What are they teaching?

londonflo · Sep 9, 2020

10 hours ago, Hoshio said:

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.

I don't want to "put words into your (mouth) writing" but isn't there a better way to get your concept across? I always hated when the staff LPN and RN would say about the new medical residents "we have to teach them how we do it here." I guess a form of molding. But, in reality what they were doing was acclimating the resident to the hospital processes. Asking a thousand questions why a resident wants a syringe was almost bordering on harassment. (that's what prompted the example above.)

JKL33 · Sep 9, 2020

57 minutes ago, rntracy1 said:

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.

You're jumping to conclusions about what I feel or what is important to me without registering the details of what I am saying. Yes, I read about things that are important to my practice all the time, including doing specific searches for research information I want to find--in addition to reading a variety of research that I simply find interesting, such as the papers I've read recently about a topic posted as a case study here on AN (for one example). However, I take the easiest way out possible when boxed in and searching for papers I can use for assignments that have a variety of limiting parameters of questionable necessity.

allnurses Guide · Sep 10, 2020

On 8/19/2020 at 5:52 PM, egglady said:

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.

Egglady LPN-- I'm not sure that classroom instructors necessarily make that point. As I mentioned to Hoosier, I recall in my program they would add their own experiences to their content laden lectures, so you'd get sort of a feel for what real nurse life actually entails.

If that didn't happen, I would think that a keen observer on a clinical placement would hardly be able to miss the stress piled on busy med-surge or LTC units.

It would be interesting to ask those new grads to describe their stress level 6 months down the road, when hopefully their learning curve doesn't look to them like they need to climb Mount Everest in front of a critical audience.

In some ways I can see why medical schools didn't drop or drastically soften the life of a first-year resident.

Hoosier_RN, MSN · Sep 10, 2020

8 hours ago, rntracy1 said:

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.

I never meant to imply that intellectual studies was less desirable. The thought that I meant to put out there at the very beginning of this thread is that too many are coming out of school with 0 basic skills in patient care. Most residency programs don't have the time or resources to go to ground 0 and start at the beginning. Some of this is due to fast track programs, others due to shoddy programs that eventually get closed down. Some are now trapped in the odd situation of CV-19 and online sim labs. It makes for a curious education situation

londonflo · Sep 10, 2020

10 hours ago, rntracy1 said:

It's hard to explain to people that 9 credits are a lot more hours than a typical associate degree student taking 9 credits.

With nursing being a practice discipline we have so many clinical hours. That, in and of itself, is hard for an English professor or history professor to understand. Some of the lab sciences understand a little bit more as most labs are calculated as 2 lab hours equals 1 semester credit.

10 hours ago, rntracy1 said:

I was actually in school more hours than they were. Our clinicals were 7-3, 2 days per week and we got 2 credits.

3 clinical hours = 1 semester credit in most programs. All in all, most ADN students graduate with much more than the 60 semester hours that defines an associate degree. When a pre-req is put in place like General Biology as a pre-req to A & P it will add at least 3 semester hours. I fought that battle with a plant biologist who was sure that students needed more biology for a better understanding of the cell structure and function. It was an uncomfortable meeting but eventually it came down to if they have High School Biology within 5 years of admission to the nursing program that's okay. Small battles make big differences with tuition costs and time to degree completion.

lifelearningrn, BSN, RN · Sep 11, 2020

On 8/23/2020 at 8:18 AM, bitter_betsy said:

Tomorrow I will begin week 2 of my floor orientation. I didn't expect it to be easy and I didn't expect to have fun (I am also on my 2nd career so I knew better to begin with). What I also didn't expect was to sit in class during orientation and listen for 2 hours to a lawyer tell me what I needed to document in order to save my butt and how to document it before I even had a documentation class. After this person spoke, a nurse came who then proceeded to reiterate how it was her job to go through our documentation to find the information needed for the lawyer and every protocol that we needed to know in order to document to cover ourselves (ie there are protocols specifically for documentation in addition to protocols for saving lives). Roughly 4 hours was spent on how not to lose my license and withstand litigation due to documentation. The following week we had documentation class and we spent exactly 6 hours learning to document. At the end of the 6 hours, not only was I terrified, I also knew nothing. We have a test environment, but we can only get to it at work. We are not allowed to work off the clock and we are not allowed to be at work not on the clock. We also can't leave our shift to go work in the test environment because we have to stay with our preceptor.

I feel that I have a pretty good educational basis from which to build upon, but I am pretty terrified of making a documentation mistake almost to the point that I don't even want to do this anymore. The program that I use at work isn't similar in any way to either of the 2 programs that I used in nursing school. Not only am I learning how to implement the skills and knowledge that I learned in school, I'm having to figure out a documentation system to cover my butt with a whole 6 hours training on it and zero printed resources for it. I'm trying to find Youtube videos to help me but I feel like I spend every moment at home trying to prepare for my moments at work. At the end of week 1 - I am thoroughly overwhelmed mostly due to documentation. I am not making nursing mistakes - I am making documentation mistakes (ie not documenting according to the protocol that will save my butt). Is it more important to follow the protocol to save a persons life, or to follow a protocol to save my license because I didn't document the nursing intervention that I used in the nursing note that I had to stop to write while my patients BP was tanking? Lets not even add covid into the mix.

