Nursing Needs To Get Back In The Hospitals

Esme12, ASN, BSN, RN · Feb 4, 2014

Yes they had endless hospital experience. They were the facilities free help. Originally they lived at the hospital in dorms. Their nursing course et al. were in the hospital in classrooms. Eventually you were allowed to live outside of the hospital and courses like anatomy/physiology were at local community colleges. They spent an average of 2-3 years every day in clinical and then worked shifts on the floors/wards.

They are by far the better prepared clinical nurse. These days usually they spend one year at a community college for thier college courses then they spend the rest of the time usually 2 years at the bedside in clinical.

pookyp, LPN · Feb 4, 2014

Yes they had endless hospital experience. They were the facilities free help. Originally they lived at the hospital in dorms. Their nursing course et al. were in the hospital in classrooms. Eventually you were allowed to live outside of the hospital and courses like anatomy/physiology were at local community colleges. They spent an average of 2-3 years every day in clinical and then worked shifts on the floors/wards. They are by far the better prepared clinical nurse. These days usually they spend one year at a community college for thier college courses then they spend the rest of the time usually 2 years at the bedside in clinical.

This sounds cool. Thanks for explaining! I would have loved to do this.

RNperdiem, RN · Feb 4, 2014

My aunt did the same hospital training too. They lived in the nurses' home and were taught in an apprentice type situation. For the first 6 weeks they were on probation. The probies were worked hard with basic tasks, and anyone who lacked stamina, discipline or ability was dismissed. After those 6 weeks was shift after shift of learning on the job. A few lectures would be held after your shift, but the emphasis was on learning by doing.

As Esme said, the hospitals loved it since the students provided most of the nursing care in the hospitals. There were fewer staff nurses needed.

I don't see this kind of training coming back. There is a lot of emphasis on college degrees now.

Esme12, ASN, BSN, RN · Feb 4, 2014

I agree these programs are days gone by...there are a few programs scattered still across the US but the are rare. While I believe the advancement of nursing requires a more collegiate education...we need to be very careful about losing out roots and the experience bedside clinical to better prepare the nurse to be just that ...a nurse. As nursing goes forward it needs to be very careful it doesn't educate itself out of a bedside job.

elkpark · Feb 4, 2014

I attended a v. well-respected hospital diploma program in the early 1980s. We were not "free help" for the hospital; we were not counted in staffing at all, same as students doing rotations now. We attended school full time, year round (we got two weeks off at Christmas and two weeks off in the summer -- the three year program consisted of 33 months of full-time study). The nursing classes were taught at the hospital by the nursing faculty; the other courses (a year of A&P, a year of organic chemistry, microbiology, psychology, sociology, nutrition, freshman English) were taught at a nearby college by the college faculty, and those were regular college credits we could transfer anywhere in the future. We took the same A&P, organic chemistry, etc., that the college's pre-med, bio, and chem majors took (we were in class with them). We started clinical within a few weeks of starting school. The first year, we had clinical two days a week and classes three days a week. The second year, we had three days of clinical and two days of class each week. The third year, we had four days of clinical and one day of class a week. I calculated recently for another thread here that we had ~3000 hours of clinical total. In clinical, we did everything (and I mean everything) the staff nurses did. There was no such thing as "students aren't allowed to do that." We rotated through all the specialty areas of the hospital (and all shifts) and graduated ready to practice, at an entry level, anywhere we happened to find ourselves.

The hospital still had a dorm for the nursing students when I was there, although many of us lived out in the community (I was an older student, and got a cheap apartment within walking distance of the hospital rather than live with the dorm rules). There were SON classrooms, labs, faculty offices, etc., built into the hospital.

We were reminded continuously throughout our education that the diploma was an entry into nursing, not a terminal degree, and we should plan on continuing our education beyond our basic nursing education. At the time I was there, the school had a formal agreement with the college where we took our science classes (which had its own BSN program) that our graduates would be guaranteed acceptance there and could finish a BSN in one additional calendar year of study (I chose not to do that; it was an outrageously expensive private college and their nursing program was nothing to write home about).

When I first graduated and took a job at the hospital while I looked for a permanent job in the specialty I wanted, I found myself working regularly with two other recent gradutes, one from the college nearby (where we took our non-nursing classes) and one from the nationally-known and nationally-respected flagship state university in that state. They had both graduated earlier than I had and had both flunked the NCLEX once, and were waiting for their next chance (this was back when it was only offered twice a year). That the local BSN graduate had failed didn't really surprise me, but I was rather shocked that a graduate from the "flagship" state uni program had -- I would not have suspected they would graduate people who wouldn't pass boards first time around (at my program, it was almost unheard of -- it was extremely unusual for us to have less than a 100% pass rate). Since they found it less threatening and uncomfortable to ask me about stuff they didn't know or didn't know how to do, compared to the other, experienced staff nurses, they came to me first with all their questions and requests for help. I was really shocked at how little they knew about nursing and practicing nursing compared to me, and wondered what they had been doing all that time in school. They both seemed comparatively clueless.

