Design the Ideal Nurse

[zenman]

We had a thread recently about what ADN grads could do vs BSN grads. Let's change course and knowing what we know about today's workplace, design the ideal entry level RN. First, I found the below blurb from the NLN interesting:

History of the National League for Nursing (NLN)

Supporting Nursing Education for over a Century

1893 - The American Society of Superintendents of Training Schools for Nurses is created. This is the first organization for nursing in the United States of America. The society is formed for "the establishment and maintenance of a universal standard of training" for nursing. Ever since that remarkable stroke of courage and spirit over 100 years ago, the National League for Nursing has continued to be the leading professional association for nursing education.

http://www.nln.org/aboutnln/info-history.htm

Looks like this is something that has been going on for a while!!

This is free-style so just start throwing out what you think re nursing education, general education, length of program, clinical, skills, types of tests, etc.. Then, when we're finished, someone will compile it all together. Not me...I'm just getting the ball rolling. Maybe we can do it in less than 100 years!

To help, I've listed program info from NSU school of nursing in Louisiana because it has ADN, BSN, and MSN programs. I've included info from the Baton Rouge Hospital School of Nursing, also in Louisiana. You can list info from each, for ex., if you think something from the MSN program needs to be taught for entry level education, put it in. If you think something from other fields needs to be included, do so. If someone has a brief blurb about diploma and BSN history, please put it in. My books are packed in preparation for a move next week and this computer at work is so slow, I can't stand it!.

Associate Degree in Nursing

A two-year technical degree nursing education program that prepares graduates for basic nursing care in hospitals and long term care settings. Four semesters of clinical are offered at Shreveport and Leesville.

Purpose

The purpose of the Associate Degree program is to provide education experiences and opportunities, which enable persons to practice nursing within the identified roles of the associate degree nurse. General academic courses in English, Mathematics, Social and Natural Sciences provide the foundation for the nursing courses. Upon completion of the course of study, the graduate is eligible to write the National Council for Licensure Exam for R.N. (NCLEX-RN).

Program Objectives

Graduates of the Associate Degree Program of the College of Nursing will be prepared to:

1. Provide nursing care founded upon selected scientific principles utilizing the nursing process.

2. Assist clients to achieve dynamic equilibrium by facilitating the satisfaction of needs.

3. Communicate effectively with clients, their significant others, health care team members and citizen groups to promote, maintain and restore health.

4. Teach clients and/or significant others who need information or support for health.

5. Manage selected aspects of nursing care for a group of clients with clearly defined health problems.

6. Demonstrate accountability for actions as members of the nursing profession and expand individual knowledge and skills through avenues of continuing education.

History

Developed by Mildred Montag from her doctoral thesis, The Education of Nursing Technicians. Started at Columbia University, Teachers College in 1952.

Bachelor of Science in Nursing

A four-year professional nursing education program that includes liberal arts education preparing graduates for beginning nursing practice in a wide variety of settings including acute and long term care, community and school health and critical care. After three semesters of academic courses and acceptance into clinical courses, students must complete five semesters of clinical courses on the Shreveport campus.

Purpose

The role of the beginning professional nurse continues to encompass three broad areas.

1. Provider of direct and indirect care to individuals, families, groups, communities, and populations.

2. Designer, manager, and coordinator of care.

3. Member of a profession.

Program Objectives

To implement the role of the beginning professional nurse which includes providing care for individuals, families, groups, and communities the graduate will be able to:

1. Integrate theory from nursing, the arts, humanities, and sciences to provide culturally sensitive care in the global community.

2. Apply the nursing process using critical thinking, communication, assessment, and technical skills.

3.Collaborate with clients and other members of the interdisciplinary health care team for health promotion, risk reduction, disease prevention, disease management, and health restoration.

4. Utilize information and health care technologies in nursing practice.

5. Integrate research findings to promote evidence based nursing practice.

6. Incorporate knowledge of economic, legal, ethical, and political factors influencing health care systems and policy to advocate for recipients of nursing care.

7. Apply principles of leadership to design, manage, coordinate, and evaluate health care delivery.

8. Demonstrate professional nursing standards, values, and accountability.

9. Assume responsibility for professional development and lifelong learning.

Master of Science in Nursing

This program provides the student with a Bachelor of Science in Nursing the opportunity to develop advanced knowledge, intellectual skills and clinical competence necessary for the role of the advanced practice nurse. Areas of concentration include: Acute Care Nurse Practitioner (ACNP), Adult Nursing Critical Care Nursing of the Adult, Family Nurse Practitioner (FNP)

Maternal-Child Nursing, Mental Health-Psychiatric Nursing, Pediatric Nurse Practitioner (PNP), Neonatal Nurse Practitioner (NNP) and Women's Health Nurse Practitioner (WHNP).

Master's Curriculum Purpose

The Graduate Studies and Research in Nursing Program's purpose is: to provide learning opportunities for development of knowledge, intellectual skills, and clinical competence necessary to fulfillment of the role for the practice of advanced nursing, to provide learning opportunities for the development of skills and knowledge to function as an educator, an administrator, a clinical nurse specialist, or a nurse practitioner and to furnish a foundation for doctoral study

Program Objectives

1. Practice nursing utilizing advanced knowledge and skills as evidenced by scientific thinking in the use of theoretical formulations in the design of nursing interventions, and self-direction in the exercise of leadership involving health care problems.

2. Consider cultural diversity of clients and practice within ethical principles and standards.

3. Function as an advanced practitioner of nursing with people of all ages and their families, utilizing critical decision making, logical thinking and reasoning through advanced knowledge, skills and clinical application.

