It has been 30 years since I began my nursing education and I laugh about what I once found stressful, but I’m never sure if I laugh because I think it is funny or out of a stress reaction. I wonder how many nurses from my era cried over care plans/maps or a thousand pages of reading assigned in one week? How many of us went to our clinical rotation after having been up most of the night preparing all the while wondering how we would ever do this for eight patients at a time.

Six months out of school everything seemed easy. I moved from wondering how I would ever do it all to why I ever thought it was hard. Therein lies the problem. I moved from a student who felt the stress to a nurse that was thinking “suck it up”. We all survived and are better prepared to care for patients as a result of those stressful and sleepless nights. But, are we?

When are we asking too much

Having worked at four universities I’ve never made it through a year without a student expressing concern about the workload and the lack of flexibility. Usually, the concern stems from an unexpected emergency, conflicting student activity, or the need to work to help pay tuition. Much of the workload cannot be helped nor can student conflicts. There is a minimal amount of content that must be taught for a student to successfully pass the NCLEX and a minimum number of clinical hours for a student to learn the necessary skills. It is a challenge for faculty and students.

When is the extra assignment too much

I think it would be good for faculty to ask what assignments are actually necessary to facilitate learning and which actually interfere with the ability to learn. If we have students spend all their time reading and doing exercises and no time remaining to reflect on the content is it as beneficial as it could be? Increasingly I believe the answer is no, but I have not found any evidence in the nursing literature to support or refute that belief. Much like the number of clinical hours and the need for content to practice safely and effectively we don’t seem to study it.

If I had an hour to solve a problem I’d spend 55 minutes thinking about the problem and 5 minutes thinking about solutions. – Albert Einstein

I have always thought it would be great to have time to sit and think about the book or the article I am reading, but even now I feel the need to push on to the next task. It is what my nursing education modeled for me?

A Chronicle article from January suggest that 5 pages were sufficient. Obviously, in nursing that is a ludicrous suggestion, but so is the belief that a student can read 500 pages in a week and have multiple assignments. I can imagine a world where we get together and coordinate reading and assignments so that it is reasonable and thus it is possible for the faculty to give more attention per assignment and the students to be able to read, think, and then apply.

What do we do when an assignment is missed

I have almost always had a statement in my syllabus that essentially says that the due date is the latest possible date due so if one is prone to illness, accidents, or the heartbreak of procrastination they need to plan ahead because late work will not be accepted. Of course, it was somewhat dishonest because I clearly intended to make exceptions for births, deaths, accidents, illness, marriages, and all manner of life events. Students are people too and life happens to them. The question is always whether to adjust the grade for the extra time that their peers didn’t get or in the case of a clinical experience whether to add extra work or a makeup day.

As I have gotten older I have mellowed. I don’t think there is any evidence that a single missed clinical day has a measurable impact on performance as a nurse. I do think that adding a makeup day or assignment unnecessarily stresses the student and the faculty member. If we can’t show that it makes a measurable difference and it clearly causes student and faculty stress then why do it?

There must be a creative way to build in a late assignment or absence without encouraging either. If you know the answer please share.