Is it possible that the shortened RN training causes more anxiety for new grads

[madwife2002]

Over the past 5years or so I have noticed an increase in anxiety in new grads and I am wondering if the shortened training is causing more problems for them.

When I trained admittedly I trained many many moons ago I trained a full 3 years in a hospital, I know we did not have such hightened anxiety that the new Grads seem to have at the moment.

We got no preceptorship or mentoring and after 5 weeks I was in charge.

Nurse training changed because we complained we weren't support at all and the powers that be wanted to give new grads more support and education, taking them away from the floor for long periods of time.

We were more annoyed that we had so much work to do and the expectations were you hit the floor running.

It seems no different today the new grads hit the floor running with less knowledge and experience.

I know here in America we pay for our education so we want to complete the education in the quickest way possible so it costs us less money in the long run.

It is now more expensive to train the new grads on how to nurse which is great if they actually get the support, mentoring and training for at least 3-6 months but longer if they need it.

It appears that in the nursing profession we can not get it right!

[okchug]

AMEN to many posts.. I tried to make the most out of clinicals BUT it's hard when the floor nurses already have too many pts and no time to teach-and get no incentive to take on students & your clinical instructor is no where to be found!

I thought it would be great, during school, to do a "mock" day- something we never really got to see. Starting with taking report from 3 different nurses on 8 patients! Noting orders..computer charting....on & on

Reality smacks ya in the face real hard when you get 4 weeks orientation and then 6-8 pts on your own.

[melmarie23, MSN, RN]

I am an 8 month new nurse and it has not so gradually dawned on me that Nursing school did very little to prepare me for the job I am currently struggling in. My school wins awards and has a great reputation...translation: High NCLEX pass rate. The disconnect between school, orientation, and the day-to-day job is downright scary. I still don't feel safe as a nurse on a regular basis.

And my anxiety level is very high.

this is me, except I am a bit newer. I've only just finished my first month. I had excellent grades in school and think of myself as pretty darn intelligent....but while at work, I realize how little I actually know, and that unnerves me a bit.

I just pray that someday it will all come together and "click." I hope.

[tiredstudentmom]

After reading this particular topic, I feel very grateful for the LVN program I am in right now. We just finished our 1st semester and we have already learned vital signs, basic assessments, take care of incontinent patients, document, and blood sugars. Also have been learning the nursing process and just started doing basic care plans. Not saying it's the best or anything but rather stating how thankful I am for the program I chose. Good luck to you all.

[justashooter]

a local ADN program has a 37 credit prerequisite for admission consideration to clinicals, then a 4 semester clinical segment. the students in this school bust caps to get thru the 37 credits in a calendar year, and are then given a clinical schedule that provides 2 lectures a week for a total of 6 hours weekly, and 2 clinical days every other week, for an average of 8 hours weekly. this is considered a full time schedule by the PT that are more bent on a high NCLEX pass rate than anythign else. sure, state and federal funding is dependent on the pass rate, but in this school the students are not given enuf time in the environment to have much skill, and really could be worked much harder. still, this program washes about 45% of those who enroll by the 4th semester. perhaps that says somethign about teh caliber of students applying for the postings...

[mpolo]

Hi,

Im doing a fast-tracked Nursing course in Australia.....and truthfully.....the anxiety levels are through the roof. The course only takes 18 months.....and it basically on steroids. no time for a cigarette break, no nothing.

many ppl dropped out of the course........we started off with like 60 odd, and had finished up with less than 30. (I elected to defer some of my classes, and complete the course in 26 months).

Also I elected to get more hands on Paid experience at nursing homes, to work on my time management, which is what I am currently doing, whilst working through the course one subject at a time/semester.

I am sure.........that fast-tracked courses are exponentially increasing the anxiety of students, and subsequent graduates once they enter the field. SURE.

