what did you learn in the real world that you wish you learned in nursing school?

CaLLaCoDe, BSN, RN · Sep 9, 2008

I learned that no matter how precise your care is, no matter how fantastic a charting you have charted, no matter how grateful your patients are with your care. Your whole practice can fall apart following two discharges and being slammed with two new patients (admits or trade outs, when a coworker goes home early). And especially when your coworker who went home early did not follow up with MDs or chart medications accurately in the MAR...grrrr.

That's the real world of nursing and I hate being in the mustard when I desperately need to ketchup. Most of all I hate the attitude of other nurses when your caught charting after shift. As if you desired to earn more with overtime. To heck with overtime (I just have to cover my a$$). And I wish I could have left early as others did, who had a get out of jail free card (kind treatment by the shift leader!)

Dear OP, Your title is misleading....I answered the title, not what you might have desired as a response.

icyounurse, BSN, RN · Sep 9, 2008

Little of what I know of nursing was learned in clinicals. Its mostly an on the job kind of learning, which is unfortunate for the new graduate but ultimately true.

I guess I wish I would have learned how different real life nursing is from clinicals.

daisey_may · Sep 9, 2008

I have to agree with icyounurse about nursing as on-the-job training. I might have learned just as much being an aid on the floor I worked as a nurse as what I learned in clinicals. Plus, there are specialties that school just doesn't have time to hit on for very long. Just take in everything that you can, but keep your mind open when you get to the floor that your education is REALLY just beginning.

iluvivt, BSN, RN · Sep 9, 2008

How utterly punitive the nursing profession can be!!!!!

If your employer really wants to get rid of you they will find a way!!!

You need to be committed to life long learning.

Some of the smartest nurses I know do not always have an advanced degree!!

Acuity does not mean a thing if patients are waiting in ER or PACU.

That do your best really means you are not getting any more help!!!

It is an honor to enter into someones life and nurse them!

Respect and care for our elderly patients they have a lifetime of experience!!!

Take care of yourself...be kind to yourself...take a break when you need to...congratulate yourself for a job well done even if not recognized....not everyone can survive in this profession.

AnnaSL, BSN, RN · Sep 9, 2008

The title has two leads, the good thing and the bad thing you have wished all of us had learned...

YES, NURSING is very different in THEORETICAL and CLINICAL.. During the THEORETICAL stage of your learning, you are actually gaining KNOWLEDGE of what the disease is about, pathology, sx and manifestations etc... You and the BOOK...

But when you start to be EXPOSED in CLINICALS, you will learn that what you learned BY THE BOOK does not always follow BY THE BOOK.. Now it's a matter of Good Judgement and Resourcefulness..

We all know that Nursing is something that deals with DEXTERITY and SKILLS.. and constant exposure is the key for you to attain a skill needed in the Profession..

Now, back to the Topic, there's nothing really in the real world that I wished I learned in Nursing School... What I want was, for OTHER NURSES to LEARN to put their HEART and Dedication to work...

It's a great profession, if only most of us REALLY CARE...

UM Review RN, ASN, RN · Sep 9, 2008

They should've thrown all the therapeutic conversation stuff out the window in school, because I had no idea that as a staff nurse, I wouldn't ever have time to have a real conversation with a patient.

grammyr · Sep 9, 2008

Just about everything

sistasoul · Sep 9, 2008

They should've thrown all the therapeutic conversation stuff out the window in school, because I had no idea that as a staff nurse, I wouldn't ever have time to have a real conversation with a patient.

I totally agree. All of those process recordings were rediculous. While I was working as an aide in school I seen firsthand that the nurses did not have time to do all of the things school had us doing. While I agree we must convey caring in how we talk with our patients but a half an hour conversation is never going to happen.

I think school emphasizes careplans to much and other paperwork such as risk management, quality control, and process recordings way too much. We needed more time clinically without having to worry about all of the school paperwork stuff. I just graduated in May and the memories are still vivid.

Trauma Columnist · Sep 9, 2008

Personally I think they should be throwing the idiotic nursing theories and nursing care plans out the window and focus on the medical model of patient care because like it or not, that is what we have. Nursing care plans aren't read or even looked at by anyone!

Then...I would add time management workshops to nursing school. I would include prioritization and triage of care as this is the reality of nursing today. I would also include some classes in customer service because again, this is the reality of nursing care.

And...finally, I would make sure that clinicals have more instructors. I remember wasting many hours in clinicals because there were too many students on the floors so few of us got to do anything.

And....really finally....I would compensate instructors much better so that being a part time clinical instructor would be lucrative.

mcknis · Sep 9, 2008

I love what Trauma said because it is so true. I just graduated in May and have realized that there are so many more things not covered in school that is needed to know, but there are also tons of things taught in school that you will never use again. I wish I would have learned about dressing changes and tips on putting IVs in. I had 4 hours on dressings and maybe the same on IVs. We had a 6hr clinical on IV starts in outpt surg which was a total forifice, but like the others have said, you get your training on the job.

I wish I had learned more of how to deal with docs/upset families/pts, code situations, (throw out therapeutic communication and replace with real-life communication), balancing time/skills/budget, delegation, etc. I had great instructors in school, but it is true that most of what you do in real life is taught during your orientation period.

FERN-tastic · Sep 9, 2008

First and foremost I think they should teach us all that we cannot be the perfect nurse. No matter how much you try, you will never be able to do all the lovely things they teach in nursing school.

Time management. That was where I really struggled when first on my own. Know what needs to be done first, what can wait. And that everything that needs to be done cannot be done now. I don't know if it can be taught, or if it just has to be learned on the job.

And they never teach the shortcuts or little tips that help in the real world. Not all shortcuts are dangerous, IMO. And I don't think you can survive without them.