I'm an OLD nurse, graduated from a BSN program 25 years ago. I see these posts about "my teacher did this" or "I want to be a nurse but....I don't want to do L&D etc", or "I got a new job but I will be charge nurse can I do it?" or "Why do nurses eat their young?" or "Am I being discriminated against?" on and on and on.....
I went to a 4 year college. My first year I did general classes that would lead me to nursing school, math, biology, chemistry, nutrition, psyc and human development etc...then the spring of my freshman year I applied to nursing school 72 were chosen out of 400.
My sophomore year in college it was game on, anatomy, physiology, microbiology, pharmacology, nursing 101, 102 (or whatever they were called) and some nursing clinical. We started out in a lab learning vital signs, making beds, general stuff I'd call CNA stuff..then quickly moved to a nursing home where we did those skills on real patients.
By the end of that year we were taking care of 1-2 hospital patients on a general medicine or med-surg or ortho floor during clinical hours. This was the days before computers. Our instructor would go on to the floor the day before and assign us 1-2 patients and that evening before clinical we would have to go to the floor and pour through the meds, the chart, the kardex and go home and prepare (pre-planning..we called it)...we had to have care plans ready, med cards ready (no cell phones to look up meds we had to look them up in a book and write them down on index cards) We had to have a plan and know how we were going to care for that patient, and we had to have in depth nursing care plans ready to go by 7am the next morning.
When we gave meds we had to have our instructor present, or sometimes the nurse overseeing the patient could watch, we had to chart, we had to do it. If you came to clinical without a starched white ironed uniform you were sent home. If you came unprepared you were sent home. If you had dirt under your fingernails you were sent home. If your shoes were not white enough you were sent home.. By junior year we were seeing 3-4 patients on a regular floor and less of course in specialty rotations.
We asked to do new things we had never done... If I had never inserted a foley I'd say to the nurses during morning conference, "If anyone has a foley/injection etc today could you let me know, I need the practice". It was a teaching hospital, they were good to help out. I practiced starting my first IVs and IM/SQ injections on each other in class and then got a little more practice in anatomy lab (we had human corpses in anatomy lab)...
We rotated through peds, psch, L&D, Ortho, OR, and ICUs that year. Our senior year was more to get us prepared; first semester I had to work with a nurse in the community for 24 hours a week, keep a journal and meet with her and my instructor weekly. I chose home health. Since she worked 8-5 I had to work 24 hours a week with her 8-5 that semester and work my other classes around that. Of course it was like with any other job in the beginning she did, I observed but by the end of the semester I was expected to be able to see her caseload, do all the necessary documentation and do what she did.
My second semester I had to pick something in the hospital, I chose peds. I worked with a nurse on the floor, again in the beginning I watched, then gradually she piled them on. I remember one day coming across a new med and I stopped to look it up, she asked me what I was doing and I told her...she told me "You have to become more efficient at this business because you can't be wasting all my time like this"...I was scared of her, but I learned so much, she taught me how to chart, how to give meds, carry a patient caseload.. I worked 8 hour nights with her again 24 hours a week was the assignment...I had to keep that journal and have weekly meetings with her and my instructor. OH and by the way in the last month of clinical if she was in charge...I was in charge...Of course she was always there to back me up for everything and she had to watch me get meds ready to give, I had to tell her how I was going to give them, and if it were IV meds or IVP meds she had to be present.
I guess what I'm saying is I don't know how nursing schools operate these days, but I hear so much whining and complaining on these nursing threads...and nurses are afraid of the new grads because they don't know anything...when I graduated after a 2 week orientation at my new hospital (I started out in peds) I was ready to take on my own assignment of 6 patients. After 6-8 months I was confident as a charge nurse. What's happening to our nursing schools and how nurses are educated?
Is it that there are so many more meds and technology has advanced so much after 25 years that it's not possible any more? Don't get me wrong...nursing school was 4 years of HELL..we didn't have computers, I had to type my papers on a old electric typewriter, I had to spend lots of time with my nose in books researching and learning...but it seems we have a different caliber of nurses coming out of nursing schools these days..Or do we?? Am I missing the mark? I'm just curious...
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
As I am a member of the "Old Bat Society" I'm have to say I agree with the OP.
I don't think the schools are teaching them "nursing" they spent very little time in clinical. They spend a ton of time on NCLEX and scores and IMHO not enough on the clinical skills they require to be nurses. They are more concerned at collecting tuition and churning out graduates to float or sink on their own, completely unprepared for what lies ahead. I think this is why hospitals are not wanting to hire new grads as they have become very expensive to train and at the end......still cannot handle a full load. My niece is in an accelerated nursing program and even though it is a good one chosen by her Mom (my sister) and her Aunt (my other sister) and we are ALL nurses.....she is going to have a hard transitions clinically, when it's all said and done........it just isn't offered.
