Am I, as a nursing student, part of the problem?

Altra, BSN, RN · Jan 7, 2008

Marie-francoise, my honest hope for you is for you to find that you enjoy your studies, then embark on a successful career ... or to make the decision to pursue something else.

Good luck to you. :specs:

nurz2be · Jan 7, 2008

Well, I have a whole lotta opinion about what you are saying but I will keep it nice and professional.

1. There is a nursing and nursing instructor shortage. Proof? Look at the numbers of positions open versus the number of Grads on any given year.

2. A LOT of us go to very strict, study intensive programs that push us to excel. Proof? A LOT, mine included, require a minimum GPA of 4.0 on pre reqs (Can't get much more higher than that), require a minimum amount of clinical experience (16 hours a week for 72 weeks) PLUS in class skills assessments, Rigorous testing (minimum now 82% on all tests). I could go on and on here on this one.

3. A LOT of schools have 95% or above first time pass rate on NCLEX, again not so shabby.

4. IF these so called students to which are so ill trained, were seeking employment in MOST hospitals, they would quickly be sent packing as hospitals and staff don't have time for hand holding.

MY OPINION, if you are in a program that has you thinking some miscarriage of justice is occurring in the nursing community, I find it sad. I, if I were you with such low opinion of nursing students ( i.e., Maybe short programs to a nursing degree are not intensive OR selective enough and contain too many low-caliber students who will not help in gaining future respect for nurses") you should either find a new school environment, or maybe consider another career. I would SERIOUSLY question myself going into a field I found, as stated by you, to be sorely misleading. Obviously you are not a nurse and have not the faintest idea of how TRULY short-handed the REAL nurses are in I would venture to say ALL hospitals and clinics are. I would love for you to share with us all the hospitals that are running full-staffed so much so that the nurses have time to do all their assignments, play solitaire, and take their 30 minute lunch breaks, OH, and get at least 2 bathroom breaks.

I COMPLETELY agree with above poster as well......

good luck in your soul searching

cowgrrlRN · Jan 7, 2008

I resent even the implication that ADN nurses are any less than any higher degree nurse. Guess what!! We ALL have to take the same NCLEX to be licensed regardless of what the letters after our names are. I graduated from a small community college but we had the highest percentage of passing the NCLEX first try than the 4yr colleges and universities in the state. The problem is and always has been how nurses are treated on the job and the public perception of nurses. If you think so poorly of your current school and the profession as a whole maybe you should rethink your decision to become a nurse. Maybe you have been mislead in your thinking and reading others responses will clear this issue up for you. :angryfire

labcat01, BSN, RN · Jan 7, 2008

Ok, maybe I read your post differently because I am not nearly as angry or offended by what you said as some of the previous posters.

I agree with what you are saying about hospitals needing to value their staff more. I think this is more evident in cities with multiple nursing schools because in those places there is no nursing shortage. There are an abundance of nurses ready and willing to take the place of the burned-out and abused.

Where I disagree with you is bringing back old diploma programs to replace the current programs because I think what you are describing is NOT a diploma program but rather you are describing medical school ("competitive" "intense preliminary didactic component" "the rest of the training be in the hospital").

I do agree with you that hospitals need to accept their share of the responsibility in terms of the nursing shortage. Do I think nursing students are part of the problem...never!

Tait, MSN, RN · Jan 8, 2008

I am an ADN. I take minimal offense to this post, but overall I completely understand what you are saying.

At my hospital I am apparently some of the last "ADN" no "BS Degree" being hired here.

Any program can churn out amazing nurses, ok nurses and bad nurses. I could easily scan my graduating class and tell you who I would and would NOT let touch me.

My roommate graduated from a prestigious 4 year program and smoked pot every day.

Nursing comes down to the person and how they use the education they selected. I am a particularly high kinesthetic and visual person. Had I to do it all over again I would do my personal ADN because I had so much clinical time. If I COULD I would have loved to have done a diploma career, because I think living at a hospital, working and learning would have been so perfect for me.

But here we are. I do not believe hospitals intentionally hire because they know there is a new crop out there. Training new nurses apparently can cost a hospital around $8,000 (from my last job) to make them safe and productive. Nurses are liabilities just like any other staff in a lawsuit happy world. Hospitals, clinics, LTC want safe, good nurses.

So where do I think the problem lies? Everywhere. I do believe we need more instructors, more funding for classes, I believe we need to raise the bar (this does not mean eliminating ADN's, most of these programs are VERY intensive and hone technical skills that hospitals need), we need nurses to take more pride in what they do, we need nurses to gain a stronger sense of self, responsibilty and pride, we need hospitals to pay us what we are worth, we need praise and good working conditions, we need everyone to take part in creating a more positive environment, we need people to stop suing each other to make money, we need insurance companies to stop trying to make money off of us and help us stay safe, we need a lot of things and it all adds up to one big glitch in the system.

