What advice to give?

[DNS on the go]

I am currently teaching a theory and clinical class for one year BSN students. All the students are college graduates and they have decided to enter into nursing.

In the clinical site, the students are being exposed to the nurses and to the various staff members who have morale issues related to the hospital's staffing and other cutbacks.

To summarize my issue, the students have entered into nursing assuming it was an easy ride to a job that pays a living wage. Now that jobs are tight and the work environment is more complex then they assumed, several of the students are now expressing doubts about taking on serious debt (the tution and fees for the program are over 80K) to get a degree in a crowded and competitive nursing job market.

One student told me that she has "haggled" before and now needs a check. She expressed concern when she saw how hard the nurses and the aides worked and is upset that she may not get a job to her liking when she graduates. Other students fear they will not get a nursing job. Stories about the reality of other fields (working for free (interning), working for very low wages, freelancing, etc) are a constant theme among the students.

Most of these students are average ability and intelligence but have a strong sense of entitlement. When I asked the question of "would you be in nursing school if your first planned career had worked out?", most said no and the others did not answer. I was shocked that not even one student wanted to be a nurse. Nursing was a job with easy access to a job and a good wage. A few saw nursing as "something to do" until the economy turns around. The mentality is not the same as my community college students or my career ladder students who want to care for the patients.

Having been in nursing education a long time,my guess is that most of these students would be in and out of nursing in less then 3 years. My fear and now the fear among the students is that they may not get the chance to get an acute care job and the training that goes with it.

Nursing requires dedication and humility. Neither characteristic is present with this group of students.

My question is what do I say to them to quell their fears? From my limited exposure to them, they are not nursing material...they do not like to follow directions or like to be told what to do. Several of them have master's degrees in various fields.

I am torn because I see this group as not making it in nursing. Academically, they will pass and get through the NCLEX without major stress. It is an unwelcoming job market that awaits then as they hold very unrealistic view of their abilities and of what nursing is about.

It is sad that as a department, we must take in the students and train them even through it is not in their best interest to waste their time or have them take on more student debt. Tution pays the instructors' salaries and benefits.

Advice, ideas or suggestions?

[tokmom, BSN, RN]

If they know what they are getting into and still want to persue a nursing degree, then let them. They are big boys and girls and don't have a gun to their head to stay in this program.

My only reservations are the spots they are taking up for those that want to be nurses, but can't get in because the wannabes are taking up space.

Hopefully a few of them will like nursing enough to stick with it. That sense of entitlement might go away once they start growing up. Nursing ain't for immature wimps.

[VioletKaliLPN, LPN]

^ i agree tokmom. students understand the insane amount of debt an accelerated bsn program can require. (no offense op) the tuition and fees are not imaginary, and they do sign on the dotted line. no one forces or coerces anyone to take out a 80k loan for a program, it is a decision those students made for themselves.

it's a shame that students have to spend 80k to discover nursing is not their cup of tea, adn programs and then bsn bridge would be cheaper, but no one forced them to choose a more expensive route.

[roser13, ASN, RN]

You are not the first instructor who has posted here regarding the "entitled" attitude of certain classes of students. (And just as a heads-up, the other poster took on alot of criticism for "pre-judging" her students.)

I agree with the previous poster. These students are big boys and girls. They are observing their future worksite and forming their own impressions. They are responsible for evaluating what they see and applying it to their own prospects. Fortunately they are experiencing this early on in the process (first year) and will quickly decided whether or not they are on the right track.

I don't think that it is your place to quell their fears. Particularly since some if not all of their concerns/fears are valid.

[cindyloowho]

I graduated from an accelerated BSN program for second degree students, and you're right; we are a different breed. I believe than many second degree nursing students have little interest in beside care and the successful ones will be more likely to pursue NP degrees or management. The only offer of advise I have for you is to encourage that path because while we need bedside nurses, we also need advanced practice nurses and ones dedicated to climbing the corporate ladder. Neither one is more valuable in the field of nursing, so we truly all can get along if we try :-) Yes, my group of students was entitled as well, but I am happy to say that out of my cohort next to our same institution's traditional program...way more of the accelerated group got jobs right away, So we may be premadonnas but we seem to be successful!

[tokmom, BSN, RN]

I graduated from an accelerated BSN program for second degree students, and you're right; we are a different breed. I believe than many second degree nursing students have little interest in beside care and the successful ones will be more likely to pursue NP degrees or management. The only offer of advise I have for you is to encourage that path because while we need bedside nurses, we also need advanced practice nurses and ones dedicated to climbing the corporate ladder. Neither one is more valuable in the field of nursing, so we truly all can get along if we try :-) Yes, my group of students was entitled as well, but I am happy to say that out of my cohort next to our same institution's traditional program...way more of the accelerated group got jobs right away, So we may be premadonnas but we seem to be successful!

But here is the deal...to be a really good NP or manager, you need to have been in the trenches. You need to hold hands of dying pt's, deal with difficult families and work the intensity of an ED, Med/Surg or ICU. How else do you really understand patients, family and other nurses??

