Restructuring Nursing Curriculum for Modern Healthcare Demands

The Evolving Role of the Modern Nurse

Nursing is a rewarding but challenging career choice. The modern nurse's role is not limited to assisting the doctor in procedures. Instead, the contemporary nursing professional takes on a partnership role with both the doctor and the 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 capacities — advocating for proper medical care while maintaining the dignity of the client.

In the contemporary world, a more holistic approach is preferable, one that sees the patient as more than their disease and advocates for that patient's proper care and assistance when they are unable to do so themselves (Koenig-Blais, 2010). This role has become even more complex as technology evolves in conjunction with the fiscal pressures faced globally by the healthcare industry.

Because of this increased complexity, nursing students require a far more advanced set of preliminary core courses in order to become fluent within the field. Without grounding in these courses, some of the more advanced and complex issues go untouched until practicum — a time that is too late for remedial catch-up and produces far more stress on both the student nurse and instructor than necessary. Medicine is not becoming less complex; quite the contrary, it is becoming more so. When one adds to this the sociological and cultural changes in the modern environment, it becomes more prudent and certainly more efficient to introduce the actual practice of nursing later in the curriculum cycle — once the basics have been presented, absorbed, and at least a foundational vocabulary has been established (Speziale and Jacobson, 2009).

Ten Trends Reshaping Nursing Education

Ten major transformations in the healthcare industry have specific relevance to modern nursing education (Heller, Oros, and Durney-Crowley, 2009):

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 and 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 and alternative therapies, and their perceptions through the media have increased 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 manage costs, there is increasing pressure for nurse managers to be fluent in business practices and techniques.

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

Interdisciplinary Issues: The modern nurse must 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 level of acumen and intellectual ability than in previous years. This translates into more knowledge required sooner for the nursing student.

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

The Learning Curve in Professional Nursing Programs

There is the matter of the learning curve in professional education. When 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 has been attributed to deficiencies in some skill sets of new graduates — an issue that pushes nursing schools and curricula 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 examine the time frame of the educational experience and ask how it can be more efficiently structured for maximum effect? Giving students more materials without any thought to how those materials will be applied does not improve their cognitive skills, nor their ability to act within a clinical setting. Indeed, there is only so much information a student can absorb in a given amount of time. Because clinical training is so important and requires more focused attention, a shift in curriculum — one that allows for more robust coursework packed toward the beginning of the experience and less bookwork with more clinical work toward the later part (from the end of the second year onward) — would benefit both patient outcomes and institutional performance (Burritt and Steckel, 2009).

Conclusion

Placing actual practical nursing later in the curriculum would serve two major improvements: first, it would allow for a more robust and meaningful clinical experience; and second, it would allow the student to concentrate on two distinct aspects of their nursing studies — theory and practice — at different times, doing more justice to both in the process.

References

Berkow, Virkstsis, Sewart, and Conway. (2008). Assessing new graduate nurse performance. Journal of Nursing Administration, 38(11), 468–474.

Burritt and Steckel. (2009). Supporting the learning curve for contemporary nursing practice. Journal of Nursing Administration, 39(11), 479–484.

Heller, Oros, and Durney-Crowley. (2009, July 30). The future of nursing education: Ten trends to watch. Retrieved September 20, 2010, from

Holzmer, W. (2006). Quality in graduate nursing education. Nursing Education Perspectives, 26(4), 236–243.

Koenig-Blais, K. (2010). Professional nursing practice (6th ed.). Prentice Hall.

Speziale and Jacobson. (2009). Trends in registered nurse education programs. Nursing Education Perspectives, 26(4), 230–235.