Nursing schools should do a better job preparing students for the grueling hours, often unrealistic expectations, and lack of respect that await them when they enter the work force, says an article scheduled for publication today in the July/August issue of Nursing Outlook.
The article describes the results of a study, paid for by the Robert Wood Johnson Foundation, that drew responses from 612 new nurses from 34 states and the District of Columbia. The study comes at a time when about 18 percent of newly licensed registered nurses leave their first nursing job within the first year, and about 26 percent are gone within two years, the article says. Meanwhile, the American health-care system is expected to face a shortfall of up to 260,000 full-time-equivalent nurses by 2025, the authors note.
The report, “What Newly Licensed Registered Nurses Have to Say About Their First Experiences,” paints a grim picture of the disconnect many new nurses say they feel between the idealistic expectations they had when entering nursing school and the reality they find on the job.
“Nurses today are intellectually, emotionally, and physically drained,” says the study’s lead author, Linda Honan Pellico, an assistant professor at the Yale School of Nursing. The school teaches relaxation techniques like meditation and deep breathing, and encourages students to keep reflective journals. “Until you take care of yourself, you can’t take care of someone else,” she says.
The report recommends changes to improve working conditions for nurses, but also describes what nursing schools can do to reduce the number of disillusioned and burned-out nurses leaving the profession.
The survey respondents recommended that nursing schools give students a more realistic idea of the pressures and workload they are likely to face in their first jobs. Rather than working four- or six-hour shifts, student nurses should be scheduled for eight-hour shifts and be given responsibility for more patients, the respondents said. When they get out of school, they are likely to face 12-hour shifts juggling four or more patients with complex medical conditions, the study noted.
The students also said they would have benefited from more practice on communications skills and conflict resolution so they could interact effectively with physicians, make proper notes in patients’ charts, and handle shift changes. Many said doctors verbally abused them.
The study noted “a disconnect between what participants were taught in nursing school and had subsequently internalized about the power and prestige of the nursing profession versus personal experience in practice.” It quoted an unnamed nursing graduate from Maine saying, “Nursing is a profession, but we are not treated like professionals. We are used, manipulated, and disrespected.”
On a more optimistic note, several nurses said that despite all the challenges, they loved their work. The researchers also noted that the respondents had all been employed for six to 18 months and that it can take at least that long for new nurses to feel confident and comfortable in their jobs.
