What are they teaching?

[egglady]

I have an honest question. I'm not being a old crabby nurse. Honest question here... What are nursing schools teaching? So many posts of new grads that didn't think nursing would be stressful or hard. Nursing is a very stressful job. Are these schools actually teaching our future nurses that nursing is Not a stressful job? If so, they are doing a disservice to our profession. I feel bad for these new nurses that seem to truly be shocked that it is a stressful profession.

[londonflo]

Quote

    rntracy1 said: 

As professional nurses, we need to focus more on the reasons why we are performing those skills, the patient's response to the intervention and patient outcomes. 

This is extremely important for the RN. The LPN's observations are always needed but the response of the patient to medications, repositioning, teaching, etc. is the responsibility of the RN (in the hospital and home health settings). NCLEX cites the importance of the evaluation step in several places of their 2019 test plan. 

17 hours ago, rntracy1 said:

it's the critical thinking, theory, college level writing and formatting, grammar and math skills, etc

What you cited in the post above are the basic elements of a college education at an associate degree level (not only nursing). While the need for these may not be obvious in a staff nurse role, any position such as case manager, educator, school nurse etc. may need to draft memos, emails to hospital leaders, handle a budget, speak to the superintendent/school board/parent organization and other activities that may not be done as a staff nurse. I applaud you mentioning grammar. I can't stand to hear a nurse tell a doctor "he don't want to do ......". For years I was in a faculty role at a school where other faculty said you can't correct them, it is part of their culture. 

I wish I had college math but I didn't have any math after high school algebra II. When I took the GRE my math score was at the 30th percentile. That means 70% of the students taking the test did better than me. Thank goodness the other scores at the time brought up my score so I received the scholarship.  The worst part was the faculty of my Master's program bringing it up in my interview and requiring me to take another statistics course. Amazingly I do use algebra fairly often.

 

11 hours ago, Susie2310 said:

 It doesn't make nurses more professional to require them to complete college courses they don't need.

The requirements for being a nursing professional are covered in the ADN curriculum (if the school is accredited, I would add). But education is never wasted and any and all course work can have an impact on the bearing, interactions, ability to problem solve and develop solutions, conflict resolution etc. Education is never limited to that 2 to 4 years one commits to basic education. 

You know what I love best about my retirement? the ability to take online and in person (before covid)  talks, lectures and courses in areas I never had the time to learn. I am starting an online 4 credit course presented by the V & A Academy in London! (the only benefits of covid for me are that I have saved money through not going out and the creation of more virtual learning here and abroad).

11 hours ago, JKL33 said:

Although...college level formatting?? I guess I do disagree that is an important part of nursing education specifically. How about we only admit people who can figure out how to utilize extremely simple APA software and call it a day.

I feel so unheard. ??

I do hear you now. It has become the tail that wags the dog to use the APA format for non academic paper uses. And it is inappropriate to make a citation and format program to be more important than the educational achievements of a well thought out, researched paper.  Do you know universities hire someone to go through all the doctoral dissertations after the degree is awarded but before they enter them into the dissertation data base to make sure everything is formated and cited correctly. 

I took a Summer class at Oxford University and we did have a paper assigned at the end. We had to cite sources and use a format method but Oxford still accepts handwritten papers! (They did not have a strong internet system in our dorm room either). I guess when you are more than 500 years old you can stick with what the students did before the typewriter was invented!

[Susie2310]

On 9/8/2020 at 8:41 PM, londonflo said:

The requirements for being a nursing professional are covered in the ADN curriculum (if the school is accredited, I would add). But education is never wasted and any and all course work can have an impact on the bearing, interactions, ability to problem solve and develop solutions, conflict resolution etc. Education is never limited to that 2 to 4 years one commits to basic education. 

This is a rather luxurious approach.  In the relative, day to day world, students/their families are charged with paying for the nursing education they receive, and taxpayers are contributing funds towards nursing programs and nursing student education.  Nursing is not a liberal arts subject; it is a specific trade that requires a specific license that is supposed to mean that one has achieved basic competency as a nurse when one begins to practice.

