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?

[Footballnut]

I got A's and B's in college and the material came pretty easy to me. It was a bit of a culture shock when I became an RN but I adjusted and flourished. Now when I get evaluations my supervisors rejoice in my critical thinking skills. Any knowledge or skill you have is valuable in your practice. Anyway, as I recall there has always been some pressure on A students to not show other people up. So use your knowledge, character, hard work ethic and street smarts to envision and develop your career and go for it!

That being said, there are other valuable traits other than good grades that make a great nurse. Use your ability to observe and learn other things that will help you develop as a nurse. The nurse as a whole person has so much to give to those they serve.

[la_chica_suerte85, BSN, RN]

It sounds like you're on top of your game, for sure. Here's my take on where this comes from:

There are far too many RN students who will say things like, "I'm not getting my license just so I can change beds and wipe butts." or "When do I get to stop doing bed baths?" They feel like their grades and them hacking the competitiveness of nursing school are what set them apart, make it so eventually they won't have to do what honestly is the blue collar, heart-and-soul work of a nurse. The true "care" aspect of nursing.

These are the ones that mistake their BSNs for a ticket to get out of the work that makes nursing what it is. This is a problem because they will not be good at taking care of their patients at the bedside. I don't think you have this problem. I thought this would be an issue for me, too, and I was afraid that I would be judged as not being able to do "the dirty work." So, I made sure I was always first to do that, even at the possible expense of an opportunity to do a skill. If a patient needs care, they need care and if it helps lighten the load of your preceptor, just do it (and seriously, that means more to them than anything). There will be plenty of opportunities to do everything under the sun. That one moment won't make or break you.

I think you're being too cerebral about this. Unless you present yourself as someone who doesn't want to do the "aide" work of nursing, then I doubt you have an issue. You seem like you really like nursing and like to care for patients. Just never forget to do the real patient care aside from assessments and med passes. It is so much more than that.

[n1wgmp]

From my personal experience,

While I was in nursing school, the majority of our exams contained CRITICAL THINKING questions, not memorization questions that you can answer from simply reading a book.

In my experience, the nurses that excelled in school also excelled in the profession. Answering these critical thinking questions correctly on the exams directly correlates for how you practice nursing in real life.

For example:

You must know that before you give Lasix you should check the patients potassium, sodium, & blood pressure because all of these factor in to whether you will be administering the drug or not.

You also must know to check you pediatric patients (& adults) urine output before administering Potassium to prevent hyperkalemia.

You must also know that it is priority to listen to your CHF patients lungs throughly to detect crackles etc. & intervene appropriately not only informing the doctor, but raising the HOB, O2 available, fluid restrictions, etc. to prevent respiratory complications.

If a student misses these type of questions on an exam, how can they properly ensure the safety of their patients at all times?

Nursing is much, much more than just following orders and giving medications.

Sure nursing is part skills as well, such as IV's. foleys, dressing changes & these can be taught to someone fairly easily.

The critical thinking aspect of nursing is much more difficult to obtain. And from my experience, students who excel in nursing school tend to be proficient in critical thinking type of situations.

So get those good grades, prove your professor wrong, & be proud of your ability to excel in through a very challenging journey!

[buttercup99]

at every turn I hear someone telling me that good grades mean absolutely nothing to being a good nurse.

This is not the same thing as "Students who get As are bad bedside nurses."

All it means is it takes a lot more than good grades. Take anatomy and physiology as an example, if you understand the WHYS rather than the WHATS, you will almost always be able to figure things out by critically thinking about what causes/affects/interacts with what. But apart from that, things like time management, effective communication, accurate documentation and fitting into the nursing workplace incl. keeping in line with scope of practice and policy, protocols &procedures, (amongst other things) are vital to succeeding as a nurse.

Having said that, at this point, expect to know near nothing and to have a lot of work to do on time management. Everyone starts out that way, and carries on that way as a student, even the smart people! If you're anything like most people, you'll walk into your first job feeling the same way! Time management is both very important and one of the skills students need to work on the most.

What I believe makes a good nurse is self reflection and an enthusiasm to learn. If you have that, which it sounds like you do, then you will be absolutely fine!

[Jewelsforme]

Jealousy rears its ugly head. They sound jealous. You just do your best without discussing how good your grades are or that you passed the NCLEX first time etc. You'll get past this and remember a whole lot more practical information to use in critical thinking when you are a graduate nurse, one who gains the confidence of patients and fellow staff alike.

