Students who get As are bad bedside nurses

[konstantine]

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?

[Whispera, MSN, RN]

Turn it around a bit. Maybe this is what was meant by what was said: Students who make As aren't always the best. Someone who doesn't make As could be a good nurse as well...

[SmilingBluEyes]

!

.

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

Ya did fine til this ignorant comment. You can't mean it. If you do, I question your "knowledge".

[Angeljho, MSN, NP]

There are many different types of students. Nursing doesn't only use the brain, so it's possible for students to be good at one thing and bad at another. For example, some students who have book-smarts are not good at hands-on skills. Some students who are more hands-on don't have much book-smarts. And you have students who have a mixture of both.

Honestly, I feel as though nursing students should focus more on their education rather than their clinical skills. You will learn your clinical skills during your first nursing job. The NCLEX will not evaluate how well your IV skills are; it will, however, evaluate your knowledge of IV care, safety, etc. No student will ever come out of nursing school ready to run the floor, yet so many students expect their clinical experience to help them do just that. I can't tell you how many of my classmates failed because they were more focused on perfecting their skills rather than understanding the course material.

[classicdame, MSN, EdD]

Does that mean "good" bedside nurses are dummies?

[Raviepoo]

That generalization is a fantasy that C students use to help themselves feel better about their grades. Students who have no compassion don't make good nurses. Students who like to avoid work don't make good nurses. Neither of those qualities has anything to do with compassion.

Students who are not comfortable working with patients need more practice. With a little work they can be good nurses. Students who don't naturally have a bedside manner that puts patients at ease need a bit of self-examination. With a little work they can be good nurses. Students who don't have good study skills can learn to study effectively. With a little work they can be good nurses. Students who lack the intellectual capacity to learn the material taught in nursing classes cannot possibly be safe, independent practitioners of nursing. They should find another line of work.

Keep you head down and your eyes on the prize. Don't listen to anyone who tries to discourage you. If you want to be a nurse badly enough, you will do what you need to do to succeed. If you are getting good grades and hearing disparaging comments like the one in the original post, just ask yourself if the commenters are jealous.

[ShelbyaStar]

It makes next to no sense and I think people tell that to themselves to make them feel better about their mediocrity as a student.

I have seen some people that miss the point, but not as much in nursing. I was once an animal science student, getting off my shift at the sheep barn, and gave some pre-veterinary students some serious side-eye when they were so busy studying in the office/supply room and gloating about their grades that they failed to notice a ewe had died. So, there are situations like that.

But to essentially say someone who works hard and is smart will be a terrible nurse is simply ridiculous. I'll admit that my test taking skills are a bit stronger than my interpersonal skills, but that is quickly improving. I don't know the exact grades of other students that are in my class, but the ones that I suspect have poor grades are similarly tripping over themselves in lab and clinical.

One girl has dropped out so far and previously she liked to whine about how unfair the tests were. Trust me, she would not have been a good nurse. She didn't just ride the crazy train; she drove it. She was always a victim, frequently threw fits, and I'm sure would have eventually at least verbally abused a patient if not physically.

[LoisLaneRN]

I'm an instructor and I don't agree with the statement. In fact, as a former A student, it pisses me off, because I am also a very good bedside nurse.

Certainly there are "book smart" students that can't apply their knowledge in clinical, but in my experience they are few and far between. The majority of my students that struggle in clinical are also C students. This makes sense because C is average and most students fall in the average range. I really hate the idea that nurses do not need a solid foundation of knowledge. Nursing goes far beyond the technical skills.

[kakamegamama]

I had students who made average grades on exams and were excellent clinically. I had students who were A students and excellent clinically. I had students who made average grades who did not pass clinically. I had students who were A students in the classroom but did not pass clinicals. Why?......no common sense. Great memorization skills...thus the A in the classroom...but no common sense, people skills, or ability to think critically about the whys of what they were doing. My average in the classroom students (Bs and Cs) did well clinically because they thought critically, had common sense, and people skills. A perfect A student does not necessarily make a good nurse, neither does an average student. Hang in there. It sounds like you are doing well. Just don't get cocky and act like a no-it-all...that may at some point be your downfall.

[NurseSpeedy, ADN, LPN, RN]

I think what your instructor meant was that making good grades does not guarantee a good nurse. I'm not sure what her exact wording was, but I would hope that she didn't say that nurses that make A's are poor nurses, because that is not only incorrect, it completely discounts what her institution has been trying to do for the students, educate them well so that they can make good grades and apply that knowledge towards becoming good nurses. Nursing is about application of knowledge, not regurgitation of a textbook. So while someone may test very well, if they cannot take that knowledge, apply it to the particular patient (which will almost always NOT be a textbook example of what is going on, because patients are complex and each has their own additional issues to add to the mix of what the textbook offers), and based on their assessment think critically to what skills they need to implement next, then yes, that person may have an A in the theory and an F in the clinical. On the other hand, if someone fails the theory some nursing schools will not allow them to proceed to clinicals in that area until they can pass it, it just depends on what the policy and structure of the program is. I think that an "average" student can turn out to be a very good nurse, they may know the information but have problems testing well and in the end be able to take that knowledge that they did infact learn and apply it to their patients to provide safe and effective care.

While this is off topic I did find one thing in your post that makes me question your instructors judgement. You said that you are a level 1 student. When I went to school our instructors were with us for every med pass that we performed as a student (and all invasive procedures). The accucheck is no issue, as techs are allowed to do that task, but I do not agree with the independent unsupervised Lovenox injection. Just my thoughts.

But no, making good grades will not adversely effect what kind of nurse you will become. It could only enhance your ability to do well.

[ShelbyaStar]

To add, I think it's a little harder to tell if one is doing poorly in clinical and thus it is easier for some people to believe they are great at it when they are not good at theory, when in reality they aren't good at either.

In theory, if you get a question wrong, it is wrong and you will lose points for it being wrong. You receive feedback on every little thing you do. In clinical, the instructor can't watch you at every moment. You may well walk away feeling like you did fantastic work, when in reality the patient thought you were rude, your fellow students find you to be totally obnoxious, and you screwed something up that will come back to bite the patient's nurse later in her shift, but everyone keeps a straight face about it and your'e none the wiser.

Had a classmate when I did the CNA course that the teacher fawned over. He ended up being one of the few to get an A in clinical. Not sure why the teacher loved him so much- I suspect it had a lot to do with him being male and ex-military. However, I got paired with him and when the instructor wasn't around, he said some very unkind and disrespectful things when his patient had a nasty accident in her brief as we attempted to clean her up, and then he threw me under the bus when the instructor wanted to know how she'd managed to get BM outside of her brief (I had struggled to get her brief on quite properly, then had to be somewhere else and told him I'd come back to help, he said he had it covered, and then she had another BM and that's when the NI checked in on him).

He got his lauds of approval of what as great CNA he'd be but I suspect he actually is not when he is not being watched. And surprise- while he got a better grade than me in clinical, I had a better one than him in theory.

[BrandonLPN, LPN]

I cannot imagine any instructor ever saying "students who get As are bad bedside nurses". That's nonsense.

I can only guess that she said something along the lines of "getting As does not guarantee a student will be a good bedside nurse". That makes more sense.

[nursel56]

It is really disappointing to hear that an instructor said that. It makes me question both her own academic record and what type of work experience she had prior to becoming an instructor.