[londonflo]

39 minutes ago, Susie2310 said:

 Nursing is not a liberal arts subject; it is a specific trade that requires a specific license that is supposed to mean that one has achieved basic competency as a nurse when one begins to practice.

I object to the labeling of nursing as a trade. If that is the case it can be taken out of the college system. Nursing professionals and educators fought a good battle for years to get nursing established as a college educated profession that is based on science and the humanities.

The impetus to move nursing into the academic environment began with Florence Nightingale. Her efforts to formalize nursing education led her to establish the first scientifically based nursing school.

Quote

Goldmark Report: published in 1923, recommended that nursing education develop educational standards, schools of nursing adopt a primary focus on education and be moved to universities, and nurse educators receive advanced education. -

Mildred Montag developed the ADN program in the 1940s. In the 1980s articulation agreements were developed.  These agreements support education mobility and facilitate the transfer of academic credit between associate degree and baccalaureate  nursing programs.

I have taught in 2 different diploma programs and the specific focus of the education was developing hospital staff nurses. There was limited discussion of other places to work. My first diploma instructor position was in the 70s. The later one (80s) did let the students have a couple observational experiences but no direct application of learning. Neither school had an articulation agreement. In fact when the latter program became a BSN program, the director wanted any diploma graduates to start at the beginning again. That's when I decided to quit.

56 minutes ago, Susie2310 said:

 In the relative, day to day world, students/their families are charged with paying for the nursing education they receive, and taxpayers are contributing funds towards nursing programs and nursing student education.

Yes, the expense of a nursing program needs to be addressed as does all of higher education.  A diploma program was much cheaper in terms of tuition because the hospital did not need to provide much of a new hire orientation.

Taxpayers are contributing funds to all community college majors and all public 4 year college majors. Nursing gets no more and no less. Taxpayers are providing funds to medical students too, through the medicare pass through monies at the hospital and for the medical schools. 

57 minutes ago, Susie2310 said:

Nursing is not a liberal arts subject;

Where do students learn about our social systems? How do they learn to advocate for those less fortunate?  One in every 45 voters is a nurse. What about some political science theory so that students make an informed choice as a voting citizen and learn how to interact with those elected officials  to effect change?

With my last teaching job a new college president wanted to relocate the nursing school into the "medical district" and was considering using classrooms in the hospitals. The ADN program director mentioned it to me and I moaned and said we spent way too many years getting the nursing students into a college library, sharing classes with other disciplines, or sharing clinical projects with the dietician students for example. The director told me she hadn't thought about those aspects and opposed the move.   We didn't move. I will object every time to any talk of nursing as a trade. Somehow our roots still haunt us. And we wonder why we have no seat at the table when the decisions are made!

 

[Susie2310]

1 hour ago, londonflo said:

I object to the labeling of nursing as a trade. If that is the case it can be taken out of the college system. Nursing professionals and educators fought a good battle for years to get nursing established as a college educated profession that is based on science and the humanities.

"The Merriam Webster dictionary provides definitions of the word "Trade" that don't preclude the incorporation of science and the humanities.

Regardless of whether one considers nursing a trade or a profession, it doesn't follow that the study of nursing should be taken out of the college system, any more than dental hygienist or radiology technician education/training, or numerous other trades that are learned in community colleges or universities, such as accountancy or construction, should be removed. All these subjects have in common that they require a significant amount of preparation, and the college environment is an appropriate place for this learning to take place.  In the past, hospital schools of nursing existed.  Education/training that now takes place in college used to take place on the job in the past.  The word "trade" is a perfectly respectful one."

The impetus to move nursing into the academic environment began with Florence Nightingale. Her efforts to formalize nursing education led her to establish the first scientifically based nursing school.

"Regardless, nurses in Florence Nightingale's time knew how to practice at the bedside, and they knew how to perform bedside nursing "skills."

Florence Nightingale was also a statistician who promoted the use of statistics in health care.  You mentioned that you didn't take college level math.  I have taken college statistics (4 units) and I find it quite acceptable to call nursing a trade.  A trade is not defined as an activity that precludes math, science, or critical thinking."

