In a perfect world, how would YOU like to see nursing education improved?

[WestCoastSunRN, MSN, CNS]

If you spend any time on AN, you'll see a common theme of dismay regarding nursing education -- especially, but not limited to, graduate nursing programs. Let's pool our ideas here about how to improve the whole system -- as if someone tasked you to come up with improvements that would actually be employed within nursing academia. We can list improvements for all levels of education. I'm sure we won't all agree on the ideas, but it might be interesting to see the variety. I'll go first.

UNDERGRADUATE:

- all ADN programs should be linked to a BSN bridge program

- chemistry and biochem should be added to prereqs (some schools do require), as well as a full year of statistics (as opposed to one semester)

- Nursing Theory should be covered (and sprinkled lightly) within the context of other classes in order to show application, as opposed to a separate course.

- Written work should be heavily focused on case studies and literature review pertaining to expected or actual clinical experiences.

- Clinical hours should provide plenty of hands-on experience for students to do bedside procedures and manage patient load.

- Clinical hours should be closely supervised, and taught, by clinical instructors (not a drop off the baby nurse and run scenario and hope you got a good nurse to teach 'em)

GRADUATE

- Tightened accreditation standards for ALL schools offering MSN or DNP programs -- regardless of APRN or not, resulting in reduced admissions and closed schools.

- Incentives for schools offering Education tracks and for students pursuing this to help meet the shortage of nursing faculty.

- Direct Entry APRN programs requiring 2,000 hours of nursing practice prior to a minimum of 1,000 hours of APRN practicum in specialty.

- ALL APRN programs requiring 1,000 hours minimum of practicum in specialty.

- DNP programs either research or clinically focused -- adding 500 clinical hours and result in adding a specialty or narrowing focus on one (cardiac, critical care, heme onc, etc).

- ALL APRN programs have a business course included.

- Paid preceptors -- preceptors are considered faculty and contracted

- Hybrid learning (online and in class) with state schools incentivized to offer programs.

Here's a few. What do others think?

[Golden_RN, MSN]

My main concern is for-profit schools that put people in debt for many years.

[Jedrnurse, BSN, RN]

I would put nursing theory into an early grave and focus on a problem-oriented system; one that admitted, yes, we're working in a medical model.

I think chem and biochem would be overkill, unless there was a class geared for people going into health professions, maybe one that combined topics from both general chem and biochem (I had a micro class like that, and I think it was much more helpful than a general micro course would have been.)

I would add a decent research course, one that emphasized critiquing studies and showing people how to dig up the best info out there. (My research course was more of an ego stroke to the professor whose book we (of course) used. I had high hopes for that class and it was one of the low points of my program...)

[llg, PhD, RN]

I agree with many of your suggestions, WestCoastSun ... but not quite all of them.

I don't think chem and biochem specifically should be pre-reqs. I think there are lots of science courses that would suffice and would prefer to give people some flexibility there.

DNP programs should not be research-focused. If you want to be a researcher, get a PhD. Nurse researchers should have the same degree that other researchers have. The DNP should focus on practice (including educational and administrative practice) and the application of research findings. We need to preserve the PhD in order to achieve/maintain equal status within the world of academia. Without it, we will become a "2nd class" discipline.

Instead of a 2-semester stats course, I would offer 1 semester of stats and 1 semester of research methods -- like most schools do now -- but I would make them more rigorous and more suitable for the entry-level nursing role. Many undergraduate research and stats courses are horribly taught, in my opinion, by people so far removed from the role of the staff nurse that the course content is not well-suited for that audience.

I would keep a theory course, but again -- improve its teaching in the undergrad curriculum to be more suitable for undergrads -- emphasizing learning how to use conceptual models and familiarization with the most commonly used theories. I would greatly strengthen the use of both theory and research in the clinical courses so that students would learn how to use both -- instead of isolating that content into their respective special courses.