Each person, student, ADN, BSN, MSN needs to take it upon themselves to advocate, show professionalism, know their limits and promote satisfaction in their work.

So you can either believe you are part of the "problem", or a step towards the "solution".

Attitude is everything :)

marie-francoise · Jan 8, 2008

I have a very high veneration for nurses, and actually think the program I am in is a good one.

A lot of my fellow students, though, don't seem to have much insight into the greater issues surrounding nursing - such as the rampant understaffing and too many requirements for documentation - so I don't have much hope that they will go up against "the system" once they are nurses, and, if they do, they will likely get pushed out of the unit they're on since the hospital can replace them with a new grad anyway. My reference to caliber is not regarding the curriculum itself.

My concern is that as long there is always a new grad ready to go into bedside nursing, the hospitals will not prize the nurses they already have, or the nurses who have left the bedside because of understaffing and other workplace problems.

I guess what I am saying, in short, is that before nursing working conditions get better, the nursing shortage will have to get worse for the "system" to start really caring to change it.

So, anyway - nursing education is something that has always interested in me, I do admire the program I am in, and I do admire nurses.

Nicky30, BSN, RN · Jan 8, 2008

are there simply too many nursing students that are feeding the mill of poorly staffed/poorly operated hospital nursing units and temporarily (until they burn out and leave) providing a quick-fix to the high turnover that results on those units from poor working conditions?
are we current students (and new grads) therefore keeping hospitals from facing the facts that retention, esp of more experienced nurses, is key to addressing poor nursing working conditions today?
maybe hospital leadership know there is a ready batch of new grads to fill a vacancy left by a burnt-out nurse. (although training a new hire is mighty expensive, and seems now to involve preceptors who are recent grads themselves, as well as decreasing preceptorship duration.)
i'm not saying we don't need new nurses - just that the system might need to be forced to prize their current nurses more, and not to be made so comfortable in the assurance that new nurses are being "churned out".
maybe the caliber of new nurses needs to be raised. maybe nursing programs actually need to be more selective. i don't know.
maybe short programs to a nursing degree are not intensive or selective enough and contain too many low-caliber students who will not help in gaining future respect for nurses? maybe we are making it too easy for people to go through a program that will end with a job that makes pretty good money compared to other jobs with similar training intensity/duration?
maybe we don't really have a "shortage" of nursing instructors - maybe programs need to be made both more selective and intense. (i don't like when the "shortage of instructors" reason is furnished for the nursing shortage - it seems more like an excuse to avoid facing the reality that there is a nursing shortage because many nurses and potential nurses don't want to put up with crappy working conditions.)
anyway, my basic question is, am i part of the problem, as a nursing stduent going through a relatively short, not very clinically intense (so far) program?
i keep wondering, though, if we should bring those old diploma programs back. maybe make them competitive, intense diploma programs with an intense preliminary didactic component for learning diseases and rationales for nursing interventions, and then have the rest of the training be in the hospital, basically.

wow there are a lot of components to your opinion and question, so much that i had to read it twice. i may also get shot down in flames for supporting some of your thoughts. :icon_roll

i have highlighted in blue what i have thought to be the most important component of your argument. the high turn over of new nurses replacing the senior experienced rn who has simply gotten sick of bandaid solutions to an ailing health care system is depolarable. australia is much the same - how can hospitals expect to maintain the high calibre of nursing student (here is where i disagree) as they transition to rn when they no longer have the senior nursing staff as support. why should the nurse who has just completed their graduation program be expected to precept a new grad (unless they want and are competent enough (ie. not everbody can educate/instruct)) when they have minimal experience to draw upon.

while i agree that turning out more nurses to fill the mass exodus is a long term solution, perhaps through desperation hosptial managers must fill there staff with warm bodies and new grads are often the only ones availabe. i also agree that more attention needs to be placed on retention of the rn's we have - how much valuable experience are we losing when they walk out the door - and management let them without thought to why????

i don't know if management are not facing the facts about their often poorly run units and hospital (maybe and individual thing), but i believe they may be constrained as much as the average nurse on the floor. no funding = reduced staff.

i don't believe that you as a student are just feeding the ongoing problem. this is more of a political issue than anything. i don't believe that the calibre of student or new grad is necessarily lower either. however, i do know of some programs that have lowered their entrance scores to increase the amount of students admitted into their programs.

if we as a profession feel (and i know we do) that retention is the key, then maybe we need to put the focus on that. i know in australia the focus here is on training new nurses, but what can we do for retention but improve working conditions.

sad that i can't see it happening in my career - still i will do, what as an individual that i can. increase the professionalism of my own practice and that of my colleagues. educate others when and where i can, and later when my body is unable to cope with the rigors any more turn to teaching and/or become actively involved with the union.

maybe just maybe one person can make a difference. i never will make a difference if i don't try?

pagandeva2000, LPN · Jan 8, 2008

Actually, I am not offended by some of the things mentioned. The reality of it is, though, that there will not be a perfect selection process to eliminate the students that will not offer a positive contribution to nursing. I also agree with the fact that the current nurses should be more appreciated and valued. This is what makes many of them leave the bedside, where the need is higher. With the constant demands of Joint Commission, administration and unsympathetic managers requiring ridiculous, useless paperwork, and infusing fear to nurses, it would be a better place. But, we are constantly worrying about covering our butts, not being able to provide proper care due to the many demands, and are frustrated.

