Are we sacrificing hands on patient care for academics?

Nurses General Nursing

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HI Everyone,

I am graduating (knock on wood) this May but I feel that I am about to graduate and going out there in the "real nursing world" with nothing. We spend only 5 hours in clinical per week and so far this semester I have yet to administer meds. Our instructor only allows one person to give meds because they have to be given before 10:30 (we arrive on the floor at 9:15).

I asked our instructor why we can't have more clinical and lab hours ( there are 6 hospitals within a 15 mile radius). I really didn't get a straight answer.

Don't get me wrong, our program is top notch. They have a 95%+ pass rate in NCLEX. But I think the program can do more. Since I can't get more hands on experience from class I actually took a job as a Patient Care Tech but it's not the same.

What do you guys think?

Specializes in Hospice.

that sounds like a program problem. I did over 700 hours of 1 on 1 with a nurse preceptor. By the end i took on a full pt load. I think some programs are better than others but i definately felt prepared. I would given your feedback to your program.

I spend 15 hours a week in clinical this semester, and that doesn't include the simulation labs that we have to attend, as well as the hours of DVD's we have to watch prior to attending clinicals. Sometimes we set up flu clinics and spend the day at a local school administering them. In clinical, everyone passes meds until they're blue in the face. Like you, I'll be graduating in May. I feel like a well-prepared, well-rounded BSN student. I feel like I've had great hands-on experiences throughout clinical because we're always rotating to other units whether it be to the ER or Endoscopy, or PACU--we haven't been limited to "observations" in any of our clinicals. However, I do loathe the fact that I have to take a HESI exam every quarter, as well as an exit HESI exam before I can graduate and collect my diploma! I don't feel the sacrifice...I'm itching to graduate!

Specializes in acute care med/surg, LTC, orthopedics.

I don't consider your program top notch if they're not giving you adequate perceptorship/consolidation experience. This would be the clinical hours where you begin by taking on 1 or 2 patients building up to a full patient load focusing on those skills you have yet to perform as well as organizing your time and preparing for a "real world" patient assignment. It sounds like you're being shafted.

Specializes in Trauma Surgical ICU.

The real world of nursing will be a major shock to you if you have not taken care of at least a few pts by yourself.. If only one person is allowed to give meds; what do the rest of you do for the 5 hours you are there?

I would say you're in a bad program. Every semester we increase the amount of hours we're on the floor. This is my third year so we're up to 2 days a week, 6 hours each day, all of us give multiple meds each day. By our final semester we will be working with a floor RN 1-1 working their shift with them, doing all the patient care with them supervising. So I would have to disagree, your program sounds like it is sacrificing care for academics, but I don't think that's the norm.

Specializes in Psych.

Yup, sounds like a program issue to me as well. We have 12 clinical hours per week, and next semester (our 3rd full semester) we will begin taking more than 1 pt. I also have the opportunity to give meds on one of our 2 consecutive clinical days per week.

We have 5 hours of direct patient care plus 3 hours of lab for med-surg every week (we are in Cardio for the next 8 weeks). For OB we have five hours for clinical and 2 hours for lab. Next sem we have two months of preceps twice a week for 8 hours each day. We will also have neuro/psych clinical 5 hours once a week. Our clinical hours are similar to other schools in the area.

I just don't think it's sufficient.

No school prepares for the real world,and I dont care how prestigious one's school might appear.

The truth is skills can be acquired through practice,theory on the other hand teaches you how to apply the information you learned in nursing school,i really do believe that it is more imporant to be knowledgeble in pathophysiology than in puttting in a foley catheter.

Specializes in Psych, Med/Surg, LTC.

I think it depends on the school. I was very ill prepared after graduating from the LPN program. I had a ton of book knowledge, but actual experience? near none. We weren't allowed to pass meds more than 1-2 times. We were used as staff slaves. We did bed baths, vitals, call bells, bed changes, etc. If we were lucky, we got to change dressings.

Then I went to an RN program, and the focus was NOT those things. We had usually 3 patients each (5 at the end of the last semester) and were required to pass all of the meds, change all of the dressings, etc. We had to do all of the charting. Yes, we had to do care on the patients, but it was not the focus. We only did care/vitals on the patients we were assigned, instead of the whole floor. There was none of this "paying your dues as a student" stuff. We were there to learn to be nurses. When we graduated, we all hit the ground running. No one in my class failed boards when they took them. Everyone passed the first time, and I haven't heard of any new grads struggle all that much. (It was an ADN program)

Specializes in Hospice.
No school prepares for the real world,and I dont care how prestigious one's school might appear.

The truth is skills can be acquired through practice,theory on the other hand teaches you how to apply the information you learned in nursing school,i really do believe that it is more imporant to be knowledgeble in pathophysiology than in puttting in a foley catheter.

I would agree with that. While i think its insane that people graduate without putting in ivs and foley's those are skills that will be learned quickly.... critical thinking and patho...not so much.

Specializes in Nursing Professional Development.
HI Everyone,

Don't get me wrong, our program is top notch. They have a 95%+ pass rate in NCLEX. But I think the program can do more. ?

Your program is not "top notch" if it is not giving you adequate clinical preparation. NCLEX pass rates aren't everything. In my state, a program is required to provide 800 hours of clinical practice to be approved by the BON. Sure, some schools provide clinical hours that are pretty low in quality ... but at least there is an understanding that school can't just be glorified test-prep programs. They have to at least make a token effort to provide actual nursing education.

Good for you, for seeking additional clinical experience on your own. That may help you with potential employers.

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