I'm sitting here musing on some posts I've read from young nurses who say they just graduated and NOW they realize they hate nursing. How does that work? I mean, don't they go to class, have clinicals? Don't they know they're going to be taking care of sick people? I just don't get how you can go through 4 years of nursing school and not know what you're getting into.
I've been a nurse 32+ years. Back in the day, we were not allowed to choose "specialties." You worked where they told you to work. It might be peds, ICU, med/surg, oncology--no choice. You passed meds, gave shots, started IVs, debrided burns, cleaned wounds, and did all your own vital signs & assessments. I understand that patient acuity is higher today(in general) but our patient acuity was pretty high back then, too. By the time I graduated we were taking a full assignment on the floor.
Seriously, nursing education needs to be revamped. More clinical, less theory. I don't think it is necessary to learn about several nursing theorists. I can tell you when I am in a critical situation I never ask myself "What would dorothea orem do?" Careplans are a waste of time now because there are so many books with different diagnoses that a student could pick a diagnosis and not really have to think about the interventions.
I've been a nurse a looong time...an RN. Nowadays it is not just nursing. It is Press-Gainy,JCAHO, repetative and redundent care plans,committees,scripting,computers designed by IT types who never ever asked a nurse what they need in a computer,financial officers who ask if we are going to start putting pain scores on the patient boards, nursing boards who act as if their mission from God is to remove or sully the license of any working nurse,managers who cannot hear what the staff says and patients who are entitled to absoulte perfection all the time no matter what the circumstances. I have always loved nursing but I am glad my chakra circle in nursing is running out.I love and enjoy my patients and critical thinking. Unfortunately, that is about 30% of my job.
Specializes in L&D; GI; Fam Med; Home H; Case mgmt.
Seriously, nursing education needs to be revamped. More clinical, less theory. I don't think it is necessary to learn about several nursing theorists. I can tell you when I am in a critical situation I never ask myself "What would dorothea orem do?" Careplans are a waste of time now because there are so many books with different diagnoses that a student could pick a diagnosis and not really have to think about the interventions.
Well said - I totally agree. LOL @ "what would Dorothea Orem do?" Hahaha! So true.
I'm a relatively new grad from an ADN program in December 2008. From what I've seen of my classmates so far, those of us who had previous healthcare experience have fared somewhat better than those who didn't. I myself did a year as a CNA while getting the first year of the program done and then my last year of the ADN program I worked as an LPN. That last year was priceless in my book. I worked at a nursing home and became proficient and comfortable with passing meds, giving insulin and other injections, respiratory treatments, doing wound care, caths, charting and time organization. You have to be when responsible for 30 residents on the floor! When I graduated and accepted a staff nurse position on a ortho/neuro/general surgery floor at one of the local hospitals, I wasn't completely terrified of the basic stuff because I'd been doing it for the last year. And after being a CNA as well, I didn't feel that I needed to go track down a patient care tech to take my patient to the bathroom or change the bed linens or give a bed bath. I'm not saying that I wasn't stressed after getting off orientation and being on my own, but my previous experience made it so much easier.
I think there is a lot to be said for a new grad these days who was a CNA or PCT previously. Besides, what better way to assess an elderly person's butt for skin breakdown when you're wiping it for them!
We had a classmate drop out three weeks into nursing school because she realized that she couldn't handle poop. Rather than putting her down because of it, we all applauded her self-evaluation skills and thought she was smart for not putting herself through the grind (and putting out all the money) associated with NS if she really hated it.
Maybe some students are afraid that dropping out is a sign of failure? I think more should be encouraged to use clinicals to determine if this is "right" for themselves. Letting them know that there is no shame in saying, "This isn't right for me." Someone good in clinicals, but who doesn't *like* patient care, will not last long in the working world, I believe.
No, it is not just you. Today's sense of entitlement found throughout society contributes to the "gotta have it perfect, my way only" mentality. People resent being told they can't just waltz in and turn everything into "their" show.
I've been a nurse for over 10 years now and both my LPN and RN programs involved 2-3 8 hours days of clinicals each week. I went into nursing young as I attended a vo-tech high school which is where I got my LPN training (my first clinical experience was at the age of 15). While more than half of my classmates in LPN school ended up not going into nursing, most of my RN classmates did go into and stay in nursing (several are in leadership/management roles now).
