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Students who get As are bad bedside nurses

This is the refrain I keep hearing from my clinical instructor and others in and around my program. What's your experience? I'm a Level 1 student. I know very well I have all of it to learn, but I don't think I'm a complete lost cause. I make good grades in class, but at every turn I hear someone telling me that good grades mean absolutely nothing to being a good nurse.

Just to validate myself. I always finish my head to toe assessment by the time it's due while establishing a good rapport with my one patient (so far). I have found things during my assessment the actual nurse missed (due to the fact that I have one patient and half an hour to assess them, while the nurse has at least 5 and significantly less time to hover over the same lung spot). I've gotten feedback from the CNAs and nurses on the floor I have clinical on that I'm the one who jumps in to do anything, while many of my classmates huddle and just answer call lights. My clinical instructor has me go in the room with other students to help them with their assessments. I'm the only person in my clinical group she's let do a glucose check and lovenox injection unobserved.

I'm not blind to my faults. Most obviously, I don't have experience. I still very much need someone to validate what I observe, because I'm really not sure I'm what I think I'm observing is correct, or if I'm missing something altogether. And I am most definitely missing assessment findings a real nurse catches. In addition, I struggle with time management. That's why I make the effort to get all my patient work and paper work done as early as I can to shadow a nurse as long as I can. I want to see how they organize their shift and how they deal with all the random stuff I'm not going to see with my one patient. I don't know what all goes in to being an actual nurse on a med-surg floor. Mostly, I don't know WHAT I don't know, but I really try to be aware of that and observe the nurses and ask what clues they got that made them do what they did.

Really, though, I just don't see how getting good grades is going to make me a ****** nurse. Is this something people say to make people who are earning grades they wish were better feel better, or is there truth to it? I'm trying to keep my confidence up, but I hear this sentiment several times a week, and I'm really wondering what I don't even know I'm missing.

In your experience, are the nurses with the highest grades in their class bad nurses when it comes to caring for real patients? If they are, what are their weaknesses, and what can those class-smart but patient-stupid do to improve?

Don't listen to these comments ; study, practice your skills, do all your readings, pay close attention to the lectures and when you have reviewed all the materials, join study groups 😉

You will be a great nurse.

If you are an organized student, you will be an organized nurse. Passing the NCLEX or getting the license wont abruptly change a person , but what you do at school now and how you practice organizational skills, time management, and managing stressful situations will change you as a person.

Good luck!

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I heard them too. I had A's in everything except nursing research and a couple of non-nursing classes, and felt very confident in school. At the bedside, not so confident. I went to one of my instructors about how different I felt in clinicals and she agreed and said some more 'cerebral' nurses had initial trouble because nursing is such a DOING kind of thing.

I think it is blatantly irresponsible and damaging for a nursing instructor to allow that crap to come out of her mouth. I'm a little suspicious of HER grades, and why she's an instructor in the first place, hmmm. Nothing in life is that black and white. I think she's got a big mouth and thinks too highly of her personal opinions.

I wouldn't say there is no truth whatsoever in this. And that 'book smart' versus 'clinical smart' aren't the only personal challenges for the up and coming nurse. Too much confidence is a VERY bad thing in a student nurse or new grad, and plain old annoying and potentially bad in any nurse no matter her experience level. Don't fall into this instructor's close-minded false dramas, it's just distracting you from what's before you. Not every nursing instructor is going to be a paragon of maturity or professionalism. Sounds like you have one leg up on her already.

If you're the type of person who "reads and recites" as opposed to understanding, I could see how you might get excellent grades and be a less stellar nurse. I think most people who have excellent grades in nursing school also have a good understanding of the subject matter, though.

In any case, don't feel sorry for yourself for getting high grades. If you don't pass, you can't be a good or a bad nurse.

I mean don't listen to your classmate's comments about not studying ....

