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.
Specializes in Utilization Review/Case Management.
Quote:
What about leaving things the way they are, but forcing hospitals into some kind of standardized training period protocol?
:yeahthat:
As a new grad one year ago, I got "3 weeks" orientation, which was actually less than one before I was expected to take total care of 1-2 patients, and by end of 2nd week, 5 patients...and preceptor complained that I asked too many questions!!! No support from management, ended up having emergency surgery two months later for appendicitis, (I didn't even know I was sick until six hours into my shift! I just thought it was stress. Still finished the shift, then stumbled to the ER on my way to the car) I don't know how I managed to go back there.
I did transfer to another unit with a great assistant manager/charge nurse who is very supportive and have learned a lot since. But I had serious thoughts of throwing in the towel because I felt that it was not safe for patients for me to be caring for them.
BTW, I have an AAS/Nursing degree...takes 6 semesters for an associate degree in nursing versus the 4 semesters for other associate degrees at the community college I attended....
Anyway, where I work, the orientation is the same for a new grad as any new hire, no matter the previous experience....This is a teaching hospital, does this make sense?
What about leaving things the way they are, but forcing hospitals into some kind of standardized training period protocol?
:yeahthat:
As a new grad one year ago, I got "3 weeks" orientation, which was actually less than one before I was expected to take total care of 1-2 patients, and by end of 2nd week, 5 patients...and preceptor complained that I asked too many questions!!! No support from management, ended up having emergency surgery two months later for appendicitis, (I didn't even know I was sick until six hours into my shift! I just thought it was stress. Still finished the shift, then stumbled to the ER on my way to the car) I don't know how I managed to go back there.
I did transfer to another unit with a great assistant manager/charge nurse who is very supportive and have learned a lot since. But I had serious thoughts of throwing in the towel because I felt that it was not safe for patients for me to be caring for them.
BTW, I have an AAS/Nursing degree...takes 6 semesters for an associate degree in nursing versus the 4 semesters for other associate degrees at the community college I attended....
Anyway, where I work, the orientation is the same for a new grad as any new hire, no matter the previous experience....This is a teaching hospital, does this make sense?
Most hospitals around here give at least a 12 week orientation. 3 weeks is obviously too short but I wonder if that is the norm around you or just that your hospital is short changing their new grads?
I agree: let's go back to the diploma programs ... or something like it.
I realized after the first semester that I wasn't going to get the training I need to function as a new grad and that I better do something about it. So I became a student extern. The gap between what they teach you in nursing school and real life nursing is HUGE.
I totally understand why new grads are going home in tears. I even feel that way as an extern, even though I still have plenty of time before I graduate, because it is so overwhelming. Regardless, I'd much rather deal with the anxiety now and get my training before the real pressure is on as a new grad.
The problem is there's only a limited number of externs that the hospitals can take, and not all of them have "real" externships. Some of the hospitals do nothing but make students do nurse's aide stuff, and don't really help train the externs as RN's.
Don't get me wrong: I believe students should help out by working as nurse's aides but hospitals should also give the students RN days where they can learn and practice their RN skills. Unfortunately, the vast majority of hospitals in my area do not do this.
If I'm not mistaken, I believe this kind of exploitation was one of the reasons diploma programs were phased out to begin with.
I think these are excellent suggestions that need to be included in any nursing program.
Again, I'm reminding everyone to just think in terms of what nurses need, and really try to forget what other professions do or what regulations colleges want fulfilled. Forget ADN. Forget BSN. Forget Diploma.
The real question is: Has the debate over which educational program is best for professional nurses become irrelevant? Because what we're hearing from the new grads themselves is that all of them fall far short of what the new grad really needs to know.
I think one of the sources of this problem is quoted earlier--too many other institutions have been allowed to define the nursing profession and chart its course.
As I read your responses, I can't help but notice that no one disagrees that there's such an animal as too much clinical. It seems to be the Gen. Ed. requirements that everyone is disagreeing about here--how much is too much? how little is too little?
And who defines that? Colleges? Hospitals? Community need? Or nurses?
And if nurses are not deciding the profession's fate, we can't really be said to be autonomous, can we?
