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.
I like all the ideas mentioned. I agree with having clinical instructors actually teach clinicals! I would increase the number of hours for entry into an APRN/NP school. It disturbs me that a brand new nurse can be in advanced practice and have no real bedside experience.
My bridge program’s sciences were biology based. I am not sure how adding chemistry will help. I did take chemistry for a different program and I struggled more in understanding A&P. The biology based program made A&P easier to understand.
I believe for-profit programs need to be discontinued. I don’t understood paying 30k plus for an ADN degree when a person can go to a community college for about 10k for the whole program.
Get RID of these foolish group projects in online RN-BSN programs. We're already working professionals; we know how to play nicely in a group setting---after all, we do it EVERY DAY! I was never a big fan of group projects to begin with for either of my degrees (non-nursing and ASN), so it really chafes that every online RN-BSN program I look at has at least one course that isn't truly online independent learning because you're at the mercy of others who may or may not take the assignment as seriously as you do. It's one thing to go above and beyond at work to pick up others' slack for the sake of the patient; it's another entirely to be back having to do so in a school setting so that your grade doesn't suffer.
Sorry posting more thoughts simply because this is a topic I feel passionate about.
I feel we need to learn from our past models of education delivery i.e. 3 year diploma RN programs that produced new grads ready to function as nurses immediately post graduation due to the intensity of their clinicals. Maybe they weren't as "well rounded" as college grads today but anyone who has gotten a chance to work with someone from a diploma program probably knows that they truly are prepared to work as an RN. Even my diploma LPN program was clinically more intensive than my RN program and I just don't feel that that's preparing students for the real world and I truly believe that the reduction in nursing curriculum is due to making room for all the general courses.
I realize that general courses have their place in formal education, however these courses also make a lot of money for colleges due to the high volume of students that take them and I think that THAT is the true reason we are told how important it is to be well rounded.
Once again maybe I'm cynical and jaded but those are my thoughts on the matter.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
18 hours ago, TheMoonisMyLantern said:
Sorry posting more thoughts simply because this is a topic I feel passionate about.
I feel we need to learn from our past models of education delivery i.e. 3 year diploma RN programs that produced new grads ready to function as nurses immediately post graduation due to the intensity of their clinicals. Maybe they weren't as "well rounded" as college grads today but anyone who has gotten a chance to work with someone from a diploma program probably knows that they truly are prepared to work as an RN. Even my diploma LPN program was clinically more intensive than my RN program and I just don't feel that that's preparing students for the real world and I truly believe that the reduction in nursing curriculum is due to making room for all the general courses.
I realize that general courses have their place in formal education, however these courses also make a lot of money for colleges due to the high volume of students that take them and I think that THAT is the true reason we are told how important it is to be well rounded.
Once again maybe I'm cynical and jaded but those are my thoughts on the matter.
I'm with you. I'm not going to disparage a university degree but I've had a successful career without one and I'll pit my well-roundedness against anyone's. Besides, I'm met too many university graduates of all stripes who demonstrate an abysmal fund of knowledge. You don't always get what you pay for.
100% agree with those who said to follow medical model. We will get nursing education so it won't be the same, but I find stuff like holistic nursing, therapeutic touch, "nursing research" (Look, if you wipe the pop, it reduces skin rash), and all these filler classes that nurses have to take so that what can be taught in less than a year is extended to 2. I remember classes like community, research, and few more utterly useless in my career. Medsurg, pharm, family, competencies should just be fine. Basically, don't try to over complicate
More time in simulation experiences and less time in clinical. Schools and hospital systems are able to allow students to do less and less when dealing with real patients, so instead of keeping students busy by having them review charts in clinicals (where they could just as easily do case studies in class)- have them apply clinical skills in a sim lab to better prepare them for the bedside.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
11 hours ago, rearviewmirror said:
100% agree with those who said to follow medical model. We will get nursing education so it won't be the same, but I find stuff like holistic nursing, therapeutic touch, "nursing research" (Look, if you wipe the pop, it reduces skin rash), and all these filler classes that nurses have to take so that what can be taught in less than a year is extended to 2. I remember classes like community, research, and few more utterly useless in my career. Medsurg, pharm, family, competencies should just be fine. Basically, don't try to over complicate
My community and global health class was probably the most applicable and important to my career. If you work outside the hospital or with populations that class is fundamental. Even if you work bedside it's still good to understand how populations are assessed and interventions are developed to address issues. It's important to understand how your patient's environment is affecting his or her health. If you didn't learn that stuff than you had a bad community class. Also, a research class is absolutely necessary. We don't need nurses who don't believe in research or evidence based practice.
