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]

On 8/20/2020 at 3:49 PM, Hoosier_RN said:

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.

I apologize for not reading through all the comments as I found this has already been discussed.

[Hoosier_RN, MSN]

7 minutes ago, londonflo said:

Why would a manager hiring an RN with only LTC skills, think the RN would have a skill level at the ICU level?

I posted earlier that she was recommended by a coworker that she was friendly with. Coworker is CNOs niece. CNO vouched for LTC nurse, as she knows her, I guess. In a case like that, while my manager friend questioned it, but she felt like she didn't have a choice. I don't have all the details, have just discussed it over a lunch or 2. I feel for LTC nurse, as my friend says her attitude and enthusiasm is great, but some basic skills are non existent.

[londonflo]

10 hours ago, 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.

I taught (am now retired) in an ADN program. We always meet with the schools offering RN to BSN education and since one of our local hospitals is a magnet hospital, we know that most of our grads will complete their BSN education and use APA. APA format is used for citations and reference lists for the most part. We give handouts, I did a bulletin board illustrating some citations (NO ONE asked me about it) and on our learning management system (Blackboard) we provided links to useful sites. All I ever heard is how hard it is, etc. Look it is not rocket science! Copy the examples putting in the information from your article. I just learned to tune it out. Formatting a paper should not take that much time if they attempt to learn it when it is first required. Our English department uses MLA (every Associate Degree English program I have ever known uses MLA). A truly educated person knows they must cite the source of the information for the reader and we all can't create our own format. When I did the formatting as a student, it did make me consider whether I truly was using sound and scientific resources.

[Guest 1152923]

30 minutes ago, londonflo said:

I taught (am now retired) in an ADN program. We always meet with the schools offering RN to BSN education and since one of our local hospitals is a magnet hospital, we know that most of our grads will complete their BSN education and use APA. APA format is used for citations and reference lists for the most part. We give handouts, I did a bulletin board illustrating some citations (NO ONE asked me about it) and on our learning management system (Blackboard) we provided links to useful sites. All I ever heard is how hard it is, etc. Look it is not rocket science! Copy the examples putting in the information from your article. I just learned to tune it out. Formatting a paper should not take that much time if they attempt to learn it when it is first required. Our English department uses MLA (every Associate Degree English program I have ever known uses MLA). A truly educated person knows they must cite the source of the information for the reader and we all can't create our own format. When I did the formatting as a student, it did make me consider whether I truly was using sound and scientific resources.

In bedside nursing (in which the majority of graduate and resident nurses will initially work) NO ONE cares about formal care plans or APA citations. Care plans, and all of the other needless, redundant documentation, don't inform nursing care and are nothing more than a series of check boxes set up by the 'pencil pushers' to justify reimbursement. My contention is that these foci in nursing programs come at the expense of teaching students additional truly needed additional knowledge and clinical skills.

[londonflo]

1 hour ago, morelostthanfound said:

In bedside nursing (in which the majority of graduate and resident nurses will initially work) NO ONE cares about formal care plans or APA citations. Care plans, and all of the other needless, redundant documentation, don't inform nursing care and are nothing more than a series of check boxes set up by the 'pencil pushers' to justify reimbursement. My contention is that these foci in nursing programs come at the expense of teaching students additional truly needed additional knowledge and clinical skills.

My first thought in reading your comment was: "Don't sugar coat it..tell me what you really think!".LOL!

I was responding to earlier comments on the forum regarding APA format. No where was I saying that it is the foci of any nursing program I have taught in. Instead I said APA is used to cite the contributions of someone else's work, when a student is synthesizing information and proposing their view of a topic in written form.

The major institution that offers the majority of nursing educational programs since the post-war period is an associate or baccalaureate setting. And professional nursing is worthy of being a college degree major. One of the student learning outcomes expected of an associate degree graduate is regarding information fluency which focuses on the students ability to use information ethically. One of the ways students achieve this is through the writing of papers. Is this the major achievement of a nursing degree? No and I did not say it was.