Although my course was a fast-tracked course.....I personally recommend that for something as important as health-care, people really should go through the longest possible way.......gain as much exposure as possible, gain as much theoretical knowledge as possible....and for all this to occur you need t-i-m-e.

I feel sorry for my colleagues who pushed on.....luckily many were already healthcare professionals (lower level nurses with years of experience, or allied health professionals), so they were in a different position to myself (medical sales background).

I fully agree with you......healthcare education should take time. The less time it takes, the more shortcuts are made and the more potential mistakes will be made (with student anxiety reaching tsunami height levels...)

Keep healthcare education lengthy....it needs to be.

[UVA Grad Nursing]

In the past year, there have been several national studies (Institutes of Medicine, Robert Woods Johnson report, AACN, NLN, etc) that have called for major reforms in nursing education. Most methods of clinical training today look very similar to models that began in the 1970s; chances are good that your faculty are teaching in the same way in which they learned to be nurses themselves. But the practice of healthcare and nursing (and especially acuity) have changed greatly in the past decade and nursing education has lagged behind these changes.

Medical education has changed greatly in the past few years (as the result of national mandates from their national agency). Gone are most of the large lectures and most education is done in small groups to foster discussion, debate, and analysis of case studies.

What remains to be seen is whether nursing schools will take the IOM and RWJ reports to heart and completely overhaul their curricula.

[mama_d, BSN, RN]

Sorry for grammar/spelling errors, my (stupid) smart phone won't let me scroll down and correct them.

I got curious b/c of this post and tried to find how many clinical hours BSN and ADN programs in my state (Missouri) required. Seems hard to get a straightforward answer! The UMKC website touts that their BSN program requires 1200 clinical hours and that most BSN programs only require 900.

My LPN program required over 600 hours of clinicals. The first 32 were in a SNF to learn the basics of pt care (and started on the fifth week of the program). The rest were in acute care settings.

So that means that a four year degree program that requires so many more hours of clinicals that it sets it apart from others only requires twice as many clinical hours as my one year diploma program. Seems a little off.

And FWIW, my program was 50 weeks in length...no real breaks, just rolled over from one quarter to another. We got a week off twice during those 50 weeks. Which meant a lot of missed time with my family...which was a sacrifice I was willing to make for getting a career. So there are people who are willing to do that kind of thing.

Also, our last two rotations we were taking "teams" of three patients for eight hour shifts. We did clinicals at a hospital that had a minimum of 24 beds per unit, and only six students per clinical site, so it worked. We were also expected to assist the floor nurses with pts who were not "ours" whenever they asked, if it was a nursing task.

The ADN program that I'll be doing my bridge with gets two pts for six hours a day on their last rotation functioning as a nurse...that is, doing all meds, treatments, and assessments on two pts the same day. Again, seems odd.

Although what will be even weirder is doing clinicals where my practice is extremely limited with only one or two pts at the same hospital where I run a team of five to six pts while working. Just keeping the two spheres of what I'm allowed to do may fry my brain.

All of the new grads who have a clue on my floor bemoan the fact that their programs, whether ADN or BSN, prepared them so little for "real" nursing. As one of them put it, "I spent a ton of money on a BSN from a competitive school just to learn how to pass a test, not how to be a competent nurse, even for a general med surg floor." They're disillusioned and ticked, /c it really is sink or swim, even with nine weeks of on the floor orientation and three weeks worth of classes. We've got new grads who can't tell the difference between different obvios skin issues, have never seen a PICC line, don't know the difference between HD accesses (like between a graft and a Quinton), don't know s/s of CVA...I could go on and on. Maybe my expectations of what a new grad should have seen during their schooling is too high, or too skewed by the fact that I've done floor nursing for so long. But I know I came out of LPN school with this kind of knowledge.

Sorry so long, my floor's been struggling with how I'll prepared most of our new grad hires are for the last couple of years, so this is something I've thought about frequently.