[tatfuturern]

Dont take that at face value some nurses who get great grades arent good bedside nurses, but some nurses get great grades and are wonderful bedside nurses it cant be gneeralized some ppl are book smart some are hands on and some can do both

[juellner]

With time comes experience and therefore confidence. Quite frankly, I don't see the correlation between top grades equaling poor clinical skills. That's two different things. A strong basis for good clinic skills is sometimes, even most times, having good common sense. Being able to prioritize and being organized are top necessary skills. Without these, I see nurses flounder. Regardless of who got A's in class.

[SopranoKris, MSN, RN, NP]

Having good grades and being a good nurse aren't mutually exclusive. Don't waste a lot of time worrying about this. I have a 3.93 GPA and I do just fine in clinicals. Never struggled at all.

I think there have been incidents of straight A students bombing clinicals, but that has more to do with their self confidence and ability to perform skills. We had a straight A student fail out for sterile technique (multiple attempts) It happens. But the ones who struggle academically also struggle in clinicals.

I think people like to perpetuate this belief in "good student, bad nurse" because it makes them feel better about their own performance.

Maybe we need a study to get some real stats on this? :)

[windsurfer8, BSN, RN]

The post is pointless and excuses poor behavior. You are saying that because "you" feel grades do not matter to whether someone is a "class smart" or "patient stupid". So what are you actually trying to do other than make yourself feel better because your grades are bad. So you as humans often do try to make yourself feel better by putting down others. You want to justify something by saying that people who get good grades are bad nurses. You have ZERO evidence. You show me a peer reviewed journal article showing that nurses who earn As have worse patient outcomes than C students. Find it and then find 10 more. Posting on a message board that good grades make bad nurses based on NOTHING but your own inadequacies is stupid and makes nursing as a professional career look bad. Go earn your bad grades...no one is stopping you. Then when you can't get into grad school you can complain that they don't know anything and you are a "good nurse".

[RNsRWe, ASN, RN]

The post is pointless and excuses poor behavior. You are saying that because "you" feel grades do not matter to whether someone is a "class smart" or "patient stupid". So what are you actually trying to do other than make yourself feel better because your grades are bad. So you as humans often do try to make yourself feel better by putting down others. You want to justify something by saying that people who get good grades are bad nurses. You have ZERO evidence. You show me a peer reviewed journal article showing that nurses who earn As have worse patient outcomes than C students. Find it and then find 10 more. Posting on a message board that good grades make bad nurses based on NOTHING but your own inadequacies is stupid and makes nursing as a professional career look bad. Go earn your bad grades...no one is stopping you. Then when you can't get into grad school you can complain that they don't know anything and you are a "good nurse".

Ummm....You owe the OP QUITE an apology.

I think you very much misread the OP. She is saying exactly the opposite of what you are inferring; she is questioning the statements of her INSTRUCTOR....not her own thoughts on the topic. And she already said she IS a good student so....not sure why you're upset here?

[Brendan D.]

Don't let people get you down because they are bitter about their own grades. I make great grades in school and I have a great bedside manner. As for experience, I do recommend you try and find a tech job! Working as a CNA has been amazing for me and I have learned a lot outside of school. And I just accepted my first position as an RN the other day..4 weeks before I graduate! Keep up the grades, learn from your clinical, and get some experience outside of the program so you can learn even more. Good luck :)

[elijahvegas, ASN, RN, EMT-P]

this is by no means a rule at all. however, i would call it more of a trend.. ive been through a couple med programs and without fail there are always a handful that can kill it in the books and are a mess in the real world, and moreso vice versa. I know a lot of people that dont always ace the tests, but are amazing on the floor. Some of the best professionals ive seen type 10 words a minute and grammar riddled with errors and misspellings but would amaze you with their clinical knowledge. fundamentally, there is a difference between knowing information, and synthesizing it for application. Moreover, there's a big difference between reading a procedure, and proceeding with it.

to say that someone good on the books WILL be bad, or even to say is LIKELY to be bad is a horrid blanket statement. Everyone is an individual in their own right, and their strengths and weaknesses are anything but universal. Some excel hands on, some excel academically, and there are those lucky son of a guns that can do both with no problem. I will say there are some that i was appalled by the knowledge they lacked, or reluctance to demonstrate even the most basic of skills when we were on the floor, though had it been a paper and pencil test would brag all day long about how they got the question right that "everyone missed"

moral of story, go about being the best you can be and don't worry about what others think about anyone else's performance but your own.