generally a two-year program we're talking about, with a pace that is not to be believed, which leaves students with hardly any time to warm dinner, much less launch and sustain a protest. Often a faint, last hope, the evaluation system at these schools is often broken. In addition, there is the reality that often the professors are good buddies with the nursing school directors (at least the ones who want to make sure they keep their jobs are), so there's no barking up that tree. As with so much, it all comes down to leadership, and there just isn't any. The 'dons' appear to be fairly well cut off from reality.

The teachers as far as I can tell have graduated from the do as I say not as I do university, the same one that imparts a teaching style of - guess what I'm thinking right now ? For example they may throw out a question about heart failure, but inevitably it comes off as sounding like, "what am I thinking right this second is the key thing you should know about heart failure, and if you don't guess what is in my mind, I will say something to strongly imply that you all are not trying or don't know jack?" And then, that's it. There's no further discussion about why that thing the professor had in his/her mind was so important. There's no building on knowledge.

From what I can tell, there is scant teaching anywhere these days, and the cottage industry of nursing "strategy" packages is a booming one indeed, complete with the hard sell and slick language of snake oil salesmen. The fact of their existence absolves nursing schools of not teaching key concepts. Yes, nowadays, you cannot be so naive as to think you can simply enroll in a pricey nursing school, can you? No, you must also be taught separately by Hurst, or Kaplan, Simple Nursing or HESI. Our nursing schools are following and cribbing from them. What does this say about our nursing schools? Not much.

There used to be good nursing schools, ones with great reputations. But I must have missed the news: at what point did these schools decentralize and hand their knowledge, power, and organization over to Kaplan, HESI, and the others? Why in the world did anyone allow this to happen? The problem with weak nursing schools, among so many, is the application. There is very little applied learning in weak nursing schools (clinical rotations), which just makes the learning that much weaker as well. And it skimps on training.

Did my school do a good job preparing students? No. They were disorganized, detached, demoralized and chaotic. But, the staff and professors could also be sociable, personable, and nice in the very fleeting attention given to individual students. But only a tiny number of them (1 or 2) truly went out of their way to make sure they covered the material as well as they could. The others were either not up to the task but tried in their own way, or else they did have the intellectual skills but for one reason or another decided to fall back and not put in the effort. With some of the others, you could tell that they didn't know the material well enough to answer questions. In fact, asking questions was frowned on. The prevailing attitude among the staff was that it was no better than when they went to nursing school. In other words, they were fine perpetuating a mediocre system of learning. Our nursing schools have become nothing more than places where you can study on your own in order to take the NCLEX. Teachers are not needed; only monitors are needed because that's all they do anyway. You will be teaching yourself all the way through.

In addition to mediocre teachers, students must also contend with materials that are internally inconsistent and workbooks with incorrect answers, the final cruelty to the struggling student.

Now, just to show that I am not a total jerk, I will ask the question: or, is the problem structural in nature? When you consider the ratio of volume of material covered to class time, it does make you pause and wonder. What happened? Was it always like this? In whose mind is two and a half classroom hours per week covering 300 pages sufficient? What exactly is the point of those hours? Maybe at some school it was worth it, because key concepts were explained and expanded upon, but not at my school. There was also the issue of students who did not put in the time to learn the material. Obviously you cannot put that over on bad professors. But bad professors nevertheless exist. To what extent one enables another is an open question - but one for another time.

What to do now?

To the majority of nursing students outside the age range of 18-20, honestly I don't know what to say. So I'll address the moms and dads out there because it's the young students that I feel have the best chance and the most hope of getting the most from nursing education. If you happen to be a mom of a teen who really wants to be a nurse, I recommend scouting out the best BSN (not RN) programs in the country and start preparing her or him now. Find good nursing schools, more than one, more than four, and start planning. Now. Unfortunately many well-known and good schools of nursing have shut down. Inadvisably. Maybe the administrations at their universities wanted to play up the 'sexier' programs, and failed to realize the power of a good solid nursing program, much to the chagrin of the longtime nurses and doctors who taught there, no doubt.

But getting back...How can I nutshell this at its most fundamental? (This goes for young learners and adult learners alike.): Find the programs with the best teachers. If you find good teachers, and you are willing to work very hard, you are all but there.

Specializes in Medical-Surgial, Cardiac, Pediatrics.

I was with you until the BSN specific point. For many in rural areas (like where I live), the closest BSN programs are hours away, and usually cost twice as much. There are more ADN programs available that are accredited and produce quality students than BSN in my area, and yes, it's an alternative track that might take longer, but there isn't a reason to discount quality ADN programs that encourage continuing education over distance. Rural areas need nurses, and sometimes the only way to guarantee that is by having LPN/ADN programs.

Though I do agree, there are systemic issues with schools involving lack of student advocacy, traditional methods that have negative impacts, and lack of support from the surrounding communities for new grads. Those are issues everywhere, regardless of the type of program.

Out of curiosity, if they were 2 good schools you attended, then why did you attend 2 instead of one? Just curious

I 100% agree with this topic.. There needs to be some revamping with some of these nursing schools. Just because anyone had a positive experience doesn't mean all nursing schools are like that. And it's crazy to blame the student if they have a legitimate complaint about how things are run at nursing schools. You don't have to graduate and have a RN liscense to know that nursing schools need to re evaluate some of their teachers... It's common sense! Personally I think a student should be able to ask a question and have it answered with why a technique should be done a certain way. The book isn't going to tell you that and it gives the student a clearer understanding:)

Well, since I can't speak for any other nursing program but my own, not sure how much significance my opinion has, if any. But wanted to say that I couldn't agree more and I was largely disappointed with my nursing program. I'm not kidding when I say i'm learning more now studying for the boards than I did in my clinical rotations.