I see many new grads that are unable to overcome the obstacles after graduation because they just weren't given the tools of coping from school. These poor folks graduate and are shell shocked at the reality of nursing but are so far in debt they can't see daylight. I do think there is a much more sense of "entitlement" and the bedside is just a mere stepping stone to the "real money". I am not so convinced it is a generational thing I think it's a catastrophic failure of the schools themselves failing to teach. Now you must have a masters to teach but they don't require clinical experience to teach these students. My instructors my have had advanced degrees....but they also were experienced bedside nurses.
Today even if you have 30+ years bedside experience....if you don't have a masters you don't have enough education to teach, a very sad waste of a valuable resource.
What you get then is the toddler teaching the infant to talk, not very effective.
We were prepared to be nurses. I had theory. I had pathophysiology. I had forensic A&P. I had Biochem and Micro. I had pharmacology (2 semesters). I had nursing legalities and ethics....all for my 2 year degree. I didn't work at an academic hospital. My instructors went into the hospital and got a list from al the charge nurses for the foley insertion, NGT for OR, drsg changes....any procedure that would need to be done that day and we had to show up before everyone else to prep the OR patients and then go to clinical for our assignment that day.
I eventually took care of 6-8 patients myself before graduation. I had to do clinical on weekends and work all shifts. Staff from the hospitals mentored us. I had to do rotations in EMS, Public Health and school nursing. My program included summers and if you didn't want that you didn't apply to this program. When I finally got my BSN, years later, it was a cake walk when compared to the initial program I had attended.
I too believe there is a generation of whiners and I do not mean just on this board and just not of a certain age........it the electronic instant satisfaction that has distorted perception. It's instant gratification. I expect people to whine here hiding by the cloak of anonymity. I am talking about the nurse at the bedside......I don't want to work nights, I can't work weekends.......what about my friends. I don't want to work holidays. I know I have only been working for 3 weeks but I have a cruise scheduled. I know they are planned a year in advance but if you are in your last semesters in nursing and you plan a cruise, wait until after your cruise to get a job. I also think the electronic age has malfunctioned the self edit button on most peoples expression.
I have had employees just off orientation take the cruise and are very angry when they find out that they aren't going to get paid because vacation time has to be accrued. I have also seen a huge lack of ownership in accepting responsibility and consequences when something goes wrong or a mistake is made. Unfortunately, from my experience, for the most part........ it is generational. Many can be mentored into great nurses but requires a huge amount of time and money......Something hospitals are no longer willing to invest in this economic climate.
Funny that we improved nursing education by requiring more and more education and it's the clinical expertise of the diploma grad the we need most and is missing.
Does Nursing Education Prepare Nurses for the Real World?In a descriptive survey design, Candela and Bowles asked 352 recent nursing school graduates how well their educational programs had prepared them for their first jobs as registered nurses, and what, if any, did they identify as the inadequacies in their education? These recent graduates said they were inadequately prepared in pharmacology, clinical practice, leadership, and the use of patient electronic medical records. Most believed that their programs prepared them more for success on the NCLEX-RN exam than for practice.
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.
This seems harsh. Experienced nurses get needlesticks every day. There are many threads about it on this board. And yes, those nurses too were taught about needle safety. People make mistakes. It happens.
The student, who seems otherwise competent, made such a mistake. The only harm that came was to herself, not the patient. I'm sorry that the paperwork inconvenienced you, but I hope compassion was showed to the student who had a lapse in judgment and was probably distraught about what could happen to her own health. But a student has a needlestick injury and you swear off students for good? Really?
Nothing much changed since you graduated. My nursing school was set up very like yours. I would have gotten a critical U if I looked anything up on my cell while in clinical and I graduated last December.
Nursing school have nothing to do with someone individual behavior. I don't see how older nurses miss this. I know some people that graduated ions ago that will pull out their cell in a heart beat. Once again, new grads are stereotyped... I'm surprised they didn't teach not to do that back in the day. My instructors taught me not to.
Specializes in Clinical Research, Outpt Women's Health.
I graduated 19 years ago and we hardly got any hands on. A shame, but we had the hard work can-do attitude and expectations so it wasn't the same kind of transition for us.
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.
There was a thread here recently which discussed re-capping of needles. More than a few RN's stated that they "would NEVER put an uncapped needle in the sharps container!" These are nurses, not students. The whole thread was baffling to me.
I think it has to do with the age of the students also - for example I have a few fresh out of high school teenagers (18-19) that are flighty, scared of their own shadow etc...then for example you take myself and approximately half of my class of 54 that are either second degree students, LPN to RN students, or students that took several years to finish pre-reqs or have had "life experience" I'm 38, had a career in insurance (got laid off) and I know how to deal with authority, difficult people and understand the "customer service" mindset...
