Should nursing programs be extended?

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Sep 11, 2016

I truly believe that the problem lies with real-world nursing being on a different scale than the classroom theory nursing.

Do clinicals and classroom instruction include any significant instruction regarding patient satisfaction surveys? Or discuss the amount of resistance to be encountered from the patients when doing what's best for them? Or even go further than a broad introduction to community health? (Home health requires a degree of professional autonomy that new nurses simply do not have).

I agree that since patients are being discharged faster, a semester with a practicum devoted solely to home health would be extremely beneficial. But a year, I'm not sure anyone would agree to that length of time on a supposedly-stable clientele.

It is my opinion, based on many years of experience, that the general public is controlling any field that wears scrubs. A few of us still stand our ground with evidence-based patient care, but it is definitely NOT easy because although it is needed, it is not what the patient wants. The sweet, innocent puppy-dog look that once was when nurses appeared is lonnnnnng gone. Because of this, institutions want experienced help to offset the possibility of lawsuits (feel free to insert patient safety in here wherever you choose).

Home health agencies are small and privately owned for the most part, true? You are getting these inexperienced folks because major healthcare environments (where there are enough people available who can actually train the newbies how to be nurses, and provide assistance as needed) can afford to have their pick of the litter.

As such, they demand a year or more of experience and can keep the doors closed to these new folks if they so choose. I dare say that most of your new hires have had the doors slammed in their faces elsewhere prior to arriving on your doorstep, and your 4 month training process still counts as paid nursing experience....8 more to go before your new hires have the keys to unlock door #1.

TheCommuter, BSN, RN · Sep 11, 2016

The diploma nursing programs of yesteryear were shorter in length (28 to 36 months), yet produced new nurses who were able to hit the ground running in a functional manner several months before graduation.

The length of nursing programs should not be extended. More time will not help the core reasons for one's inability to get up to speed. Rather, the nursing profession shot itself in the foot by moving nursing education away from the hospital and into academic settings such as community colleges and universities.

Nursing leaders probably envisioned more respect for the profession if our education was shifted into academic settings. However, this move was fraught with unintended consequences that reverberate to this very day.

HelloWish, ADN, BSN · Sep 11, 2016

Unless hospitals develop hospital based nursing programs like the previous poster stated, then I don't think extending education in a brick and mortar school will help much. Nursing students don't receive enough clinical time and are mainly preparing for the NCLEX. That's why hospitals are developing residencies and internships! I just graduated and I am working in a residency. I am so thankful for the opportunity to be in a residency, otherwise I would be lost!

llg, PhD, RN · Sep 13, 2016

I've come to believe we need to change the model of "transition to practice" -- by having a better-defined step in between school and practice. The realm of internships, residencies, externships, etc. needs to be fleshed out and made more prevalent. It's not realistic to expect a new grad of any program to step into 21st century practice without a transition period.

Even the new grads of the "old diploma programs" could not step into the practice world of today without a lengthy transition. I live in an area in which 4 diploma programs have closed/converted in the last 15 years -- the last one just a year ago. Those new grads couldn't do it on day #1 either. That's what convinced me that the need for transition programs is universal and not just for grads of the more academic programs.

Farawyn · Sep 13, 2016

The diploma nursing programs of yesteryear were shorter in length (28 to 36 months), yet produced new nurses who were able to hit the ground running in a functional manner several months before graduation.
The length of nursing programs should not be extended. More time will not help the core reasons for one's inability to get up to speed. Rather, the nursing profession shot itself in the foot by moving nursing education away from the hospital and into academic settings such as community colleges and universities.
Nursing leaders probably envisioned more respect for the profession if our education was shifted into academic settings. However, this move was fraught with unintended consequences that reverberate to this very day.

