difference in nurse ed

danh3190 · Jun 5, 2011

I wonder how they managed to get all the skills checked off. I went to a very good hands-on diploma program, but with all the students we had there was no way to participate in 10 deliveries. They were very eager for us to have practical experiences, but if a patient didn't need an intervention they didn't need it. Our ICU experience was very good and I learned a lot there, but even so, not enough to be in any way competent.

DemonWings · Jun 5, 2011

My psych instructor was from the philippines and she told us stories like this as well, I was amazed. She said they had to live at a campus near the hospital, and in their OB rotation, when a delivery was happening they got called in to assist, even if it was 3 am. She also told about her experiences on the med/surgical units, there would be two nurses to 40 patients!!

okchug · Jun 5, 2011

I'm sure there are issues. She spoke of the labor ward....large rooms with many pts, no pain meds, no epidurals, etc...I was just amazed at the things students were doing and it made me think about my own clinicals and how many new grads we have on here (me included) that are struggling in the transition.

BTW, I would not want to deliver a baby just wonder how to better apply the book/critical thinking as a student to the clinical side of things.

SummitRN, BSN, RN · Jun 5, 2011

There's more cultural differences that allow for some of these differences. There are many differences, starting with the fact liability and patient rights/attitudees there isn't the problem it is here, and all that entails (no mothers or doctors going "GET THAT STUDENT OUT OF HERE!"). The birthrate in the Philippines is TWICE that of the USA. Further, if med surge floors run 20:1 (d/t less liability) they produce less nurses per capita. Standards are what they because their environment allows. (Keep in mind it is probably the best graduates from the best programs in the country that get to come to the USA).

Most nurses will NEVER be L&D. I think it is a waste we spend so much time on it. It is so incredibly specialized.

You want to talk about ed differences, why don't we look at the lower rung RN programs in the USA that never get their students inside a hospital. Let's talk about the programs that have their peds rotations that are observation only because they can't get students into a peds floor so they have to go to daycare and after hours clinic.

But on the other hand, we have great programs too. We have programs that put people into 400 hour hands on ICU rotations as an internship plus 200 hour 1:1 student to preceptor final practicums in specialty units.

okchug · Jun 5, 2011

Good points about access and liability.

and yes, you are very right. There are huge discrepancies between programs across the board: in classroom, lab skills, and clinical hours. I don't know what the solution is.

BUT, unless a grad is lucky enough to land a residency/new grad position- they're screwed. There's not enough time, staff or money to fully train a new nurse. Most are out there with only a few weeks of orientation and little support, having been hired to regular staff positions. We are seeing many posts regarding the lack of preparedness, increasing frustration, and new nurses wanting to quit.

I would have given anything for an internship/practicum like that!

ZippyGBR, BSN, RN · Jun 5, 2011

and in the absence of even stricter requirements than the EU directive and consequent National Law that underpins pre-reg courses in EU nations it's unlikely to improve ... Even the 4600 hours 50 /50 uni/ placement split would be a start...

allnurses Guide · Jun 5, 2011

okchug:

i know we all had a required number of clinical hours, but those are not always very well spent. there needs to be more balance of book & applied knowledge and more structure to the clinical experience.

no, the clinical hours are not always well spent.

and don't anyone tell me, "you get out what you put in" because sometimes that's like getting blood from a turnip.

what about getting floated to follow the np around because the icu is near empty... bullocks!

what is that?

how is watching what the np does, going to help me with what i'm trying to do today... which is just learning to deal with the responsibility of floor nursing, learning to think and deal with things the right way... and being safe?! :confused:

wouldn't it have been better to find me a spot where i could be put to work and get some hands-on?

but they can't just do that and won't do that.

wasted days, i tell you.

calinurse11:

she said they had to live at a campus near the hospital, and in their ob rotation, when a delivery was happening they got called in to assist, even if it was 3 am.

ah! the days of hospital-based nursing schools. i'm sorry i missed that! that would be the way to go. total immersion.

summitap:

let's talk about the programs that have their peds rotations that are observation only because they can't get students into a peds floor so they have to go to daycare and after hours clinic.

we have no peds class... it was "incorporated" into ob. we spent a day in a daycare and a day in clinic. only a blurb (maybe) in each class about something peds related. took the practice nclex... and was brutalized by the peds questions.

guess what i'm going to be working on, before my nclex? ouch! :eek:

there was no pharm course, either. it was more of a math for meds... but not really learning about drug classes and actions, side-effects, etc.

no kidding.

i had to figure out, on my own (late in the game) that the way to learn your drugs is by class... lol. i didn't know that. talk about learning the hard way! :nuke:

but i can rattle off nursing diagnoses and write a mean careplan... will that be sufficient? :rolleyes:

klone, MSN, RN · Jun 5, 2011

I think that like new physicians, all new nurses should go through a residency program. Not as lengthy as a physician's, but maybe 6-12 months.

Horseshoe, BSN, RN · Jun 5, 2011

we were lucky to even witness a birth during our whole three days of l/d rotation let alone be involved. her list went on...in every area they had to check off a number of times on real patients and take their own pt assignments. on many floors we were limited, like icu- couldn't touch the pts, and onc- couldn't even enter the room without the nurse!

i just thought it was interesting because of a recent post regarding nursing ed....the more i think about it, the more i do see how they teach to the nclex. i know we all had a required number of clinical hours, but those are not always very well spent. there needs to be more balance of book & applied knowledge and more structure to the clinical experience.

that is odd. we did everything in our oncology rotation that we did anywhere else. in fact, i gave the majority of my ivp drugs in oncology. my instructor or the nurse would be present for those, but not for basic nursing duties! my oncology rotation and time spent on a tele floor were my most productive. i did my l & d rotation at a large county hospital, so i saw lots of babies born, though certainly did not participate to the degree that your friend did in her program in the philippines.

nurseprnRN, BSN, RN · Jun 5, 2011

"btw, i would not want to deliver a baby just wonder how to better apply the book/critical thinking as a student to the clinical side of things."

oh, heck, my son-in-law the history major just caught my grandson in their living room (precipitous delivery, to say the least) and he did fine (though he had to clean up the carpet later, lol). it was their second child, labor about an hour (!), first had 18 hours of labor, no suggestion that this would be any different. midwife arrived an hour later.

you would do fine too.

returning to regularly scheduled thread ...

Fiona59 · Jun 5, 2011

I think you should have a read in the Phillipines Forum here before you get all misty eyed about their educational system. Many posters are telling stories of not being able to get near the patient because of the huge number of students currently on the wards.

The education of nurses over there seems to have radically changed since the 1990s, with hundreds of schools popping up. When my health authority did a huge hiring drive there about three years ago, we found that many of the new grads were poorly prepared and lacking in skills. Staple and suture removal was "doctors job" according to several who worked our unit. They all came from different nursing schools. Some of our nurses who had moved from the Phillipines in the mid-1990s were the first to comment on the changes.