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.

[Hoosier_RN, MSN]

26 minutes ago, llg said:

A school can do a great job on one question and a terrible job on another.

Or both or neither...

[macawake, MSN]

On 8/20/2020 at 10:59 AM, Hoosier_RN said:

APA isn't research, it's a typing format. And judging from research papers that I've graded in the past, APA formatting doesn't make the material any more valid than non APA format.

So at that, yes, having some skills are important from the get go.

A new nurse using their head is important, but APA formatting has little to do with that

If I’m honest I’m disappointed by your answer. Since your post that I quoted and responded to was a direct response to RNperdiem’s post ”I just returned to school. So far I have learned a lot about research and correct APA format. Interesting stuff”, it gave the impression that it wasn’t only the focus on the technicalities of APA formatting that you were critical of. Was that incorrect?

I didn’t ask you if you think that being able to insert a foley catheter from day one is more important than being the master of all things APA. I specifically asked about being research literate due to all its implications for evidence-based practice.

[Salisburysteak, BSN, RN]

On 8/20/2020 at 12:06 PM, macawake said:

If I’m honest I’m disappointed by your answer. Since your post that I quoted and responded to was a direct response to RNperdiem’s post ”I just returned to school. So far I have learned a lot about research and correct APA format. Interesting stuff”, it gave the impression that it wasn’t only the focus on the technicalities of APA formatting that you were critical of. Was that incorrect?

I didn’t ask you if you think that being able to insert a foley catheter from day one is more important than being the master of all things APA. I specifically asked about being research literate due to all its implications for evidence-based practice.

I think what the other poster was stating about APA format is that it is the focus of many Nursing classes. From reading your previous posts you are not in the US and US Nursing Schools are focusing more on the theory aspect of Nursing. While that is not a bad thing; however, it takes away from the students learning hands on nursing like inserting F/C and even learning how to interact with the patients. The classes are so focused on theory that they(instructors) forget to teach how to be a nurse. I hope that makes sense.

I believe many become nurses for the higher than average income. So many who go to Nursing School really have no clue what the job/profession is all about. Many new grads do NOT want to put in the time at the bedside and become seasoned before they jump on the NP or CRNA bandwagon. They really feel bedside nursing is beneath them. That is what is so frustrating!

[JKL33]

1 hour ago, macawake said:

If I’m honest I’m disappointed by your answer. Since your post that I quoted and responded to was a direct response to RNperdiem’s post ”I just returned to school. So far I have learned a lot about research and correct APA format. Interesting stuff”, it gave the impression that it wasn’t only the focus on the technicalities of APA formatting that you were critical of. Was that incorrect?

Hi macawake -

Not trying to speak for anyone else, but I do agree with the sentiment of the other poster. I don't think anyone means to discredit the idea of learning research principles or the importance of being able to find information.

It seems to be a common experience in our programs: An over-the-top preoccupation with APA formatting to the point that instructors will even add this requirement to assignments that are not remotely amenable to it. ??‍♀️ Worse is when all of this is combined with instructors who don't understand that there are nuances, choices to be made, etc., about how to cite something even within APA format.

I hate to say it and might get some flack for this, but this whole topic is not unlike "nursing math" where we just have to be special...we somehow barely teach the principles and big concepts and instead get completely bogged down in making 4th grad math into this seemingly difficult thing, nursing math.

I don't know....it's disappointing. Always just a little bit off-focus, we are.

[llg, PhD, RN]

Maybe if students would just focus for a little bit and learn the APA basics and how to do 4th grade math ... then teachers could move on and focus more on the other things. As it is, the number of students who don't even bother to try to format their written work correctly is appalling. As long as they refuse to even try to comply, the more I will take big deductions from their score.

However, the students who make an honest effort to learn how to write at a college level and format their papers ... when they make a few mistakes, I take very little off because I can see they tried. I am more interested in the content of what they have to say.