Why is it important to seek out new ideas? Well, if we want to continue to practice 2020 nursing in 2030 we can just stop now with thinking up ways to better the profession. How have looking at ways to improve the patient experience actually improved the patient experience? I graduated from nursing school in the 1970s and worked on a surgical floor. We did not only have post-op patients but we had everyone who was going to have surgery be admitted the day before for diagnostic studies and pre-op teaching among other things (surgical scrubs, consent signed, morning of surgery we took away their teeth, rings, necklaces, underwear, glasses and filled out the pre-op checklist.etc). When I was in graduate school I was part of a study to see if patients could spend the night before at home, getting a better night's sleep in their own bed, surrounded by their own environment. We developed a pre-op teaching program and were not alone in being successful in that as I am not aware of anyone admitted to the hospital the night before surgery now and of course many now go home the day of surgery. Nursing has a big role in getting a patient ready for surgery and nursing's input in this change was important and the change was going to happen if nursing chose to develop their role or not. No insurance private or governmental is going to pay for a night's stay in the hospital for someone who doesn't need it. You know what? Nursing had a whole lot more control of a patient and their actions when they came in the night before surgery. We could make sure they were NPO before midnight, we got the permit signed, TED stockings ordered, were able to look over the lab and x-ray findings etc. Was that the best way for the patient?

I have taught in diploma, associate and baccalaureate degree nursing programs. I have strong beliefs that the nursing process is the essential core of practice for the registered nurse to deliver safe patient-focused care. There are many learning activities used to help students master the skills of nursing and this is one of them . Of course, clinical hands-on practice is the best as students can immerse themselves in the place where nursing is performed and perform it themselves. I believe in a program with a strong clinical component and have always ensured the programs I was involved in, had a strong clinical emphasis.

[Hoosier_RN, MSN]

10 hours ago, londonflo said:

I taught (am now retired) in an ADN program. We always meet with the schools offering RN to BSN education and since one of our local hospitals is a magnet hospital, we know that most of our grads will complete their BSN education and use APA. APA format is used for citations and reference lists for the most part. We give handouts, I did a bulletin board illustrating some citations (NO ONE asked me about it) and on our learning management system (Blackboard) we provided links to useful sites. All I ever heard is how hard it is, etc. Look it is not rocket science! Copy the examples putting in the information from your article. I just learned to tune it out. Formatting a paper should not take that much time if they attempt to learn it when it is first required. Our English department uses MLA (every Associate Degree English program I have ever known uses MLA). A truly educated person knows they must cite the source of the information for the reader and we all can't create our own format. When I did the formatting as a student, it did make me consider whether I truly was using sound and scientific resources.

Every nursing program that I know of uses APA, whether ASN, BSN, or higher. There are many apps that a student can download to use to assist with formatting. I did have a student once write a paper in text language. Her mom came to my office complaining when "Susie" failed. How dare I not recognize Susie's genius? Mom even said she'd have my job, and this was after reading the rubric which listed APA as a requirement. That, and the sources weren't valid. This was probably one of the strangest things I've ever encountered in my career while teaching. But that's a whole 'nuther thread.

But most of the complaints I ever heard while teaching was having to write the papers, period

[Jedrnurse, BSN, RN]

26 minutes ago, Hoosier_RN said:

Every nursing program that I know of uses APA, whether ASN, BSN, or higher. There are many apps that a student can download to use to assist with formatting. I did have a student once write a paper in text language. Her mom came to my office complaining when "Susie" failed. How dare I not recognize Susie's genius? Mom even said she'd have my job, and this was after reading the rubric which listed APA as a requirement. That, and the sources weren't valid. This was probably one of the strangest things I've ever encountered in my career while teaching. But that's a whole 'nuther thread.

But most of the complaints I ever heard while teaching was having to write the papers, period

I wonder if mom shows up to wipe this little gift-from-god's patients's butts (if she ever even became a nurse).

Or, maybe mom just chews out the CNAs...

[direw0lf, BSN]

23 hours ago, Hoosier_RN said:

Yep, that'll help you with a new role for sure. Most new grads also know APA (or software), but have never inserted a foley. SMH

This is what I was told as to why nursing education is like that. It’s because of salary. So diploma nurses could only make so much. To get higher salary they needed ADN and BSN. So they had to deduct clinical time and skills to add in the university education requirements. Personally I loved and got something out of almost every university class I took but I really felt like clinical was a joke. We used to love it if we could give a aspirin to a patient and the big WOW!! was if we could give insulin. And most of the time by the time we got to clinical the techs had already did the bathing/adl care so we couldn’t even do that.

