Introduction of prenursing students to nursing in later education

¶ … nursing is a rewarding, but challenging, career choice. The modern nurse's role is not limited only to assist the doctor in procedures, however. Instead, the contemporary nursing professional takes on a partnership role with both the doctor and patient functioning as an instructor, individual counselor, caregiver, medical researcher, emotional and psychological counselor, and personal case manager. As an amalgamation of these roles, a nurse must assist the client in all physical, mental, and psychological roles that advocate proper medical care and maintain the dignity of the client. In the contemporary world, it is important to note that a more holistic approach is preferable, seeing the patient as more than their disease, and advocating for that patient's proper care and assistance when they are unable (Koenig-Blais, 2010, intro). This role has become even more complex as technology evolves in conjunction with the fiscal issues faced globally in the healthcare industry.

Because of this increased complexity, students of nursing require a far more advanced set of preliminary core courses in order to be fluent within the field. Without a grounding in these courses, some of the more advanced and complex issues fall by the wayside and are left untouched until practicum -- a time that is too late for remedial catch-up and produces far more stress upon both the student nurse and instructor that necessary. Medicine, in fact, is not becoming less complex -- quite the contrary, it is becoming more complex. When one adds to this to the sociological and cultural changes in the modern environment, one finds that it would be more prudent, and certainly more efficient, to introduce the actual practice of nursing a bit later in the curriculum cycle; once the basics have been presented, absorbed, and at least the basic vocabulary is fluent (Speziale and Jacobson, 2009). In fact, the ten major transformations in the healthcare industry have specific relevance to modern nursing:

Trend

Relevance to Nursing

Changing Demographics

The modern population is far more ethnically diverse; both the nursing population and the client population. Each demographic and psychographic change requires a different approach to teaching nursing.

Technological Explosion

Advances in technology mean more information at a quicker pace; greater accessibility to clinical data, resulting in more efficient case management. This also means the modern nurse must be adept in using this technology.

Globalization

Globalism changes the amount and accessibility of information, as well as the universe of opportunities for the modern nurse.

Educated Consumer

The consumer is far more educated in medicine, alternative therapies, and their perceptions though the media which increases their expectations from the healthcare system.

Complexities of Care

Medical advances create a more complex system of care protocol.

Fiscal Issues

While organizations struggle to make ends meet, there is increasing pressure for nurse managers to be fluent in business speak and techniques.

Bureaucratic Issues

With increasing bureaucratization comes the requirement of a greater understanding of legal and social policy issues.

Interdisciplinary Issues

The truth is -- a modern nurse now needs to wear many hats and have expertise in many areas.

Nursing Shortage

Nursing shortages have a negative impact on patient care and thus require more sophisticated professionals within the field.

Advances in Nursing Science

Along with the complexities of medicine, advances in nursing research also require a higher acumen and level of intellectual ability than previous years. This translates into more knowledge sooner for the nursing student.

Source: (Heller, Oros, and Durney-Crowley, 2009).

This is not a negative or prescriptive suggestion; it is practical. If nursing students are being asked to absorb 30-40% more information during undergraduate years, it is logical to see that they do so early in their academic career -- almost as a prerequisite for more advanced practicum.

Then, of course, there is the matter of the learning curve in professional education. If one compares schooling for registered nurses with that of physician's assistants or physicians, one often sees a growing gap between the clinical abilities of nursing staff and actual patient care needs. This cause has been attributed to deficiencies in some skill sets of new graduates -- which has the effect of pushing nursing schools and curriculum toward more robust materials (Berkow, Virkstsis, Sewart, and Conway, 2008). However, is the solution simply adding more materials to memorize and read, or might it be more efficient to take a look at the time frame of the educational experience and ask how it can be more efficiently portioned for maximum effect. Giving students more materials without any thought to how those materials will be used does not improve their cognitive skills, nor their ability to act within a clinical setting. Indeed, there is only so much information that a student can absorb in a given amount of time. Because clinical training is so important, and because it needs more attention, a shift in curriculum that allows for a more robust packing of coursework toward the beginning of the experience, and less bookwork and more clinical work toward the later part -- say end of 2nd year on, would assist both patient and organization (Burritt and Steckel, 2009).