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Nursing Education Has To Change (stop getting your feelings hurt)

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Nursing Education Needs to Change!

There is a major flaw with humans . . . we are wholly susceptible to cognitive biases. What are cognitive biases?

Tendencies to think in certain ways that can lead to systematic deviations from a standard of rationality or good judgment.

There are literally hundreds of different “kinds” of cognitive biases, but I want to discuss just one and how it pertains to the glaring reality that nursing education has to change!

Types of Cognitive Biases – Source: By Jm3 – Own work, CC BY-SA 4.0


What is Confirmation Bias?

The specific cognitive bias that I want to focus on is Confirmation Bias.  I’m sure that you’ve heard of it before, and no doubt experienced it at one time or another. The following definition comes from Psychology Today:

Confirmation bias occurs from the direct influence of desire on beliefs. When people would like a certain idea/concept to be true, they end up believing it to be true. They are motivated by wishful thinking. This error leads the individual to stop gathering information when the evidence gathered so far confirms the views (prejudices) one would like to be true.


. . . [W]e embrace information that confirms that view while ignoring, or rejecting, information that casts doubt on it. Confirmation bias suggests that we don’t perceive circumstances objectively. We pick out those bits of data that make us feel good because they confirm our prejudices. Thus, we may become prisoners of our assumptions.

In essence, once we have fallen into confirmation bias, there is no amount of evidence that will allow us to see the truth.

Confirmation Bias in Nursing Education

Becoming a nurse educator is a demanding task.  Generally, the nurse educator has worked several (3-5 at a minimum) years on the floor as a nurse, after which, they have obtained an MSN (Masters of Science in Nursing) degree with a focus in Education.  This education usually comes with additional student debt.

Following all these years of education and experience the new nurse educator begins teaching nursing students.  They join the ranks of “Nursing Educators“, tasked with educating a new generation of nurses.

BUT . . . 

There are several problems facing nursing education right now and I fear SOME nurse educators, administrators, and colleges are turning a blind eye to the problem due to confirmation bias . . . (yes, I get it . . . this is gonna piss a lot of people off).

According to an AACN publication:

  • The average age of nursing faculty was 56 years.
  • The average age of retirement from nursing education was 62.5 years.
  • There was a 12% shortfall in the number of available educators.
  • 56.5% of nursing schools said they are unable to find “qualified applicants”.

The NLN found that:

  • 42% of full-time and 39% of part-time Nursing Professors were >61 years old.
  • There were 1,072 nursing faculty vacancies.
  • 83% of nursing programs were seeking to hire new faculty.

In addition to all the above, the NLN also found that:

  • in BSN programs, only 18% of students were over 30.

What’s the Problem?

When we become a part of a group, especially a group that is so underfunded and understaffed (like Nurse Educators) it becomes very easy to defend every action and every individual.

(In the past, I have mentioned several things that I feel need to change in nursing education.  You can read about that here  and here.)

This is flawed however, because doing so denies the issues and neglects the need for change.  Rather than keeping an open mind about how to improve, the moment we try to protect or defend an entire industry, we enter into confirmation bias and inhibit our ability to objectively see the need for change.

I know, without a doubt, that whenever I mention the need for change in nursing education we will get an email or two from a professor or administrator ranting up and down saying . . . (my answers below each one).

  • “How dare you say there are flaws in nursing education!”
    • It is completely asinine to assume that there are NO flaws in ANY industry, company, or individual.  Hell yes there are flaws in nursing education . . . you know what?  There are flaws with NRSNG and with Jon Haws too.  None of us are perfect.  It’s time to be a bit more humble about what needs to change.
  • “You are everything that is wrong with nursing!”
    • Ummm . . . if pointing out areas of improvement and then creating those lifelines for nursing students after the educators they have relied on have failed them is “what’s wrong” with nursing . . .then we have much bigger problems.
  • “If students weren’t so lazy.”
    • No doubt, there are some lazy students out there.  However, all 300,000+ nursing students are not lazy just like all nursing educators are not “bad”.   Lazy students do not preclude the educator from educating.   Just as poor educators do not preclude the student from graduating.
  • “We don’t know the professors side of your story.  I’m sure you were in the wrong.”
    • I state exactly what I did wrong on this post.  Being will to openly share my failure shouldn’t grant you the right to attack my vulnerability and excuse poor education.
  • “Nursing school was hard for me, so it needs to be hard for other students . . . it’s the school of hard knocks.” (p.s. this one pisses me off more than any other)
    • Is this a joke?  Like seriously, is this a joke?  It’s your freaking job to educate.  I would NEVER wish on anyone to work on a floor where this mentality was adopted.  Imagine working with nurses who think it’s okay for other nurses  to struggle just because they’ve had some hard shifts.  Like . . . is this a joke.  If you see a co-worker struggling you just turn your head and let them sink rather than throw them a lifeline.  Get over yourself.
  • “We will NEVER share your material with our students.”
    • Thanks.  You just proved my point that nursing education needs to change!  How juvenile it is to deny your students of helpful materials just because your feelings got hurt.  The funniest thing about this email is that they are emailing us AFTER finding AND using our materials.  Then, they get their feelings hurt and refuse to distribute anything NRSNG to their students.  Dude!  You just proved the point. Some administrators have gone as far as to BAN myself (Jon) from physically coming on their campus.  Come on!  It’s time to grow up, recognize the flaws, and provide your students with anything that will help them.
  • “You are a bad example of negativity in nursing.”
    • I take offense to this.  Our podcast has 800+ episodes covering an enormous amount of material on positivity.  Our blog has 800+ posts, our YouTube channel has 400+ videos, our Instagram account has 700+ posts . . . 99% of this material is positive to nursing and nursing education.  If I point out one flaw or state that “nursing education needs to change” and you see that a “negativity in nursing”, I fear we are so deep into confirmation bias  . . .

