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Nursing Education - Generalist vs Specialist ?

Specializes in Emergency.

I'm doing a project for one of my nursing classes on nursing education, and whether it would be more beneficial to remain a generalist education system or to specialize from the beginning. I have done a little research already, but I'm curious to hear your thoughts on the matter.

Right now, as I see it, nursing education prepares students to be generalist. To know a little bit about many areas, but not to know ALOT about any area in particular. Nursing students do not really have specialized education to go into any area in particular, and could equally go into virtually any area w/ the same amt of basic education. It is up to the hospital who hires the student to provide the specialized education, which may result in an inconsistent level of knowledge and training being given.

How would you feel if nursing schools implemented specialized education programs, so that nursing students could have a 'major'. Basic nursing education with a major in pediatrics, or critical care, or OR/Surgery. I would imagine the system to kind of be a bridge between a new-grad & certification b/w the ANA/CNA/etc.

Do you feel that this could help to expand the role of nurses in specialty areas? Do you feel that nurses who have the specialization could have an even more expanded practice role in the specialty setting?

Obviously not all schools could specialize in every area, so students specializing in a certain area may have to travel/move to a school with their specialty/major.

One of the concerns I could see coming from this system, is that it could make it much harder for nurses to jump between specialties, without the extra education before their orientation. However, new graduate students would know that much more about their area of interest in particular.

Does anyone know if a specialized type of nursing education already exists somewhere in the world? Perhaps the UK??

I realize that nursing education is unlikely to change from its present system, even if the change was heavily supported, but how would you feel about the change? And lastly, which do you prefer, a generalist nursing education or a specialist nursing education

llg, PhD, RN

Specializes in Nursing Professional Development.

I would like to see an in-between approach. I don't think it has to be all or nothing.

For example: Students could get a general introduction to all of the major areas within nursing during their first 75% of their clinicals -- and then be allowed to focus on a specialty are for the last 25%. Or maybe it could be 50% general introductory principles and 50% specialization.

Another in between approach could be accomplished by defining "specialties" broadly. For example ... specialties could be ... Maternal/child, Adult med/surg, Psych, Peri-operative, and Community Health ... rather than very specific specialties.

So, it could be done in a lot of different ways. After a brief time learning some basic principles of all the specialties, students could focus on their general area of interest and be better prepared in that area on graduation.

However ... a big down side is that students prepared in such a way would have a hard time getting hired as new grads in areas in which they had not specialized. A lot of people could get hurt that way. I think it would be important to give every student enough of a generalist perspective (before the specialist portion of their education) that they would be able to get jobs in any specialty after graduation.

JBudd, MSN

Specializes in Trauma, Teaching.

I think all nurses should have a general, fairly broad basic core of knowledge. As we are striving to have the public accept us as professionals, there needs to be a certain level of expectations that we meet. If I meet an architect, I expect him/her to be able to understand blueprints, designs, wind tunnels, etc., all the things you hire an architect to be able to advise you on.

When someone says "I'm a nurse", there are certain expectations of education that goes along with it. There is so much to learn, to be an all around nurse, that specialties should wait to after graduation. Not to say undergrads shouldn't be able to take extra courses in psych or peds, etc., as electives, but the sheer volume of basic knowledge rules out specialties IMO.

I know that having worked in different areas in my years, the "specialty" expertise comes with experience; the areas I haven't had contact with tend to fade. When I need help for a family member, I'll tell the team, this isn't my area, please explain more; my generalized background lets me understand more easily but I still need the reminders!

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