[WestCoastSunRN, MSN, CNS]

1 hour ago, llg said:

DNP programs should not be research-focused. If you want to be a researcher, get a PhD. Nurse researchers should have the same degree that other researchers have. The DNP should focus on practice (including educational and administrative practice) and the application of research findings.

Makes sense. Although I do think APRNs should be able to deepen their clinical practice, or expand it with a DNP (without adding hours for post -grad certs).

I agree with you and the previous poster, also, on the idea of stats and research methods.

As for the hard sciences -- well I've been removed from them for quite some time, now. But I find many nurses struggle with application of patho in practice and am interested in ways to bridge those learning gaps.

Thank you for your thoughts!! ?

[Swellz]

I too would like clinicals to actually mimic real world nursing. I had max two patients in clinical on med-surg/tele floors, and was expected to carry at least four when I graduated. I just wasn't prepared for the reality of the job.

[FolksBtrippin, BSN, RN]

Students need more supervision in clinical; perhaps by being assigned to nurse preceptors who get some kind of benefit, pay or CE for example.

My A&P course skipped the chapter on electrolytes. Unbelievable.

I took chem and that was helpful for learning dimensional analysis to use for drip rates. Also, for a better understanding of acid base balance, etc.

[CKPM2RN, ASN, EMT-P]

How many years do you propose for an ADN at this point? A full year of statistics? Chem and biochem? The schools would love this idea, the more requirements, the more cash they can make off the students. Hey, let's add a full year of languages and psychology credits just to cover everything.

[TheMoonisMyLantern, ADN, LPN, RN]

I definitely agree with a more rigorous curriculum for both undergrad and grad students. Too many people use nursing as their "plan B" and don't give 2 flying figs about taking care of people. Not everyone should be a nurse, and there's no shame in that. Currently our education requirements are simple, pay your tuition, do your time and 9 times out 10 you'll graduate. Then when you see what bedside nursing is like you do what everyone is doing right now and become a nurse practitioner by going to another "pay 2 win" online school where you do your time and you graduate with minimal effort.

Maybe I'm just jaded but I've had to precept too many people recently that quite simply couldn't be bothered on strengthening their clinical practice, all they wanted was to ca$h that paycheck and to do the bare minimum to scrape by until they could become an NP and make the big money. I'm all for people making money but at the very least earn your keep.

[llg, PhD, RN]

1 hour ago, CKPM2RN said:

How many years do you propose for an ADN at this point? A full year of statistics? Chem and biochem? The schools would love this idea, the more requirements, the more cash they can make off the students. Hey, let's add a full year of languages and psychology credits just to cover everything.

4 semesters, maximum -- just the basics, not advanced content (whatever that is). The whole idea of the ADN is to have a lower level degree that can help someone get their foot in the door of a nursing career quickly ... get an entry level job ... and that's it. If people want nursing careers that involve higher levels of responsibility, they should be required to get the higher level of education (BSN). But the ADN should not be "beefed up" to try to compete with the BSN. It should be clearly different -- and accompanied by a different set of job expectations. That just muddies the waters and causes confusion.

[amoLucia]

All very interesting suggestions from prev posters. But I would suggest something different. An intro course that would discuss the finances factors that impact healthcare.

I realize that this class would take time away from an already too few true nursing class hours curriculum. But ....

Too few beginning nurses know the difference between Medicare and Medicaid, how healthcare insurances work, profit vs nonprofit, etc.

As my career progressed, it became eye-opening as I learned more & more about little things that influenced the delivery (or non-delivery) of healthcare tasks. And I learned how little I knew about those things when I was a newer nurse. I wondered the big WHY things had to be certain ways.

I just wish something like that had been avail way back for me.

[TriciaJ, RN]

A class on Labour Laws for Nurses. Pros and cons of labour unions (not propaganda for or against). Still too many newer nurses being threatened with "patient abandonment" for refusing to pick up extra shifts. Other issues with nurses not knowing their rights under the law.