Curriculum for Diploma in Nursing

Altra, BSN, RN · Aug 25, 2006

I don't know about the curricula in the 80s, but I can tell you what it looks like now - I graduated last year from a diploma program.

Oh, and if you're researching this, you'll want to note that the dearth of diploma programs is a geographic thing - while there are some areas where they seem to have vanished, there are 8 within 50 miles of me here in western PA.

Our curriculum included 30 credits from a local university partnered with our school (university faculty, classes taught at our campus adjacent to the hospital): A&P I & II, microbiology, intro to psych & intro to sociology, clinical nutrition, 6 credits of composition & a computer applications class.

The nursing curriculum included fundamentals I & II, med-surg, and 8-week accelerated courses in peds, mother-baby, critical care and psych nursing. Final capstone course in nursing leadership/trends included 1 week NCLEX prep course and a 120+ hour clinical preceptorship.

Hope this helps. :)

elkpark · Aug 25, 2006

I attended an excellent diploma program in the early '80s. The SON had an arrangement/contract with a nearby liberal arts college so that all our non-nursing courses were offered through the college and were regular, transferable college credits. The actual nursing courses were taught at the hospital (in the separate SON building on the hospital grounds). We did most of our clinicals at "our" hospital, but also did clinical in other area hospitals and agencies.

I'm recalling this off the top of my head, not looking at a transcript, but we had Intro to Psych, Intro to Sociology, a year of organic chemistry (the same course the college chemistry and pre-med majors took), a year of A&P, nutrition, microbiology (one semester each), and a year of freshman composition. Nursing courses consisted of a year of Fundamentals (at the same time we were taking all the academic courses above), with two days of clinical a week, and then quarterly rotations through general medical nuring, general surgical nursing, OR, peds, OB, psych, ED, and critical care. For each of those rotations, we spent (Jr. year) two days a week in 4-6 hours of class, and 3 days a week in clinical, or (Sr. year), one 4-6 hour day a week in class and 4 days in clinical. We rotated through all shifts and worked up to carrying about half the patient load of the staff nurses. In OR, we passed instruments for six weeks and circulated for six weeks. School continued through the summers -- we got two weeks off at Xmas and two weeks off in the summer, and the "3 year" program literally consisted of 33 months of full-time school. It was extremely rare for any of the graduates to flunk boards (although it did happen once in a while :)), and, when we graduated, you could drop us down anywhere nursing was happening and we were prepared to do the job, without any extensive orientation.

There are many reasons why diploma schools have been eclipsed by the ADN and BSN programs, and there are multiple older threads on this board you can search and review to find discussion about that question. Although I am as big a fan of "more & better" education for RNs as anyone (I have since gone on to complete a BSN and MSN, and am probably not done yet), I do feel strongly that this is one of the (several) instances of nursing throwing the baby out with the bathwater. I am aware that, like anything else, there were good diploma programs and not-so-good diploma programs and I was fortunate to be at a good one, but I received a far superior education in nursing there to anything I've encountered in the several ADN and BSN programs with which I've been involved since then, not just clinically, but also in terms of critical thinking, ethical/legal issues, management/leadership, professionalism, and all that good stuff. I am, frankly, shocked at how little nursing students learn in nursing school these days, and cannot imagine why that is considered adequate or acceptable.

suzy253, RN · Aug 25, 2006

Elkpark: AMEN!!! I graduated a 3-yr diploma program in May, took and passed my NCLEX in July and am working as an RN (actually started working after school as a graduate nurse). My diploma program has been educating nurses for 100+ years so they're doing something right. Also have a 100% NCLEX pass rate for the past 5 years. It's a shame that there aren't more diploma programs out there. I've been told, and I truly believe it, that diploma grads 'hit the ground running'.

suzy253, RN · Aug 27, 2006

Hiya MLOS...long time no see! (I passed!!!)