However, despite the number of clinical hours I had in both nursing programs, I never had more than two patients (well except when I had two moms and their two babies in OB, but that doesn't really count). After completing my LPN program and gaining employment at a nursing school after licensure, I experienced horrible culture shock going from 2 patients to 30 residents! Oddly enough, while I chose nursing for the money (hey, I was a teenager when I chose that career!), I was fortunate to have gone into a career that I absolutely love (even on the roughest days!). This is a hard career that can be extremely stressful in the school phase, and even more so when you are on your own.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i graduated from a bsn program in 1977 and went to work at a community hospital that still had an active diploma program associated with it. they hired most of their nurses from their own diploma program; i was the first bsn they'd hired. in school, i had less than 8 hours of clinicals a week -- two hours to get a patient, read their chart and get started on a care plan, and then 6 hours caring for my one patient. (i don't think i ever had two except in ob.) the diploma rns graduated ready to just step into the role due to the many clinical hours they'd had.
i hated nursing my first two years; absolutely hated it. my orientation was awful -- it consisted of one day of hospital orientation to sign up for benefits and a tour of the unit. then i was out on my own, expected to function as a nurse. i had no idea how to function as a nurse. i worked all the way through school -- two and three jobs at a time, but none of them were in health care. i suspect i was nuts to go into nursing in the first place. i got enough of poop cleaning up after the critters on the farm when i was a kid. quitting was not an option; i was supporting a husband and putting him through school. so i sucked it up and dealt. the hospital had no idea what to do with me - they had expected me to function as their diploma rns did, only with more letters after my name.
my first four or five years, i cried a lot. i cry on the way to work and i'd cry on the way home. but i learned. omg, did i learn! i had no idea what nursing was all about when i graduated, but after five years on various floors, i knew. by the time i was free to pursue a different dream, i had realized that i liked nursing after all. go figure.
the difference, i think, is that these days new graduates feel entitled to just quit if they don't like it and go on to school or move in with their parents while they decide what they want to do next. a new grad i worked with couldn't get into anesthesia school after barely a year in the icu -- six months of it on orientation -- until her dad made an enormous cash donation to the school. another left her sunroof open in a rain storm, with predictable results. the interior of her car was ruined, so daddy bought her a new one. she didn't like working weekends, nights or holidays, so daddy sent her to graduate school so she could become an np. that didn't happen at the time i graduated . . . at least, i didn't know anyone it happened to. i had no options other than to support myself and my husband. so i did.
In my diploma program, nearly 40 years ago, we started out with nearly 100 students, and about 30 were gone by the end of the first year. We graduated about 65. No one that I am aware of decided they didn't like nursing after the first year, I think it was due to the fact that we had plenty of clinical time.
i agree, in that i graduated from a superior, 3-yr diploma program...
lots and lots of clinical experiences.
i do think however, that schools just do not prepare you for the impossible demands that nursing entails.
they don't warn you about understaffing, crazy-nutso pts and families, the violence from coworkers & drs, and the total lack of respect from admin.
we are treated like peons yet expected to keep everyone happy, healthy and satisfied.
and finally, while it is deeply ingrained that we are pt advocates, there is lots of hell to pay, should you dare speak up.
of course we all know or have heard about the pervasive bullying, harrassment, termination and subsequent black-balling that happens, when a nurse advocates for pts, substandard treatments or even work conditions.
there really are valid reasons to hang it up after such a short time.
it is the rare nurse who has mastered and overcome said obstacles, w/o remaining tarnished and jaded.
as i've stated, nsg is a tough, tough profession...
where only the stubborn and determined, need apply.
I think part of it is the lack of clinical time, but also the lack in quality of clinical instructors--I am a fairly new grad...been a nurse for about 5 years. I did an accelerated program, so my clinicals were 2 12 hour shifts every other weekend. And most of my instructors were drill sergeants...they had to be in order for us to learn how to do everything that we needed to do...the day program clinicals were 1-2 days a week for 4-6 hours. How many nurses work 4-6 hour shifts?! When I graduated, and saw the day program instructors on the floor with their students, their attitudes were very different as well--they would come in around 8AM, get report, maybe give out some meds, do a little assessment, help each other give some baths, GO TO LUNCH, and then post conference. Things were very laid back--they never did fingersticks, they were never interested in learning new things, if we were inserting a foley or an NG tube, the instructors were usually off in "lala land". And it's a shame, because you can't blame the students, they really don't know any better--but they definitely could use better leadership.
Just out of curiosity, could some of the seasoned nurses chime in and tell us how many of their classmates decided that nursing wasn't for them back in the day. Thanks in advance!
I graduated from a very competitive ADN program in 1979 and, honestly, I don't recall very many students dropping out. I think most of our program's attrition came from students not passing either the nursing courses or the required sciences. I remember one student very vividly, though. She didn't want to be a nurse but her father insisted that she go to nursing school because her grandmother had been a nurse, her aunts had been nurses, etc. (I always wondered why the dad didn't become a nurse if he thought so much of the profession...) Anyway, she started the program but didn't want to be there and she flunked out the first term. It was sad because she had to please her father first before she could do what she really wanted.