While I am a big believer in higher education and moving the profession forward (since then, I've completed a BSN and MSN, and have taught in ADN and BSN programs as well as supervising graduate students), I feel strongly that nursing has largely "thrown the baby out with the bathwater" when it comes to nursing education. The longer I've been out of (that) school, the more I appreciate what an excellent nursing education I got there. Of course, I'm aware that there were mediocre and poor diploma schools also, just like there are excellent, mediocre, and poor ADN and BSN programs.

Esme12, ASN, BSN, RN · Feb 4, 2014

I attended a v. well-respected hospital diploma program in the early 1980s. We were not "free help" for the hospital; we were not counted in staffing at all, same as students doing rotations now.

I meant no disrespect. Even in my ASN program years ago we were used on the floors A LOT although we were not counted as staff. Clearly we were learning a the entire time at clinical.

When my sister went to a diploma program (2 years prior) she had to stay at the school. They were not allowed to be married until the last 2 semesters. They were required to do nights and evenings after clinical and took a patient assignment under the guidence of the floor nurses....they were not paid for this time so in essence they were the "free help"...again not a bad thing. when I went to my ASN we had to work off shifts as well and weekends. We were required to go in early for all the pro-op insertion of foleys, NGT's for the morning cases or tests...again without being paid and on our "own time" THe clinical expereince gaind was valuable but we did take and assignment "for free" meaning our payment was not monetary but experience....which as far as I am concerned... was priceless.

OCNRN63, RN · Feb 4, 2014

I went to a program similar to the one elkpark described. The older I get, the more I appreciate the education I got there. I've had opportunities to work in several specialties, and while it took work on my part to learn what I needed to know to become certified in those areas, it was because of the foundation I received from my program that I could move around from one specialty to another. Back when I graduated, it was a big deal to be a graduate from "X Hospital School of Nursing."

We had so much fun as students there. While we all commuted, there was still a big sense of camaraderie. Some of the best memories I have are of those days.

RNGriffin · Feb 4, 2014

I agree with the motive behind this author's comment. We're churning out worse new graduates ,because instructors fail to allow them to hone their craft. I remember being in nursing school and ******** my professor out for not allowing me to do IV set ups and starts until my 4th semester. They take Nursing students in the hospital, but train them fundamentals the entire time. I've seen senior students come onto the unit & still have no idea how a bladder scanner works, how to start an IV, how to safely turn the patient, how to critically think lab values through. (these are the fundamentals of nursing) You shouldn't be asking your professor if it's ok to turn your patient as a senior.

I become upset with my coworkers who become ecstatic for nursing students to come onto the unit, but only want them to place the patients on bedpans. I mean, seriously?

Katniss88 · Feb 5, 2014

In my opinion, hands on experience goes a long way. You can only learn so much from textbooks and your instructor lecturing you on a certain subject. I graduated from an ADN program where we did lots of clinical hours each semester. For me, hands on experience is where I learn the best. Education on the various disease processes and A&P while in nursing school is very important in building a foundation to become a great nurse, how can you take care of your patient when you don't understand why they're in the hospital.

In nursing school you are expected to learn all this information and learn it quickly in order to pass the test, you may or may not truly understand the concept of what your being tested on. When I was in school that first semester was so difficult, trying to learn how to pass those tests nearly drove me crazy. You can't memorize facts and expect to pass, you have to truly understand it and that's how you pass those tests. Although, as we all know this is easier said than done. With that being said, there is SO MUCH you cannot learn in nursing school(because there's not enough time) or in the classroom. Clinicals are where you learn through hands on experience and using what you've learned in school and applying it to the clinical setting.

I think if there were more emphasis on clinicals we would have better prepared graduates. The textbook knowledge makes you a better nurse because you are able to understand why your pt is sick. I have always thought experience is so much more valuable than years of textbooks knowledge. The experience, in addition to textbook knowledge will make you a better nurse.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Feb 5, 2014

I thought I was a seasoned nurse with my many years under the belt. But after reading some of these testimonials, some of you can be found in a wine cellar! (Before anyone bites my head off, I mean that in the context of getting better with time)!

Madras · Feb 5, 2014

Everyone looks at me like I have ten heads when I say how much I would've loved a hospital based nursing education with tons of clinical hours!

IMHO, nursing students are totally ripped off these days.