Just curious, What do they teach in Nursing School these days?

allnurses Guide · Apr 3, 2012

You are missing the mark. You said yourself you didn't have computers. Therefore whatever griping and moaning went on happened in person, over the phone or in letters. Generally speaking, people who are coping well or not in need of extra support aren't online posting about it. Therefore what you are seeing here is a skewed sampling of the student nurse population. Additionally, people are more educated now about what constitutes lateral violence, abuse and effective teaching techniques. Just as women are no longer expected to stay in their marriages no matter what, students are aware that abuse of authority is wrong and that as a consumer of education they have expectations of a healthy learning environment. Listening to people complain ineffectively is tedious and tiring and after a time it does come to sound like whining or entitlement. But if there is so much of a pattern, it may bear consideration that investigation could be warranted rather than a sweep-arm technique of "this is a generation of whiners". Likely it is some combination of all of the above - a technology generation with the illusion of anonymity, a generation that believes it is more entitled or certainly more aware of its rights combined with the natural human tendency to complain when the opportunity is given. Bulletin boards are open-ended opportunities for expression of feelings and thoughts. People in general tend to do this more when they have something to gripe about.

I graduated this past December. Am I ready to take on 6 patients? Oh heck no!! There is a great deal of focus on theory, development, research and evidence based practice these days that I believe has superceded the focus on skills that may have been a stronger focus 20 years ago in nursing education. Hospitals are having to bring new graduates up to the speed you got to graduate with, thus increasing the expense and hassle of hiring new grads...in essence, finishing their education. The cost of that is being born out now in the hiring patterns we are seeing, with new graduates struggling to find places willing to hire them and give them that extra orientation time. Certainly not the fault of the graduates, who have zero say in what rigors nursing school entails. There seems to be a disconnect in what the market demands and what the schools provide.

If you have been a nurse that long, then you know sweeping generalities are never accurate. I understand the frustration of hearing people complain. It gets old. Many here choose not to read threads by students for that reason. I encourage you to exercise that same power if it is getting tedious. :)

AMN74 · Apr 3, 2012

Thank you for that perspective. I did grow up in a generation where I did what I was told, and I feared and respected my elders, my parents, and my instructors. We had some old army nurses for instructors and it was like drill sergeants before clinical in the morning before clinical. We had to know our stuff or we were considered not prepared and sent home.

We as BSN students did have a lot of theory in our nursing classes, and the old days of sitting through 2 days of an NCLEX exam coloring little dots on a piece of paper no longer exist. I guess I feel the sense of entitlement that the younger generation has is misplaced and lacking in respect.

I do not read student posts unless they filter onto the general nursing board discussion. I, being a nurse of 25 years used to love taking out new students with me in my current home health job...but the last student I took...was a disaster and I said NO MORE.

It was in April, she was a BSN student graduating in May, and we were on our way to see a little old lady that we had to give insulin. She correctly did an assessment, checked her blood sugar, I watched her draw up the insulin and give it, and she was walking the needle back to the sharps container on the patient counter when the patient asked me a question so I stopped watching the student and bent over to talk to the hard of hearing, blind patient. When my eyes left the student she recapped the needle and stuck her own finger. She had 1 month until graduation from her own BSN program.

When do you get taught not to recap needles...In 1985 they were teaching never to recap needles in MY FIRST year of a nursing program. I spent all day with the student getting tested, filling out reports, and it was a mess. I didn't want any more students after that. My experience up until then had been great with students.

I do see that my perspective may be skewed, and maybe I am missing the mark in the days of technology and an "open world"...but I guess growing up in my generation taught me respect, honor, and integrity. And for that I am NOT ASHAMED. I am proud of the education I had, ready go go out and "attack" the world, and being confident in doing so... Thanks for your input!

DookieMeisterRN · Apr 3, 2012

Nursing schools focus more on keeping pass rates up than theory and practice. How is it acceptable that the nursing programs can say, 'oh you'll get on the job training, don't worry about practicing skills in labs/clinicals you'll get 6 months of orientation, we need to focus more on ATI and NCLEX prep than to focus on actual skills.'

I hear this too frequently here and in my workplace with students from 4 different NS.

12 years ago after graduating from my ADN program I had 3 weeks of orientation on the floor and than was ready to take a full load of 5 pts. Our instructor's expectation in my clinical preceptorship was that the student will be ready to take a full pt load by the end of our nursing program thus starting out ready to take a full load sooner on the job.

Consequently, it takes longer to get today's new hires up to speed with what they should have gotten from NS, costing the hospitals more, but also passing students that may really not have earned it just in order to keep NCLEX pass rates up.

75% of the students I encounter today scare me at how little they really comprehend with very little incentive to go above and beyond.No sweeping generalizations here, it's what I personally witness.

