No, really - what is your EMERGENCY?

This used to be the journal of a nursing student at a prestigious 4 year university that will still remain unnamed. This is now the journal of a Registered Nurse working in an Emergency Department in a major US city. All names have been changed to protect the stupid and the mean. There is no educational value in this journal, sometimes it will be downright mean and catty - this is where I come to vent!

Friday, September 14, 2007

Ok, ok you talked me into it

Ok, ok. You talked me into it. I will continue to post - a little. The title for the blog has changed a little - it is now Pissed Off New Grad Nurses. I'm not as creative as the person who came up with the original name - this was the best I could do. One other change - I will now be blogging with my real first name. I will still not divulge what school I went to, what hospital or what town I am working in, and all my coworkers names will be fake - I've got to keep some anonymity!

So, nursing is no different from many other careers - your education never really ends. However, I was kind of looking forward to getting away from the classroom setting for a while. HA. This is not to be the case. Today, I spent 8 hours in a classroom (the second of two sessions) learning about how to analyze EKG strips. Ok, definitely a useful skill. A need to know. A professional requirement. I'm paid the same for this time as I'm paid on the floor. I have no problem learning it. I have no problem sitting in a classroom with 50 of my fellow new grads while you teach it to me. But DO NOT talk to me like I am a toddler. I am a grown human who graduated from college - I am not a total idiot, you do not have to speak slowly and over enunciate your syllables.

I am all about the pre-test for a lot of these things. Would it be that hard to give us a pre-test and if you pass it, then you just tested out of the period of instruction. I really think it would save us and the educators a lot of time and effort. And that way, they would have much more time for the people who don't understand the stuff and need a little extra instruction. Some of us had this stuff in school and listening to it again in such a patronizing way is like sticking ourselves in the eyeball with the calipers. It is really sad when I would rather be reading my required reading for my Marine Corps Command and Staff course than listen to Heavy D (that is what we nicknamed the instructor owing to her big size) drone on about junctional rhythms again.

So, I am a person who learns best through doing things. Lucky for me, my preceptor understands this and she is of the, "watch one, do one, teach one" philosophy. I like this - I get to do a lot of new things this way. The new grads in the ED are way ahead of our counterparts in the ICUs. They are not allowed to do anything. They are not even allowed to suction their patients, they don't pass meds, they can't even document in the patient chart. They are still being treated like students, complete with clinical conferences where they discuss their clinical experiences for the day. I'm all about supervised practice, having preceptors, I don't want to be thrown to the wolves all on my own too soon. But it is almost as if they have gone back in time to their first semester in nursing school. I get that we don't have very much experience, but the way you get experience is by doing things, not just talking about them.

Ok enough. I have two days off in a row - I've got to get a whole lot of fun in during those 48 hours!


  • At 1:28 PM, Blogger Sassenach said…

    I heard on the radio yesterday that the University of Iowa is cutting the number of slots for undergraduate nursing students (BSN program -- is that right?)in HALF due to a shortage of nursing instructors. They will instead significantly expand their MS and PHD programs in nursing. Doesn't sound like a shortage of nursing instructors to me. Sounds like....something else, but I'm not sure of what.

    Meanwhile there's a shortage of nurses and new grads are treated like idiots. Is that because the quality of BSN's is dropping? Or because an influx of capable RN's threatens the status quo (however miserable it is)?

    Whatever. Have a good weekend -- you've spent years earning some genuine time off.

    Keep us posted!

  • At 2:44 PM, Blogger Shannon said…

    There is a huge shortage of nursing instructors at all levels. The job doesn't pay anything and for every nurse you pull out of the workforce to instruct, you just opened another "shortage" spot that needs to be filled. I am surprised that Univ. of Iowa has reached the point where they had to cut BSN spots. Expanding their MSN and PhD programs will generate more nursing instructors. You have to have at least an MSN to instruct at the BSN level. And, they don't need as many instructors for the MSN and PhD programs - those are often a lot of self study.

    Also remember there are 3 ways to be an RN. You can do a 4 year BSN program, you can do a 2-3 year Associate Degree (ADN) program at a Community College or you can do a diploma program at a hospital that offers one. None of these programs make you an RN, all they do is make you eligible to take the licensing exam to be an RN. You very well could graduate with a BSN or ADN, never pass your boards and never be a nurse. Obviously, the ADN programs can put out nurses faster because the program is slightly shorter. It is also usually less expensive for the student. Therefore, a lot of states have put more funding into the ADN programs in order to increase the number of nurses available.

    Bottomline: there is much less of a shortage of people who want to be nurses (when I applied, there were 4 applicants for each spot) than the shortage of people who want to teach nurses. Don't forget also that there are classroom instructors but there are also clinical instructors as well. Clinical instructors usually don't have more than 10 students so you need a whole lot more of them. If we don't start paying instructors more and making it more appealing we will continue to have a nursing shortage.

    Personally I don't think the quality of BSN's is dropping. In fact, I think you are getting a better product now that we have so many 2nd degree and "non-traditional" (read: older) students. Keep in mind that the BSN program is geared to produce those who will hopefully become nursing leaders, nursing instructors, nursing researchers, etc. Many of the nursing leadership positions require an MSN (and by default a BSN). That is why there are so many RN-BSN programs for those with ADNs or diplomas. All the skills you learn in nursing school are just a foundation. When you start your first job, you will have to learn how to do all of those skills according to your hospital policy and probably with different equipment. There are alot of nurses out there who feel like they can teach the skills when you get to the floor, but nursing school needs to teach the foundation and the "thinking skills."

    Ok, the soap box has collapsed....

  • At 8:41 AM, Blogger Sassenach said…

    "Also remember there are 3 ways to be an RN...."

    Or, you can take the 4th way that my ex-daughter-in-law (thank goodness, it's ex) took, which was to "attend" a 4 year BSN program and spend most of her time shopping, thereby leading to failing the state licensing exam three times and ultimately ending up as a sales clerk at Nordstrom's, where she consoled herself by emptying out the joint bank account and maxing out credit cards. Did I mention she is an "ex" daughter-in-law. But I digress.

    Thanks for the answer, I appreciate having a much better understanding of the situation.

    As a patient, I do think the quality of nursing care has fallen markedly in the past decade or so. Certain areas of care seem to be better than others -- for example, the marginal English speakers on my mother's medical ward (who also nearly gave her a drug for which her allergy was prominently posted in several places) were not in evidence once she was transferred to the surgical floor. In other instances, I see a lack of skill beyond very basic nursing tasks.

    OK, I'll stick my toe in and wonder: is what I'm seeing the result of the qualitiative difference between an average ADN program graduate and a BSN? As a patient, I hardly know who graduated from what -- I can only sense that there's a difference in something, somewhere.


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