Taxpayers are contributing funds to all community college majors and all public 4 year college majors. Nursing gets no more and no less. Taxpayers are providing funds to medical students too, through the medicare pass through monies at the hospital and for the medical schools. 

"This is a nursing forum and we are discussing nursing education.  The fact that taxpayers fund education for various programs doesn't mean that taxpayers shouldn't hold an opinion about what these funds are used for, or that the stewards for these funds should not be receptive to public opinion, or that the stewards of these funds should not be good stewards of the funds they are responsible for spending."

Where do students learn about our social systems? How do they learn to advocate for those less fortunate?  One in every 45 voters is a nurse. What about some political science theory so that students make an informed choice as a voting citizen and learn how to interact with those elected officials  to effect change?

"I didn't need to go to college to learn about the world around me, or to learn about our social systems.  I didn't need to go to college to learn how to advocate for those who are less fortunate than me.  I learned these things through life experience, through being interested and concerned.  Today, there is plenty of information on these topics available on the internet and in libraries. I took political science at college level as part of my general education prerequisites for my ADN program, but taking these classes at college wasn't necessary for me to learn about these topics.  With intelligence and the right attitude, one can accomplish a great deal of learning without attending college."  

 

I have added my thoughts in bold below yours.

[Hoshio, RN]

Nursing schools these days all just throw a bunch of information at students without really emphasizing to them on applying it to the clinical setting - let alone helping them learn valuable clinical skills. It really is on the individual to put the puzzle together themselves. And unfortunately, critical thinking, data collection, and bringing ideas & skills together is so foundational to nursing. 

As someone mentioned earlier, a new nurse who has the ability to comprehend why actions are being taken, the risks associated with that action, and being able to anticipate and or identify when things are working are not working are more valuable than a nurse who has been on an assembly line and only know how to do tasks without any understanding. 

From experience on my own floor, new graduates that come in wanting to learn, are asking for help, and attempting to identify concerns are all easily mold-able into great floor nurses for our floor. On the flip side, we've had a few who come in, and either have no ability to connect the dots - even when you've drawn a map for them. Some new nurses also don't seem to get that someone else's life is in your hands. You could very well kill someone - and some of em wouldn't even have that thought cross their mind, which is scary. 

[londonflo]

10 hours ago, Susie2310 said:

"The Merriam Webster dictionary provides definitions of the word "Trade" that don't preclude the incorporation of science and the humanities.

Quote

TRADE: A skilled job, typically one requiring primarily manual skills and special training. PROFESSION: A calling requiring specialized knowledge and often long and intensive academic preparation with continued learning during the practice of the profession.

 

10 hours ago, Susie2310 said:

"I didn't need to go to college to learn about the world around me, or to learn about our social systems.  I didn't need to go to college to learn how to advocate for those who are less fortunate than me.  I learned these things through life experience, through being interested and concerned.

 

 

How do we ensure all potential nurses have your drive and motivation?

10 hours ago, Susie2310 said:

 Today, there is plenty of information on these topics available on the internet and in libraries.

To truly use the materials that reflect facts and informed opinions, many need some expert guidance. But, I agree, there is so much information available at our fingertips!

 

10 hours ago, Susie2310 said:

"Regardless, nurses in Florence Nightingale's time knew how to practice at the bedside, and they knew how to perform bedside nursing "skills."

Before Nightingale, nursing was not a respected profession at all. With the exception of nuns, the women who worked as nurses were often ill-trained and poorly disciplined.  Nightingale was determined to encourage educated, 'respectable' women into nursing. Her parents refused for her to go to a German nursing school for years until they finally relented. For a primary source of what the early Victorian times were like, nursing in particular, one need only look at the popular writings of the day. Charles Dickens wrote of what he knew in the early 1800's. His character of Sairey Gamp is a nurse (in Martin Chuzzlewit). Mrs. Gamp is dissolute, sloppy and generally drunk. She became a notorious stereotype of untrained and incompetent nurses of the early Victorian era, before the reforms of Florence Nightingale. Nightingale's book "Nursing What it is What it is not" is the first nursing textbook published and still to this day explains the basic tenets of the care of the sick.

