So, a representative from the California Board of Registered Nursing visited our school and asked us for feedback on our program. We had been encouraged to be on especially good behavior during the visit, but I couldn't keep my big mouth shut when the rep said that we should all be looking to the future to get our DNP degrees. I told her that I felt our BSN program seemed designed to push us towards grad school, but that I personally had no plans to become a nurse practitioner or to get an advanced nursing degree. I told her that I felt our program put too much emphasis on pathophysiology and clinical decision-making from the point of view of a physician or nurse practitioner and that we hardly spend any time in lecture discussing nursing procedures, nursing care, or the role of the nurse.
The Board of Nursing representative looked at me as if I was crazy, like I had just complained that the sky was blue. She said it was all about pathophysiology and clinical decision-making "to anticipate the doctor's orders." Am I being ridiculous to expect that lectures will cover nursing care? Is actual nursing care so simple that it does not need to be taught in lecture? Or is it just understood that any nursing care will be learned in clinicals and on the job?
I'm 75% of the way through my BSN program and I still can't wrap my head around how material is presented. It is always from the point of view of a physician; taking a history, doing a physical exam, deciding which diagnostics and lab tests to order, reviewing lab results, making a medical diagnosis, deciding which medications to administer, deciding whether the patient will need surgery and so on.
There are never any phrases in our case studies or lectures such as, "Given these findings, what diagnostics would you expect the DOCTOR to order next?" Or, "Dr. Jones has prescribed amlodipine. Do you think amlodipine is the right medication for this patient?" It may have been stated by an instructor early in the program, but I cannot recall any instructor saying, "Now I know that you are nurses and that in real life you cannot prescribe medications except under certain protocols, but in this class we are going to present all material as if you were physicians so that you can understand how a physician thinks and therefore you will be able to realize if a physician has made a mistake in planning treatment for a patient."
Instead, material is simply presented as if we ARE the doctors. It's very strange. It's like preparing to work at a hospital where there are no physicians, only nurses making all decisions. I get the idea of learning some pathophysiology and clinical decision-making to understand what's going on with the patient and how the medications work, but it just seems weird that I am expected to make medical diagnoses and prescribe medications without going through the more extensive pathophysiology and pharmacology training that physicians are given. I feel like I'm already being pushed to become a nurse practitioner before I've even finished RN school.
Is this normal for a BSN program? How can I adjust my thinking so that I don't feel frustrated? Thank you very much for any advice.:)