I was always taught nursing would be tough though and figured the coursework was to reflect that. I’m so glad I was a tech, it was the best thing to prepare me really.

[Hoosier_RN, MSN]

31 minutes ago, direw0lf said:

This is what I was told as to why nursing education is like that. It’s because of salary. So diploma nurses could only make so much. To get higher salary they needed ADN and BSN. So they had to deduct clinical time and skills to add in the university education requirements. Personally I loved and got something out of almost every university class I took but I really felt like clinical was a joke. We used to love it if we could give a aspirin to a patient and the big WOW! was if we could give insulin. And most of the time by the time we got to clinical the techs had already did the bathing/adl care so we couldn’t even do that.

I was always taught nursing would be tough though and figured the coursework was to reflect that. I’m so glad I was a tech, it was the best thing to prepare me really.

Oddly enough, I've been licensed and worked in 5 states. No pay difference for degree level. But the schools sure tout it!

[OUxPhys, BSN, RN]

Im 34 (graduated 5 years ago, 2nd career) and from what I've noticed it isn't a generational thing but more so a personal thing. I see younger nurses who moan and complain about working holidays and weekends (I have a life outside of work!) but there are plenty of nurses who are my age or older who use their kids as an excuse to not work weekends or holidays or to get special scheduling privileges. I used to work with a nurse who if they didn't get every single day off requested because of her kids she would just call off. I work with an older nurse now who uses her kids as justification to try and get the absolute perfect schedule.

I think the biggest issues with nursing schools is they haven't quite adapted to the times. Nursing isn't considered a calling anymore. It's a job. It's a career just like any other profession in the healthcare world.

[JKL33]

11 hours ago, londonflo said:

I have taught in diploma, associate and baccalaureate degree nursing programs. I have strong beliefs that the nursing process is the essential core of practice for the registered nurse to deliver safe patient-focused care. There are many learning activities used to help students master the skills of nursing and this is one of them . Of course, clinical hands-on practice is the best as students can immerse themselves in the place where nursing is performed and perform it themselves. I believe in a program with a strong clinical component and have always ensured the programs I was involved in, had a strong clinical emphasis.

Agree with you.

Back to APA - there is no problem with it. I do absolutely think that nurses should be able to research a topic, know the basics about how to critique what they're reading, select valid sources of information and write coherently.

But (seemingly) at the same time that we have been increasingly emphasizing this type of knowledge, difficulties have cropped up in the clinical environments and that piece seems to be falling apart. Throw in a little starry-eyed fascination with simulation....ugh. The bottom line is that things are unbalanced.

Just read this...for one example. ?

https://www.wolterskluwer.com/en/expert-insights/nursing-simulation-scenarios-preparing-tomorrows-nurses-today

[londonflo]

23 minutes ago, JKL33 said:

Throw in a little starry-eyed fascination with simulation....ugh. The bottom line is that things are unbalanced.

I agree. A publisher disguising an ad for a product describing it as the next "best thing" is all too common. The whole simulation industry sprung up because nursing schools have such a hard time getting clinical hours in the acute care hospitals. I taught at a hospital school of nursing in the mid eighties that had 800 beds. Several schools of nursing used it for clinical experience and there were plenty of patients for all! That same hospital today runs a census of 300-500. Decisions for clinical placement are made and not everyone is accommodated.

Many BON have set limits on the balance of sim hours to clinical hours. For profits (which are last on the list to get a clinical placement) began to schedule sim experiences for the majority of the clinical time.

Sim mannequins are extremely expensive but are often donated by families in memory of a loved one who received care from a school's student. I asked our Dean why we couldn't use the donation $$ for supplies such as IV tubing, dressing change and trach materials etc. I was told that people like to "see a permanence" for the things they donate and they like seeing how the mannequin is revolutionizing health care education for all disciplines. Meanwhile I am having a 15th student try to prime the same used tubing.

In full disclosure, I have never taught sim classes and always was in the clinical setting. Nor was I ever interested in any mannequin except the trainee ones for dressing changes, trach care, foley and straight cath instertions, NG insertions etc.