[Rensoul]

I don't remember how many hours our program requires, but I do know that for fundamentals we spent 6 days in LTC learning how to pass meds and do ADL's (depending on the acuity of the patient) for med surg we got 2 days a week (8 hr days...ish) for 6 weeks rotating through Ortho, cardiac telemetry, and Oncology, with 2 days in periop, and a day in an Oncology clinic as well as a day of skills lab. In OB we had 1 day of skills lab and then rotated thru L&D, Post-partum, and Nursery, one day for each. Personally for me this is more of an overview of skills, and while I can go and practice in lab (and do), working with a mannequin is not the same as working with a person. I wish we had a larger hands on component of classes/ clinical. Just because I'm going to school to be an RN doesn't mean that I won't be expected to know how to do basic tasks, or have knowledge of basic procedures....

I would love to have a clinical course doing nothing but hands on skills.... even if it's in the form of a CEU after I graduate. I know that on the job learning is a big component...however, not knowing basic skills is a hindrance not only to the SN, but to the nurses that share pt care w/ that SN.

Just my

RenSoul

[manchmal]

For my ADN program I'm counting 280ish clinical hours in the hospital or similar

over two years across multiple disciplines (a renal floor, an oncology floor, a tele floor, CVIU, OB, psych, peds with one day rotations to doc offices, outpatient clinics, ER, etc.) Plus 120ish lab hours with mannequins. And the last semester is a 140 hour preceptorship where we work with one RN and do 80-90% of his/her patient assignments, which I am very very grateful for. I wanna do psych nursing and I spend a lot of time at a hospital volunteering with psych so I'm comfortable in that environment and am not as anxious when I get a job as an RN.

My numbers may be a little off but they're close.

Edit: Gah! Was adding up classroom hours. Need a non-phone calculator. Sorry. :)

[Quark09]

I agree with the PPs who wrote that more clinical time would be helpful. When I was in school, we had a ton of class time compared to actual clinical hours, and the experiences available weren't much beyond med-surg (two 8-hour rotations in OR, ONE day in L&D, ONE in ICU)... it did seem that the focus was on passing NCLEX and less on actual patient care. I hit the floor pretty quickly and was lucky to get some great on-the-job assistance, but extra clinical time would have been very beneficial.

[madwife2002, BSN, RN]

I have noticed too that whilst it is part of our job description to teach clinical skills to new grads, it is not always welcomed by 'seasoned' RN's.

You can either strike it lucky and get a mentor from Heaven

or

completly strike out and get the mentor from hell

[mktinpiano]

I am a non-traditional student in a 2-year college seeking my ADN/RN degree. My sister is getting her BSN at a local college also. So far I have found the difference in our programs is that the information we need to know is compressed into a shorter/brief program. I am extremely disappointed at the amount of online content we are given each semester. I feel that in order to safely care for patients in the "real" work world, I not only need more clinical experience where I am actually performing under the direction of a licensed RN, but definitely more lectiure time from experienced professors who have not forgotten the basic fundamentals of nursing. As the previous posters have noted, I've gotten good at taking the Elsevier quizzes and NCLEX type questions, and feel that I could and will pass the NCLEX, but when am I actually going to start an IV, insert a foley/straight cath, flush a pic line, perform CPR, give injections, etc. I've started an IV on a fellow student in lab one time, last semester, and haven't been allowed the opportunity since. While in clinicals, I find myself being a tech to the nurse I'm working with, instead of learning and performing valuable skills I will need to proficiently do myself one day. I realize that our teachers and preceptors are allowing us to practice on their license, but someone had to do it for them before! If I were lucky enough to pass the NCLEX with 100% right now, I don't feel like I have the clinical experience or knowledge to safely practice nursing. My school has just been approved for a BSN program, so I can stay in school an extra year and graduate with a BSN instead of an ADN. But for .50 cents more an hour, I'm not sure it's worth the student loan debt if I'm not going to get any training or experience.