I don't think there are many (if any) whole courses that focus on APA. I believe that what happens is that students rebel and refuse to follow it. So the school has to keep emphasizing it in their grading to try to get students' attention -- and to separate out (via grades on papers) those students who follow directions and those who don't. If the students would simply accept that they have to learn the system (and get it over with), everyone could move on.

[macawake, MSN]

20 minutes ago, JKL33 said:

Hi macawake -

Not trying to speak for anyone else, but I do agree with the sentiment of the other poster. I don't think anyone means to discredit the idea of learning research principles or the importance of being able to find information.

It seems to be a common experience in our programs: An over-the-top preoccupation with APA formatting to the point that instructors will even add this requirement to assignments that are not remotely amenable to it. ??‍♀️ Worse is when all of this is combined with instructors who don't understand that there are nuances, choices to be made, etc., about how to cite something even within APA format.

I hate to say it and might get some flack for this, but this whole topic is not unlike "nursing math" where we just have to be special...we somehow barely teach the principles and big concepts and instead get completely bogged down in making 4th grad math into this seemingly difficult thing, nursing math.

I don't know....it's disappointing. Always just a little bit off-focus, we are.

I understand what you’re saying, and it’s not as if I think APA is the be-all and end-all of nursing. I don’t. But my question is really simple and I’m just curious to see how some other nurses reason?

Given the choice between a new graduate who is what I call research literate but has never inserted a Foley, or perhaps has just done it once or twice, but doesn’t feel 100% confident OR one who’s mastered the art of Foley insertion but has no, or rudimentary at best, knowledge and understanding of how to find and interpret research, which one would you prefer? For me the choice is easy. It doesn’t take me long to teach them how to insert a Foley and be there as a support until they feel confident in their manual skill.

[llg, PhD, RN]

I'm with macawake, MSN. It's much easier to teach a new grad a few technical skills she might have missed in school than to try to teach someone about the high level conceptual thinking, data analysis, research processes, etc. who was never exposed to that in school.

[macawake, MSN]

On 8/20/2020 at 12:49 PM, Salisburysteak said:

I think what the other poster was stating about APA format is that it is the focus of many Nursing classes. From reading your previous posts you are not in the US and US Nursing Schools are focusing more on the theory aspect of Nursing. While that is not a bad thing; however, it takes away from the students learning hands on nursing like inserting F/C and even learning how to interact with the patients. The classes are so focused on theory that they(instructors) forget to teach how to be a nurse. I hope that makes sense.

I believe many become nurses for the higher than average income. So many who go to Nursing School really have no clue what the job/profession is all about. Many new grads do NOT want to put in the time at the bedside and become seasoned before they jump on the NP or CRNA bandwagon. They really feel bedside nursing is beneath them. That is what is so frustrating!

Thanks for your response. You’re correct, I’m Scandinavian. I have some grasp of how nursing education is in the U.S., but it’s pretty basic and comes mostly from what I’ve read through the years on this forum. The one thing I’ve noticed is that it seems to be much more of a ”hot button” topic over there, compared to here.

Don’t all nursing students have to have clinicals in order to graduate? It’s such a foreign concept to me that someone can go through nursing school without figuring out what the profession ”is about”. I know that one often doesn’t get the ”full experience” regarding exactly how stressful it can be. But the basics of nursing should be hard to miss.

You’ll have to correct me if I’m wrong, but I’ve gotten the impression that students don’t always get a whole lot of hands-on training when on clinical placements? That they don’t always get to do everything? Perhaps because law suits is much more of a thing than here? Or because several students share one clinical instructor? I’m just guessing here, so any information about this is appreciated ?

If anyone is interested, this is an abrreviated version of my first nursing degree (It’s BSN for entry here).

This is from memory so I might be a week off +/-on some of the longer placements.

Geriatrics 4 weeks

LTC 2 weeks

Med-surg, two placements: 7 weeks and 6 weeks.