AMN74 · Apr 3, 2012

It seems like if the nursing schools would teach you to be a nurse...the nursing questions would also "fall into place". It's been 25 years since I took the nclex or even looked at nclex questions, the nclex questions should be incorporated into your practice to become a nurse. I'm glad I went to a nursing school that taught nursing, not a school that taught how to take a test..that test is 1 DAY of you life (granted if you fail it's a problem...but there are kaplan and other training courses to teach nclex test questions)...being a nurse is what the rest of your life is about...why go to school to learn to get through ONE day when you need what should be taught in school to help you get through the rest of your career?...thanks for your guys input... I just see though these boards and through out the community as a whole just how much society is changing so quickly. I'm no longer in the "hip crowd" of people..at the age of 45 I'm in an older generation...but a generation I'm proud to be from!

allnurses Guide · Apr 3, 2012

I am from your generation too! And yeah....teaching to the NCLEX is a large part of what makes learning to be a "real" nurse difficult. I wish they would teach prioritization more, time management, communication skills, conflict resolution and, of course, more real life type of nursing scenarios. My NCLEX experience had a ton of questions on things that were so specific as to have little bearing on reality. I passed in 75 questions, 45 minutes. Chasing my tail like a mad dog during my current internship though.

classicdame, MSN, EdD · Apr 3, 2012

I recommend reading about generational differences. Us old-timers lived in a totally different world than what exists now. Patients are sicker. More is expected of nurses. Use your vast knowledge to give someone else a leg up

wish_me_luck, BSN, RN · Apr 3, 2012

you always have to remember, around 25 years ago, there were not many nursing schools and it was a tedious interview process that went with application. My mom is a nurse and she went to school in the 70s, so she told me all about it. They had more picks for patients too, meaning they weren't fighting with other schools for "floor time" and what not. Now, there are several nursing schools in areas. There is no interview process (just application), which means most people get in and nursing is a money making program. They want to grow it. That means less floor time for students and we get to see and do less now. And there are observation days in clinicals rather than all hands on patient care now. Mom never had "observation" days.

I will, again, say nursing students try very hard (most do anyway...not all but most) and we aren't trying to be a burden. But, sometimes we just haven't done something and we don't know how to. Reading it in a textbook and doing it are different. I just get frustrated with the "stupid nursing student" sentiment. Also, I have days where I get confused because I am a person that goes by the textbook. A lot of times, that's not what P and P manuals say or how the facility does it.

One thing I will throw out there. I feel like it's a double edge sword. If a student is quiet and doesn't act like a "know it all", they are treated like they are dumb (this is what I have experienced) and "didn't they teach you that in school?" comment/attitude; but if they speak up and have a little confidence, then they are an arrogant "know-it-all" that knows nothing about the real world of nursing.

Nursing students can do skill stuff (foleys, IV starts, dressing changes, etc.), assessments (we did full ones for most of school, only focused during practicum...needless to say, I prefer full ones out of habit; feels awkward not doing full one but I did what my preceptor does), charting with co-signing, medication pass, discharge teaching, CNA stuff like baths, vitals, tele hook up, feeding/tray pick up; etc. We can't check blood; sign off on orders (that I know of; i.e. "noted by Jane Doe, RN"); etc.

Despareux · Apr 3, 2012

As an older nurse, you've had plenty of years to adapt to changes in the field. New nurses are taught in two-years of nursing school what you currently know from many years of experience. You were once a new nursing student who required a period of orientation suitable for your "era". I'm not surprised at how long it takes to orient today's new student to their nursing jobs; especially considering the lack of exposure to old and new technologies, along with rapid changes in best practices.

As for NCLEX style questions...I love them and I'm very happy about being taught how to answer them. Those questions have really helped me to view situations with different perspectives--certainly nothing wrong with that.

wish_me_luck, BSN, RN · Apr 3, 2012

herasheis, I agree. I know there are things that seasoned nurses say that's how you do it or they just learning the changes and we were taught the changes in school. For example, they used to do homan's sign to check for blood clots; now, they don't because it can release the clot. They used to say IM injections (like flu) were given 4 finger breadths down and lower on the deltoid; now, it's 2 finger widths below the acromion process and higher on the deltoid. Also, we were actually told to aspirate before injecting to check to make sure it's in the muscle, not the vein (changes the route); but new CDC guidelines (2011 last updated) say it is not necessary because with proper technique (i.e. doing the 2 finger widths thing, etc), you should not hit a vein and the deltoid is not very vascular.

There are things that seasoned nurses (mainly my mom) have taught me, that work wonderful. For example, using a fracture pan when putting in a foley on a female; using warm wash clothes to get a vein to stick up (one seasoned nurse said it doesn't work; but I have tried it, and it does work).

It's give and take, I guess.

Horseshoe, BSN, RN · Apr 3, 2012

I agree that the acuity of patients seen in the hospital is higher than in past eras. In the old days, people stayed in the hospital for many many days after routine surgeries. These patients were often walkie talkies and didn't need the kind of intensive attention that many on the floors need now. I think the ratios of high acuity patients to nurses is actually quite scary now. Also consider the technology that is in place today-that was not a part of nursing 25 years ago. I think new nurses might come in knowing less than in past eras, but they have a lot more that they need to know.

I graduated 16 years ago. Afterward, I did a critical care internship which lasted several months. I rotated through all of the ICU's and worked closely with preceptors. When I was pushed out of the nest to go "solo," I had a decreased patient load until both I and the NM were confident that I was a safe nurse. No way would I have been ready to go into an ICU environment after only a few weeks of orientation, and I had a nursing school experience similar to that of the OP (though I had a word processor to write papers rather than on an old fashioned typewriter).

I believe it's too bad that nurses are not given better orientations. They'd be stronger nurses once set loose on their own, they'd make fewer mistakes, and retention would be better.

mibrow81 · Apr 3, 2012

I am from your generation too! And yeah....teaching to the NCLEX is a large part of what makes learning to be a "real" nurse difficult. I wish they would teach prioritization more, time management, communication skills, conflict resolution and, of course, more real life type of nursing scenarios. My NCLEX experience had a ton of questions on things that were so specific as to have little bearing on reality. I passed in 75 questions, 45 minutes. Chasing my tail like a mad dog during my current internship though.

yeah, i wish they taught us more on prioritization because when i took my NCLEX-PN i had a hard time on that type of question... but thanks GOD i passed. :)