imenid37 · Aug 27, 2006

MLOS and suzy congratulations! Elk park...you are right on! Let's start our own nursing program(LOL). I feel many new grads are ill prepared and we need them up to speed more than ever. Being clinically skilled, IMHO, is top priority. The nursing program should be supported by a variety of science and liberal arts classes BUT the main focus of the nursing program is nursing education. This includes nursing skills, nursing theory, and decision making/ prioritizing. So many new grads are ill-prepared and leave their first jobs frustrated because there is way too much expected of them for the level preparation they have had. It is ironic how the hospitals got rid of diploma schools because they cost too much. I wonder how much it costs to lose such a high percentage of new grads after spending thousands on their orientation. There is actually a new diploma program in Lewistown PA that started a couple of years ago. I don't really know much about it, but I think it was born out of a need for more nurses in that area. I did not get enough clinical time in my ADN program almost 20 years ago. I think they get less now. This does the students and ultimately the patients such a disservice.

km5v6r, EdD, RN · Aug 31, 2006

I graduated from a diploma program in 1984. At that time freshman year was spent split between the hospital and the local community college. The college courses consisted of pychology, sociology, organic chemistry, A&P with lab, nutrition, human development, English classes, and speech. Clinical was started the second week of school working basicially as a nurse's aide. Aides weren't certified at that point. After about 6 weeks of clinical we were allowed to take positions on the floors as aides for pay. Junior year was sent completely at the hospital with classes in various conference rooms. That year's focus was basic med/surg with ortho, neuro, recovery room/ICU and a little community health thrown in. Clinical for the most part was 7-3 but we also did 3-11's. Senior year was the specialty rotations of peds, psych, and L&D post partum. By senior year class and clinicial were daily with class in the units conference room. I remember a very specific checklist of clinical experiences had to be completed before you actually moved on to the next rotation. Our instructors hunted down pt's all over the hospital for certain task like inserting a foley or placing an NG tube. OB was my last rotation before graduation. I had completed all the class work, had more then enough clinical hours; my follow through Mom had a long over night labour; and had gone home a little early. I got called at home and told to get back to the hospital. My instructor was not letting me graduate without seeing or scrubbing in on a "normal" lady partsl delivery. I had seen forceps, c-sections, and several complications but not a normal delivery. I usually came around the corner in time to hear the baby cry. I made it in time for that one. When I graduated I was ready to hit the floor running and had a variety of experiences that prepared me for real life. Looking back the only area I would say that was not covered extensively was dialysis as the hospital didn't do dialysis and there were no dialysis clinics in town. Actually I don't think any of my instructors were very experienced in dialysis at that time either. The year following mine the school made some major cirriculum changes and revamped the whole program. They also changed right back when for the first time in the school history the board failure rate went up. I think 5 people failed that year. Most years no one failed. My year 1 person with severe test anxiety failed by a few points.

catlady, BSN, RN · Aug 31, 2006

I graduated from a Catholic hospital diploma program in 1985. The prerequisites were freshman English, psych, and sociology. We started with Fundamentals of Nursing, A&P, Microbiology, Organic Chemistry, and Nutrition. Clinicals began the first week. We started with two days and then worked up to three after a few weeks, and were never in clinicals for fewer than three days the rest of the program. We did basic rotations through all the disciplines the first year, and the second year we were able to pick an advanced rotation. Mine was OB and I saw seven babies being born. Of course, I've never worked a day in OB since graduation. :) Along the way, we also had classes in Pharmacology, Growth & Development, and probably some other stand-alone courses, but pretty much after the first semester the classroom content mirrored the clinicals. I got to do a few things like visit a day-care center for pedis, and go out on Meals on Wheels for gerontology, but pretty much it was all hospital based. The last month of the program we took a course in Professional Development where we talked about nursing management and did some career planning. In clinicals we were supposed to be shadowing the charge nurse, but on the floor I was given, the charge nurse had a patient assignment, so I got stuck with taking care of her patients and never spent five minutes with the charge nurse. My instructor dinged me for not meeting the objectives.

My school closed a few years ago, and even the hospital where it was based closed. We had close to a 100% pass rate every year, but they were fervent about weeding out people they didn't like or didn't think were going to pass. Every year we had a lot of "retreads," people who'd washed out their first year and came back a year later to try it again. They usually did quite well.

Edited to add that I wonder if we're filling out someone's school assignment...