10 hours ago, Susie2310 said:

Florence Nightingale was also a statistician who promoted the use of statistics in health care.

 YES, by using applied statistical methods, she made a case for eliminating the practices that contributed to the unsafe and unhealthy environment. Her work in statistics saved lives.

 

10 hours ago, Susie2310 said:

"This is a nursing forum and we are discussing nursing education.  The fact that taxpayers fund education for various programs doesn't mean that taxpayers shouldn't hold an opinion about what these funds are used for

Like everyone else I have opinions on the use of my tax dollars. I approve of the use of tax monies in providing nursing education as I use the health care system and want to have the nursing services there when I need them. A couple of years ago I broke my hip. Since there is a limited hospital stay, I came home with home health services. I was so happy to see the RN visit the next day. I needed help! If I had had to wait (like I did for OT to come and help set up how to shower) I know I would have had complications. The lack of showering (OT) would not have had such an impact on my health as a lack of nursing care. Several of the nurses who came I had taught at the Community College, as was my main hospital nurse when I was admitted and the day of surgery. I knew my tax monies (both local, state and federal) had assisted in their education and I benefited with a good post op course! Sometimes you don't know the value of something until you need it.

I leave you with a drawing of Sairey Gamp

[rntracy1, BSN, RN]

15 hours ago, Susie2310 said:

This is a rather misinformed comment:  "The thing I think most RN's don't understand is, it's the critical thinking, theory, college level writing, and formatting, grammar and math skills, etc that separate us from LPNs'?"  

No-one has said that RNs' are solely focused on hands on skills, or that they should be.  Of course they aren't/shouldn't be.  But they need to be able to perform them when needed in the course of providing patient care, and being trained to do so in the course of their NURSING education is the backbone of the discussion on this thread.  

The nursing scope of practice is greater for an RN (thus requiring more education/training than an LPN), and the level of responsibility for an RN is greater.  RNs' have more nursing education/training than LPN's. This is the most important difference between RNs' and LPNs'; not that RNs' may have a greater ability/proficiency at English/math than LPNs'.  RNs' have often taken more college English and math classes than LPNs'; the pre-requisites for ADN programs when I was a student required college English and elementary algebra (of course, some students have already completed courses at higher levels than are required by the programs).  Nursing math uses arithmetic and elementary algebra in dosage calculations, so there is no need for higher level math at the bedside (where the majority of nurses are employed).  It doesn't make nurses more professional to require them to complete college courses they don't need.

In the ADN program I attended, the ability to write and comprehend at the level of College English papers and to do basic math at the level of arithmetic/elementary algebra was presumed as students had completed these prerequisite courses.  If students couldn't perform at this level and were unable to complete their nursing coursework to the required standards of the program, or perform adequately in clinicals', they would not have been allowed to continue in the program; there wouldn't have been any remedial English or math classes that took time away from the subject the entire class were there to learn, namely, how to practice as a nurse.

Of course critical thinking is important (have you noticed people refer to the importance of using the Nursing Process?).  Of course nurses need to know why they are performing clinical skills and to be able to evaluate the patient's response to the nursing interventions, and be able determine patient outcomes (all learned in my community college ADN program) - why would this be otherwise? In addition, many clinical "skills" also require clinical knowledge (learned in my ADN program) and knowledge of anatomy/physiology, etc. (covered in pre-requisite classes for my ADN program) to perform safely.
 

 

 

I feel it is you who is misinformed. I was responding to llg who was responding Hoosier's comment about nursing schools being more focused on APA format than teaching skills.  Hoosier was implying that learning the skills is more important than formatting a paper, and my response was that it was not. I may have been a bit extreme in saying that "if your sole focus is on skills" there are others who can perform skills, but I was trying to make the point that a skill can be learned fairly quickly and easily.  You can't even learn to insert an IV until you become a licensed RN. You may not get the chance to see the delivery of a baby during L&D rotation. If you want to learn skills in nursing school, you have to seek them out too. There isn't always something going on during a particular rotation that gives you the opportunity to learn that skill.  When you do a psych rotation, you aren't going to see every single psych disorder and be able to practice dealing with it.  Some skills you have to learn on the job.  You aren't going to come in knowing how to do everything.

