Experienced Viewpoint Please?

[bitter_betsy]

I am currently in the process of applying to schools. I am looking into 4 different programs near me. Because I have a degree already, I can complete each program in 4 semesters once accepted. I know that there are routine and sometimes heated discussions on here about BSN vs ADN. I'm not trying to take into consideration the cost or the type of degree really. My concern is coming out of school and feeling confident. In your experience what produces your most confident new nurses? Am I better off going to an ADN program - do they have more hands on clinical time? Are there specific criteria in a program that I can look for? Does it all just boil down to me and how I react to things, or maybe just my luck of the draw in clinicals?

For those of you that have been there and mentored and guided new nurses on their journey - what knowledge can you share with me to pick the right path? I know that ANY program will prepare me to pass the NCLEX, but can I make choices now before I start school to better my chances and feeling more confident when its time for me to lace up my shoes as a "new nurse"? If so - what would those choices be?

I appreciate your time and value your feedback!

[llg, PhD, RN]

Find out how much clinical time you get in each of the schools. The more clinical time, the more comfortable you're going to be coming out of school. t.

I have to disagree with that, Ruby. The quality of those clinical is also important. Where I live, there are some programs whose students have a reasonable number of hours of clinical -- but the quality of the instruction (and the amount those students are allowed to actually do in clinical) is pathetic. You can't just look at the number of hours of clinical -- but you have to look at the quality.

For me ... choosing a school should be about determining the quality (with an eye also on cost). Look at the number of students who flunk out of the program and the NCLEX pass rate. Also, look at the amount of clinical hours.

But also look at where those hours of clinical are done. Are they done at the leading facilities in the region? If not, why not? Do those leading hospitals not accept those students?

Also ... if you can find out ... where do most of the new graduates find jobs? Are they the types of jobs you want? If not, why not? Will the leading hospitals rarely hire those graduates often -- or just ocassionally?

[caliotter3]

Agree about the quality of the clinical placement. Had a clinical where the clinical instructor, after the first meeting, spent the entire term on her vacation. Prior to leaving, apparently she had instructed preceptors on who was to pass and who was to fail and the preceptors followed through. Hard to understand how the university allowed her to get away with that. And don't ever talk to the students with the preceptors that were told to fail the student. People did not find out about that requirement until it was too late to do anything about it.

[snowflower2016]

I would recommend finding out what type of clinical placements each program offers. Some programs place their students in long term care facilities for their med-surg clinicals, which will not prepare you well if you're interested in working in acute care. Some programs also have "simulation-based" clinicals if they don't have access to a site with a particular specialty (I work with nurses who had simulation-based clinicals in pediatrics and women's health.) I would encourage you to choose a program where you can work with real patients in all areas! Then you'll have a better idea of what type of population you like to work with.

[bitter_betsy, BSN]

Thank you all so much!! Your responses have led me to a few more questions if you would be so kind.

It should worry you. They weed out all but the best students in order to make their NCLEX pass rate high.

So if they only graduate 25% and their NClex is still only about 87% - this shouldn't be my top choice correct?

Ok, my comment is going to make some "pop some popcorn "

diploma hospital based program, if you can find one

I wish that I had this here but I don't (I don't think its available in my state - I've looked at the licensing page and it lists ADN and BSN programs). The closest I have is an ABSN at a Medical University - its the most expensive option.

Find out how much clinical time you get in each of the schools.AND many of them think they know more than the mere BSN nurse because of their MSN . . . not knowing how much they don't know.

I was certified as a Personal Trainer and an Aerobics instructor. I was even certified at one point to train aerobics instructors to teach - I know exactly what you mean by "not knowing how much they don't know". I can't say I won't ever make this mistake - but I am certainly aware that I more I learn the more I realize that I can't even begin to ever know enough. This is actually the reason that I want the best skills I can get coming out of school. I can learn the book stuff later, but there isn't a replacement for in person learning.

The quality of those clinical is also important. Where I live, there are some programs whose students have a reasonable number of hours of clinical -- but the quality of the instruction (and the amount those students are allowed to actually do in clinical) is pathetic. You can't just look at the number of hours of clinical -- but you have to look at the quality.

For me ... choosing a school should be about determining the quality (with an eye also on cost). Look at the number of students who flunk out of the program and the NCLEX pass rate. Also, look at the amount of clinical hours.

But also look at where those hours of clinical are done. Are they done at the leading facilities in the region? If not, why not? Do those leading hospitals not accept those students?