This.

sallyrnrrt, ADN, RN · Sep 13, 2016

The diploma nursing programs of yesteryear were shorter in length (28 to 36 months), yet produced new nurses who were able to hit the ground running in a functional manner several months before graduation.
The length of nursing programs should not be extended. More time will not help the core reasons for one's inability to get up to speed. Rather, the nursing profession shot itself in the foot by moving nursing education away from the hospital and into academic settings such as community colleges and universities.
Nursing leaders probably envisioned more respect for the profession if our education was shifted into academic settings. However, this move was fraught with unintended consequences that reverberate to this very day.

i concur with the commuter.....

sallyrnrrt, ADN, RN · Sep 13, 2016

I've come to believe we need to change the model of "transition to practice" -- by having a better-defined step in between school and practice. The realm of internships, residencies, externships, etc. needs to be fleshed out and made more prevalent. It's not realistic to expect a new grad of any program to step into 21st century practice without a transition period.
Even the new grads of the "old diploma programs" could not step into the practice world of today without a lengthy transition. I live in an area in which 4 diploma programs have closed/converted in the last 15 years -- the last one just a year ago. Those new grads couldn't do it on day #1 either. That's what convinced me that the need for transition programs is universal and not just for grads of the more academic programs.

in 1972 I graduated 11am, and was charge nurse in CCU, that evening at my hospital based program.....of course I had spent solid 9weeks on same unit for charge nurse experience last of my senior year.....

grammy1 · Sep 13, 2016

The diploma nursing programs of yesteryear were shorter in length (28 to 36 months), yet produced new nurses who were able to hit the ground running in a functional manner several months before graduation.

I agree with you 100%. I have a friend who graduated (ADN), passed boards and had never started an IV. There is no way that would have ever happened in a diploma program. There are still some diploma programs around, and they have a lot more clinical hours than the colleges do.

Farawyn · Sep 13, 2016

The diploma nursing programs of yesteryear were shorter in length (28 to 36 months), yet produced new nurses who were able to hit the ground running in a functional manner several months before graduation.

I agree with you 100%. I have a friend who graduated (ADN), passed boards and had never started an IV. There is no way that would have ever happened in a diploma program. There are still some diploma programs around, and they have a lot more clinical hours than the colleges do.

Yes.

I don't see why they can't combine all the extra fluff of the BSN (you know of which classes I speaketh!) with more clinical hours.

SATURATE the students with clinical. It's the only way they are going to learn.

Wile E Coyote, ASN, RN · Sep 13, 2016

I personally have made the same statements typed by Commuter. Only just recently have I come to question this after seeing the deliberate tract AWAY from acute care hospitals which is only set to increase in the coming years. I think residency programs that fill the gap between a school's generalist approach and a given specialty's obviously focused approach should be much more widespread.

llg, PhD, RN · Sep 13, 2016

in 1972 I graduated 11am, and was charge nurse in CCU, that evening at my hospital based program.....of course I had spent solid 9weeks on same unit for charge nurse experience last of my senior year.....

My point was that this is not 1972 anymore. Back in 1972, it was possible. It is not happening today.

I graduated from a BSN program at the age of 22 back in 1977. Within 6 months, I was orienting to be Charge Nurse in the NICU -- and I had never set foot in a NICU as a student. Does that mean that most new BSN grads can do that today? No. It means that health care was different back then. Your history (and mine) don't say anything about what is true today.

As I said in my earlier post, I now live in an area that until recently had 4 hospital-based diploma programs. We would hire their new grads -- but even those grads could not step into practice like new grads did in the old days, when you and I were young. Those new grads still needed the extensive internships in order to function in a specialty unit. While many good transition to beginner-level tasks on a general care unit, they needed extra help when they tried to advance to positions of more authority -- and so overall, they were not considered superior to their BSN colleagues in the long run. In the end, all those programs closed for a reason. Even their own hospitals realized that their graduates needed the BSN content to function well to the full extent possible for an RN.

Things are different today -- and the old solutions of the past don't/won't work like they used to. It's faulty logic to believe that our past strategies would yield the same results today.