Susie2310 said: "In the ADN program I attended, the ability to write and comprehend at the level of College English papers and to do basic math at the level of arithmetic/elementary algebra was presumed as students had completed these prerequisite courses."

Then why do so many people have such a problem with it?  If every student came in to the program with this already mastered, why would they be complaining that nursing programs are focused on it rather than teaching skills? If everyone is already proficient with APA format and basic math and elementary algebra, then they wouldn't be so focused on it.  Everyone would already know it and be doing it automatically.  I did college level English in 1989 and went into nursing school in 2002, so it had been a few years since I had APA format.  Maybe others, like me, need a little reminding.  

The only point I was trying to make is that nursing is more than learning a skill. Skills are important, but there isn't always an opportunity to learn every skill while in school. Writing and communicating is also a big part of nursing.  

[rntracy1, BSN, RN]

15 hours ago, JKL33 said:

Although...college level formatting??

Ha ha, LOL.  I meant to say college level writing and formatting. LOL. My mind was going faster than my hands could type.  And, I obviously didn't proofread my work.  LOL.  

[rntracy1, BSN, RN]

15 hours ago, londonflo said:

Do you know universities hire someone to go through all the doctoral dissertations after the degree is awarded but before they enter them into the dissertation data base to make sure everything is formated and cited correctly. 

In my BSN program, we had to enter our papers into a program that made sure they were properly cited and that nothing was plagiarized.  No more than 30% of our paper could be quoted from other works, and the whole reference section was included in that 30%.  I will get a lot of backlash for all my admirers here but, I agree with the universities going through the dissertations to make sure they are formatted and cited correctly.  First of all, doctoral level candidates should be formatting their papers correctly, but references need to cited correctly to avoid plagiarism. That can be a big issue. I am assuming that is what you are referring to when you say cited correctly.

[rntracy1, BSN, RN]

32 minutes ago, londonflo said:

PROFESSION: A calling requiring specialized knowledge and often long and intensive academic preparation with continued learning during the practice of the profession.

londonflo, you are so right. Nurses have worked so hard to classify nursing as a profession rather than a trade.  I mean, just the hours required for the courses in the ADN program is more than any other Associate degree program.  When I was in the ADN program, I was trying to get my son into the daycare on campus.  I was told I couldn't get the reduced student rate because I wasn't a full time student!! My director of nursing had to write a letter stating that, although I wasn't earning the typical 12 credits full time students earn, I was actually in school more hours than they were.  Our clinicals were 7-3, 2 days per week and we got 2 credits.  That's more than a full time load right there.  Now add in my other courses and lab.  My son was accepted into the daycare program, but only because of the letter.  It's hard to explain to people that 9 credits are a lot more hours than a typical associate degree student taking 9 credits.  We as nurses need to proud of our accomplishments and continue to fight for respect as the professionals we are. 

Anyone can learn a skill. It isn't just nurses. For example, I am a school nurse and I was co-signing orders with a nurse at another school one morning.  I informed my principal I would be a few minutes late, we have 1 hour to give our meds. So an 8:30am med can be given by 9:30am.  I got there about 9:10 or 9:15 and my principal informed me that she and the counselor had given the meds. Uhhhhhh, what!!?? Anyone can open a bottle and give a pill.  Did they give the CORRECT med to the CORRECT child? Did they give the CORRECT dosage? Who is supposed to sign off on that med now, that they legally weren't supposed to give? (They have spare keys to give to a sub nurse if I am not in the building, that's how they were able to get into my med cabinet).  Did they watch the child for side effects/adverse reactions? Did the child have the desired response to the medication? They performed the action of giving a pill, that's it. And I was supposed to sign for a med I didn't give, and hope for the best? It takes more than being able to perform a task.  