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Fr what it's worth: Every bit of knowledge you gain makes you better able to advocate for your patient. Do what you're doing and believe what you tell yourself over the noise you will hear from others in this life. Time will tell: they cannot. Looks like you're off to a good start if you ask me!

IMO, people CAN and ARE both A students and A++ nurses. People are always going to judge. As long as you are safe, advocating and have good rationale for what you are doing, to heck with what everyone else says. Sometimes people say things to make themselves feel better. Focus on you and your patients!

You do need to learn in order to have a sense of WHY you are doing something, and what it means as far as the big picture (ie:patient goal).

As a pp pointed out, part of what you are learning will help you to be a better patient advocate.

Any good clinical skills you can be involved in, the better--and assessments are so important. So is knowing your resources.

Make sure that if your instructor tells you that you can do things on your own, that you are 100% sure of the process, and go over it with her before doing anything (for instance Lovenox should always be given in the abdomen stuff) JUST so you have yourself covered in the event of an error. And depending on the facility, the goal is to be able to have the patient be functional--and to give (or family member give) their own lovenox shots. You should understand why they are getting this injection, and is it a bridge to other anti-coagulants, and if there is any printed patient education that you can give to the patient to read. So in other words, it is not just the skill but the thought of how to make the skill clear to the patient.

You can get "A's" in everything, and still have no clue how to apply it. Just like people can be stellar in practice, but really not so stellar when it comes to grades. There are book smart students, and hands-on students. Grades were important in high school--honors tracks, AP classes...all to raise a GPA to be able to attend the college of one's choice. Your general education classes are sometimes grade dependent to be able to go on to the next level of becoming a nurse. Beyond that, it is a mix of what you know, and how you apply it.

I would most definitely shadow as much as you can, and at the same time, start experimenting with how you can be organized, and stay organized in the unit setting. Paper brains, clipboards, a notebook--whatever works for you organizationally. Most nurses have anywhere from 5-8 patients at a time. So one of the important things is how to keep on top of that patient load.

Finally, I would at least get the work email of any of the nurses with whom you have shadowed and worked with the most. And whose advice and guidance you most admired. Be sure to thank them for said guidance. Also, this will establish your reputation and network. Finding a job can be networking, as well as letters of recommendation some day.

Best wishes!

klone, MSN, RN

Specializes in Women's Health/OB Leadership.

Hogwash.

There are people who get straight As in book learning and are awkward and uncomfortable at the bedside.

There are also people who barely pass and are equally awkward and uncomfortable.

And there are people who are the opposite.

There is no one rule.

It is true that good grades in didactics is not a great indicator of how well one will perform at the bedside. They are two different skills. But it is certainly possible to be good at the book stuff, and also be good at the hands-on stuff.

My knee-jerk reaction is your instructor is an idiot. Is this her way of telling you that she was an awful student, but a wonderful nurse? Or that she was a wonderful student, but is an awful nurse? Really, she can't win her via her OWN statement!

We see it here on AN all the time, people complaining that So and So never got good grades but is an excellent nurse, and Such and Such was an exceptional student but is a terrible nurse. Why do people so frequently go to extremes in these kinds of scenarios?

Here's another one: "I know plenty of LPNs who run circles around RNs" or "I know plenty of ADN RNs who run circles around BSNs".

With all this running around in circles, how is anyone ever determining WHO is good and WHO is bad? ;)

flyersfan88

Specializes in Trauma, Orthopedics.

When your instructor says grades aren't everything and that straight A's doesn't make the nurse...that doesn't mean she implied the opposite. You can get good grades and be a good nurse. But reciting things from a text book means nothing. It's about application. I think you misconstrued the entire point.

