Why is it difficult to transition from nursing student to working Nurse?

brownbook · Dec 18, 2017

It was very difficult for me. I had no family or friends who were nurses. I knew nothing about how a hospital functioned. How a patient got admitted, what a chart or Dr. order was. I don't think the teachers appreciated how DUMB I was inspite of being a straight A student.

Honestly I don't know how I made it through the first year. Pure fear, denial, I actually hoped I'd make a sentinel event mistake so I'd get fired.

Fortunately it is really hard to harm a patient. There are so many safeguards built-in.

In the nursing program a teacher said some cultures believe a hospital is where people go to die. I thought.....well isn't it?

I'd encourage any green as grass applicant thinking of becoming a nurse to work as a CNA.

jennylee321 · Dec 18, 2017

Probably because nursing school is trying to teach you all the skills and knowledge that a nurse should have in a relatively short period of time. Time management falls by the wayside. The way you do things in clinical just doesn't match up to the real world of nursing. In a nursing clinical you may just get to do one med pass for one patient and as you pass each med you are saying the 8 rights aloud to your instructor. Now how do you think this translates to the new grad nurse who had an hour to pass 8 patients meds, or try quadrupling that for LTC.

In nursing school you learn how to do a simple sterile dressing on a mannequin. In the real world of nursing it's a uncooperative patient with confusion and multiple other wounds that you may be caring for, and your other patients are on the call bells and the lab is calling you with a critical result and your other patient is due to go down for a test.

They don't really simulate these complex situations in nursing school because it would probably fluster you from getting what the main lesson is supposed to be ie. How to a dressing and follow sterile technique.

But I do think nursing schools could probably do a better job at building up to these more realistic land or at least giving you a few patients to look after during a simulation

vanilla bean · Dec 18, 2017

Because, IMO, nursing school prepares you to take the NCLEX and not how to deal with the realities of the job itself. Learning to manage your time efficiently can be a steep learning curve. Learning to manage the constant demands for your attention and having to split your focus between multiple priorities simultaneously can be a steep learning curve. The pressure of trying to satisfy demanding employers, providers, patients, and families can be overwhelming. Being the point-person for each patient when it comes to all of the other disciplines involved in providing care (radiology, lab, ST, OT, RT, etc.) can be overwhelming. The skills to be able to negotiate the demands of the job are learned over time, so in the beginning, it can make one feel "overwhelmed, incompetent, and extremely nervous."

Davey Do · Dec 18, 2017

On the flip side of things, I felt well prepared when I began working at an LTC facility after completing the LPN program. I believe it was because about half the LPN program consisted of clinicals. Basically, a day consisted of 4 hours working the floor and 4 hours of classroom training.

For example, as an LPN student, I spent 3 weeks, 4 hours a day, in the OR. In the RN program, it was one day in the OR. I was allowed not to attend that one OR clinical since I had worked in OR as an LPN scrub nurse.

The "P" in LPN truly stands for "Practical".

JKL33 · Dec 18, 2017

I think at least some portion of it is that we are drilled with various information about all of our ethical duties and then there are conflicts the instant you walk onto a floor. Nursing students should be better prepared for this; it is definitely discussed, but in terms that made it seem like we would just have to do x, y, z thing (follow the chain of command, call the doctor, use therapeutic communication, etc.) and the problem/conflict would be solved, with our sense of duty and ethics remaining nicely intact. Ha. Ha.

Cat365 · Dec 18, 2017

Nursing school is a lot of bookwork. How to prioritize, critical thinking, and of course how to pass the NCLEX. You don't spend a lot of time actually doing the work. Inserting catheters, IVs, NG tubes. Not on live people anyway. My hands on course was at the beginning of my schooling before clinicals. Makes sense right? You need to know how to do these things before clinicals. Thing is I never did a single one of those things during clinicals. We were on Med surge units and many of those things just don't happen that often. We were specifically prohibited from inserting IVs (a huge thing where I work ER) because of liability issues. I know several students that did urinary catheters but I never did.

Even our days on the unit we were expected to gather enough information on our patients to write detailed care plans and you had to hand write most of the information since you couldn't print it due to HIPPA. That's a lot of clinical time where you are not delivering hands on patient care.