I do not think that students or new grads add to this problem.

Dolce, RN · Jan 8, 2008

I don't necessarily think that every nurse having their BSN is an answer to our current nursing shortage problem. My RN-BSN program was practically junk. I learned very little that could be applied to "real life" nursing.

Why can't colleges advance themselves and make relevant RN-BSN programs that help nurses become stronger clinically? I know I would have loved a class that was focused specifically on surgery. We could have observed in the OR and learned all the new useful information about the OR. Same goes with pharmacology, pathophysiology, lab, radiology, medicine, psychiatry, legal matters, etc. Why not have classes that teach about the in depth specialties that some of us know almost nothing about? I would have loved to have taken a class on neonatology for my BSN.

My BSN was not relevant to my nursing practice because the classes were all "theory." They included research methods, statistics, healthcare finance, leadership and management, blah, blah, blah. These classes do not specifically benefit staff RNs. No wonder people don't want to get their BSN! It doesn't always benefit them in there work setting!

I wish that all nurses had their bachelor's degree so that we could perhaps be more respected by other healthcare professionals. But, in my experience the current BSN programs do not do much for teaching us what we would really like to know.

locolorenzo22, BSN, RN · Jan 8, 2008

Personally, I am a ADN student(last semester, whoot!) and find that I get much more hands on expeirence for less money than I would in the local 4 year BSN program....Those students came to my floor during days...for 6 hrs 1 day a week! Passed only 8AM meds, would not touch meds beyond those times, would barely do patient care, and basically did very little when on the floor! It is generally accepted that new grads from that program need more training, due to the fact that NO one is a supervisor right out of school!

Me? I work 36 hrs a week, have to maintain a 80% average on everything, am expected to ALWAYS be professional and find something to do during clinicals, I feel that I can do something, even if the rest of them don't feel that way....and provide ALL Patient care during my clinical(baths, visits, appointments in the outpatient center across the street, etc....)...

I don't think that the quality of nurses suffers, I think the bad ones get out quickly, either through faults of themselves, or the exposure to the "real world"...We are needed to replace the ones who leave....and if you care, and you are a good nurse, you'll find your niche, and stand out.....

PS there is a shortage!!! Nobody wants to do that much work for less than their worth...part of the reason my career goal is to go get my masters and teach! I'll find a job somewhere!

marie-francoise · Jan 8, 2008

I don't necessarily think that every nurse having their BSN is an answer to our current nursing shortage problem. My RN-BSN program was practically junk. I learned very little that could be applied to "real life" nursing.
Why can't colleges advance themselves and make relevant RN-BSN programs that help nurses become stronger clinically? I know I would have loved a class that was focused specifically on surgery. We could have observed in the OR and learned all the new useful information about the OR. Same goes with pharmacology, pathophysiology, lab, radiology, medicine, psychiatry, legal matters, etc. Why not have classes that teach about the in depth specialties that some of us know almost nothing about? I would have loved to have taken a class on neonatology for my BSN.
My BSN was not relevant to my nursing practice because the classes were all "theory." They included research methods, statistics, healthcare finance, leadership and management, blah, blah, blah. These classes do not specifically benefit staff RNs. No wonder people don't want to get their BSN! It doesn't always benefit them in there work setting!
I wish that all nurses had their bachelor's degree so that we could perhaps be more respected by other healthcare professionals. But, in my experience the current BSN programs do not do much for teaching us what we would really like to know.

Migosh - I could have written this post! You put into words what I felt about the BSN program I was in.

I was in a BSN program years ago that I had to leave (I was doing very well, but for family reaons + the fact that the program stank, I left).

Anyway, I'm now in an ADN program that costs a fraction of the BSN program, and am learning so much more.

The 1-year accelerated BSN program I was in was all about communication, leadership, theory, and other fuzzy things. They kept teaching these fuzzy things, and I kept waiting to learn about concrete things.

Anyway, I'm much more satisfied with my ADN program, not to mention the cost!

THAT SAID, I guess programs will vary in quality no matter if they're BSN or ADN. Depends on the curriculum and the faculty, I would imagine.

As for the quality of the students - that is, if they would be ones to "stand up to the system" once they're nurses - I don't know the best way to select for nursing students who will face the system and try to change it. It's a multi-factorial problem, and "fighting City Hall" is hard to do, esp if it risks losing your job.

Maybe the best nurses will just get fed up with the system and leave for better jobs. I don't blame them - I'd likely do the same.

The ones who "served in the trenches", though, are the very ones who would be the most credible & useful advocates for change.