I can teach my husband how to insert a Foley catheter or hang an IV bag, that doesn't mean he understands WHY he's doing it or the implications of what he's doing.  Susie 2310 said, "have you ever heard of the nursing process". Yes, I've heard of the nursing process, they teach us that in school.  They focus on that because it is an important part of nursing. They focus on it more than learning skills, which was my entire point.  Someone else here said (I'm not going to dig to find out who said it) I'm paraphrasing here, "I don't think about the duties of an RN compared to the LPN."  Hmmmmm.  So, you've never had to IV push a med for an LPN on the floor because they weren't allowed to do so?  You never had to hang a blood transfusion for an LPN on the floor because they aren't allowed to do so? In my state LPNs aren't allowed to do those things, so it's important that as an RN, I am aware of their limitations in practice. LPNs cannot do patient discharge teaching. Have you ever had to draw blood from a PICC or central line because the phlebotomist isn't allowed to do so? I have.  I had LPN students at my hospital and they came to me with a checklist of skills they had to be checked off on.  RN students don't have to be checked off on skills.  They gave us a list of skills that we should try to perform, but we didn't fail if we weren't checked off on them.  As an RN, it's pretty "misinformed" to not understand the difference between the duties of an RN and LPN.  In the school setting LPNs cannot do Epi Pen training or write up nursing care plans.  LPNs work under RN supervision. If you are delegating to an LPN, it would be in your best interest to understand their scope of practice.  You cannot delegate something that is not within their scope of practice. Just FYI.

I'm with you londonflo, education is never wasted.  I'm not sure which courses nurses have to take that "they don't need" but I feel everyone can benefit from education.

When I did the RN-BSN program, all I did was write papers. Research and write.  Watch webinars and write.  Interview nurses and write.  I feel I learned from all of it.

You have some great insight and your input is greatly appreciated.

[JKL33]

I think the things we are discussing can be boiled down quite easily:

At some point in the history of nursing it was recognized that it would be good if nurses knew how to do [xyz] things that would make them well-rounded professionals. The question at that time could have been asked, "If they are spending all of their time learning about [the tasks and skills associated with the direct provision of nursing care], when will they have time to learn about [xyz/scientific writing, research, theoretical underpinnings of the profession, etc.]?"

Accordingly, many steps have been taking to incorporate these other important matters into the proper education of a nurse. It would be fair to say these efforts have been a major focus.

It is indeed possible, in my humble opinion, to induce the opposite problem, which is represented by the opposite question: "If they are spending most of their time learning about research and theories and writing, when will they have time to adequately learn all of the knowledge and skills (not just "tasks") necessary for the provision of excellent nursing care?"

I also take exception to the implied idea/belief that critical thinking is what is being taught exclusively by these other educational experiences, as if it is not and cannot be learned through nurses' other experiences. I just haven't found that to be the case for myself. In fact I feel that the kind of hoops nursing students are asked to jump through (*not* by reading or writing itself but by the manner in which the assignments are set up and conveyed to students) constitute one of the top mind-numbing, anti-intellectual experiences I have had in life. That is what I am arguing against--*not* the idea that nurses should be capable of reading, evaluating research and writing at a college level.

Sometimes I think it's no wonder that nurses come out of school ripe for being treated...well, the way they/we are treated...our profession itself is busy telling ourselves and everyone else that the provision of nursing care is not as important as other (supposedly more intellectual) things.

I also think there is an element of being confused about what actually constitutes intellectual activity. Taking the easiest parts of any subject matter and contorting them in a way to make interacting with them challenging does not constitute intellectual activity. This is what nurses commonly refer to as jumping through hoops. It is not intellectual activity but boils down to basic but annoying problem-solving: ("Well, I'd like to research and write about and learn more about *this* [xyz problem that I am encountering frequently in my nursing practice], but since it doesn't appear that any 'nursing researchers' have published 'original nursing research' about it 'in a major nursing journal' 'in the last 5 years', I will pick this other topic that everybody and their brother/sister has written about in the last 5 years so I can find the 3 research articles I need to write this paper.") This does not constitute intellectual activity.

