Published Apr 5, 2004
jjjez
32 Posts
Nursing education. good or bad?
I am currently in my second year at a very prestigious london nursing college (hint - she had a lamp that she liked a lot)
My main concerns are the lack of formal practical training we get on the wards.
once we are on the wards we are left usually in my case with a mentor. they are great, mainly because they have to try and teach you, whislt caring for their own patients (this may not be the case elsewhere but it is here!)
now if we imagine a classroom, with 30 kids and 1 teacher, can she teach them all?
Proabably
now imagine that say 15 of them need regular medication and observations etc. can she teach them all?
unlikely
now imagine that on top of all this , she has to try and teach 30 kids, who are ill plus train another student teacher. can she teach them all now???
It's looking a bit dodgy now eh?
wards are great, but it relies on student nurses to learn from routine, which is a good base, but no two days are the same, once you move away from the stuff you do do everyday. but wards are not the same for everyone. i feel that the experience is not equal for all nursing students, and while it is up to us to get the most out of out placements a ward should also be a place to consolidate our learning also. and following someone around all day insn't always convinient for the student or their mentor, who most of the time cannot give you protected time for 1 one 1 learning (especially as my placement is at the UK's busiest renal transplant unit.
My main whinge is about the lack of practical skills, e.g. why are things like venepunture and cannulation, catherization, etc post registration. those three study sessions probably don't even make up a week.
so why are they not pre- registration? it makes more sense to teach as much as possible before we come out, no?
These skills aren't hard, otherwise we wouldn't have nursing assistants and phlebotomists doing them, but we can't really always rely on them.
if accountability starts from day one, then so be it.
if all newly qualified nurses are preceptored then what's the problem. why add more stuff on once the real learning has started
my suggestion is that we steal an idea from medical school training. skills books.
they work like this: can insert cannula - tick box and sign.
see, it proves that they can do it.
if were not sure about just the one go then why not make it 3 attempts, or 5?
why don't we learn these new skills year upon year?
Currently my placement book involves me singing copius forms about whether i know how to treat the ptient as an individual (not applicable on the cloning ward) and whether i know about enhancing dignity etc.
These are great (if not extremely long worded) things to concentrate on, but all the respect, dignity and individuality in the world aren't going to make them better is it?
To me nursing is a blend of practical AND other skills but these seem to have been shunted aside in my experience in order to make my patient feel better.
Personally (my opinion!) i feel that we are treating our patients too much as customers, yes we are providing a service but such as are most complaints in the NHS they don't go high enough to reach the people who can decisively do something.
I really think we need a bit more bulk in our course, actually to do with physically nursing a patient, mainly because other than biology and psychology, the rest should be fairly obvious.
treat you patients nicely, don't whip the curtain round without asking whether they're decent and ask them to do stuff! you can't teach that, well you can but it's a bit of a waste really innit'!
karenG
1,049 Posts
some things never change!!!!
wasnt that good when I trained.............. we were of the 'see one, do one' culture. yes its tough.. nursing is! You do get a heck of a lot more input than we did. we did 10 introductory block then joined the work force! sometimes they let us attend school for a 2 week block but we were there to work! and work we did!! practical skills were taught by students ahead of us.
not sure how you address the problems or how you think your training needs should be met??
Karen
purplemania, BSN, RN
2,617 Posts
I have only lived in two states since getting my RN, so can't speak for all 50, but our nursing schools have check lists as you described. Then, when you actually begin working you get another list (different level of responsibility and there are some things only the RN can do legally). While it is true most tasks can be learned on the job, it is also true that new nurses are generally anxious & lack self-confidence. So I agree with you---more time ought to spent on learning labs while in school so that the nurse has a measure of confidence before learning it "the real way we do it". The emphasis recently has been on critical thinking, not tasks. However, in my case I need a comfort level regarding the task before I can think critically about doing it.
When you get qualified and begin working with students, remember how you felt at that point in your career.