Protecting Our Own

As we become part of a group we take pride in being a part of that group.  We start defending our group of people (career, team, etc) to the point that we fail to see the flaws.

If you can’t see the flaws you become unable to see a need for improvement.  You begin to defend your group regardless of what they do.

Here’s an example . . . at the risk of sounding political.  If you consider the “Blue Lives Matter” movement in response to “Black Lives Matter” movement, what we saw were two deeply entrenched groups unwilling to see a flaw with their own movement or group. In EACH of the cases, one side (or both) made mistakes, but the two competing groups had become so bias that they were unable to see any flaw in their own side. To say that no police officer ever made a mistake or acted in prejudice is just crazy.  You simply can’t defend an entire group or career field like that.

That is really dangerous. I would never state that every nurse is perfect, without flaw, or even caring.  Some nurses are just bad nurses.  There are some that I would prefer not to work with.  There are some who I think are unsafe nurses and should not be working in the field. There are 3.1 million nurses in the US . . . we’re not all perfect (gasp!).

My fear is that some in nursing education have adopted this sentiment, circled around each other, buried their head in the sand, and are now attacking even the slightest mention that MAYBE . . . just MAYBE they can improve.   Instead they are so focused on protecting their own that they are unable to see the need for change in nursing education.

In a beautifully formatted paper discussing nursing school attrition rates, written by a top nursing education company to nursing educators they outlined WHY they think nursing students fail out. Here’s what they said:

  • Inability to cope with stress
  • Preparation
  • Integration into the program

Notice anything about that list?  Not once did they mention things like:

  • Staff development and training
  • Teaching methods
  • Tutoring
  • Counseling services

Rather than pointing out those things that the school can do to improve a students chances for success, they put the blame entirely on the student.  This is wrong.  From my experience and from talking with hundreds of thousands of nursing students around the globe, I’ve found that fixing attrition rates and helping students depends on the second list much more. – Going Out of Business would be out of business if nursing schools were doing what they are supposed to be doing without any problems.  If students were being taught, supported, and encouraged as they should be . . . . we’d be out on the streets.

That would be a GREAT thing!  I would love it if nursing students were being taught as they should.  I would be ecstatic if NRSNG had to close it’s “doors” because nursing schools were doing their job.


Instead we are growing exponentially.  Students are LOVING us.  NRSNG is becoming grass roots.  Students love that not only are we calling to light what needs to change, but we are CREATING that change.  Sadly, rather then being a part of the change, some professors are getting their feelings hurt, deepening their confirmation bias, refusing to see the need to evaluate themselves and deepening the void between them and their students.

As of March 2017:

  • 3,100,000 podcast downloads
  • 200,000 social media followers
  • 160,000 blog subscribers
  • 5,397,000 website page views

Our customer service department has had to grow faster than any other part of NRSNG.  We get literally HUNDREDS of emails a day from students all around the world telling us that we saved their education.



Now, at the same time we’ll get maybe ONE email a MONTH from a professor all upset telling us how horrible we are.  I try (nicely) to help them see that maybe it’s time to reevaluate the way we teach nursing students.

My Story

What I’ve done with NRSNG from the very beginning was try to share my story.  I didn’t start with a vendetta on all nursing schools (believe it or not I have a tremendous respect for nursing educators). But here’s what happened . . . my story resonated. I realized very quickly that I wasn’t the only one who struggled, pointlessly, through nursing school.

I respect that nursing education is difficult. I mean learning about how to care for a human in their most desperate time is tough . . . BUT . . . the entire process has become over complicated and turned into an US vs THEM with professors. Calling that out and trying to create a lifeline for students should not turn into a battle.  Rather, educators (some) need to attempt to peel themselves away form the confirmation bias and see that  . . . .

“wow!  These poor kids really are struggling.  I mean, yeah, MedSurg is hard, but should my students be struggling THIS much?”

Nursing Education Has to Change

Mainstream nursing education is NOT working.  We are rushing kids through school and leaving a trail of depression, broken dreams, and beat up students in the wake.

To those schools, administrators, and educators who are searching (humbly) for ways to improve the system, THANK YOU!

We (as educators) must do a better job.  We must confront out biases and improve our systems.  We must stay current.  And ABOVE ALL, we must realize that nursing students are people.  We need more nurses (who give a damn).  Stop burning students out.  As educators, it’s our job to EDUCATE.  Some students will need the extra boost, motivation, hand holding . . . not everyone learns the same.

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