I too believe there is a generation of whiners and I do not mean just on this board and just not of a certain age........it the electronic instant satisfaction that has distorted perception. It's instant gratification. I expect people to whine here hiding by the cloak of anonymity. I am talking about the nurse at the bedside......I don't want to work nights, I can't work weekends.......what about my friends. I don't want to work holidays. I know I have only been working for 3 weeks but I have a cruise scheduled. I know they are planned a year in advance but if you are in your last semesters in nursing and you plan a cruise, wait until after your cruise to get a job. I also think the electronic age has malfunctioned the self edit button on most peoples expression.
I have had employees just off orientation take the cruise and are very angry when they find out that they aren't going to get paid because vacation time has to be accrued. I have also seen a huge lack of ownership in accepting responsibility and consequences when something goes wrong or a mistake is made. Unfortunately, from my experience, for the most part........ it is generational. Many can be mentored into great nurses but requires a huge amount of time and money......Something hospitals are no longer willing to invest in this economic climate.
Funny that we improved nursing education by requiring more and more education and it's the clinical expertise of the diploma grad the we need most and is missing.
Just my :paw:.
I will say that some of my best nursing instructors were Diploma grads (who all went on to advanced degrees), which was not offered anywhere in my state when I went to nursing school. Too bad that's no longer offered much.
The employees angry about not having immediate vacation time when they start a job? Can we say "CLUELESS?"
As for the lack of ownership of one's actions and accepting responsibility and consequences of behavior, I couldn't agree more, though it's rampant in all arenas, not just nursing. It seems to have started with the parents who are in MY generation (or perhaps just before mine), which I find rather hard to understand as most people of my generation were NOT raised like that. Yet so many of my generation coddle their kids, defend them to the death even when they are wrong, deflect blame, helicopter, and demand the trophy for "participation." I don't get it, and we are not doing our kids any favors with these actions. I guess we are seeing the results of this parenting style in the floors of hospitals and the hallways of businesses. I confess I haven't worked with a new grad in quite a while, so haven't been exposed to this. I've read about it a lot recently, though.
some Grade school, middle schools and high schools often "teach to the test" for funding so we should not be surprised that some nursing schools do the same. Hospitals are flooded with schools trying to find clinical shifts for students so the students end up in nursing homes, geri-psych facilities and other nonacute settings to learn. Students at my facility last week had to be firmly asked to leave the desk computers where they were doing homework so the Drs could do their orders. This group of students weren't interested in helping with anything that was not for their one pt.
As for pts being sicker these days: "back in the day" when a pt had their GB removed they came to the floor with an NG, IV, Foley, T-tube and a huge incision. Laminectomy pts log rolled for a week ....and that meant they were basically total care because they had to be turned q2h, fed, etc. I know the expectations of nurses have changed over the years but basic nursing hasn't...
Personally, I believe that nursing school is far more difficult to get through than it was when I graduated in the mid-70's. There is SO MUCH MORE TO KNOW! I have had 35 + years to absorb the information that students now have to know before they can graduate and pass the NCLEX. I graduated from a Catholic University BSN program, and in looking back, a lot of the worry about how we dressed, how neatly our uniforms were starched,how white our shoes, making sure we wore our caps, concern about how perfectly we made the bed, with the nuns bouncing a quarter on it to see if our mitered corners were tight enough,(but not necessarily noting how comfortable my patient was!) blah, blah, blah, have gone by the wayside. What we saw as vital skill was entirely too often just busy, superfluous work. Even in those days, we would be writing elaborate care plans that were never referred to, and only saw the light of day to be critiqued in a classroom.
The technology has changed by leaps and bounds- I remember what a big deal it was when my hospital got its first infusion pumps, for heaven's sake!
What worries me is that even with all the experience and certifications I have earned over the years, would I even be able to pass the NCLEX if I took it today? I am NOT so sure.
I don't have time to read through all the posts, (I'm on break at work). However, I will say that it's not so much Nursing School as it is something else. My experience (as an old guy of 37) supervising folks of different ages in a completely different industry has been an interesting, if not 'trying' experience. I see a continuation of these differences and attitudes in school (many students of many age groups) right now, and it all correlates wonderfully. It's not all cut and dry, and there are exceptions to the rule, so I don't want to say it's "everyone in this age group is like X", but sometimes.....
I'm being intentionally vague because I didn't bring my Nomex Underwear today.
