What should they teach in nursing school but don't. What do they teach but shouldn't?

Published

My impression of nursing school based on my very limited experience is that there are many things taught that while perhaps not a waste of time are none the less perhaps not the best possible use of that time. If you were made the supreme overlord of nursing school curricula what things would you delete? Conversely, what things would you add both in terms of content and methodology (perhaps you would teach the same stuff but would do so in a different manner). Could nursing schools today implement your ideas (if they wanted to) or would they be prevented by accredidation bodies from straying from approved curriculum?

Specializes in private duty/home health, med/surg.

There are some good suggestions in this thread. It amazes me to see the wide variations in getting the same degree from one program to the next.

I think my CC's ADN program has trained me about as well as can be expected. It has trained us to "think like a nurse" right from the Fundamentals class. I look back on the older assignments that I struggled through in 1st semester and I can tell how my ability to critically think has been shaped. Our theory classes have case studies/scenarios/ethical dilemmas integrated into nearly every assignment.

Now that I'm in the final semester, I am done with theory and lab -- YAAAY! I have four 8 hour days of clinical a week, 3 weeks per clinical area. In one of our rotations, we will be taking care of up to 5 patients (geriatrics). In the OB rotation, we may or may not get a lunch. I think this semester will provide excellent learning opportunities, but I can also see how I have so much more to learn once I am a "real nurse" working a real job.

Up Vote Up Vote ×
:chuckle :chuckle :chuckle

And that would be fine if the onsite learning was done with full supervision of qualified staff. But it isn't - graduates may have extended periods of orientation, but pretty much from day one they have a patient load for which they are responsible. However good they are, however well they learned the theory, if there wasn't a clinical connection the theory doesn't become concrete. For example:

Quote:

Originally Posted by rngreenhorn

I did have a patient who had an MI while I ambulated her I will never forget the signs and symtoms of MI.

And I'll bet that you learned them in school, but I'm guessing that the theory, divorced from clinical experience, means that they weren't real or accessable to you until this experience - please correct me if I'm wrong :)

When you're learning about the heart, or cardiovascular disease, or when you're asked about the symptoms of an MI, everything comes gushing forth. When you're walking a post-op woman with no cardiac history to the bathroom and she becomes a little short of breath, has a little chest tightness, looks a little pale, and says "I'm fine, dear" because she doesn't want to worry you, an MI is not the first thing that will come to mind.

QUOTE]

BINGO!!! That is exactly what happened... I mistook her s/s for anxiety... I just happened to be precepting at the end of 4th semester. My preceptor was the one who called to doc and got an order for CPK and troponins and to cover her for the EKG which, she had already ordered.

My only complaints about my ADN program is not enough clinical hours... and like you (taxanda) I beleive the theory is important. When I sat down later to write a 14 page careplan, I had time to really analyze what had happened. The connection between the A & P, s/s and intervention really made sense.

Without my awesome preceptor the MI might have gone undiagnosed (until the big one). The next day the pt had a cardiac cath and ended up with a stent.

Up Vote Up Vote ×
Ok I like your answer and I feel it is very well thought out and reasonable, however I feel that as I mentioned earlier LP/VN programs spend much more time on clincal experience(hands on)and while they also teach basic entry level education, they are also able to give a practical experience that builds a good solid base of experience as well. I don't see why BSN programs can't incorporate a bit mor of this, I understand that BSN programs are attempting to teach a knowledge base with deeper critical thinking and thought process implications but I also feel that most people reinforce book learning by performing skills related to material.

I understand that programs are structured for "maximum" effect but I really feel that BSN programs c/should give a more focus to skills!

Sure. I understand what you’re saying. Incorporating more practical skills in place of some theory may be a better solution overall—I really don’t know. One thing is for sure, though—a curriculum that is rarely revised is probably a poor one.

Up Vote Up Vote ×
Specializes in Telemetry.

i was told "nurses eat their young" i have found this to be true especially for nursing instructors!!! as far as i can tell they are more interested in insuring that nursing school is as much hell for their students as it was for them!!!! if they cared about actually passing on knowledge they actually have(?) they would teach it - not give a basic 2 hr lecture covering 700 pages of a text book and then make the entire 700 pages, that were hardly even covered in the lecture, testabke. if you ask them go give you a little focus for the test it usually goes like this-"oh, everything i covered in lecture and all the assigned reading, any questions". i even had an instructor tell us that any materials that came along with the textbook, (cd, handouts, references), were also testable. this is an effort to see if we can live without sleep! by the way not a single student has received an "a" in any nursing class i have attended for three semesters. i overheard two nursing instructors speeking in tones of great pride over this accomplishment!!!!! (their words)

my adn program was more like gompers' bsn program (maybe 2 pts. by the end). this thread interests me a lot, as i am in an ms-education program, and my group project is to come up with an entire curiculum. basically taking into consideration everything discussed here. after reading these posts, i'm completely overwhelmed.the bottom line is, there are not enough hours in a semester (or 4, or 8) to teach everyhing that needs to be taught. the role of the nurse is so much more complex, and academia has not caught up with it. i don't think it is possible to teach to the nclex and reality in 2 or 4 yrs. and some people are 'accelerating' to try to do it in less time?!!?!? :uhoh21: i think it is dangerous.

and i have to respond to the "those who can't do..." :angryfire :angryfire :angryfire do you really believe that this is true?!?!? do you think we're willing to take that paycut because we 'can't do it'? do you think that i would risk my career and put my self in a position where my license is on the line if i couldn't do it?!?!? don't generalize. some of us actually care about our young, and about making a difference.

