Nursing Student Socialization

So here I am, two weeks from the start of school and mute on the evidence-based blogging front.  Sorry, folks!  My time off this month has been a bit of a roller roaster.  But then again, what better time to discuss research about the nursing school experience than when thousands of students are returning for another year, and thousands more are just beginning the journey?

I thought I’d initiate this blogging experiment by addressing an article that caused quite a stir within my own cohort.  Just ‘cuz I like to rock the boat. 🙂

The study in question (Utley-Smith, Phillips, & Turner, 2007) discusses the “returning to school syndrome model,” which was first identified among RNs returning to academia to earn their BSN degrees.  The model is applied this time to accelerated nursing degree students, who have professional/academic backgrounds in something besides nursing and have decided to enter the nursing profession.

The reason this led to controversy among my classmates was that the article identifies “hostility” as one potential pitfall of being a second-degre nursing student.  Because the article was sent to us by a not-so-favorite faculty member, some people interpreted her distribution of the article as a passive aggressive way of calling us “hostile” and took immediate offense.

Reading the article, however, I believe that this knee-jerk reaction has way more to do with our own cohort’s baggage related to this particular professor, and very little to do with what the article actually says…

The returning to school syndrome model lists three phases in the socialization of second-degree students into the nursing profession.  Although the boundaries between these phases are fuzzy, there are definitely hallmarks of each:

  • Honeymoon – This period often coincides with the first semester of nursing school.  You’re excited about being a student again, you’re confident that you’ve made the right choice and you’re optimistic at the first signs that you might actually be able to figure this stuff out.  I remember turning to a friend halfway through one of our first clinical rotations and exclaiming, “I might really be able to do this!!!”  It was invigorating and I was in love with nursing.  The honeymoon phase is all about the romance of nursing and is critical to success because it makes you believe that this experience is worth all the challenges to come.
  • Conflict – The conflict phase is tricky.  Utley-Smith et al. noticed that this period often occurs during the second semester, when clinicals get more intense and classroom material gets harder.  The skills you knew well in your life B.N. (“Before Nursing”) don’t get you as far, and the expectations are higher.  Our second semester featured part two of our Med-Surg nursing course, during which we were expected to build on the skills learned in part one and really take off.  And I did notice A LOT more conflict during this time.  More fatigue, more anxiety and much more complaining, often about issues that were out of our control.
  • Reintegration – Reintegration actually begins with hostility, in many cases.  External factors are blamed when students don’t live up to their own standards of success.  I believe that in our cohort’s case, we’re still muddling through this part.  We’re all used to being really good at things – we succeeded in school and previous jobs, and we got into a very difficult nursing program.  So when the grades are less than expected and the G.P.A. doesn’t glow as we think it should, we look for culprits, whether they be administration, faculty, the program itself, or sometimes a peer.  Hence the “obnoxious” remark about my finishing exams quickly.  Hostility hopefully (and usually) evolves into positive resolution, when you figure out how to integrate “self B.N.” with “self R.N.”, and understand how you have been transformed into a nurse.

Returning to school is difficult.  Returning to school to study nursing is even harder, especially when you have been successful in your life before nursing.  Not only do you learn extremely difficult material at a rapid, break-neck pace, but you also are thrown into a completely new culture.  And to top it all off, learning in the classroom is very different from learning to think on your feet, and in nursing school, you have to do both.

I’m not intending to scare anyone off from nursing, or from second-degree programs.  If you’ve read through any of this blog, you know how intensely rewarding and exhilarating my own experience has been.  But I do propose that you be aware of some of the emotional and mental responses you may have to the experience, responses that may surprise and shock you. I hope that your nursing programs include some of these issues of adjustment in your orientation and nursing foundations class – if they don’t, ask for it!

I also advise that you cut yourselves a little slack and realize that no matter how many A’s you got in your prereqs or how many stellar references you got from your former boss, you are starting from Square One.  The skills, the language and the culture will be foreign concepts, and you don’t have to master them right away.  But your interpersonal qualities, work ethic, and passion for providing care to others – which undoubtedly got you in to begin with – are important to hold onto.

And when you start to doubt whether you can do this, you can.


Utley-Smith, Q., Phillips, B., & Turner, K. (2007). Avoiding socialization pitfalls in accelerated second-degree nursing education: The returning-to-school syndrome model. Journal of Nursing Education, 46(9), 423-426.

NOTE: I will always include reference(s) at the end of these research-based posts, in case you wish to read the original articles.  Happy researching!

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