I'm in NS school now, and yes they constantly tell us not to recap needles.......EXCEPT IN CLASS. In our lab bags, we're given a total of 3 syringes. If you want to practice more than 3 times, you have to recap. I'm sure your new grad knew not to recap, but I imagine after having to do it in school so much, it becomes a reflex
I have also seen a huge lack of ownership in accepting responsibility and consequences when something goes wrong or a mistake is made. Unfortunately, from my experience, for the most part........ it is generational. Many can be mentored into great nurses but requires a huge amount of time and money......Something hospitals are no longer willing to invest in this economic climate.
:paw:.
Esme12, ASN, BSN, RN
20,908 Posts
As I am a member of the "Old Bat Society" I'm have to say I agree with the OP.
I don't think the schools are teaching them "nursing" they spent very little time in clinical. They spend a ton of time on NCLEX and scores and IMHO not enough on the clinical skills they require to be nurses. They are more concerned at collecting tuition and churning out graduates to float or sink on their own, completely unprepared for what lies ahead. I think this is why hospitals are not wanting to hire new grads as they have become very expensive to train and at the end......still cannot handle a full load. My niece is in an accelerated nursing program and even though it is a good one chosen by her Mom (my sister) and her Aunt (my other sister) and we are ALL nurses.....she is going to have a hard transitions clinically, when it's all said and done........it just isn't offered.
I see many new grads that are unable to overcome the obstacles after graduation because they just weren't given the tools of coping from school. These poor folks graduate and are shell shocked at the reality of nursing but are so far in debt they can't see daylight. I do think there is a much more sense of "entitlement" and the bedside is just a mere stepping stone to the "real money". I am not so convinced it is a generational thing I think it's a catastrophic failure of the schools themselves failing to teach. Now you must have a masters to teach but they don't require clinical experience to teach these students. My instructors my have had advanced degrees....but they also were experienced bedside nurses.
Today even if you have 30+ years bedside experience....if you don't have a masters you don't have enough education to teach, a very sad waste of a valuable resource.
What you get then is the toddler teaching the infant to talk, not very effective.
We were prepared to be nurses. I had theory. I had pathophysiology. I had forensic A&P. I had Biochem and Micro. I had pharmacology (2 semesters). I had nursing legalities and ethics....all for my 2 year degree. I didn't work at an academic hospital. My instructors went into the hospital and got a list from al the charge nurses for the foley insertion, NGT for OR, drsg changes....any procedure that would need to be done that day and we had to show up before everyone else to prep the OR patients and then go to clinical for our assignment that day.
I eventually took care of 6-8 patients myself before graduation. I had to do clinical on weekends and work all shifts. Staff from the hospitals mentored us. I had to do rotations in EMS, Public Health and school nursing. My program included summers and if you didn't want that you didn't apply to this program. When I finally got my BSN, years later, it was a cake walk when compared to the initial program I had attended.
I too believe there is a generation of whiners and I do not mean just on this board and just not of a certain age........it the electronic instant satisfaction that has distorted perception. It's instant gratification. I expect people to whine here hiding by the cloak of anonymity. I am talking about the nurse at the bedside......I don't want to work nights, I can't work weekends.......what about my friends. I don't want to work holidays. I know I have only been working for 3 weeks but I have a cruise scheduled. I know they are planned a year in advance but if you are in your last semesters in nursing and you plan a cruise, wait until after your cruise to get a job. I also think the electronic age has malfunctioned the self edit button on most peoples expression.
I have had employees just off orientation take the cruise and are very angry when they find out that they aren't going to get paid because vacation time has to be accrued.
I have also seen a huge lack of ownership in accepting responsibility and consequences when something goes wrong or a mistake is made. Unfortunately, from my experience, for the most part........ it is generational. Many can be mentored into great nurses but requires a huge amount of time and money......Something hospitals are no longer willing to invest in this economic climate.
Funny that we improved nursing education by requiring more and more education and it's the clinical expertise of the diploma grad the we need most and is missing.
Does Nursing Education Prepare Nurses for the Real World?In a descriptive survey design, Candela and Bowles asked 352 recent nursing school graduates how well their educational programs had prepared them for their first jobs as registered nurses, and what, if any, did they identify as the inadequacies in their education? These recent graduates said they were inadequately prepared in pharmacology, clinical practice, leadership, and the use of patient electronic medical records. Most believed that their programs prepared them more for success on the NCLEX-RN exam than for practice.
The Rise of "Modern Nursing" Education
Curriculum Revolution
What Is Missing in Nursing Education?
Are There Better Ways to Teach and Learn?
Nursing Degrees: What's in Their Future?
Does Nursing Education Prepare Nurses for the Real World?
The Imperative to Change the Educational Paradigm
Medscape: Medscape Access you will need to register but it is free and has a ton of information (no strings)
Just my
:paw:.