Guest column by Jennifer Toth | Clinicals — to me, they mean everything




L ast Thursday, like thousands of other people on campus, I looked forward to reading 34th Street’s spring shoutouts. Unlike most other students on campus, though, I did so after a 12-hour-long day of clinical — physically and emotionally exhausted but proud of the work I had done. So you can imagine my surprise and disappointment when I read: “To the Penn nurses: A two–year associates degree will get you the same job. But keep talking about those clinicals like they mean something.”

Let me start by saying that I don’t need your recognition or affirmation to feel fulfilled by the work that I’ve chosen to pursue. I also know, though, that you’re not the only one who misunderstands what we do as nursing students, so on behalf of all of my fellow nursing students I’d like to address the two parts of your criticism: that we’d be just as well off in an associate degree program and that our clinical experiences are meaningless.

First, associate’s degrees and bachelor’s degrees are not equivalent in any field, nursing included. The emphasis on research, evidence-based care and nursing leadership in the curriculum here at Penn simply cannot be found in an associate degree program. A 2010 report from the Institute of Medicine and the Robert Wood Johnson Foundation recommended increasing the percentage of bachelors-prepared nurses from 50 percent to 80 percent by the year 2020.

This recommendation is based on research showing that BSN nurses have more proficient assessment abilities, better research and evaluation skills and improved patient outcomes, including lower mortality rates, than RNs without bachelor’s degrees. For this reason, many hospitals no longer hire RNs without a bachelor’s degree.

Additionally, a large percentage of our class will go on to get master’s and doctoral degrees, working as nurse practitioners, nurse anesthetists and nurse researchers. A bachelor’s degree is preparing us for those careers by teaching us to think critically and act confidently in patient care situations.

Nursing workforce logistics aside, it was the second part of your criticism that grabbed my attention and stung more: that our clinical experiences are meaningless. Unless you’ve spent 12-hour shifts caring for critically ill patients or have yourself been one of those patients, I would ask you not to jump to that conclusion.

Teaching parents how to care for a four-week-old baby who has already undergone multiple open-heart surgeries and has never left the hospital? Definitely meaningful. Talking to an elderly cancer patient about his fears of dying while also administering the antibiotics he needs to stay alive? Not a waste of time. Teaching a homeless woman about the importance of her medications and collaborating with her social worker to ensure that she can actually afford to buy them? I hope you don’t actually think that is meaningless. I can’t think of anything I’d rather spend my time doing. As someone who personally spent months in and out of the hospital for cancer treatment as a kid, I can assure you that nurses are in a unique position to support families during the worst times of their lives and that they have a lifelong impact on their patients.

Now I’m not saying that nursing is more valuable than the many other disciplines that people are studying at Penn. I couldn’t do my job without the work of engineers who have designed the high-tech medical equipment I use to care for my patients, without the researchers who have explained the psychology of development in a hospitalized child or without the business people who make it possible for a hospital to operate in the first place. Just as I recognize the importance of those disciplines, I hope that you would be able to do the same for nursing.

I pray that you reading this never find yourself in one of the hospitals, clinics or rehab centers where my classmates and I spend our days. But I certainly hope that if you do, you will have nurses — Penn grads or not — who will care for you with the skill and compassion that we as students strive to learn at clinical every week.

Jennifer Toth is a Nursing junior from Vienna, Va. Her email address is ?jentoth@nursing.upenn.edu.

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