let's pretend that we agree to disagree on the adn vs bsn debate and start all over again with nursing education. let's call it a "professional registered nursing degree program."
first, answer the poll question: do you believe that the rn's educational needs--both clinical and theoretical--are fully served by today's adn or bsn education programs?
then, tell us what types of courses today's nurse needs in order to be best prepared to enter the workplace.
Doctors learn to think like a real doctor during residency. When do we get do it? On the job. That's not OK. We need some kind of standardized support, internship, whatever, that hospitals are held to. Longer than 6 measly weeks. It will help with retention, errors, stress. And alleviate the "shortage."
Stepping off the box for now...
So you're saying that since orientation and experience are such basic tenets of nursing, that hospitals shouldn't be solely responsible for this aspect of nursing education, but that maybe nursing schools should be? Or maybe nursing schools and hospitals should partner much like medical schools and teaching hospitals do?
Specializes in Telemetry, ICU, Resource Pool, Dialysis.
Interesting thoughts.
Do you think the dissolution of diploma schools did both hospitals and nursing students a disservice--we lack clinical skills and experience; hospitals now have to basically train the new grads and pick up on the costs (and liability)?
I didn't used to think that. But now I do. I think diploma schools would have evolved like medical schools have. Requiring some form of college education before admission. You don't need a full degree to get into med school. You could have 3 years of college under your belt consisting of most of a bachelor's degree in English - cram 1 year of pre-med courses, and you can apply. Why can't nursing do the same?
Specializes in Telemetry, ICU, Resource Pool, Dialysis.
So you're saying that since orientation and experience are such basic tenets of nursing, that hospitals shouldn't be solely responsible for this aspect of nursing education, but that maybe nursing schools should be? Or maybe nursing schools and hospitals should partner much like medical schools and teaching hospitals do?
I live in PA, the diploma nursing capital of the U.S. We still have quite a few diploma programs here. Most are now 2 years not 3. In many which are 3 years, nursing classes are introduced in the 2nd of three years, not in the first year. In other words, they are very similar to the ADN programs, except the bulk of the clinical experience is at one facility rather than multiple sites within the community. We have even had a NEW diploma program established at Lewistown Hospital in the past couple of years to address the needs of a rural community which is pretty remote from the closest college nursing programs. My "dream" nursing program would include an AD or diploma prep and then a couple of years working coupled w/ some in depth classroom experience and granting of a BSN after attaining certain "benchmarks" and possibly taking an exam to certify the extra qualifications. This way the BSN would have "more" nursing experience and improve upon basic nursing schooling. Right now, BSN programs are not preparing nurses to do or perform in any way superior to ADN programs. In many areas NCLEX pass rates and skill levels of new ADN grads are very similar or in fact, exceed those of other local BSN grads. I think the BSN never caught on because it never did and still hasn't after 40+ years built a better nurse. It's great to have theory and critical thinking skills, but less essential to success at the bedside than being able to give an injection, auscultate breath sounds, listen, or pass medications safely and effectively. ALL nursing programs should be emphasizing time management and problem solving WAY more than they are. WE should be required to mentor others who are new to the profession. This could "help with the eating our young phenomena." I'd like to see a nursing residency program for 6 months post graduation to foster basic skills in specialty ares. If you change specilaty area as an experienced nurse, you could have a mini residency. I know it's all too much money! :)
ALL nursing programs should be emphasizing time management and problem solving WAY more than they are. WE should be required to mentor others who are new to the profession. This could "help with the eating our young phenomena." I'd like to see a nursing residency program for 6 months post graduation to foster basic skills in specialty ares.
Maybe something like nursing school requires all candidates to have at least an Associates in Science--then on to nursing school with a lot of clinical and theory?
In a way, that's what I'm doing. I have my ASN, but fully intend to go back for my BSN in a year or so. The bridge program I'm looking hardest at is one year, all nursing classes. I have been told by some that it's a "waste of time," and some of the courses may not sound too useful to me, but others sound pretty valuable, and I like the idea of having a BSN for future flexibility. I'm not very interested in taking a lot of liberal arts courses--I can learn as much of that as I want in my own time. I don't for a moment question the value of the humanities, arts and sciences, but I don't see the need for college credit in them. I purely loved the Am. Gov't course I had to take for my ASN. It was great. I can see me someday using my BSN to get into law school (I mean, I don't plan to, but it could happen). But this course is completely irrelevant to my nursing practice. We did have a 2 semester-hour course in nursing that dealt with nursing practice, delegation, etc., and that was important.