But are the new grads really falling short of what they need to know or are we falling short of what and how long we should be precepting them upon starting as a new nurse?
Sometimes I think it's a little of both but more often I think that new grads are "going home in tears" as Lizz puts it because we often expect too much too soon from them and want them off orientation too early.
On top of it, many get a crappy orientation to begin with so they are doomed from the beginning.
So to clarify your question, are you asking what kind of nursing education would make new grads hit the ground running upon graduation with minimal or no preceptorship/orientation? I'm puzzled.
So to clarify your question, are you asking what kind of nursing education would make new grads hit the ground running upon graduation with minimal or no preceptorship/orientation? I'm puzzled.
Let's put it this way: Is it really the responsibility of the employer to complete the new nurse's education? Can hospitals really afford to do this? Shouldn't we, as nurses, be concerned about what kind of drain that causes on health care resources?
Does nursing burnout begin at orientation? Is it because our educational programs are truly inadequate for our needs?
Would a partnership similar to a diploma program work better for the new grad's orientation?
What are new grads lacking? How can the nursing education be changed so that it satisfies those who say we need more well-rounded Gen. Ed. coursework as well as those who simply don't feel they've gotten a good grasp of "real-world nursing" while in clinicals at a college program?
I submit that the reason that the Diploma vs ADN vs BSN debate has raged so long is that NONE of them adequately prepare nursing students to work as nurses.
So we need to go back to Square One and redo nursing school education and standardize it into ONE PROGRAM nationwide.
What kinds of things must it have to meet the needs of today's nursing students?
Let's put it this way: Is it really the responsibility of the employer to complete the new nurse's education? Can hospitals really afford to do this? Shouldn't we, as nurses, be concerned about what kind of drain that causes on health care resources?
Does nursing burnout begin at orientation? Is it because our educational programs are truly inadequate for our needs?
Would a partnership similar to a diploma program work better for the new grad's orientation?
What are new grads lacking? How can the nursing education be changed so that it satisfies those who say we need more well-rounded Gen. Ed. coursework as well as those who simply don't feel they've gotten a good grasp of "real-world nursing" while in clinicals at a college program.
Isn't that what hospitals use to do when they sponsor hospital based diploma programs? Programs that were aimed at using students as staff?
And they did use them. I entered a diploma program in 1964. Fortunately, my program was sponsored by NYSDOMH and students could not be counted as part of the staff. We could not work evenings and we could not work nights. We attended a liberal art program four days a week and nursing classes one day a week our first year. We never worked evenings until 18 months into the program and never nights until our last semester. Kings County SON, right next door, threw their students on to a floor within four weeks. And evenings and nights within the first semester. Did they turn out better nurses? Well, we certainly didn't lose as many students and we all managed to pass our two day state boards, on the first attempt. And almost everyone of our graduates went on for BSNs and MSN.
This need to take nursing back, instead of forward is sad. What some view as a better form of nursing education is really a step back into the past. The past where students were used, abused and misused. And if you do not think this is so, either you have (and I mean you generally) a glorified idea of what nursing education was really about or you really don't have a clear gasp of the true purpose of education. Education is meant to furnish the basics of a profession. It is not meant to turn out a throughly competent RN, ready to jump into a staff slot, in ICU, a Burn Unit, an ER, or any specialized area.
I submit that the reason that the Diploma vs ADN vs BSN debate has raged so long is that NONE of them adequately prepare nursing students to work as nurses.
I can't really agree with this, since i know of a diploma program that a lot of people have gone through has just RAVED about. The instructors have been in it for years, it is VERY hands-on, and very thorough. If i lived closer to it, i would have try my best to get into it. How often do you hear a huge number of students who can't say enough positive things about their nursing program?
I want the best education i can get for my RN (i got the best, IMHO, for LPN), whatever the degree is (it'll be an ADN in this locale, since the local BSN program is famous for emphasizing "the aides are to do the dirty work, you're to do the paperwork). Unfortunately i'm contracted now, so i can't go to that diploma program, but then again the cost of living is pretty high there as well.
