Colleges spitting out new nurse without any training?

nyteshade, BSN · Oct 26, 2009

Yes, I've dealt with this too (all degree levels) and it's a very scary trend. We really can't do much about it. I guess people will just get themselves sorted out. Nursing schools are like assembly lines now...

scootertrash nurse · Oct 26, 2009

back in the day when I was in school (1985) when we had clinicals we had to go to the hospital on our own time get full hx, meds and know them,dx have 3 care plans and be at report the morning of and while at clinical we did patient care not more school paperwork. Now I have never seen a student do that with in the last couple of years it like the politically correct has taken over and you cant make me do something on my time I may be wrong but thats what I see

Boog'sCRRN246, RN · Oct 26, 2009

I know when I went through LPN school, clinicals were a joke. The nurses on the units we went to really were not very receptive to us. It was a good day if we got to pass some PO meds. Other than that, it was CNA work all day. It didn't help matters that the hospital where we did clinicals wouldn't hire LPNs. As far as this particular nurse not knowing the steps of a BS check or insulin injection...In my LPN clinicals, we weren't allowed to check blood sugars as it was a "lab value"(the CNAs who worked there could do it, but we, as nursing students weren't allowed :rolleyes: ), and our instructor specifically told us, if we didn't check the blood sugar ourselves, we couldn't give insulin. Absolutely ridiculous. I definitely not making excuses for this person, however, b/c these things could've been learned in the lab.

jtmonique · Oct 26, 2009

It depends on the program In my program we had to do things on our own time and be completely prepared to care for our pt's. We had to be tested on nursing skills not only in class and lab but on the clinical floor Failure to perform a task correctly or not knowing what to do during a clinical experience would result in being sent home for the day. The hospital I was at had students from all of the local schools and it was amazing how little students from the other programs where required to do. ....It is a very scary thing.

tookalongtime · Oct 26, 2009

I start my new RN job tomorrow. I am a new graduate and I haven't done blood sugars and insulin injections since my med/surg 2 clinical last spring. I am going to need a quick refresher on what to do. It doesn't mean that I was never trained to do it, if you don't do something over and over it is easy to forget how to do it. A lot of times you get to do a procedure and you get checked off for doing it and you may not get the opportunity to repeat the procedure. So it is very easy to forget how to do something, and then we are so afraid we are going to screw something up as a new grad that we may ask for guidance on how to do something. Please remember what it was like as a new graduate. I am scared to death that I will appear stupid to my preceptor. Most of the time during clinicals we did mainly CNA work. So it is not that we are not being trained, it is that we do not get to practice over and over what we have been taught. If you were taught something 6 months ago and never saw that procedure again, could you just pick up and know how to do it again??? Just a thought.

shoegalRN, RN · Oct 26, 2009

Just another reason why I'm all for nursing students working as techs/nurse interns while in school.

I worked as a nurse intern during my junior year in nursing school where I did blood sugars, foley insertions, IV removal's, etc. I learned alot more during my time working as a nurse intern than I did while in nursing school all put together.

And that background is helping me in my new RN role. Nursing schools are NOT preparing students for the real world of nursing. They are so focused on NCLEX pass rates, as well as powerpoints, theory, and presentations, they figure you will eventually learn how to be a nurse while actually working as one.

It's a shame that nursing students are graduating from top schools and have never started an IV or inserted a foley, but can tell you all about nursing theory.

readytoroll · Oct 26, 2009

I am a brand new LPN. When I was in school, we had three day (at least) a week clinicals, had to go the night before and pick up our assignments, passed all meds on our patients. Write care plans, know the significance of each and every lab that was abnormal on our patients, provide wound care, etc, etc, etc. If we had an observation in surgery or some other specialty we were expected to report the next day what patients we saw, what brought them there, outcomes etc. We also had a week long preceptorship in which we cared for a full patient load on the floor (3 for me as I was in the CCU) I graduated in July. I feel very competently trained. I have been at my job for 6 weeks and have been on my own on the floor for the last three. I work a 40 bed Alzheimer unit. My managers all tell me that they are impressed by my training. Which, I feel, speaks volumes for my school since it is in Florida and I now live in New Mexico, so there is no "reputation" factor! :bow:

matchsticktgt, LPN · Oct 26, 2009

back in the day when I was in school (1985) when we had clinicals we had to go to the hospital on our own time get full hx, meds and know them,dx have 3 care plans and be at report the morning of and while at clinical we did patient care not more school paperwork. Now I have never seen a student do that with in the last couple of years it like the politically correct has taken over and you cant make me do something on my time I may be wrong but thats what I see

I'm 1/2 way through my LPN program, and the above is what is expected from us during our next clinicals (Med/Surg). My just finished term's (Foundations) clinicals were not much better than CNA work, but I understand that a lot of students have never had any healthcare experience, so it's better to get some on hands training before letting us lose on patients! With that said, I had the full hx, meds, care plans plus patient synopsis/physiology for each diagnosis/condition patient had, and a full head-to-toe physical assessment, then write up of said assessment. We did get to pass meds, but no injections at this time (due to clinical site restrictions). So we've checked blood sugars, taken vitals, etc...the CNAs at our clinical facility were nice and helpful, and didn't act like they got the day off when we had one of their patients!

jjjoy, LPN · Oct 26, 2009

Has anyone else noticed the new nurses aren't getting much training? Has anyone else oriented a new nurse, very recently, and wondered how in the world they passed their state boards? .....
I had to take her through all the steps of blood sugar checks, insulin injections, she didn't know how to apply a DSD.

1) Passing the NCLEX has very little to do with one's clinical abilities.

2) Many schools focus primarily on students NCLEX pass rate and meeting the criteria to be legitimate schools. Meeting that criteria does not assure that students get a strong clinical foundation. There are liability issues, overworked nurses who don't want to deal with students, CI's who don't work to assure maximum opportunities, and more. Even if a student must thoroughly prepare the night before, most learning won't be available for quick recall and application until there's been a good deal of repeated experience working in real time. Plus, much of the night before prep work may include trying to create one's nursing care plan to fit whatever varying expectations each CI may have. For some, that may mean hours digging around for how to acceptably word the nursing diagnoses, interventions, and goals.

jjjoy, LPN · Oct 26, 2009

Just another reason why I'm all for nursing students working as techs/nurse interns while in school.

I'm all for it, too. Unfortunately, there often aren't many internship available out there so only a few people can take advantage of them. Some also may promise a lot of learning but end up being mostly bed baths and enemas. Some NA jobs also are quite limited in activities and the workload too heavy to allow the student to learn much beyond their job. I agree that it's usually better than no experience but it may only go far in helping a new grad be prepared to work as a licensed nurse.

Sun_danc3rRN · Oct 27, 2009

I graduated in May with my ADN, and I got a job right off with a hospital on med/surg. I can honestly say that I had a great education, clinicals and all. When we tested on a skill it was usually video taped. If we knew we messed up during competencies(our skills tests), then we had one chance to self correct, and if we did that we failed it. To fail competencies meant you failed your semester. In clinicals in the hospitals during school, we did everything with someone watching. I left my clinicals fully prepared to do dsg changes, foleys, iv's, ng tubes, im,sq, iv, etc, the list goes on and on. There is very little that I have to ask for help when doing a skill on the floor. I work with others who are new grads from other universities and I am always surprised when they don't know how to do a skill. I am very thankful that my education, and my educators were getting me ready for the real world as a nurse. I think the best thing is that most of our instructors for didactic and clinical are still working nurses. They knew the skills that were important for their soon to be new co-workers to have, and they made sure we did it! I am a big fan of the watch one, do one, and teach one practice!