More time in simulation experiences and less time in clinical.
Noooooo. More clinicals with smaller clinical groups and instructors who are truly invested in their students. Reviewing charts is not a clinical activity. Nursing students need way more hands on with actual real humans.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
On 5/13/2019 at 6:15 PM, TriciaJ said:
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.
My school offered a free class on nursing law. It was taught by a nurse-lawyer-professor and was extremely helpful to me. The info I got from that class conflicted with a lot of what I've heard here.
My state supports unions, so here presenting pros and cons of unions is kind of like presenting pros and cons of clean drinking water. All you have to say is that you have a union job and everyone knows you have a great job. It's not like we're split on that.
Noooooo. More clinicals with smaller clinical groups and instructors who are truly invested in their students. Reviewing charts is not a clinical activity. Nursing students need way more hands on with actual real humans.
More time in simulation experiences and less time in clinical.
No way.
If clinical time isn't useful, that's the problem - but more sim isn't the answer. There's already a problem with too much pretending what one might do and not enough actually doing it IRT with guidance. The pretending becomes especially worthless about the time random nursing instructor tries too hard to make it tricky.
And what kind of chart reviews are you doing at clinical? Reviewing the details of what is happening with one's assigned patient(s)? If so, that is far more valuable than what is typically gleaned in reading random cases with no RL connection - - although it is an activity that used to be expected to have been completed before becoming involved in that patient's care. I understand that's more difficult with greatly reduced LOSs, but one way or another students need to understand the big picture of what is going on with the patient. Maybe you're talking about another type of review of random charts (agreed that wouldn't be a great use of clinical time).
But I still don't understand why you would say that clinical time is being wasted on reviewing charts and the solution to that is to do clinical skills in a sim lab....How about doing the clinical skills while you're at the clinical site...??
My community and global health class was probably the most applicable and important to my career. If you work outside the hospital or with populations that class is fundamental. Even if you work bedside it's still good to understand how populations are assessed and interventions are developed to address issues. It's important to understand how your patient's environment is affecting his or her health. If you didn't learn that stuff than you had a bad community class. Also, a research class is absolutely necessary. We don't need nurses who don't believe in research or evidence based practice.
Thank you. I hate when these nursing education debates become so stringently anti-ANYTHING remotely intellectual. Nursing is more than just a series of tasks that need to be mastered! Yes, the pendulum can swing too far and there are issues with some nursing theory and research, no doubt. But keeping your head in the sand and pretending like nursing is going to stay the way it always was is ridiculous. Healthcare has completely changed within the last few generations when diploma nurses were the norm. We need nurses to have a stronger educational foundation than just mastery of hands-on tasks.
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Salisburysteak, BSN, RN
164 Posts
I like all the ideas mentioned. I agree with having clinical instructors actually teach clinicals! I would increase the number of hours for entry into an APRN/NP school. It disturbs me that a brand new nurse can be in advanced practice and have no real bedside experience.
My bridge program’s sciences were biology based. I am not sure how adding chemistry will help. I did take chemistry for a different program and I struggled more in understanding A&P. The biology based program made A&P easier to understand.
I believe for-profit programs need to be discontinued. I don’t understood paying 30k plus for an ADN degree when a person can go to a community college for about 10k for the whole program.