After 5 years as a nursing student ( I failed a clinical and had to repeat a year) I am looking back at what was and what will be for the "caring" profession. What I have witnessed leaves me very concerned.
In the past nursing education was very practical. A nursing student was taught what to do in situations and what not to do. Indepenant thinking was a liablity and not encouraged as MDs were to be our brains. Currently we have expanded our profession to the degree level and are developing critical thinkers to be nursing leaders and promoting the concept that nursing has a distinct knowledge base to draw from that is invaluable to the holistic care of clients.
So far so good I believe.
While I wholeheartedly agree with this I am still concerned about the "student nurse experience" during their educational years.
Educators with the credential required by universities are hard to come by, thus creating a system were advance degree nurses are becoming eductors without the mindset or skills to be a positive influence on our professional young. Also many professors have PhD in area unrelated to nursing (another shortage issue).
This produces a system were nursing students are taught by very therothical educators that have conceivable spent as little time as possible at the bed-side. These individual are now responsiable with developing the programs that will produce the next generation of nurses, and many seem more concerned with imposing their acedemic values on their students that preparing them for entry into practice.
This bring me to an interesting question, should the education of entry level nursing be primarily practical or theorthical in nature. I believe in trying to produce so many nursing leaders we are harming the profession because many new grad have very lacking clinical skills as a result of the overly stress theorectical curiculum.
I feel that as a student we should have a curriculum that is very well founded in material that is relevent to entry-level nurses. Very few of the hundreds that graduate have any interest in becoming research nurses, DON, PhDs etc. So i feel that filling the 4 year currictum with these types of courses should be the responsibly of a Masters program not the BSN or ASN program.
Also because of these issues there is a notiable dissatisfaction many new grads have with their education and combine this with negative experiences with nurses on units or preceptors and it is not surprising that so many new nurses already have cynical ideas about nursing.
By the end of my first year most student stop advocating for themself as this made them targets by educators. By forth year most were willing to "anything" to just get out of the program.
We were not 'indentured servants' to the hospital but students in the same way medical students and residents are. Our docs taught many of our classes and we were expected to participate in a percentage of 'grand rounds' along with the med students in order to learn. Our school environment was quite strict and regimented (almost military) by today's standards, but quite effective IMO. We were not required to do 24 hour shifts--that special treat was reserved for the house officers! LOL! I do remember having to take 'call' for certain procedures in order to gain the required experiences necessary in my clinical rotations. But since most of us lived in dorms on hospital grounds this was not a big problem. Those living off campus bunked in with one of us for their 'on call' days.
We could choose (or not) to work at our facilities as NA's and NT's-- it was not required. It was the BEST OJT experience IMHO---it was an expectation that all staff take an interest in students because it was a teaching/learning environment. We were paid for our work hours (not for our clinical hours which were a whole different thing).We did team nursing and it worked well because we had no shortage of good help. Medical Residents and students were also paid for their work time should they choose to make a few bucks on the side (and most did--we were all struggling starving students.)
In our short staffed hospitals of today, wouldn't it be nice to have nursing students working with you on your busy unit? I always enjoy the few student nurses who still choose to still work on the floors as CNA's--they are so enthusiastic, demonstrate their interest, and find their coworkers become actively involved in their education. This was certainly my experience and my classmates felt similarly.
IMHO, we have lost a great deal in our move away from hospital based nursing programs into university based nursing programs.
Hope this answered some questions about 3 year diploma programs. :)
I wonder why there couldn't be a nursing program that offers what the diplomas did but also offer the BSN at the end? Why can't you have clinicals like that BUT also offer the BSN courses? I mean, you may have to pick and choose from the both of them and eliminate this and eliminate that to fit it all in - but couldn't it be done?
That's it. When I graduate and finally become an educator I will design a curriculum that emcompasses all of that. You will my see name some day in textbooks...to hell with Watson and her touchy-feely caring theory..... Susy K's theory will be born!
