Should Nursing Education Begin in the Hospital?

fergus51 · May 23, 2004

I say it should begin in nursing school only because a nurse can't just walk onto the floor and function without hurting patients. They need some background knowledge and like it or not, that comes from school. There is nothing worse than a student who devalues their class time and thinks that nursing is an apprenticeship from day one. It isn't. It becomes one, but can't begin as one.

RNPATL, DNP, RN · May 23, 2004

Just need a roll call here, add a little comment if you like, but we are really interested to find out how many nurses agree with "nursing education should begin in the hospital."
If you disagree or don't have a comment, please at least hit that quickie response form and let us know.

Nursing is so varied and diverse anymore that initial education should begin in the university system. Nurses work in many different places and have many different options today. I know of plenty of nurses that went from nursing school into industrial health, pharmacy sales, school nursing, etc .... that having their initial education beginning in the hospital would have been a waste of their time. Certainly hospitals play a pretty significant role in a nurses education, but should not be the focus of their education.

Dixiedi · May 23, 2004

I say it should begin in nursing school only because a nurse can't just walk onto the floor and function without hurting patients. They need some background knowledge and like it or not, that comes from school. There is nothing worse than a student who devalues their class time and thinks that nursing is an apprenticeship from day one. It isn't. It becomes one, but can't begin as one.

Oh goodness, I didn't think anyone would not understand how a hospital based nursing school prepares their nurses!

Hospital prepared nurses spend a lot of time in the classroom. For example, when I went to school, we had claasroom for quite some time to prepare us to begin our clinicals. (it's been 30 years, I don't remember how long) then when we were prepared to do simple pt care, we started clinical rotations and went to class. 1/2 of the class did rotations in the morning and class in the afternoon, the other half reversed. This was 7am - 5pm everyday except during evening and night rotations.

Our assignments were based on what we were studying.

No wonder there is such a rift in beliefs about how nurses should be educated. Apparently the university nurses haven't spent enough time in a hospital to know what's going on in there!

pickledpepperRN · May 23, 2004

My nursing education began as a volunteer candy striper. I took books and magazines to patients. Even for THAT I had to undergo an orientation so I would not give an NPO patient food or drink, or try to "help" a patient out of bed.

Later I took a certified nursing assistant course in adult school. We had 16 hours of classroom first. We made occupied beds with 'dummies' to simulate a patient, safety information, and learned to take each others vitals before the big day we were assigned to greet and take the vital signs on our first patient.

After working a few months as a CNA I went to LVN school. The first two weeks were classroom only. Then it was three 8 hour shifts in the hospital and two six hour days of lectures and exams. It was a 49 week full time program. (A full year).

17 years later I was taking prerequisites to enter an ADN program. Loved the science classes. It was exciting to finally understand WHY I had been doing things. Challenged one year of nursing basics. Earned my RN after 19 years working as an LVN. Worked nights and went to school days.

Eight years later finished my BSN one course at a time.

Started grad school taking coursework for becoming a CNS. I learned a lot but quit to have more time with my DH.

Working full time in hospitals in five decades (med/surg, telemetry, and critical care) I have experienced many new grads.

When very new LPN/LVNs and diploma RNs are more experienced and able to perform procedures.

After a couple years there are no trends. Some LVNs learn so much they are as capable as the average RN but without the legal authority or pay for what they have learned.

The BSN who graduated without inserting an NG tube may become the one we all go to to help with the difficult insertion.

As someong mentioned in another post hospitals need to provide an orientation sufficient for each nurse to learn the competencies for the unit where he or she will work.

A resource nurses, usually in charge, must be available to assist new nurses, floats, and registry nurses.

Our work is so valuable I think we should do our best and be very proud of what we do.

Sorry this is so hospital oriented, I have only worked in the hospital setting.

obeyacts2 · May 23, 2004

I checked undecided on this poll because I think that schools and hospitals should be more cooperative in trining nurses- I get the impression its the us vs them thing going on. In my own training I think the ADN program should be restructured. We take all this theory, then get turned loose in the hospital. Some of my fellow students have strange ideas what nurses do all day- to quote- "all RNs do is chart, pass meds, and tell techs what to do". Another of my classmates was scared of handling SALIVA in a physiology experiment. Several of us with pt care expereience pointed out she better get over it, as RNs deal with alot grosser stuff than that. I just think as a prereq to any ADN program should be CNA training or some other entry level experience. Our program gives credit for EMT training or another program I forget which.

Laura

fergus51 · May 24, 2004

Oh goodness, I didn't think anyone would not understand how a hospital based nursing school prepares their nurses!
Hospital prepared nurses spend a lot of time in the classroom. For example, when I went to school, we had claasroom for quite some time to prepare us to begin our clinicals. (it's been 30 years, I don't remember how long) then when we were prepared to do simple pt care, we started clinical rotations and went to class. 1/2 of the class did rotations in the morning and class in the afternoon, the other half reversed. This was 7am - 5pm everyday except during evening and night rotations.
Our assignments were based on what we were studying.
No wonder there is such a rift in beliefs about how nurses should be educated. Apparently the university nurses haven't spent enough time in a hospital to know what's going on in there!