Last reason is that nursing school is general information. A unit is very rarely general. There are burn units, neurological, orthopedic, pediatric, maternity, OR, ER, psych, etc. You don't have enough time in school to learn each in detail. That's why there's always a learning curve even with experienced nurse when switching specialties.

RNperdiem, RN · Dec 18, 2017

Imagine if you took a swim class where you were taught the theory of motion, hydrodynamics, body mechanics, and swim stroke techniques. You only had a few hours a week in the pool- in the shallow end with an instructor right there.

Once you passed your certification, you would be a fully qualified swimmer. Dive in the deep end and get swimming!

Nursing was once taught as an apprenticed trade. The student would work long hours in the hospital learning by doing.

This was the diploma method of nursing school.

To become more professional, nursing was moved to university and community colleges. A more theoretical approach with more emphasis on science, research, and a deeper understanding of why things were done the way things were done.

The trade-off was less hand-on learning for the student. The idea was that the hospital would pick up the training role when the student graduated and got their first job.

Crush · Dec 18, 2017

Because, IMO, nursing school prepares you to take the NCLEX and not how to deal with the realities of the job itself. Learning to manage your time efficiently can be a steep learning curve. Learning to manage the constant demands for your attention and having to split your focus between multiple priorities simultaneously can be a steep learning curve. The pressure of trying to satisfy demanding employers, providers, patients, and families can be overwhelming. Being the point-person for each patient when it comes to all of the other disciplines involved in providing care (radiology, lab, ST, OT, RT, etc.) can be overwhelming. The skills to be able to negotiate the demands of the job are learned over time, so in the beginning, it can make one feel "overwhelmed, incompetent, and extremely nervous."

I feel the same way. I think that most nursing programs focus on passing NCLEX which is sometimes a bit different from reality of working the floor, especially with time management and all the other stuff as described in the quote. I think one thing I would want to see taught more in schools is dealing with difficult families and patients.

ruby_jane, BSN, RN · Dec 18, 2017

Imagine if you took a swim class where you were taught the theory of motion, hydrodynamics, body mechanics, and swim stroke techniques. You only had a few hours a week in the pool- in the shallow end with an instructor right there.
Once you passed your certification, you would be a fully qualified swimmer. Dive in the deep end and get swimming!
Nursing was once taught as an apprenticed trade. The student would work long hours in the hospital learning by doing.
This was the diploma method of nursing school.
To become more professional, nursing was moved to university and community colleges. A more theoretical approach with more emphasis on science, research, and a deeper understanding of why things were done the way things were done.
The trade-off was less hand-on learning for the student. The idea was that the hospital would pick up the training role when the student graduated and got their first job.

Per Diem nailed it, as did the others who tell you you're being taught to a test. The nurses who did the best out of my graduating class had actually taken tech jobs while in school and were familiar with the floor and the flow.

Good luck. One day you will wake up and it will all make sense. I promise.

pixierose, BSN, RN · Dec 18, 2017

Because, IMO, nursing school prepares you to take the NCLEX and not how to deal with the realities of the job itself. Learning to manage your time efficiently can be a steep learning curve. Learning to manage the constant demands for your attention and having to split your focus between multiple priorities simultaneously can be a steep learning curve. The pressure of trying to satisfy demanding employers, providers, patients, and families can be overwhelming. Being the point-person for each patient when it comes to all of the other disciplines involved in providing care (radiology, lab, ST, OT, RT, etc.) can be overwhelming. The skills to be able to negotiate the demands of the job are learned over time, so in the beginning, it can make one feel "overwhelmed, incompetent, and extremely nervous."

Nailed it. ^^^ This.

nursemike, ASN, RN · Dec 18, 2017

Some very good points have already been made, but it occurs to me that, for me, the most difficult thing about my first year was that it was difficult. Now that I've been doing it for a while, a lot of times it's still pretty hard. Nursing school wasn't a picnic, either, come to think of it. Well meaning people, including me, will say you have a big challenge in front of you, but it's also fair to note that if you are a licensed RN, you have a pretty big challenge behind you. You can do this--but it is hard. Soon you, too, will have a list of things nursing school didn't teach you.