Hi y'all :) I'm a first timer on here, although I have been reading the forums for a while. I just feel that this is an issue that is important to comment on, because it's an issue that people will individually take personally.
A little on me for perspective purposes, I have a bachelor's degree, but not in nursing. I went back to school and got my AS in Nursing.
I don't think the question about BSN v. ADN can specifically be broken down to "what classes" or "what clinical experience." Because, let's all be honest, book knowledge is great and experience student-nursing is great.... but true knowledge comes from hands-on experience as a practicing RN.
I believe the debate can be looked at from a broader perspective, that can be applied to all professional careers. Please know what I am about to say is NOT a dig on anybody, but... there is a certain amount of discipline implied when someone carries a bachelors degree. Furthermore, I think that many of the professions that require a bachelor's degree don't require it because the person holding it has more knowledge than someone without it, but because the person holding it went the extra mile, took a lot of classes they despised but did them well, and finished a 4-year degree because they had the determination to do so.
Do I think that someone with a BSN is a better nurse than myself? Absolutely not. Do I think that pay differential should come into play between myself and someone with a BSN? No, I think that should start at Master's level. Do I plan on eventually going back and finishing classes for my BSN? Absolutely!
I believe in education, and I believe nursing is a profession. A professional nurse should always strive toward making him/herself more knowledgaeable. I don't think a nurse with more letters after their name is BETTER, I think they are more disciplined and show that they strive for more from themself.
Thanks for letting a nebie get on a saopbox :chuckle
Truth be told, I think there's a lot to be said for leaving things as they are, too. It certainly isn't ideal, but I do think the different routes into nursing provide a variety of perspectives. My ASN may lack some of the academic preparation of a BSN, and some of the clinical experience of a Diploma program, but it does make it more feasible for someone with my life experience to enter nursing. The new kids going through orientation with me appear to have all the tools they need to become excellent nurses, but all of us need to gain experience to achieve that.
I don't think it's going to be possible to avoid fairly extensive orientation in the hospital for new hires, either. Each institution--each unit!--has its own policies and procedures, and no school could cover all of those.
Personally, I wouldn't see a problem in distinguishing between levels of education in entry-level nurses RN I and RN II, or Registered Technical Nurse and Registered Professional Nurse. At present, I don't really see enough difference between an ASN and a BSN to justify it, but it could be done. An RTN program could be the length of an ASN, but replace some of the Gen Ed with nursing. An RPN could be a BSN, with perhaps a little more liberal arts than a present ASN, but less than a present BSN, again adding more nursing.
I'm having a little trouble deciding what the difference in scope of practice would be, though. Maybe an RPN would be able to cover and LPN/LVN, but an RTN wouldn't? Or maybe an RPN could go straight into critical care, but an RTN would need prior experience in med-surg?
Even under the present system, I do feel a bit more pay for BSNs would be appropriate. Those leadership and management classes are worth something. Not as much as "real" nursing courses, but something.
Oh, and welcome to the boards, NewRNinNC. Nothing like jumping right into one of the most heated topics--although I do think this thread is generating more light than heat.
Angie, you did a nice job of setting a tone for this one.
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trudlebug
92 Posts
Quote:
What about leaving things the way they are, but forcing hospitals into some kind of standardized training period protocol?
:yeahthat:
As a new grad one year ago, I got "3 weeks" orientation, which was actually less than one before I was expected to take total care of 1-2 patients, and by end of 2nd week, 5 patients...and preceptor complained that I asked too many questions!!! No support from management, ended up having emergency surgery two months later for appendicitis, (I didn't even know I was sick until six hours into my shift! I just thought it was stress. Still finished the shift, then stumbled to the ER on my way to the car) I don't know how I managed to go back there.
I did transfer to another unit with a great assistant manager/charge nurse who is very supportive and have learned a lot since. But I had serious thoughts of throwing in the towel because I felt that it was not safe for patients for me to be caring for them.
BTW, I have an AAS/Nursing degree...takes 6 semesters for an associate degree in nursing versus the 4 semesters for other associate degrees at the community college I attended....
Anyway, where I work, the orientation is the same for a new grad as any new hire, no matter the previous experience....This is a teaching hospital, does this make sense?