Psychiatry 4 weeks

Pediatrics 4 weeks

Mother-baby or L&D 2 weeks

Ambulance 2 weeks

Primary care facility 4 weeks

ER 2 weeks

OR 2 weeks

Anesthesia 2 weeks

(Feels like I’ve left one out but I’m drawing a blank.. ?)

One week = Either 4 days, 32 hours clinicals plus one eight-hour study day when you had various writing assignments (APA? You betcha) in connection with the placement OR five eight-hour days, 40 hours.

In these placements you have a nurse employed by the facility and working on the floor/unit in question as an instructor/preceptor and the school instructor showed up for weekly evaluations (verbal and written) and to observe you. (Yup, that’s the way it works here).

Then there was of course all the core subjects ? ? of nursing... and..... research. And yes, APA ?

The paper I wrote was at the end of it all was probably the most challenging I did during the entire time. It was supposed to be 10 full 40 hour weeks, but in reality I spent around 10 hours or more each day. So 50+ weeks. At the end of it all, you had to defend it. Part of the defense is open to the public so the school posted time and date everywhere ? It was also open to academics from other institutions/universities. I sent out copies of my paper to these schools about three weeks prior to THE DAY, and one of the persons who showed up was a bigwig from the neighboring military academy. So I wasn’t only grilled by my own instructors, but also by a colonel ?

For those of you not bored to tears by now and who are miraculously still reading this... I inserted more than 200 intravenous catheters in my clinicals. About 50 Foley catheters. NOT a single nasogastric tube. Administered more pills, intravenous and subcutaneous meds than I can count. Never took care of a trached patient. Not one. Never did an arterial stick either.

I managed to nurse just fine even though a kind coworker had to hold my hand for the first couple of times I dropped an NG and a physician taught me to do arterial blood draws.

And I’m darn glad I went through the pain of writing that paper. It has served me well.

If you made it all the way... I’m impressed. And thank you ??

[Hoosier_RN, MSN]

On 8/20/2020 at 12:06 PM, macawake said:

If I’m honest I’m disappointed by your answer. Since your post that I quoted and responded to was a direct response to RNperdiem’s post ”I just returned to school. So far I have learned a lot about research and correct APA format. Interesting stuff”, it gave the impression that it wasn’t only the focus on the technicalities of APA formatting that you were critical of. Was that incorrect?

I didn’t ask you if you think that being able to insert a foley catheter from day one is more important than being the master of all things APA. I specifically asked about being research literate due to all its implications for evidence-based practice.

If you look, you quoted my response, thats why you got my reply. My reply to that stands, sorry if that disappoints you

[RNperdiem, RN]

Going back to school for a BSN has been interesting. The APA format has been a steep learning curve for a person whose last research paper was written in MLM format and printed on a dot matrix printer.

But to survive professionally as an older nurse in a tight job market, I have to evolve with the times.

[macawake, MSN]

1 minute ago, Hoosier_RN said:

If you look, you quoted my response, thats why you got my reply. My reply to that stands, sorry if that disappoints you

You are of course under no obligation to answer what I’m actually asking. I’m just surprised by the reticence I’m sensing. It’s a pretty straightforward question. I guess I’ll have to live in suspense ?

[Hoosier_RN, MSN]

1 hour ago, llg said:

I'm with macawake, MSN. It's much easier to teach a new grad a few technical skills she might have missed in school than to try to teach someone about the high level conceptual thinking, data analysis, research processes, etc. who was never exposed to that in school.

I agree to an extent. Not all graduates get a good orientation, or have someone reasonable to teach skills. My manager friend at hospital ICU says 1 nurse she recently hired from LTC has no clue on some basic skills, never did them in 5 years. She is having her transferred to another dept to build a skill base since there isn't time to teach basics on top of the other very short orientation that this nurse needs. APA isn't going to help at this point...I don't have a good answer