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]

2 minutes ago, morelostthanfound said:

This^^^ APA-a complete waste of time for most bedside nurses not wishing to pursue further education. If only the time spent learning this nonsense was instead devoted to subjects that would actually enhance existing clinical knowledge/skills-ie: advanced pharmacology, higher level anatomy and physiology, healthcare delivery systems......

this^^^ things that would actually help a bedside nurse

[llg, PhD, RN]

41 minutes ago, morelostthanfound said:

This^^^ APA-a complete waste of time for most bedside nurses not wishing to pursue further education. If only the time spent learning this nonsense was instead devoted to subjects that would actually enhance existing clinical knowledge/skills-ie: advanced pharmacology, higher level anatomy and physiology, healthcare delivery systems......

... and adult med/surg, adult physiology and physiology, etc. is not very helpful to people who are going to spend their careers in the NICU. But the NICU folks endure it and learn what they can from those adult-focused courses. As londonflo wrote in an earlier post, not everything in a curriculum is going to be used by every student.

The school's job in the United States is to teach the basics of ALL aspects of nursing, giving the graduates the options of entering every specialty and going down every career path. We all make our choices and expand on the knowledge we need for our careers and let go of some of the things we learned that we have chosen not to use. That's OK. It doesn't mean we should not have learned them as part of our basic introductory education.

[Guest 1152923]

1 hour ago, Hoosier_RN said:

this^^^ things that would actually help a bedside nurse

I have been an RN for almost 30 years and worked in numerous states and practice settings. I, and I'm sure many other bedside nurses, have never been aided in their job duties by their knowledge of APA or their research literacy. Sorry, this is real world bedside nursing (not academia), where there is barely enough time to finish assigned care, let alone perform a deep dive literary search on a practice issue. The academics have done a true disservice by not properly preparing graduate nurses for the rigors and true demands of the job.

[Hoosier_RN, MSN]

57 minutes ago, llg said:

... and adult med/surg, adult physiology and physiology, etc. is not very helpful to people who are going to spend their careers in the NICU. But the NICU folks endure it and learn what they can from those adult-focused courses. As londonflo wrote in an earlier post, not everything in a curriculum is going to be used by every student.

The school's job in the United States is to teach the basics of ALL aspects of nursing, giving the graduates the options of entering every specialty and going down every career path. We all make our choices and expand on the knowledge we need for our careers and let go of some of the things we learned that we have chosen not to use. That's OK. It doesn't mean we should not have learned them as part of our basic introductory education.

You are talking about specialties of nursing, I'm talking about APA, which is formatting for research papers. I think it's apples to oranges. In the US, you train for all because you never know where you'll end up. But that's just my opinion

[llg, PhD, RN]

55 minutes ago, Hoosier_RN said:

You are talking about specialties of nursing, I'm talking about APA, which is formatting for research papers. I think it's apples to oranges. In the US, you train for all because you never know where you'll end up. But that's just my opinion

And many nurses will end up in graduate school and/or in jobs requiring them to write professionally. Not every nurse will need APA, but a lot of nurses will. Just like not every nurse needs the details of adult physiology or pregnancy, etc.

And besides, the nursing students are currently IN academia, studying to be nurses. They need to learn the language of academia and how to appropriately communicate with other members of that environment while they are students.

[JKL33]

1 hour ago, llg said:

... and adult med/surg, adult physiology and physiology, etc. is not very helpful to people who are going to spend their careers in the NICU.

It certainly is, especially when the alternative is having less of that and more nursing theory and research principles. There are significant differences in the populations, yes, and we all know that children are not mini adults and neonates certainly aren't either. But we're still talking about the human body, not a different species.

---

I don't think it will be good for bedside nurses (or patients) if we don't re-focus on achieving actual patient assessment and intervention expertise at the bedside and if we continue refusing to produce grads who are empowered through being very competent at these things so that they can hold their own as a well-regarded, bona fide member of the health care decision-making team.

We are at crisis level (not related to covid) with duties and expectations vs. empowerment at the bedside, in the bedside role. Not some other role. Becoming more knowledgeable about "something else" most certainly isn't going to change that.

We can agree or disagree and we can like it or not like it, it doesn't matter: Whatever we are currently doing (now matter how it is justified) has not remotely calmed the tidalwave of employers' expectation of a constant supply of more RN widgets for the bedside. Nurses lacking expertise in bedside matters at the bedside (no matter if these involve a manual skill or a patient management skill or an assessment skill or a skill of ethics and communication or some other necessary bedside skill) is a key factor in producing the circumstances that are needed for employers to treat registered nurses (both the professional ones and the non-professional ones ?) like easily-replaceable widgets.

If we want to give up the bedside role to some other type of provider....let's just declare that and move on. Because that's what we are acting like.

[londonflo]

3 hours ago, morelostthanfound said:

This^^^ APA-a complete waste of time for most bedside nurses not wishing to pursue further education.

2 hours ago, morelostthanfound said:

I, and I'm sure many other bedside nurses, have never been aided in their job duties by their knowledge of APA or their research literacy.

Knowing how to research the information one is seeking is the sign of a true professional.

Have you ever read something and looked at the credentials of the person writing it? (Here on AN have you ever looked at what the writer says they specialize in to see if their opinion may be based on clinical education and practice) Even in the newspaper -- was it written by the entertainment editor of the health editor? Do you know and read about evidence-based practice? Otherwise your knowledge base stopped the year you graduated and you do not have the right to say you are a professional. What's worse is when your proud of it and wish to take it away from others. APA is just a format for citing information for the reader to follow up on if they wish. How much time did it really take in your basic education?

3 hours ago, Hoosier_RN said:

to subjects that would actually enhance existing clinical knowledge/skills-ie: advanced pharmacology, higher level anatomy and physiology, healthcare delivery systems......