Really, though, I just don't see how getting good grades is going to make me a ****** nurse. Is this something people say to make people who are earning grades they wish were better feel better, or is there truth to it? I'm trying to keep my confidence up, but I hear this sentiment several times a week, and I'm really wondering what I don't even know I'm missing.

yes. it's also a way to drag you down and make you feel insecure. it sounds like you are both patient-smart AND book-smart; if other people feel threatened or jealous because you work hard and have developed skills in both areas, they can up their game or they can keep deluding themselves with the idea that they are somehow at an advantage because they are less successful academically. don't let it affect you.

unfortunately some nursing instructors are just as bad; it's as if they don't want students to be over-confident so they go overboard in trying to make them feel as if they know nothing and are one step away from failure. you absolutely can have both people skills and academic intelligence.

Edited by RobotNurse

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro.

Sounds like someone wants an excuse for being a C student. :sarcastic:

Think about it...what about a student knowing the material means they won't be able to apply it?

That makes zero sense. Keep studying and getting those A's, and doing well in clinicals! :up:

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Here is an educator's view on 'A' students:

"...People who have an easy time of things, who get 800s on their SAT's, I worry that those people get feedback that everything they're doing is great. And I think as a result, we are actually setting them up for long-term failure. When that person suddenly has to face up to a difficult moment, then I think they're screwed, to be honest. I don't think they've grown the capacities to be able to handle that.”
http://www.nytimes.com/2011/09/18/magazine/what-if-the-secret-to-success-is-failure.html?pagewanted=all&_r=0

Several times a week your classmates and instructor just randomly go about announcing that good grades don't make a nurse? There has to be some context for this to come up.

dudette10, MSN, RN

Specializes in Med/Surg, Academics.

There is so much wrong with extreme statements, as a previous poster pointed out. It is an individual thing. Average students can become great nurses, as can exceptional students. And the opposite is true also.

Commuter's posted article talks a lot about character. Determination, the desire to succeed, how one handles failure. For younger people, whose only measure of success for the first 21 years of life is academic accomplishment, failure is a hard pill to swallow. The main interviewee in that article is a headmaster at a prestigious school where academic accomplishment is everything, so I can see where he gets his POV.

Grades don't mean the "whole nurse", however I was a 4.0 GPA student and a pretty good nurse, too, I think. Don't listen to the noise. I know of classmates who were not A students who are outstanding nurses, others whom I would not trust with a houseplant. Someone mentioned character, and I agree. Character is who we are when no one is watching. I try to remember that. I have definite improvements I could make, myself.

Everline

Specializes in public health, women's health, reproductive health.

I graduated with a 4.0 GPA. While the school at large recognized this achievement, no one cared in the nursing department. There was zero motivation to achieve academically. C = degree! I did it for myself and for future academic pursuits. I have previous degrees and I had never before experienced an environment where high grades were disparaged or disrespected. As it turned out, my grades have given me an advantage when getting into residencies and applying to other colleges.

I was never a confident student academically or clinically. I worked my bottom off. I studied constantly and worked on my skills. It did not come easy to me. I accept and look for constructive criticism and work on bettering myself. I'm not sure why people would say based on my grades I would not be a good nurse. It has never, in fact, been said to my face but I have heard the general sentiment many times over. I simply ignored it when I was in school. Now that I have graduated, when I hear it or read it, I consider the source. I know that all my studying and resulting academic achievement gave me a great foundation for critical thinking in a clinical environment. I also know I have a lot to learn and I will continue to apply my best effort towards my progress as a nurse. I am sure you will do the same. People say a lot of things for various reasons. Just continue to press on and achieve high levels in all you do, to the best of your abilities.

Are you sure you didn't misunderstand? They might mean that great grades doesn't necessarily mean a great nurse - and they would be right.

getting great grades doesn't mean you'll make a bad nurse either!

Theory is one thing - being able to apply it is another.

The ones likely to give you a hard time are the old hospital trained dinosaurs anyway who feel threatened by nurses with knowledge!

Nursing is a performing art. Getting an A on my dance theory test is good, but it doesn't mean I am a better dancer. Now, the people who are motivated to put what they have learned into nursing practice and are willing to learn become great nurses. Many of these people are A students.

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