Specializes in Bloodless Medicine, Hospice, Holistic.

Wow, I did not know you went to my school. Oh wait, it was almost 2 decades ago that I got my degree. It could not have been the same school. While I agree with you, there is a problem with this thinking. Let me explain.

I do believe it is a multifaceted problem. Precepting those coming out of schools, it is apparent that many were not taught critical thinking. This is a problem that goes back to high school. Forget critical thinking, we were not taught to think. It seems obvious that we all know how to think but as a professional, do we really.

Once when managing, I saw a patient with pain in his contracted hand, most likely arthritis as it only appeared when it was raining. The relatively new nurse in a SNF, on being told of the pain, drew up some acetaminophen. On asking why, she indicated that it was all that was ordered. On asking if she questioned the doctors orders, she said no. Forget questioning the doctors orders, even questioning whether acetaminophen even worked (three studies show placebos work better) was the bigger issue.

A quick call to the MD and on his request, a suggestion, (yes, become an expert at something and doctors will ask your opinion), we put the patient on a combo of siniment and baclofen. It worked. I learned this because when things did not work, I started asking what would.

Here is the problem. How did some of us get to the point where we are even though we went to the same schools. At some point, it is up to us as students. Although I did have a pilot program called Critical Thinking in High School, there are others nurses who went to the same nursing schools and in spite of the school,became incredible clinicians. They learned to think.

How did they / we do it, in spite of the school.

Specializes in CRNA, Finally retired.

There are no mindless papers; only mindless writers.

Wow so many emotions, experiences and disappointments have been shared amongst the original post and replies. I too felt a lot of these issues during my PN program. Since I am not a "spring chicken" I feel I might be a bit more discerning than some of the younger students who have fewer life experiences to draw upon for comparisons of professionalism. I will not continue with the same school if I decide to complete an RN program even though the ADN instructor is the only one in the department with any actual teaching talent. There was too much contradiction between lecture and text that I felt the instructors hadn't prepared for class other than reading the slides. They didn't even value questions trying to lead them to correct their contradictions between the text and what they said. Fortunately I had one compatriot student who kept reminding me to keep my mouth shut. I felt their requests for questions were insincere when I realized they didn't know the answers.

I enjoy learning and don't mind the difficulty, however when the instructors claim we needed to cover certain material on our own (more than one instance) I felt the program was not very thorough. I paid for this program and expected it to be complete. If there needs to be more classes/hours then the program should be modified, especially since my school prided themselves on their NCLEX pass rate. It is not the school's pass rate since the students were advised to follow-up with other programs i.e. Kaplan, Hesi, ATI, NCSBN Learning Extension, etc.

Some of these NCLEX prep programs cost a lot of money. The one recommended by our school was a good review covering some of the material left out as previously mentioned, but the practice testing section had pitiful rationales (if any at all), circular explanations for "Test Taking Tips," and expected the student to be a mind reader of where the question was leading. This same program cited sources none of which were more recent than four years old and some 10 years old.

Also during my PN program we learned of the phenomenon of "nurses eating their young." This was vehemently discouraged as an approach in future practice, however, I felt it in regular treatment from our instructors. This was not the case with other nurses during clinicals. I wonder if this falls under the category of "this is how it has always been done." Well, that is one of my greatest pet peeves-life is about what happens, growth, learning, experiences, change. We change our underwear, hairstyles, diets, cars, you name it life is about change. Why can't nursing education change to include compassion for students as human beings or to advocate more of what is taught - like therapeutic communication. Why are students less deserving than patients? Why do we not tell a patient "everything will be fine" whereas more than one instructor has given false reassurance.

I have many more emotions resulting from experiences during my PN classes including a few positive ones. I originally came to allnurses.com this evening to find support for a different issue but NormaSaline's post caught my attention. Now I feel some relief.

wow grandmabutterfly! Did you go to my school? It sure does sound exactly like the program I went to! It was a total complete disaster... and people (including the board of nursing) act like these situations don't even happen... haha... figures!

Specializes in Bloodless Medicine, Hospice, Holistic.

I have to say, the nursing boards were a breath of fresh air. The tests were grammatically correct. I was done with the LPN in the minimum number of Questions. A few months later when I sat for the RN (I did classes back to back where I could) it ran me through all the questions. I thought I had aced it but the questions kept coming. We were told that a percentage of tests would be automatically the full number. I passed either way. Those tests were the only bright spot for me.

Specializes in Med-Surg, NICU.
But your MSN instructors sure can write a mean paper in APA format. Nursing education (both ADN-BSN and MSN) needs to be revamped to EXCLUDE mindless paper writing.

Yikes.

Huhh. I had a very similar experience to that of NormaSaline and ChemStickPro, only in PA school. It was to put it nicely, a horse and pony show. You know something is wrong when resident instructorS (plural) say "I don't know what you need to learn. I'm just here because they told me to." Or when a professor teaches something only after reading an intro book and cannot answer of your questions because he himself is a novice. Anyways, I'm just venting.

Don't pick a school based on some rating from US News! Just because a program is old and established doesn't make it good. Pick a school because of it's good reputation from those that have been through the program. Speak to faculty and students who are able to provide constructive criticism in addition to praise for the school that pays their salary or hands them a degree. Speak to the director of the program! If something doesn't feel right get on the web and ask questions.

Your money. Your time. Your well-being and sanity. You future ability to be a good clinician are on the line! So choose carefully.

I definitely agree with the original poster on the part of the nursing prep industry. It goes to show you how capitalism has eroded the educational system and allowed these private corporations to profit from standardized testing.

My problem with the prep programs like Kaplan is that many of them actually freaking work. But unfortunately they are obscenely expensive especially for working class students. It's a travesty!