Question for new nurses

[long26]

As a full-time nurse educator for the last 7 years(and many years as clinical instructor), I have been fortunate enough to keep in touch with some former students as they transition into the RN role. Sad to say, many seem to be having a tough time of it. I got into nursing education because I appreciated the difficulty that I, and many of the new nurses I precepted, had in the transition to the RN role. I'm interested.....What suggestions would you offer to schools of nursing to assist in making your transition from student nurse to registered nurse a smoother time?

[SrnD]

i loved my nursing school (a 2 year college) and really felt they did a wonderful job of preparing us. most of their graduates share that sentiment.

what i liked about the program was that they didn't baby us. we were held responsible for a lot of information and work in a short amount of time. it was hard work but definitely doable.

also, i myself always learned a great deal from having practice scenarios. for example, the floor i work on had a mock code for the new grads/residents and i honestly feel like in a real code i would be slightly more calm than i would be had i not seen the mock one.

i do wish though that we had taken on a larger patient load to help with time management. our max at senior year was 2 pts. i would've liked to go up to 3 maybe to gain more experience.

[JenniferSews]

Larger patient loads would help. We had a max of 2 as well and it was no prep at all for handling 15 sub acute patients with three days of orientation. Less emphasis on preparing for NCLEX and more on things that we'd actually be doing. Some time management strategies and what to ACTUALLY expect. Our school functioned on the old model that they needed to get us through NCLEX. Some things, like wound care, was barely covered since "hospitals have wound care teams." LTC facilities often don't have wound care teams and I'm having to learn on my own. They told us once we had hospital jobs we'd have a nice 6 month orientation where we would learn time management. The reality is that is rare now and we were left to sink or swim.

[backinwonderland]

How to deal with unemployment after four years of school? Kidding! ...kind of;)

I wish that we had more time in the sim lab at school to deal with more "hands on" experiences. I understand that school is mostly about the theoretical knowledge, but I felt like I didn't get nearly enough time actually doing basic nursing tasks. Ideally that would mean more time with actual patients and a full patient load, but even the sim lab is better than nothing.

[JeanettePNP, MSN, RN, NP]

I'll echo what others have said -- more rigorous and demanding clinical experiences. I feel that I spent too little time on the floor, and too little time actually doing anything while I was there. Fortunately for me I'm a quick learner and after doing a procedure 1-2 times I feel comfortable with it... but there are so many basic procedures that I have never even seen outside a lab video, let alone practiced them myself.

[BettyBoop01]

My school did not offer a preceptorship or externship program, it was just classroom and clinical. Clinical groups were too big, so when I graduated I felt like I had no experience. And we just had a few weeks peds, a few weeks maternity and 1 day OR. So applying for jobs against people who have hands on preceptorships in a specialty are going to get the job before me, and do better.

In school we only took 2 patients tops, I think the second year we should have taken more, like 3 then 4.

[biblepoet]

Have the students at the end take on more pts. I have 8-15 normally and only had one or two at the most. Learning how to organize that would be great.

[shoegalRN, RN]

I would say MORE clinical time, less classroom time.

And for the love of God, please stop the practice of going up to the hospital to get your pt info a day BEFORE clinical. This does not help in the real world. I would suggest going in @ 0645 and getting report like a RN. Maybe the instructors can go over what to expect in report the day before in class, practice it, and give the students a report sheet to fill out. Then let the students go in cold like everyone else. Allow them time to look up their meds after report and then spend 12 hours on the floor instead of 6.

And those careplans? It shouldnt take HOURS to complete one care plan. In the real world, care plans are completed by one computer click.

[IknowIcanRN]

I just graduated from a second degree BSN program in August. I found that I learned very little in clinicals. There were usually 10 students per instructor, so if you got to see your instructor for five or ten minutes you were lucky. The rest of the time we were just thrown in with the patient not knowing what to do. Once in a while I experienced kind nurses that remembered what it was like to be a student and offered to help me do different skills, but this was very rare. My point is that it would help if there were fewer students assigned to each instructor, so the instructor could actually help you learn nursing skills.

[eyeball]

I agree with so many points made by previous posters. In retrospect, my clinicals were an almost total waste of time. On only two occasions did I have more than 1 patient and all I did was bath, assessment, accuchecks, meds sometimes not all the time because the CI was too busy to do it with each of us. I am floored by what nursing school did NOT teach me. As other people have posted it was all about exams, busy work, how we dress, and passing the NCLEX. Passing the NCLEX was easy. Learning to be a decent floor nurse is a whole new and very difficult ball game.

[backinwonderland]

I would say MORE clinical time, less classroom time.

And for the love of God, please stop the practice of going up to the hospital to get your pt info a day BEFORE clinical. This does not help in the real world.

Oh Lord, I think I repressed all of my memories of "pre lab" until just now! So. Unhelpful.

I think it would be so much of a better learning experience to get report with the nurse, and then AFTER your clinical do some kind of write-up on the patient so that you have a real life situation to reflect on. I know for me personally, understanding the pathophysiology of a disease process is a snap once I've actually seen it manifested in a patient.

[annaw05]

The most possible clincal hours is key and having patient's take on larger loads. I also think that in my clinical group we may have learned more if there weren't 10 students in one class.