Yes it is stressful - but I didn't expect so much stress due to documentation.

I'm curious if in any of those class sessions, did they advice you to get your own malpractice insurance?

If not, get it, if only for peace of mind. It's not expensive (I think I pay $120 a year)..

bitter_betsy, BSN · Sep 15, 2020

On 9/11/2020 at 1:59 PM, lifelearningrn said:

I'm curious if in any of those class sessions, did they advice you to get your own malpractice insurance?

If not, get it, if only for peace of mind. It's not expensive (I think I pay $120 a year)..

@lifelearningrn they did not... however - I tried to get it through NSO and even though it took my payment, it never did anything else. I called and they told me that since I used an apple product to purchase it - to "give it a couple days and call back"..... so who do you recommend? Most of the students in my cohort use NSO if they have it (and I honestly have not searched forums yet). Thank you for the kind reminder because I had completely forgotten to follow up on this. I've had a rough week and it slipped through the cracks.

londonflo · Sep 15, 2020

In called my local independent insurance agency - one who offers all brands of home, car (not like State Farm, All state). They found a plan for me.

Hope this helps.

lifelearningrn, BSN, RN · Sep 15, 2020

13 hours ago, bitter_betsy said:

@lifelearningrn they did not... however - I tried to get it through NSO and even though it took my payment, it never did anything else. I called and they told me that since I used an apple product to purchase it - to "give it a couple days and call back"..... so who do you recommend? Most of the students in my cohort use NSO if they have it (and I honestly have not searched forums yet). Thank you for the kind reminder because I had completely forgotten to follow up on this. I've had a rough week and it slipped through the cracks.

I use NSO and have never had any problems. I'm not surprised they didn't advise you to have your own. They like to throw nurses under the bus in malpractice suits, often they'll tell you not to get it because the hospital has malpractice insurance. They don't like it when the sacrificial lamb has the means to fight.

AnxietyMaven, BSN, RN · Sep 18, 2020

On 8/19/2020 at 7:52 PM, egglady said:

I'm going to attempt to answer this question from my perspective as a new grad, and from my experiences in my nursing school.

I feel our instructors did a good job at relating the possible hardships as a nurse. I had one clinical instructor ask each of us "why do you want to be a nurse" with the explanation that our jobs as nurses would entail some of the worst of the human condition. If one of the students said "for the money" ? she'd reply that they needed to rethink their career choice.

Our instructors ALL relayed the working hours expected, and the fact that most nursing is not a 9-5 job.

The problem (from my perspective) is that people didn't listen and didn't throw themselves into clinical work. I had a buddy call in tears because she was moved to work as an aide because her unit was shut down due to covid. Cue the horror when she had to change a patient diaper and give a bed bath. She'd never done it in clinical. Meanwhile I was laughing the whole time she was talking because I'd been cleaning butts since our first clinical rotation.

As far as skills go..geez... All of this made me laugh. Some of my clinicals were at cancer hospitals that had IV teams. I never stuck a single patient in the clinical setting. The nurses on the floors didn't even start IVs or draw blood. All of that was handled by IV teams and phlebotomy techs (lucky them right). I bet you those specific skills degraded over time with experienced nurses, but that doesn't make them any less of a nurse. I guess some commenters may think so.

I guess what I am saying here is that it all depends on the individual experience. I'd appreciate it if all new grads weren't lumped together as lazy, or lacking skills. The truth is most new grads don't make it to 5 years at the bedside. It may be because they get in and hate it, or it may be more experienced nurses looking down on them. Be Kind.

Hoosier_RN, MSN · Sep 18, 2020

On 8/20/2020 at 4:54 PM, llg said:

I can see that. If a nurse works for an employer that doesn't provide a good orientation ... he/she won't develop some of the skills as a new grad either. Depending on their career path, that may or may not be important. If that RN in your example never switched out of LTC, she may have been a great, successful nurse.

Why would any manager think that someone who had only worked in LTC for 5 years would be able to step right into an ICU? It makes no sense to hire someone for that job with that background!

Actually, not really different than getting a nurse from any other background. After 5 years, you do expect at least a basic level of skills and competence to build upon.

Hoshio, RN · Sep 18, 2020

6 hours ago, AnxietyMaven said:

z... All of this made me laugh. Some of my clinicals were at cancer hospitals that had IV teams. I never stuck a single patient in the clinical setting. The nurses on the floors didn't even start IVs or draw blood. All of that was handled by IV teams and phlebotomy techs (lucky them right). I bet you those specific skills degraded over time with experienced nurses, but that doesn't make them any less of a nurse. I guess some commenters may think so.

Even when I started working we were never shown or taught how to insert an IV. My employer told me at hire that IV skills were gone over in orientation fully - it was a lie/joke how they even showed us. Needless to say I learned IV insertion from just doing it on patients. Some of the nurses I work with use to practice on each other in order to not look stupid in front of a patient who needed IV access.