[rntracy1, BSN, RN]

32 minutes ago, JKL33 said:

I think the things we are discussing can be boiled down quite easily:

At some point in the history of nursing it was recognized that it would be good if nurses knew how to do [xyz] things that would make them well-rounded professionals. The question at that time could have been asked, "If they are spending all of their time learning about [the tasks and skills associated with the direct provision of nursing care], when will they have time to learn about [xyz/scientific writing, research, theoretical underpinnings of the profession, etc.]?"

Accordingly, many steps have been taking to incorporate these other important matters into the proper education of a nurse. It would be fair to say these efforts have been a major focus.

It is indeed possible, in my humble opinion, to induce the opposite problem, which is represented by the opposite question: "If they are spending most of their time learning about research and theories and writing, when will they have time to adequately learn all of the knowledge and skills (not just "tasks") necessary for the provision of excellent nursing care?"

I also take exception to the implied idea/belief that critical thinking is what is being taught exclusively by these other educational experiences, as if it is not and cannot be learned through nurses' other experiences. I just haven't found that to be the case for myself. In fact I feel that the kind of hoops nursing students are asked to jump through (*not* by reading or writing itself but by the manner in which the assignments are set up and conveyed to students) constitute one of the top mind-numbing, anti-intellectual experiences I have had in life. That is what I am arguing against--*not* the idea that nurses should be capable of reading, evaluating research and writing at a college level.

Sometimes I think it's no wonder that nurses come out of school ripe for being treated...well, the way they/we are treated...our profession itself is busy telling ourselves and everyone else that the provision of nursing care is not as important as other (supposedly more intellectual) things.

I also think there is an element of being confused about what actually constitutes intellectual activity. Taking the easiest parts of any subject matter and contorting them in a way to make interacting with them challenging does not constitute intellectual activity. This is what nurses commonly refer to as jumping through hoops. It is not intellectual activity but boils down to basic but annoying problem-solving: ("Well, I'd like to research and write about and learn more about *this* [xyz problem that I am encountering frequently in my nursing practice], but since it doesn't appear that any 'nursing researchers' have published 'original nursing research' about it 'in a major nursing journal' 'in the last 5 years', I will pick this other topic that everybody and their brother/sister has written about in the last 5 years so I can find the 3 research articles I need to write this paper.") This does not constitute intellectual activity.

Yes, you're right. I haven't found it to be the case either, where programs focus so much on the writing, research, and theory aspect to the exclusion of teaching any skills.  Now, I will have to admit, I didn't learn every single skill I would be using in my practice, there are some that just aren't practical and/or available to learn while in school, as well as some that you may have done once or twice but need some "refinement" so to speak.

I may have sounded like I was implying that the "intellectual" was more important than the skills.  In fact, I'm sure I did, but that is not what I meant. Obviously being able to perform a skill is very important in a profession that is very skills oriented.  I just felt that toward the beginning of the thread, some were implying that the intellectual aspect of nursing wasn't as important.  I think they are equally important.  In fact, I think skills are so important and they take time to hone.  More time than you can possible get in nursing school.  You can check off that you placed a Foley, but it takes time to do it with perfect, sterile, precision.  Obviously we can't check off IV insertion (at least not in my state) until we are licensed. But inserting 1 or 2 IVs doesn't make you skilled.  It is definitely something that some people are good at it and others just aren't.  It takes time to be good at IVs.  So, even if you learn a skill in school, it's going to take time to perfect it. That is going to take experience on the job. I guess I didn't express that in my responses.  

I agree with you about what constitutes intellectual activity.  However, even if you can't find articles on the exact issue you want to research, you can still find something to learn about without taking the easy way out, right? LOL. (meaning, something that not everyone and their brother has written about, LOL). I mean, as a school nurse, I still like to read and research other issues that don't pertain to school nursing. 

But yes, performing skills in our practice is VERY important. I just feel that it isn't the end of the world if we didn't get a chance to perform every skill while still in school. We are going to be honing those skills for a long time to come. That's my feeling, I know everyone doesn't agree with that.