Many times, I’ve had cause to question just what the heck I was thinking when I decided to work full-time nights as a hospital CNA while going to nursing school. I stumble/limp into lecture after a shift, feebly clutching a giant latte, hoping to stay awake for most of the lecture. I would be lost during this second year without my trusty digital recorder, although I’m currently avoiding becoming the class bee-yotch (no, I will not post all the lectures so the rest of you can leech off my effort – the nice guy who did that for y’all last term failed out, so I’m leery of following in his steps). Yes, health insurance is a nice thing to have, but I still question my choices – especially when my grades are not on a par with those of those that don’t work (except at school, which is hard work enough).
So the other night at work, one of my nurses asked me to help her student RN (from a distinguished local BSN program) with a bed bath on a vented patient. The experience went well, as I like to teach (although I have a hard time keeping my hands in my pockets so the person learning actually has time to learn). The student was careful, and seemed to treat the experience seriously.
So where was the problem? The student said that she had taken a CNA class, but that she never really wanted to do “that kind of work.” (‘Scuse me? I mean, I didn’t know that the work many choose as a long-term career was on a par with pole dancing, or something. No disrespect meant to the dancers out there. . .I’ve seen your tax returns, ladies, and you sure have to spend a lot on shoes. Noamsayne?) I bit back on my hair-trigger response, and asked the student what she meant (because I prefer not to second-guess people). The student said “well, they are such different jobs, and the CNA job doesn’t really have that much to do with the RN role, so I didn’t want to get confused.”
Fair enough – I’ve sometimes had difficulty trying to step beyond the CNA mindset at my own clinical shifts – which is task-based, because it has to be, or you’ll drown/cry after every shift/get fired. But it’s not impossible, as evidenced by the many RNs I work with who were CNAs first.
I would argue that students should not be allowed into nursing school until they have worked in some clinical situation – medical assistant, EMT, ED tech, CNA, assisted living aide, whatever – because the practical experience gained is invaluable. As a grunt, one is in a unique position to observe and learn in many situations – particularly in critical care or the ED. I’ve been a helper/fly on the wall during codes, new admissions, transfers, road trips to CT, etc. Each experience has taught me things I need to know as a nurse, in any situation where I find myself after graduation.
I asked one of my coworkers if lack of clinical experience and skill displayed by this BSN student, compared to the students in my community college ADN program, was typical in our geographic area. She responded that in her experience, that was generally the case, if the student had not worked in the medical field before. I have heard – not just from this coworker, but also from others, that BSN programs prioritize teaching the leadership aspects of nursing over skill development, telling their students “you’ll learn your skills on the job.”
I wonder to what extent this has contributed to the woes new graduate nurses experience when trying to get jobs in the current tight nursing job market? Is nursing education shooting itself in the foot in the effort to “professionalize” nursing? The statistics would seem to indicate that BSN program graduates are successful in being hired. Are the educators attempting to shift clinical training back to the hospitals, where nurses used to be educated and trained, not colleges and universities?
Even though this student’s opinion of the value of CNA work caused me to have an indignant knee-jerk reaction, I am glad she shared it, because it’s helped me do some thinking about the future of nursing education in this country.