Question for new nurses

[RNlvn]

I think externship or CNA class because one time in the first day on of class in my BSN program this dude was like "oh Ill just have the LVN do it:uhoh3:" when ask about cleaning up a patient oh and I was working as a LVN then. I was like what obviously this dude has no experience.

[ToughLover]

Man, I don't even know where to start. I already wrote something and deleted it because it was a rant. Something that would be super helpful would be to require students to take ACLS in school and go over the skills in class. If I had come out of school knowing what to do in a code it would've helped so much. I'm still waiting to take my hospital provided ACLS course and I've been working for 4 months now in a critical care unit which I find baffling. I also can't believe how much we focused on NCLEX by doing HESI tests all the time (which are nothing like NCLEX) when NCLEX has no relevance in the real world. "Perfect world nursing" doesn't exist and it's just a test. Focus on what you'll see in real life. It would also be great to teach technical skills hands on in school besides just the simple first year stuff so when you get out and see an art-line you know how to use it instead of staring at it like a moron. It'd be awesome if hospitals could donate some supplies and you could teach your students how to set up and use real equipment because you don't always get the chance to see everything in clinicals.

[I RN A]

1. Please, don't tell your students they would be able to find a job anywhere in the US and right after the graduation. Tell them to be prepared to be unemployed and to take a job anywhere else to pay their bills.

2. Cut down on nursing theories and increase clinical time, test on critical thinking in clinicals.

3. Cut down on nursing care plans.

4. Create clinical time as the real world nursing. Clinicals with 12 hours shifts and all of the demands as a real nurse, not a student.

[Lovely_RN, MSN]

I definitely co-sign on making students have more realistic patient loads before graduating.

I think that nursing schools need to tell their students how physically demanding bedside nursing can be. Bedside nursing is hard work and you don't get a sense of that during clinicals. I thought I would die during my first days of standing on my feet and walking up and down long corridors all shift long.

I would also like to see nursing schools focus on turning out bedside nurses. There is nothing wrong with getting an advanced degree or becoming an APRN (which I hope to do someday) but the reality is that most RNs are going into bedside nursing. I felt like it was pounded into us from day one that bedside nursing was only the beginning and that we were losers to even think of staying at the bedside. It was like advance or die! If there are other schools like mine then this might be why we get so many new grads on AN inquiring about becoming an APRN before completing even one year as a staff nurse. Though I won't lie, I've thought about it too.

Another mistake my school made was letting us observe so many procedures during clinicals. I loved going to the OR and getting to watch but it didn't serve me one bit as an LPN or RN. Students need to be on the floors learning the basics of safe medication administration, wound care, documentation etc. A course or a couple of lessons in conflict resolution (families, MDs, your fellow nurses) and job politics would have been helpful too.

[BettyBoop01]

PRN meds! Everyone on my floor does them differently. I know every hospital has their own policy but in the beginning it was so confusing to me to have a patient on scheduled lorazapam, plus prn ativan etc. I think med administration was not covered well. We only gave meds 1 or 2 times per semester and that was not enough.

[feelingbetter]

Thank you for asking the question, your students are already fortunate to have you! I am probably repeating everything that has been said... As a new graduate who has been fortunate enough to find work in this economically I am constantly questioning myself! I also had two patients on my clinicals and spent HOURS writing care plans, researching the diagnosis, medical and nursing... It really has not yet helped me.. I think schools that have students work with preceptors and actually WORK in a real nursing situation are helping their students tremendously. Yes, we need to pass the Board but if that is all we can really do, then what?

I feel cheated by my school! I have a license and a large school loan but I wake up every day terrified that I will lose my job! School did absolutely NOTHING to help my self esteem.

[TheEmmyRN]

In my program we spent A LOT of time in clinical and our last semster we precepted with an RN and eventually picked up their entire Pt load. We had simulation labs in a room with a one way mirror, dummies that could speak to us and a monitor that showed vital signs/ Pt history. AND IT WAS VIDEO RECORDED! I LOVED simulation lab, it was a nice safe place to make mistakes that we hopefully never make again.

I went to a community college and they have a great reputation with the local hospital systems for training new RNs (and our NCLEX success rate is nearly 100% for most of the graduating classes).

Does that mean that I have transitioned seamlessly to my role as a RN (graduated 6months ago) . . . NO! But I feel like they gave me the experience and background I need to at least survive.

[bennyRN]

Unfortunately I think that its the nature of nursing not to feel prepared in your job after graduating from school. I feel that no matter how much you learn in school, you will never be prepared for the real deal of doing the job. The only way to get comfortable with it is by doing it for real. I've been in my first RN job as a new grad for 3 months now including orientation, and I think I've learned more in this time than I did in school....and I have a LONG way to go! I guess more clinical time in school would always be helpful and doing a larger patient load, but again as a nursing student, you're not licensed to do it "for real" so you wont get that experience till you are.

[birdcage]

remove the unnecessary stresses from school so the student can focus on pt care and theory. if i could have chosen the structure for school here is what i would have done:

2 days of classroom, 2 days of clinical, 1 short day for tests

clinical days would be 2 consecutive 10 hr days (30 min lunch and 1 hr post-conference) with a written report due the following week for each pt that includes a textbook definition of diagnosis and procedures and a layman's explanation for the pt and family; everything possible about routine and po meds that the pt is taking; longhand charting; self assessment of student nurse's struggles and/or triumphs during the shift.

and most importantly, all nursing programs need to have a "shut up and listen" clause that prohibits the obnoxious know-it-all students from disrupting other students (and nurses). three strikes and you are out!

maybe the "shut up and listen" thing is too harsh...