Up Vote Up Vote ×

A course toward the end of the program r/t ...stress management,prioritizing,delegation,public relations...title this course "Reality Check"...I think ALL of us were overwhelmed as new grads dealing with the 'realities'.....give real instances and discuss how to handle them...what's most impt., how to keep from pulling your hair out...lol :)

Up Vote Up Vote ×

I worked for the Visiting Nurses Assoc. for 1 year. I walked in blind, 1 day of useless training and was off and running. I knew I wanted to be an RN (changing careers) and thought it would be best to get a little experience. I started at the bottom wrung of the ladder and dove in head first. The apt. complex I worked at housed 4 quads (1 also has severe CP), 4 residents with CP and a gentleman who has RA and had had a stroke a year ago. We did every kind of personal care and then some imaginable. I made no $, performed more bowel programs I ever thought possible and can cath a man with my eyes closed. I wouldn't trade that experience for the world. We were telling their case workers (nurses and social workers) about the residents. They didn't have a clue. I think everyone going into the health field should have to spend a pretty good amount of time working in some sort of personal aide situation.Talk about thinking on the run!! I'd like to see Drs. and some nurses treal not only the physical disabilities; it would be great for them handle all the emotional situations which also arise.

Up Vote Up Vote ×
Specializes in ICU, ED, Transport, Home Care, Mgmnt.
I spent an entire quarter giving bed baths. I would like to see LESS emphasis on AM care in clinicals, and MORE emphasis on teaching us the skills we need. And every time we ask for more exposure to skills, we are told that we learn them on the job, and so we shouldn't worry our pretty little heads over it.

I would like clinical instructors to do more "Grand Rounds". On clinical days, we may have 1 or 2 patients, but not get to look at a variety of patients, and see different conditions, or see assessments done on those patients. I feel vastly underprepared for patient assessment.

LESS psychosocial mumbo-jumbo. I didn't come to nursing school for a psych degree (which I already have), I came to learn nursing. Considering how few people become psych nurses, MUST we spend so much time on nurse-patient interaction, especially when floor nurses are so busy, they certainly aren't clarifying, reflecting, confronting, etc. etc. Give me more hard knowledge.

LESS paperwork, MORE patient contact.

That's my $.02 worth for now!

oldiebutgoodie

I think there needs to be more realistic nurse patient interaction for nursing students. Unfortunately I hear of too many instances where a nurse has opened her mouth and stuck both feet in and begun chomping away in front of patients and family. Nurses need to know how to talk to thier patients, what is appropriate or not appropriate. We are seeing lots of psych patients with medical problems, many times they are our most reliable frequent flyers. Nursies must know the best way to deal with these patients, otherwise they will driver YOU nuts.

My biggest wish for the perfect nursing school would be for at least twice the hours of clinical for students, that's is where nurses are made, not the classroom.

Up Vote Up Vote ×

How about reducing pre-requisites to ONE semester and expanding actual nursing courses into SEVEN semesters (and here I am obviously speaking of BSN programs). Futhermore, how about scoring the NCLEX beyond just pass fail. In other words passing the NCLEX with eighty five questions rather than 200 would become a "part" of your resume. This should have the effect of helping to "focus" nursing education more on things that are most clinically relevent (albeit with the price that all such standardized tests carry, namely that such focus may in some way limit the educational experience in terms of "teaching to" the test).

In addition, I have proposed in a previous post the establishment of "nursing skill centers." These would be places that aspiring nursing students, actual nursing students, and current nurses could go to refine and upgrade their clinical skills in an environment that was low stress, and which offered encouragement. It would contain state of the art lab simulations, videos, computers, guided instruction, case study analysis ect. In addition, it would feature actual discussion groups which met to discuss real world client management examples. You could participate in these centers by paying a nominal monthly fee (consider that the YMCA charges $60.00 per month, I would pay at least that much to improve my odds of becoming an excellent nurse, let alone to survive nursing school). Furthermore, I have little doubt but that additional funding could be secured from governmental, and private sources to fund such an endeavor.

Up Vote Up Vote ×
Specializes in Cardiac - Med/Ortho/Surg/Gyn.

it doesn't matter which nursing school you attend. you never feel like you're fully prepared to meet the real world of nursing. there are 2 things i was not prepared for.

1.) the smell of gi bleeds:uhoh21:

2.) how disturbing/annoying patients families can get.:uhoh21:

Up Vote Up Vote ×
Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

please keep in mind that debates are about a subject and not about defamation of other posters. watch what you say. the terms of service are at the bottom of every forum page. https://allnurses.com/forums/showthread.php?t=31788

Up Vote Up Vote ×

I am currently in my second year of the rn program, and the one thing that needs to be present, that can not be taught, is maturity. I think that an interview process should be mandated for all nursing applicants.

In terms of teaching gaps, here they are using the pbl system, which quickly shows who is up to the task and who is not.

Up Vote Up Vote ×
Specializes in Med/Surg.

Time management and general organization...there should be a whole class on it. It is something you use every day as a nurse, and if not, you'll have a rough time.

Up Vote Up Vote ×
+ Join the Discussion