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ADVANCE Perspective: Nurses

Two Nursing Worlds that SHOULD Collide

Published August 19, 2014 9:54 AM by Guest Blogger

By Casey Hill, MSN, RN-BC, CEN, who is a nurse educator in Connecticut.

Recently I attended a nursing orientation at a hospital, composed of both new graduates and experienced nurses. As a nurse educator, I enjoy being in this type of setting, seeing former students grow into their new role as a registered nurse.  Yet, like my former students and everyone else in the room, I was there to get credentialed on a skill for hospital protocol purposes.

The nurse educator leading the presentation was informative, humorous and kept the tone light. When it came time for skill practice she said something that would really challenge my thought process over the next several days. She stated, “You’re not in nursing school anymore; let’s practice the real way.” 

My former students looked back at me and I laughed. I knew the instructor meant no harm in the statement and every experienced nurse knows about the two worlds that exist; Nursing school and professional practice settings. I thought nothing of at the time.

But over the next several days those nurse educators’ words couldn’t escape me. Why are there two worlds? Isn’t my purpose and everyone’s purpose as a nurse educator to be teaching best practice, to develop a competent, compassionate and safe future nurse? Moreover, after graduation and licensure, shouldn’t that nurse be empowered to take those practices learned in school and continue them when caring for patients?

It seems we have a major disconnect here in our profession. Two worlds existing at the same time does seem counterintuitive.  I have lived both aspects, I understand both perspectives. You go through school as a student; things are taken at a slower pace, every procedure dissected. Sterility held to its highest regard and every medication researched. Then as a professional nurse, conditions are altered in an instant, patient nurse ratio’s climb and both time management and prioritization must be perfected to survive.

But, now as a nurse educator, instructing the nurses of tomorrow, I feel we simply cannot have mentality of the “nursing school way” versus “real world, professional nurse way.”

Medications need to be researched whether someone is studying to be a nurse or practicing it every day. Sterility should always be maintained and time management needs to be practiced as a student, so it can be perfected as a professional nurse.

The method of caring for patients in nursing school and caring for patients as a professional nurse should be uniform. Yes, the experienced nurse is able to be more efficient and proactive.  But, being experienced does not mean that now corners should be cut and procedures should be streamlined. This is not to imply that every experienced nurse practices this way, but, I do believe this has become a sub-culture of our profession.

At the end of the day, it is all about the patient. That is something every nurse seems to agree upon. But, I believe the student nurse who learns to develop a solid foundation in nursing school, maintains it and builds upon it as a professional nurse, will be able to deliver the best nursing care possible for their patient.

So, if it really is all about the patient then, it’s about time these “two worlds” collide and experienced nurses stop forgetting about the “nursing school way” but rather embrace all that they have learned during their career. It will only make them a stronger and safer nurse.


My husband was in the hospital for 4 days.He has Parkinsons,4.5 yrs,PEG tube,3 mos.frequent falls,skin tears.I take total care of him @home.The nurses and techs did a great job of caring for him,with reduced help and a full hospital.But nurses do not have time to spend on the patients like we did back in the day.Paperwork requirements take a greater share of their time,pt care done mostly by techs.There were4 different roommates in 4 days.That is how busy they were.New regulations w/ACA made things more difficult for everyone,doctors,nurses,techs,other support staff.I think it is very difficult today for nurses to do as they were taught in school because of the demands on their time.They are spread thin.But I cannot find fault with the care given.It is good that I am able to do the wound care,peg tube feedings and stoma care,bathing,ambulating and transferring of my husband.A layperson confronted with all this would find it difficult to learn much because of the time constraints on nurses today.They work 12 hr shifts and still have a hard time getting everything done.I worken in hospital from 67-81, and Home Health I work full time taking care of my husband.

sue , Home Health - RN, retired August 20, 2014 10:58 PM
jackson MI

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