Just because you graduate from the program and are deemed successful because you land a job, doesn't make you understanding of what it really takes to work in health care.

[Esme12, ASN, BSN, RN]

I graduated from an accelerated BSN program for second degree students, and you're right; we are a different breed. I believe than many second degree nursing students have little interest in beside care and the successful ones will be more likely to pursue NP degrees or management. The only offer of advise I have for you is to encourage that path because while we need bedside nurses, we also need advanced practice nurses and ones dedicated to climbing the corporate ladder. Neither one is more valuable in the field of nursing, so we truly all can get along if we try :-) Yes, my group of students was entitled as well, but I am happy to say that out of my cohort next to our same institution's traditional program...way more of the accelerated group got jobs right away, So we may be premadonnas but we seem to be successful!

Hospitals also know you have a mountain of debt to pay off and are less likely to blow off your job responsibilities. My personal opinion is this is what is troubling nursing.......the "It's a paycheck" attitude and then finding out how hard it really is and how little we are paid for what we do is what I believe leads to all the negitivity and bad attitudes. The saving grace......this too shall pass the economy will turn and there will once more be a mass exodus leaving those who really want to be here at the bedside and those who have little interest at the bedside should find another profession. JMHO..

[Art_Vandelay]

I would advise they take their sense of entitlement and flush it down the toilet. Nursing is ANYTHING but easy, and I am in awe of the fact that executive directors without nursing degrees are the ones determining the staffing ratios. Quell their fears? Nope. Let experience teach them. I just hope it leads them away from healthcare because I don't want them determining my patient load.

[MN-Nurse, ASN, RN]

Idvise, ideas or suggestions.

Yes, treat them like nursing students. I saw what my instructors did when they ran into this attitude and it was pretty fun to watch.

The whiners can either quit or get with the program.

[leslie :-D]

i wouldn't advise them of anything.

rather, i'd give them the lowdown of nursing...the rewards, the challenges, and considerations.

if some are looking for easy money, i would emphasize this is anything BUT easy money.

if they want to quit, adios...and don't let the door hit you on the way out.

i seriously do not want students in nursing, if they don't want to be.

or, if they continually whine, complain, and rebel against the defining qualities that make a nurse.

so...my advice?

if you're not willing to work your butt off in order to succeed and flourish, then you need not apply/continue.

and, have a good life.

leslie

[cindyloowho]

But here is the deal...to be a really good NP or manager, you need to have been in the trenches. You need to hold hands of dying pt's, deal with difficult families and work the intensity of an ED, Med/Surg or ICU. How else do you really understand patients, family and other nurses??

Just because you graduate from the program and are deemed successful because you land a job, doesn't make you understanding of what it really takes to work in health care.

Not buying it. Ive been in the trenches, done all that you've said above and then some, and will be for awhile longer before going for my NP. if I'm only a bedside nurse for 4 years, does that make me incapable of being a good NP? I think not! I've done a lot of cool things in my careers and I have a wealth of experience, empathy, and professional strengths. I don't need 25 years of taking orders from docs to be able to give my own :-D I fully appreciate your outlook and I do actually agree with you. But the mentality that you have to be a bedside nurse for x amount of years before moving on is a fallacy in my mind...success depends on the individual and their own learning curve. Experience helps tremendously but everyone's individual experience does not equal the person assigned to the room next to them.

[DNS on the go]

As a nursing instructor and as your colleague, I have an issue that I would like advise on. If you read my previous post, from previous semesters you would see that the issue of training new nurses who would rather not be nurses is a major issue. I have asked other nursing instructors to give me their ideas.

You do not realize how hard it is to educate someone with fundamental skills when that person believes that they are above what you are telling them, believe they are not going to be doing "nursee" things and believe that their previous education, degrees and "whatever" makes them better then everybody else.

My question to you is: are you an educator or a nurse manager? If you were either, you would not understand the issue I am discussing.

is it morally right to have these student take out loans for over 80K and consume one year of their life when the job market is so tight?

By the way...the job market will not be opening up in the near future.

What do you say to the nurses who have graduated in 2008, 2009, 2010 and now 2011 who do not have a job.

You may not be aware but nursing education is contingent upon your first employer training you. What you get in school is a very basic introduction. This is regardless of your entry in nursing. Once the profession moved away from hospital based 3 year programs, the clinical skills that were developed in these programs was never seen as a priority in the AAS or BSN programs.

When your doctor finishes medical school, he or she must spend at least 3 years as an intern/resident in a hospital so as to learn his or her trade. Nurses are expected to get a job in a hospital and then be trained. Well guess what...hospitals are now slow to hire, can hire experienced nurse or use agency (agency costs are down so much this is now an viable option and in some cases cheaper then paying time and a half for OT).

Add to this the advise to go to LTC or HH. Well I have news for you...they are not hiring in mass either and do not have the resources to adequately train/orient nurses straight out of school. You might say to me...well they will figure it out on their own but the dilemma is what if the new nurse doesn't "figure it out on their own". Remember their is a patient in the bed. That patient may be you or your loved one someday. I hope not!