4. Demonstrate independent-thought and action, professional autonomy, and effective communication in collegial and collaborative relationships with peers and with members of allied disciplines.

5. Function independently in providing nursing care and interdependently with other health professionals in the coordination and delivery of health care to individuals, families and communities.

6. Implement effective strategies for management and utilization of health information to improve quality of care, contribute to the development of nursing knowledge, and facilitate interdisciplinary communication in support of the business of health care delivery.

7. Implement the research process within the context of Evidence-Based Practice as a producer and consumer of research evidence to contribute to nursing theory and improve nursing practice.

8. Analyze the needs of health care delivery systems at the national, state, and local level, and evaluate and/or prescribe nursing's present and emerging role in these systems.

9 Function as a consumer advocate in the delivery of health care by utilizing knowledge of the sociocultural, economic, and political forces which influence the health of humankind.

10. Analyze strategies to effect change relevant to the nursing profession and the health of humankind for the betterment of health care and the improvement of nursing education and nursing practice at the local, state, and national level.

11. Utilize knowledge of organizational behavior and role theory for the delineation and development of a functional role consonant with individual career goals.

12. Implement professional standards of practice by serving as a role model in the demonstration of responsibility and accountability to clients, to the nursing profession, and to society.

13. Continue learning through further graduate study and/or other avenues for post master's education.

BATON ROUGE GENERAL MEDICAL CENTER SCHOOL OF NURSING

The mission of the school of nursing is to prepare registered nurses for entry-level practice. The nursing program will prepare the graduate to practice nursing safely and effectively as a novice in a generalist setting. The graduate nurse accepts responsibility for continuing the process of personal and professional growth in the advancement from novice to expert. Faculty members expect the graduate to serve as a positive role model in the practice setting by promoting principles of heathful living and participating in the process of bring healing to the sick. The program provides graduates with a foundation to accept responsibility to develop and maintain their expertise in practice and accountability to the public.

[teeituptom, BSN, RN]

I would have to say me, except maybe with a slightly better golf swing

[Indy, LPN, LVN]

All right. Ideal nurses have experience to back up their education, whatever the education may be. They can learn new computer charting systems in a week or less, have numerous "brain" things to try out depending on where they may be working, are never caught without tape or scissors or alcohol in their pockets. They can explain "why" to anyone, regardless of who's asking, without making the person feel dumb, whether it's a family member or student or fellow nurse. They can and will stand up for weaker people: patients, coworkers, etc.

I don't think you can make an ideal nurse out of ANY nursing program. That's where experience, both good and bad experiences, and good preceptoring come in handy. It simply takes time. Now... what in the nursing education programs will help this process along to give new nurses a better foundation?

1. PHARMACY courses, people!! My nursing program didn't have one, that's why I'm still reading my lehne book every week two years later, and will continue to as long as I need to know stuff.

2. NANDA/NIC/NOC needs to go bybye. That stuff is for the birds. You want the nurse to be accountable for what the doctor orders, don't confuse the poor student with a whole system of diagnosis that has very little to do with anything. Now the interventions are fine... but more in a "what do you do when you see this" type format with a healthy dose of why.

3. Pathophysiology courses as such, not a little dose of "you must understand the patho in order to write your care plan, dear" in each and every nursing course. Or better yet, put the patho into the anatomy and physiology courses. Make them more than an exercise in naming stuff.

4. I really would have no problem ditching the care plans as such. Yes, it's useful to make the students do writing exercises and make them in the correct format, etc. I mean, you must make sure that you are graduating literate people because not all high schools guarantee this. But I don't believe in nursing diagnoses as a separate system that deserves as much air time/class time as it gets. It is so complicated that when students hear specific diagnoses they don't automatically think about what to DO for the patient, they are stuck in care plan mode instead.

5. More clinical time. In every program. I don't care what wonderful school where does what with its clinical time, it's not enough.

6. The structure of RN's clinical time can be improved as well. For instance, "observation days" if they don't come with a mandatory written report can lead to too much standing around looking at the ceiling. The instructors should have specific things they want answered in the reports, to give the shy student things to look for and ask about. There should be clinical time that specifically puts the student smack in a CNA's shoes and has her taking manual vital signs until sick of it, without care planning. Some things have to be learned by repetition and VS, turning and repositioning, butt wiping, bed bathing are some of them.

I'm not advocating these things to be "eating my young" either. But in an ideal world the new nurse might come equipped to do tech work straight from school, even if they have no previous experience with it.

7. The ideal employer of new nurses would have long internships starting with "how to pass your nclex" classes combined with tech work if the student needs more hours (and more pay) and continuing with internships that span different departments to promote a more well rounded nurse instead of the frustration that we typically see with today's new grads. Frustration being with other departments, that comes from not understanding how they operate when you're new and barely keeping your own head above water. The employer who wants to keep these nurses should spend a bit of time training preceptors instead of just willy nilly assigning them to new grads, and should make sure they have the people skills and the clinical experience to teach them properly instead of taking advantage of them. Of course since this is an ideal world I have yet to see this.

It's also my opinion that any bridge between ADN and BSN degrees ought to have more pharmacology and more pathophysiology. I love the ADN degree for the simple fact that it is accessible to more people at the moment. But the core classes could contain some of the elements that I mentioned above; at my school they didn't. Education as a whole on the level of the junior/tech college and below seems to be suffering, this is my accross the board opinion.