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June 2016   Comments

Our training, our education

After reading Dave Bateman’s article (Last Word, April), I felt I had to write. He writes that academically based education is a problem and that he doesn’t believe that “nursing schools employ equal numbers of experienced clinical instructors and research-driven professors,” yet he provides no evidence to support either statement. That contention, based on opinion only, is an example of the value of an academic focus. Nursing programs teach students the difference between making decisions based on opinion and conjecture as opposed to evidence-based knowledge.

Mr. Bateman also states that he has personally never felt the need to legitimize nursing. I contend that this is because he is a man and has never had to legitimize himself about anything in our society. Historically, while men had their choice of occupations, nursing was one of the only legitimate professions for women. Even then, for a long time, nurses’ knowledge was considered to be inferior to (male) doctors’. It is not surprising that nurses worked hard to legitimize their knowledge.

Today, nursing is in the process of moving from being seen as less-valued women’s work to being seen as a scientific profession incorporating both evidence-based practice and caring human touch. Mr. Bateman would do well to reflect on the hard work of the many nurses (mostly women) who worked to develop nursing into the profession it is today.

– Erica Roberts, MSN
North Vancouver, B.C.

I thought this was an interesting article and one of my pet topics. Most recently as a patient myself, I have found that most patients need a family member to provide the hands-on care and to occasionally tell the nurse what is needed.

My original nursing education was through a three-year hospital training program. As time goes on, I realize what an excellent program it was — we were on the wards after three weeks and soon found out if nursing was really for us. We had at least some experience in all specialties. We also spent many hours of classes in theory, to contradict one of the criticisms of hospital programs.

After 12 years, I entered a BSN program and was taught by nurses with variable knowledge. In fact, two of us with recent hospital experience taught several of the classes, as the professors admitted they had no experience in those topics. In our community course, one of my non-RN classmates taught the prenatal class on labour and delivery; she admitted that she had never witnessed a delivery.

I believe some nurses are excellent teachers, some clinicians, some researchers and some administrators. We should use their expertise in the appropriate areas.

– Jennifer Richmond, BSN
Vancouver, B.C.

As a nurse who will soon retire, I am somewhat disheartened as to where our profession is going educationally. I agree that nurses need to have a bachelor degree to practise, but the hands-on experience is being sacrificed. I have practised in a variety of specialty areas in many roles, including bedside nurse, educator, manager and navigator. Too many times I have encountered nursing students who, in their final years of the program, realize that nursing is not their calling. What a waste of time, money and resources! Having a foundation of actual patient care experience for a concentrated time enables students to be better nurses and decreases the need for intensive mentorship for graduate nurses when there is little time and resources. A number of students have lamented to me the lack of bedside care opportunities. They don’t want to be good; they want to be great nurses.

I also agree that the requirement for a near-perfect GPA is no indication that an individual will be a competent nurse. There are many people who do not excel in high school for various reasons but can excel in the profession when it is their passion. I have seen and worked with many people who had the academic marks but were neither competent nor caring.

– Judy Soroka, RN, BN 
Calgary, Alta.

As a senior staff nurse in a rural setting, I concur with Dave Bateman’s Last Word. It is great to see nurses graduate with a well-balanced education, but they need to have the skills and knowledge to do the job. It is distressing to see new RNs who lack assessment skills and clinical knowledge. New methods of delivering health care in new settings are great improvements, but hospitals are still the largest employers of nurses. It has been researched that patient outcomes improve with the care of RNs because they are clinically prepared.

It has been my experience that the most prepared young nurses in our facility are those who worked as undergrads in a hospital setting, gaining their own clinical experience. New nurses need the mentorship of senior staff, but that is not always happening because of workload.

It is great to see new research and management skills developed by nurses, but you need something to research and manage. Do we want to leave bedside nursing to health care aides and licensed practical nurses? Is that the goal of nursing education? Nursing still involves task completion alongside critical thinking skills; new grads need to come with both.

As a nurse with thoughts of retiring at some point, I appreciate the technological abilities of my young colleagues, but, especially in a rural setting with limited resources and staff, I see these ill-prepared young people being put in precarious situations. It’s scary for all concerned.

– Shirley Hagstrom, RN
New Norway, Alta.

Finally, someone else who shares my views. I imagine Canadian Nurse will receive letters from angry nurses who have spent thousands of dollars and many years getting a PhD in leadership and the like. I feel for them and for others who want to advance in our profession because actual experience as a working nurse doesn’t seem to count if you don’t have a degree. That being said, I think there is a role for our colleagues who choose academia, as not all nurses should be at the bedside. We do need nurses to conduct research pertaining to nursing perspectives because, frankly, no one else is going to do it. (I am interested in emergency medicine, but the only journals I have access to and find relevant are those directed to physicians.) The problem, as I see it, is that policy is often driven by those who have not worked at the bedside, in the clinic or out in the community. Balance and diversity of experience and education is needed in our educators and in our managers. Unfortunately, we seem to be grooming future nurses to think that having extra degree abbreviations tacked on after their names is what makes nurses worth their salt.

– Adam Henderson, RN, BScN
Nanaimo, B.C.

Many nurses cannot define, for themselves or anyone else, what it is that is unique about nursing. Caring certainly isn’t unique to nursing; every health-care discipline has that to offer.

It took me a while to pursue more learning, but I think nursing is right on track by encouraging more academic study. I started my BSN 36 years after obtaining my nursing diploma. As I worked my way toward a degree, I was amazed at what I learned about nursing, about myself and about how to care for someone in a more holistic way. Exposure to nursing theory changed how I viewed the profession. Theory gave me a voice and empowered me to speak up and say what it is that is unique about what nurses do. In other words, I became a better nurse.

When I am sick and in hospital, I want a nurse who sees me, not just my illness or injury, who can work together with me in deciding what is best for me, and who has advanced knowledge and understanding. As Albert Einstein said, “Any fool can know. The point is to understand.” That’s what higher learning did for me. Before that, I thought I knew pretty much all there was to know about nursing. The more I learned, the more I understood how wrong I was, and the more I knew I needed to learn.

– Lyn Merryfeather, RN, BSN, PhD
Lake Cowichan, B.C.
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