I like the idea of a built in six-month residency. I feel like I am learning as much in nine weeks of orientation as I did in two years of school. Six months of this would be awesome preparation.
I'm not sure what you're saying here. Can you elaborate on what you mean by "disease control". I have an idea, but would rather here what you're meaning. Sorry, but I'm drawing a blank as to the meaning of "EIDs".
Thanks. :)
sorry i'm in micro right now so the lingo is kind of in my head! EID= emerging (or reappearing) infectious disease.
sorry i'm in micro right now so the lingo is kind of in my head! EID= emerging (or reappearing) infectious disease.
Despite the fact that I think my idea is a good one, I post it here with trepidation because when I posted in on the OR nursing section the discussion became so heated that the moderator closed the thread. In my plan nursing students could start with a two or a four year program. However, in the two year program the student would choose a specialty and go with that specialty in all clinicals. So at the end of two years, the hospital should be delivered a product that requires minimal mentoring. Now here's the part that really angered the OR nurses. I've been working in OR's for 25 years and I could never figure out why we had to have RN's working in the OR. Nor could one single RN explain to me what component of their job consists of "nursing." We have an increasing shortage of OR nurses since no one rotates through the OR in school anymore (do the educators know something that we don't?) and the aging work force and blah, blah. The skills we need in the OR are not skills taught in nursing school. Every case involves technology for the nurses - not direct patient care. We don't need an RN to put a grounding pad on a patient but we do need people who can trouble shoot a VCR and design patient safety systems. A special designation would be made for an ORN (operating room nurse). They would have a two year degree which would include a clinical rotation in their hospital of choice so that they can graduate on Friday and start taking call on Monday. Otherwise, it takes about a year to train (train, not educate) a nurse well enough to take call because there's so much equipment to be located quickly. All graduates of the two year programs would be able to transfer all credits and would not have to retake the courses in their specialty. If the two year people criticize the four year people for lack of clinical skills, how could you learn more in only two years? Let's make the two year folks specialists and give them full credit for their original programs if they should decide to move on. Naturally, their boards would be more limited in scope that the four year folks, but their questions would explore their specialty in more depth.
Nor could one single RN explain to me what component of their job consists of "nursing." We have an increasing shortage of OR nurses since no one rotates through the OR in school anymore
I could list PLENTY of "nursing" components in the OR, and i'm not even an RN! (But i won't since i'm on call and i need sleep in a bit)
Taking into consideration that there are at least 7 school in this area i live in, and all of them have days in the OR.
Going back to the hospital based education to give hands on clinical training with blocks of study in between and year long certification courses afterward, be it management courses, psychiatry, ICU etc. The good old fashioned diploma RN course was a true formula for success. Senior students in their last year could mentor and preceptor younger ones to get that experience. There should be a course which gives the student a full understanding of interdisciplinary functions and importance thereof, maybe having the chance to job shadow some of these other disciplines. I think nurses could draw more effecively on the knowledge of these other fields and would help to effectively manage the inter- professional jealousy that exists so universally. Is this addressed in depth nowadays in the programs?
Going back to the hospital based education to give hands on clinical training with blocks of study in between and year long certification courses afterward, be it management courses, psychiatry, ICU etc. The good old fashioned diploma RN course was a true formula for success. Senior students in their last year could mentor and preceptor younger ones to get that experience. There should be a course which gives the student a full understanding of interdisciplinary functions and importance thereof, maybe having the chance to job shadow some of these other disciplines. I think nurses could draw more effecively on the knowledge of these other fields and would help to effectively manage the inter- professional jealousy that exists so universally. Is this addressed in depth nowadays in the programs?
I agree copmpletely. I have a on nursing Bachelor's and the diploma program I attended was exactly what I needed to be come a competant clinician. Like the OP said above, also, we DID do a rotation in the OR and even had to scrub. We did 24 hour on call in the delivery room as well. I still like the idea of making a BSN 5 years, if there ever has to be an entry level to nursing.
I feel that nursing will NOT increase the "professionalism" of the field by making a BSN an entry level to the profession. I think that concept backfored in their faces.
I am all for advanced education, but let those who wsh to seek it go for it. The only other area where I feel very strongly is that I feel that ANY administrator (in any field) should ha to have the hands-on experience first, before moving into managment.
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UM Review RN, ASN, RN
1 Article; 5,163 Posts
So you're saying that since orientation and experience are such basic tenets of nursing, that hospitals shouldn't be solely responsible for this aspect of nursing education, but that maybe nursing schools should be? Or maybe nursing schools and hospitals should partner much like medical schools and teaching hospitals do?