Nursing Educators with compassion and the drive to change a poor curriculum do exists and they can on rare occassion be found as a clinical instructor. But they are like the famed WHITE RHINO, a breed that are wonderous and a gift from god to come by. Unfortunately that are often hunted and exterminated my the usual small clique of Nursing PhDs that run the show at university's. These individuals often do not value anyones advice if they do not see the title Dr. infront of that persons name. At my university the best loved and respected educators (by students) are the sessional facilty that have the most formal reprimands from the higher ups. The facility that run the show do not want some petty ASN or BSN or even MSN telling them that they are missing the mark.
Many of the best educators have no afflication with school because of this. They remain in the real world were they can teach what need to be taught and not have woefully inadeuate curriculums shoved down their throats
On a beautiful sunny afternoon, a white rhino comes to my school with a calling to teach its young the means of survival. IT know the wonderful life ahead of them and wants to convey to its students the nature of its role in the universe. Alas the hunters arrive and they see a mass of flesh fit only for their consumption. The Rhino endures wound after wound, until it can no longer remain on its feet. Then quitely melts back into the shadows where it eventually pass away from exisitence; and my soul silently screams for we, the students have lost another of gods treasures.
That evening the School of Nursing serves its students White Rhino stew for dinner.
Nurses not only eat our young, we sometime consume our most positive resourses.
I understand how your mom feels. As I said in an earlier post, I've heard the words "lawsuit & lawyer" more in the past year than I ever did in 26 years of bedside nursing. I'm not sure if this behavior is due to the times, or what. I do know that some students come to school, woefully unprepared for the tasks ahead, like, simple math, english, reading skills. My daughters are amazed by what my students get away with, they are both in college, not in nursing. Their comments usually are "and these people will be taking care of others? They can't even take care of themselves" As far as the hospital nursing education goes, there is a movement afoot to reinstitute "institutional liscensure", not a good way to go IMHO.
Zhakrin, I agree with your asessment of our 'higher' education system and this phenom destroyed my diploma school. TPTB would simply not 'merge' the diploma theory with the degree theory, (it's a great idea, Susy, but it seems to be two different worlds) thus when I thought I would have a BSN on graduation it was not to be. It was about power and money; the PHD university types thought they knew better than the medical school theorists when it came to nursing education. It really wasn't about the best program or helping nurses really 'learn', it was about the supremacy of 'higher' learning.
Somehow medical schools have made this 'merge' of theory and practice ...perhaps we need to move towards this too. Diploma hospital programs combined academic college courses with strong OJT and did a wonderful job----but they are the dinasaurs now in our day. Where do we go from here?
Great thoughts everyone...I enjoy reading all the viewpoints. :)
As you stated, if medical schools are able to combine these two schools of thought to a curriculum without being seen as exhibiting some "supremacy" of higher learning, why is it that nursing schools can't? There seems to be some discrepancy there.
mattsmom81
4,516 Posts
Old diploma nurse here.
We were not 'indentured servants' to the hospital but students in the same way medical students and residents are. Our docs taught many of our classes and we were expected to participate in a percentage of 'grand rounds' along with the med students in order to learn. Our school environment was quite strict and regimented (almost military) by today's standards, but quite effective IMO. We were not required to do 24 hour shifts--that special treat was reserved for the house officers! LOL! I do remember having to take 'call' for certain procedures in order to gain the required experiences necessary in my clinical rotations. But since most of us lived in dorms on hospital grounds this was not a big problem. Those living off campus bunked in with one of us for their 'on call' days.
We could choose (or not) to work at our facilities as NA's and NT's-- it was not required. It was the BEST OJT experience IMHO---it was an expectation that all staff take an interest in students because it was a teaching/learning environment. We were paid for our work hours (not for our clinical hours which were a whole different thing).We did team nursing and it worked well because we had no shortage of good help. Medical Residents and students were also paid for their work time should they choose to make a few bucks on the side (and most did--we were all struggling starving students.)
In our short staffed hospitals of today, wouldn't it be nice to have nursing students working with you on your busy unit? I always enjoy the few student nurses who still choose to still work on the floors as CNA's--they are so enthusiastic, demonstrate their interest, and find their coworkers become actively involved in their education. This was certainly my experience and my classmates felt similarly.
IMHO, we have lost a great deal in our move away from hospital based nursing programs into university based nursing programs.
Hope this answered some questions about 3 year diploma programs. :)