Also ... if you can find out ... where do most of the new graduates find jobs? Are they the types of jobs you want? If not, why not? Will the leading hospitals rarely hire those graduates often -- or just ocassionally?

Ok - so here's the scoop on this.... the 2 year school with the low graduation and an 87% NCLEX rate puts their students in small regional hospitals within 60 miles. I haven't spoken to students in the last 2 years about what actual hands on they are doing. They used to get a pretty good bit of hands on training with people right on top of them but I don't know any current or recent students to ask.

One state 4 year school places you in the local "good" hospitals. The majority of the students get placements in the residency programs upon graduation. Their NCLEX average over the last 4 years is only 83%. I know a girl currently in school there and they are doing the online HESI thing now - where they constantly have to do online training - my guess is to pass the NCLEX.

The other state school puts you in another "good" hospital - but I choose not to use that "good" hospital as I've personally had many issues with it and treatment of my daughter. I can't say I won't ever work there, but I will do lots of investigation first and choose carefully. Their NCLEX pass rate is 87% also.

The last school is a Medical University - I'm fairly certain you stay there for clinicals but I don't have any idea what their placement rate is. Its the highest $$ of the schools. Their NCLEX pass rate is 92%.

If I put them in order by $$ it would be: ADN, BSN with 83%, BSN with 87% and ABSN with 93%. There is a $25k difference between highest and lowest.

If I put them in by choice it would be ABSN, BSN 83%, ADN, BSN 87%.

The ABSN is 4 consecutive semesters (including a summer semester), the remainder of the programs are 4 semesters - no summer options available.

I guess I will start investigating clinical hours as best I can.

I really do appreciate all your help!!

Thanks so much.

[mmc51264, BSN, MSN, RN]

I have a BS in biology. I missed the deadline to apply for the local ABSN program so I opted for an ADN program at comm college. Cheap. 600+ hours of clinical time. Got a job right away. Got my dream job about a year later and this organization offers tuition for ADN and then after 2 years, I qualified for tuition assistance for my BSN. Did my BSN online in a calendar year. With the assistance and a scholarship for good grades, cost me nothing. I think I got more out of the BSN program after working for 2 years. It gave me more context to answer questions with. Just finished my MSN with more assistance from work, it did not cover all of my expenses, I did have to borrow some, but a fraction of what I would have if I had tried to go to the school that is associated with my teaching hosp.

Someone mentioned diploma programs. Watts School of Nursing is still going strong and they have an agreement with a local school to help the diploma students bridge to their BSN concurrently. Duke hires the diploma students from Watts.

[winniewoman9060ret]

I would avoid the school with the low rate.

[bitter_betsy, BSN]

I have a BS in biology. I missed the deadline to apply for the local ABSN program so I opted for an ADN program at comm college. Cheap. 600+ hours of clinical time. Got a job right away.

Thank you for the info. I wish that I could go the Watts route I used to live near there, but I don't any more. I am blessed that I can travel to 4 different schools, but I can't actually move. I moved my mom and gramma here so I'm sort of "stuck" in that I can't leave here now. I'm in a pretty good geographical location - I have just decided that my mom and gramma will be my priority and I just can't leave them to someone else to care for. Luckily they are still healthy and I hope they stay that way through college.

[bitter_betsy, BSN]

I would avoid the school with the low rate.

Thank you! Its currently the "top runner".

[c27_AEMT, BSN, EMT-I]

Just my thoughts, as I was in your shoes not too long ago.

I went with an ASN. It was cheaper, I would be an RN sooner, the NCLEX pass rate was near 100%, and the clinical placements were great for final semester, not to mention that during the program the clinicals were of higher quality than the BSN in town due to the instructors and how the director of the program ran things.

I could have done an ABSN but even with the GI bill it would have been around $30k. My program was a few thousand a semester for around 16 months.

To those who say you can't get a job with an associates...that has not been my experience. I made a list of 50+ hospitals across the country where I was interested in working. I contacted their recruitment departments since many websites said BSN required. Only three had a hard requirement for BSN. About five others had fewer openings for ASN, and the others didn't care but put that on their websites to get more BSN applicants.

I work in a large academic setting now where the pay is ok and the benefits are amazing bordering on insane. I just finished my BSN (paid in full by work) while some friends who started the BSN are just graduating or will be graduating next semester.

I am not one to say which is better, but despite all the naysaying about ASN that I heard when starting nursing school, it worked out great for me financially and professionally.