I finished my BSN in 1983 and among the first class in that program to do the RN to BSN bridge. We had a few dropouts in the bridge program, mostly nurses who had conflicts with work and family and just could not balance their multiple responsibilities. I don't think we had many people from the generic program who dropped out---and I don't recall that many flunked out, either.
We had clinicals twice a week, 5 to 6 hours a day, in my AD program, which, in retrospect, doesn't seem like very much. We didn't talk that much about reality shock back then---most of us kept our concerns to ourselves so that we didn't seem like we were weak. I can tell you that reality shock hit me like a Mack truck and the first few years were difficult. I was only 20 when I became an RN and I feel like I had a lot of growing up to do---which I did---but I think a few more years of life experience would have given me better skills to cope with the realities of bedside nursing. Maybe it's the same way with new graduates who feel frustrated today. A little life experience gives one a perspective that cannot be matched any other way---not through more education, not through more clinical---just living life and growing up.
I hope this helps answer your very thoughtful question, Mukfay.
I think part of it is the lack of clinical time, but also the lack in quality of clinical instructors--I am a fairly new grad...been a nurse for about 5 years. I did an accelerated program, so my clinicals were 2 12 hour shifts every other weekend. And most of my instructors were drill sergeants...they had to be in order for us to learn how to do everything that we needed to do...the day program clinicals were 1-2 days a week for 4-6 hours. How many nurses work 4-6 hour shifts?! When I graduated, and saw the day program instructors on the floor with their students, their attitudes were very different as well--they would come in around 8AM, get report, maybe give out some meds, do a little assessment, help each other give some baths, GO TO LUNCH, and then post conference. Things were very laid back--they never did fingersticks, they were never interested in learning new things, if we were inserting a foley or an NG tube, the instructors were usually off in "lala land". And it's a shame, because you can't blame the students, they really don't know any better--but they definitely could use better leadership.
I do hear what you are saying but please help me to understand how the lack in clinical time and/or experience is due to the perceived poor quality of clinical nursing instructors. Clinical instructors, many of whom are on the bottom of the academic food chain, don't have a lot of input into the hours that they teach. In other words, it isn't up to the instructor if he/she has a four hour clinical or a twelve hour clinical. It depends on the school, the availability of the facility, and whether there are other programs competing for clinical time on certain floors. I was a CI on a floor that was experiencing low census and had several schools cycling through for their clinical experiences. Somedays the patients would have a student from one program in the morning, another student from another program in the afternoon, and a third student who was doing a last semester preceptorship---all in one day. The staff had difficulty keeping the students and instructors straight and I remember one staff nurse yelling at me because she didn't understand why the practical nursing students had more responsibilities than my BSN students. It was because my BSN students were in their first semester while the practical nursing students were ready to graduate. The BSN students were not at the same skills level as the practical nursing students and my hands were tied. I could not assign them to tasks they had not learned in school yet.
Some instructors are off in "lala" land. Others try their damnedest but cannot be in two places at once. I had students split between two floors and inevitably, someone would page me when I was helping another student with a procedure or when I was in the stairwell between two floors. It was difficult and I felt it was not the most optimal learning experience for the students. But again, I was on the low end of the food chain and could not affect meaningful change in the program. Yes, I voiced my concerns to the head of the program but nothing changed. After I left, the school continued to use that facility as a clinical site and I just did not feel the students got the education for which they paid there. It was very frustrating.
Additionally, it is difficult enough for most schools to find clinical instructors but almost impossible to find instructors who are willing to work twelve hour shifts every other weekend. The staff nurse who has expertise on a floor---who might be a great clinical instructor---may have to work every other weekend so why would he/she want to sacrifice the other weekend to teach? Additionally, the pay is lower so that's another disincentive for someone to go from bedside nursing to teaching clinicals. If you have to work every other weekend, why not at least get adequately paid?
Please understand that I am not trying to make excuses but that I am trying to present the other side of this issue. Yes, there are some bad clinical instructors out there but a student cannot always blame the instructor for problems in a clinical site or for not providing enough opportunities to perform certain skills. Sometimes there are problems with clinical sites that cannot be overcome. And sometimes programs are set up so that students don't get enough skills lab practice or that they aren't being taught what they should know prior to setting foot on the floor.
How does that work? I mean, don't they go to class, have clinicals? Don't they know they're going to be taking care of sick people? I just don't get how you can go through 4 years of nursing school and not know what you're getting into. 
RN1982
3,362 Posts
Seriously, nursing education needs to be revamped. More clinical, less theory. I don't think it is necessary to learn about several nursing theorists. I can tell you when I am in a critical situation I never ask myself "What would dorothea orem do?" Careplans are a waste of time now because there are so many books with different diagnoses that a student could pick a diagnosis and not really have to think about the interventions.