I am aware that hospital based programs include class time, and that was what I was trying to point out: that nursing education begins BEFORE they get to the floor. Your question was "should nursing education BEGIN in the hospital?", and that's just not realistic which is why no program does it that way.

Coincidentally, the way you described your program is the same way my university program was run. I have spent enough time in the hospital to know what is going on, thanks.

Dplear · May 24, 2004

And this type of debate is precisely why we are never really considered professional in the eyes of our co workers or in the public eye. Professional means higher degree means university.

Dave

fergus51 · May 24, 2004

Personally, I think all nurses should go through a program that is run with hospital experience as a priority and it should grant a BSN on completion. I think Diploma and ADN students are getting ripped off. When most of them spend 3+ years in school anyways, they should get a bachelor's degree and have all the options that provides. So my vote would be for a BSN program with lots of clinical time.

My BSN program was the same as the Diploma program. The only difference was the Diploma students stopped after the third year, and the BSN students did 2 more semestres. Clinical time was well balanced with class time and I although I was scared when I first graduated, I did ok.

fairyprincess2003 · May 28, 2004

Ok

here is one thing I just wanted to respond to that is bothering me. This is not saying anything bad about any education, BUT I keep noticing that people keep posting how most hospital or ADN's is just about the same as the BSN bc most people take about 3 years to complete it anyways. Well, in my experience MOST people take at least 5 years to complete the BSN if not 6. It is not an easy program, I am sure the ADN is not easy either. But my point is, degree goes upon credit hours and not time spent in school. Also, the petty little things/classes you must take to complete a degree. I didn't say it was fair, but that is the way it goes. I have 190 credits right now, and still have to finish a few more courses for my second degree(bio) even though I have a BSN, I still have to complete a few lower levels classes. That is just the way it goes.

I do think combining more clinicals with education would go a long way. Education is very important, and I feel it should eventually be a standard. I do feel however, regardless of education, people are leaving nursing bc the way nurses are treated plain and simple. I love assessing, I love dressing changes, I love IV's, etc. I HATE cleaning rooms, emptying trash cans, and being a secretary. I didn't have to go to school for that(none of us did) Until nurses put their feet down, and set some sort of guidlines as to our job description people will continue to feel overwhelmed, belittled, and confused. Why should nurses have to keep improving education, procedures, etc, and STILL have to do everything and anything. It does not make sense. It would also be much safer for the patients if you could focus on your nursing abilities and worth instead of being treated like everyones slave.

Personally, I think all nurses should go through a program that is run with hospital experience as a priority and it should grant a BSN on completion. I think Diploma and ADN students are getting ripped off. When most of them spend 3+ years in school anyways, they should get a bachelor's degree and have all the options that provides. So my vote would be for a BSN program with lots of clinical time.
My BSN program was the same as the Diploma program. The only difference was the Diploma students stopped after the third year, and the BSN students did 2 more semestres. Clinical time was well balanced with class time and I although I was scared when I first graduated, I did ok.

Dixiedi · May 28, 2004

Just to let everyone know I started this thread and am thrilled with the way we are posting our opinions without arguing the benifits of one over the other. I am interested in knowing what others think and this is why I started the thread. I am colating the responses (not using anybody's name or ID) so I can define what nurses really think they needed in an education.

Great job everybody! Thank you so much and I hope the responses keep coming in! A handful of responses does not make a very scientific study!

fergus51 · May 28, 2004

Ok
here is one thing I just wanted to respond to that is bothering me. This is not saying anything bad about any education, BUT I keep noticing that people keep posting how most hospital or ADN's is just about the same as the BSN bc most people take about 3 years to complete it anyways. Well, in my experience MOST people take at least 5 years to complete the BSN if not 6. It is not an easy program, I am sure the ADN is not easy either. But my point is, degree goes upon credit hours and not time spent in school. Also, the petty little things/classes you must take to complete a degree. I didn't say it was fair, but that is the way it goes. I have 190 credits right now, and still have to finish a few more courses for my second degree(bio) even though I have a BSN, I still have to complete a few lower levels classes. That is just the way it goes.
I do think combining more clinicals with education would go a long way. Education is very important, and I feel it should eventually be a standard. I do feel however, regardless of education, people are leaving nursing bc the way nurses are treated plain and simple. I love assessing, I love dressing changes, I love IV's, etc. I HATE cleaning rooms, emptying trash cans, and being a secretary. I didn't have to go to school for that(none of us did) Until nurses put their feet down, and set some sort of guidlines as to our job description people will continue to feel overwhelmed, belittled, and confused. Why should nurses have to keep improving education, procedures, etc, and STILL have to do everything and anything. It does not make sense. It would also be much safer for the patients if you could focus on your nursing abilities and worth instead of being treated like everyones slave.

Just to be clear, I also think it's silly that a BSN should take 6 years. You should be able to complete a Masters in that time. It's because schools run things so ridiculously. Going full time for 4 years a person should be able to get enough credit hours for a BSN (our program ran that way). The problem comes when schools schedule things so that can't happen (pre-reqs are not run certain semestres, etc) and you're forced to take another year. That's just a money grab.