How about seeking out the resources for the subjects themselves and reading about them? A life long learner is a characteristic of a college educated individual who doesn't wait for the information to be right in front of them.

BTW taking away general education-based courses and increasing nursing content changes the profession into a vocation which a subsequent decrease in salary. No thanks!

[llg, PhD, RN]

2 hours ago, JKL33 said:

It certainly is, especially when the alternative is having less of that and more nursing theory and research principles. There are significant differences in the populations, yes, and we all know that children are not mini adults and neonates certainly aren't either. But we're still talking about the human body, not a different species.

---

I wasn't suggesting that we drop adult med/surg content from the curriculum -- just pointing out a few things.

1. That not every part of a curriculum is equally relevant to the type of nursing that every nursing student will do in life

2. That in spite of #1 above, we should all accept the fact that we won't be equally interested in every element of an educational program -- but that we should accept its inclusion in the curriculum any. We may find it unexpectedly useful at some point -- and its function in the curriculum may be to teach us mental habits and ways of thinking that will be of value even if the actual facts discussed in class don't exactly match our career dreams. Adult med/surg content is used to teach basic concepts and ways of thinking that can be applied to NICU even if the physiology and pharmacology are different.

[RNperdiem, RN]

I think nursing has something of an identity crisis.

Our roots are working class, but nursing in many sectors is trying to gentrify and become more like the professions. There nursing tries to distance itself from its "trade" origins to fit in with the kids at the professional table.

Unfortunately, a lot of the real skills an excellent nurse has gets degraded as "tasks" and devalued, even if the tasks/interventions are informed by critical thinking. Good patient care depends just as much as what we can physically do as well as what we know.

A good nurse needs both knowledge and skills. I hope one day nursing education will embrace the best of both worlds.

[azreddun]

On 8/20/2020 at 11:12 AM, 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.

Putting in my two cents. One of the frustrations of nursing is being trained in conceptual thinking, data analysis, research process, etc. ( which I was with BSN and later a non-nursing masters) Then being treated like a trained monkey by physicians, patients, administration, etc.

[guest1115066]

I'm in an ADN program now, and have worked as a CNA for 4 years. Most programs (including mine) don't require CNA or prior medical experience, so students don't fully understand what a day in the life of a nurse looks like. My teachers don't fully dive into how stressful the job is, what a 12 hour shift looks like, how many patients you would have on what floors and how to manage your time. I agree, they are doing a disservice. However, the students need to take it upon themselves to look into the career before committing to it.

[macawake, MSN]

4 hours ago, londonflo said:

Knowing how to research the information one is seeking is the sign of a true professional.

Quote

Do you know and read about evidence-based practice? Otherwise your knowledge base stopped the year you graduated and you do not have the right to say you are a professional.

Quote

How about seeking out the resources for the subjects themselves and reading about them? A life long learner is a characteristic of a college educated individual who doesn't wait for the information to be right in front of them.

Quote

APA is just a format for citing information for the reader to follow up on if they wish. How much time did it really take in your basic education?

I don’t have much time at the moment so I haven’t read all the posts made since I last visited. But this one really caught my eye. I agree wholeheartedly.

We all aim to practice evidence-based, don’t we? I’m completely confused by how we’re supposed to do that if we don’t have the necessary knowledge to figure out what the best available evidence on a given topic is. Are we just supposed to rely on others (managers? physicians? policy and guideline authors?) so that we can keep abreast of new research as it evolves?

If one has no ability to identify a poorly constructed design or methodology or understand what confounders are, how du we evaluate the information that’s presented? What kind of evidence do we need before we start applying the findings on real, live, breathing patients? When is it acceptable to do a retrospective study, but compeletely unethical to do a prospective one? Can we ethically do randomized controlled trials with all kinds of treatments and is it always okay to have a placebo arm? Why is it a good idea to always start by looking to see if a recent well-conducted systematic review is available covering the topic you’re researching and if not, work your way ”downwards”. Are there times when case control or cohort studies might trump a RCT? What’s the difference between filtered and unfiltered information when we’re discussing evidence-based practice? (I could go on and on, but this paragraph already violates my too long paragraph-rule).

Let’s say I love coffee. As I’m walking home from work, I see today’s edition of The Daily Rag and the headline is screaming: Five cups of coffee per day decreases the risk for heart attacks and type 2 diabetes. (The second headline is that Elvis has been spotted on the Piazza San Marco in Venice, but I quietly ignore that part because confirmation bias is bliss ?) Being such a coffee lover I think ”great” and I smile contently and just a wee bit smugly. Then I continue my walk for a few more blocks and walk past another vendor selling The Evening Tidbit. The headline screams in bold font: Warning! Drinking coffee increases your cholesterol ☠️

Okay... Now what? I guess I could make an appointment with my physician and ask him/her if I can safely continue drinking my beloved coffee... OR... I can find out for myself ??‍⚕️

Just a side note, I don’t understand the fixation some appear to have with APA. Darn, that’s just a minor detail in a much more useful bigger picture.

Ever since I became a member here, at regular intervals I see threads started about flu vaccines and there are always many posters (some brand new just for the occasion, and some forum veterans) who claim that they got the flu shot and then got influensa a couple of days, or a week later. And others who say they’d never take it because it’s contains ”toxins” and will cause autism. Granted, we don’t know that each poster is actually a nurse, but some of the posters are people I’ve seen posting through the years and I actually think are nurses. Yet they spread misinformation. Is everyone I’ve seen criticize APA in this thread also an anti-vaxxer? Of course not! But I think it’s a whole lot harder to reject science if you can competently analyze it. Being research literate is to me both a useful ”self-defense” skill in my everyday life as well as a professional obligation.