Speak Your Mind

June 29, 2011

The folks over at BestNursingDegree.com want to hear from you! They are in the midst of developing additional resources for nursing students and new grad nurses and would love to get your feedback on two important issues:

Expectations versus Realities as a New Nurse

NCLEX Study Tips

Click on the links above and let them know what you think!

And if you are a second-degree nursing student or nurse…

I am working on an article for for BestNursingDegree.com about the particular experiences and challenges of going BACK to school to become a nurse. If you are interested in being interviewed, please contact me at nurseteeny@gmail.com for more information! 🙂





The Myth of the Second Degree Nurse

January 31, 2011

I’ve had enough.

Enough of being told that people like me may be “smart”, but can’t make clinical decisions where it counts. Enough of having derogatory labels bestowed upon me.

It’s time to set the record straight. I present to you my favorite myths about second degree nurses and nursing students (SDNs).

  1. SDNs are ambitious/cutthroat/want to skip the whole “patient care thing” in order to climb the ladder faster and higher. My classmates and other SDNs I have met became nurses FOR THE PATIENTS. Or for the intellectual challenges. Perhaps a few for job security (too bad the economy proved nothing is recession-proof, not even nursing). But the vast majority are here because of the patients. Our nursing school admissions essays read the same as anyone else’s. The difference is we’re entering this field after a lot of life experience and deliberation, so we usually have a pretty good understanding of where we want to go with it. Hence why a second-degree master’s program, that culminates with the opportunity to advance our knowledge and practice, makes sense to many of us.
  2. SDNs only have “book smarts”. Oh please. I can name countless examples from my own cohort of how we were told that we entered our clinicals and jobs extremely well-prepared and capable. I was told by experienced critical care nurses that I had good instincts. Many of us are already being asked to orient new grads, only one year after being in their shoes. Because they trust us and our clinical knowledge. One of my good friends, an L&D nurse, has been complimented not only for seeking out opportunities to expand her professional understanding through certifications, but for also knowing the limits of her new practice and not being afraid to ask questions. With life experience comes wisdom. Which can be just as important as either book smarts or clinical knowledge.
  3. SDNs skimp on clinical hours. I can’t speak for all nursing programs in the country, but I can tell you this… My program is broken into two distinct sequences: pre-licensure, in which we prepared to become RNs, and graduate-level courses, in which I am now enrolled. Our pre-licensure coursework was insanely challenging and our clinicals were insanely intense. In fact, we had more clinical hours than our BSN counterparts at the same university. And our clinical rotations featured clinical instructors who supervised our groups and led post-conferences. Regularly. We were not left to our own devices any more than an ADN or BSN student would be.
  4. SDNs skimp on nursing content. The only reason we didn’t actually get awarded BSNs at the point we finished our prelicensure track was some mumbo jumbo about undergraduate vs. graduate status and confusing the financial aid office (plus we needed two university-required religion classes that they could have easily built into the curriculum). But don’t get me started on that. My point is, my prelicensure program lasted longer (17 months) than some accelerated BSN programs and contained the same nursing content. Because we all had previous Bachelor’s degrees, we didn’t need to re-do an undergrad core curriculum.
  5. Who needs a nurse with an undergrad degree in French (or Anthropology, or Business, or Math)? I do! I’d also like a nurse who’s traveled the world, experienced a loss, had his/her own children and worked on a team. We may need a few tries learning how to start an IV or put in a Foley (doesn’t everyone??), but the skills and life experiences we bring into our work are unique and offer opportunities to find common ground with patients, express empathy and simply share what it means to be human. When we are invited into the intensely human experience of suffering, these abilities are irreplaceable.
  6. SDNs are released into the wild with zero nursing experience. We completed our prelicensure courses, successfully negotiated 180-hour capstone rotations, sat for the NCLEX and became new grad RNs just like everyone else. We struggled to find our first nursing jobs just like everyone else. But as I work on my graduate courses, I’m a practicing RN with a regular job. By the time I finish my MSN in 2012, I’ll have almost 2.5 years of direct care experience under my belt.
  7. SDNs can’t be Advanced Practice Nurses/ Clinical Nurse Leaders with so little experience. See #6 above – I’m already building my clinical experience. And depending on our program, we may have many more years of school and clinical hours before we are licensed in an advanced practice role. Not to mention the certification process it takes to become advanced practice nurses – it’s no walk in the park. And then there’s the CNL, who is not intended to be all-knowing about all-things – we are equipped with a skill set that can be applied across multiple settings. CNLs are resourceful coordinators of care and advocates who can support direct care nurses by providing information about evidence-based practice. Graduates of my program have been tapped to manage departments and coordinate quality and process improvement programs at hospitals because of these skills. Being an effective leader is about clinical knowledge and then some.
  8. SDNs are inflated/egotistical/think the nursing profession didn’t exist before we came along. I have enormous respect for the nurses who have taught me in my clinicals and on the job. Except for instructors and professors, very few have had advanced degrees (heck, most had ADNs and were just fine with that). The knowledge and wisdom I gain from your clinical expertise should never be dismissed or negated, and I hope that I have expressed (and will keep expressing) how much I learn from you. But as a long-time outsider looking in, and now as a newbie nurse, I have a fresh pair of eyes that sees a health care status quo that is unsustainable. I am not here to threaten your job or question your judgment. But I am also not afraid to question the way things work and wonder if it could be better. And believe wholeheartedly that nurses can lead the way.

Feel free to agree or disagree. There may be concerns about individual second-degree nursing programs, and those concerns may be valid. Might I also point out that not all ADN or BSN programs are created equally, either.

But please avoid making gross generalizations or attacking an entire population of well-educated professionals. We’re here to stay and we’re in it for the same reasons the rest of you are.

So if we could refrain from the eating of the young, I would greatly appreciate it. 🙂

Nursing Student Socialization

August 25, 2009

So here I am, two weeks from the start of school and mute on the evidence-based blogging front.  Sorry, folks!  My time off this month has been a bit of a roller roaster.  But then again, what better time to discuss research about the nursing school experience than when thousands of students are returning for another year, and thousands more are just beginning the journey?

I thought I’d initiate this blogging experiment by addressing an article that caused quite a stir within my own cohort.  Just ‘cuz I like to rock the boat. 🙂

The study in question (Utley-Smith, Phillips, & Turner, 2007) discusses the “returning to school syndrome model,” which was first identified among RNs returning to academia to earn their BSN degrees.  The model is applied this time to accelerated nursing degree students, who have professional/academic backgrounds in something besides nursing and have decided to enter the nursing profession.

The reason this led to controversy among my classmates was that the article identifies “hostility” as one potential pitfall of being a second-degre nursing student.  Because the article was sent to us by a not-so-favorite faculty member, some people interpreted her distribution of the article as a passive aggressive way of calling us “hostile” and took immediate offense.

Reading the article, however, I believe that this knee-jerk reaction has way more to do with our own cohort’s baggage related to this particular professor, and very little to do with what the article actually says…

The returning to school syndrome model lists three phases in the socialization of second-degree students into the nursing profession.  Although the boundaries between these phases are fuzzy, there are definitely hallmarks of each:

  • Honeymoon – This period often coincides with the first semester of nursing school.  You’re excited about being a student again, you’re confident that you’ve made the right choice and you’re optimistic at the first signs that you might actually be able to figure this stuff out.  I remember turning to a friend halfway through one of our first clinical rotations and exclaiming, “I might really be able to do this!!!”  It was invigorating and I was in love with nursing.  The honeymoon phase is all about the romance of nursing and is critical to success because it makes you believe that this experience is worth all the challenges to come.
  • Conflict – The conflict phase is tricky.  Utley-Smith et al. noticed that this period often occurs during the second semester, when clinicals get more intense and classroom material gets harder.  The skills you knew well in your life B.N. (“Before Nursing”) don’t get you as far, and the expectations are higher.  Our second semester featured part two of our Med-Surg nursing course, during which we were expected to build on the skills learned in part one and really take off.  And I did notice A LOT more conflict during this time.  More fatigue, more anxiety and much more complaining, often about issues that were out of our control.
  • Reintegration – Reintegration actually begins with hostility, in many cases.  External factors are blamed when students don’t live up to their own standards of success.  I believe that in our cohort’s case, we’re still muddling through this part.  We’re all used to being really good at things – we succeeded in school and previous jobs, and we got into a very difficult nursing program.  So when the grades are less than expected and the G.P.A. doesn’t glow as we think it should, we look for culprits, whether they be administration, faculty, the program itself, or sometimes a peer.  Hence the “obnoxious” remark about my finishing exams quickly.  Hostility hopefully (and usually) evolves into positive resolution, when you figure out how to integrate “self B.N.” with “self R.N.”, and understand how you have been transformed into a nurse.

Returning to school is difficult.  Returning to school to study nursing is even harder, especially when you have been successful in your life before nursing.  Not only do you learn extremely difficult material at a rapid, break-neck pace, but you also are thrown into a completely new culture.  And to top it all off, learning in the classroom is very different from learning to think on your feet, and in nursing school, you have to do both.

I’m not intending to scare anyone off from nursing, or from second-degree programs.  If you’ve read through any of this blog, you know how intensely rewarding and exhilarating my own experience has been.  But I do propose that you be aware of some of the emotional and mental responses you may have to the experience, responses that may surprise and shock you. I hope that your nursing programs include some of these issues of adjustment in your orientation and nursing foundations class – if they don’t, ask for it!

I also advise that you cut yourselves a little slack and realize that no matter how many A’s you got in your prereqs or how many stellar references you got from your former boss, you are starting from Square One.  The skills, the language and the culture will be foreign concepts, and you don’t have to master them right away.  But your interpersonal qualities, work ethic, and passion for providing care to others – which undoubtedly got you in to begin with – are important to hold onto.

And when you start to doubt whether you can do this, you can.


Utley-Smith, Q., Phillips, B., & Turner, K. (2007). Avoiding socialization pitfalls in accelerated second-degree nursing education: The returning-to-school syndrome model. Journal of Nursing Education, 46(9), 423-426.

NOTE: I will always include reference(s) at the end of these research-based posts, in case you wish to read the original articles.  Happy researching!

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