[PamelaJean]

Hi everyone;
I am curious about what people think about nursing programs being run as ladder programs. By that I mean that as you complete certain sections of the program you can work as a LPN, RN and then as a BN. If you finish a section and don't want to continue you can stay working as an LPN or RN.

I think that if we had this we would all be better prepared for the real world of nursing, plus we would be able to earn a decent paycheck to help us pay for school. This would also help alleviate the nursing shortage becasue we could work sooner.

The majority of the nurses I work with think this is a great option. This idea came about when I started my BN and realized I was not receiving credit for the nursing diploma I have already worked very hard for. As I am working toward my BN I am frustrated by the fact that a large majority of the content I have already learned and impliment when I am at work as a LPN.

Just a thought and I wanted to see what others think.

Pamela
3rd year BN at University of Manitoba

[Fiona59]

Funny you brought this up, I was just thinking about it last night at work. We have list of skills that second, third, fourth years BScN students and LPN bridge students can do supervised and unsupervised up on one of our walls.

Everything I do as an LPN would need to be supervised on clinical rotation time. I would not be allowed to carry the narcotics keys.

As an LPN, after completing the bridge core courses, I would be admitted to the second year of the degree programme or the diploma programme. I have enough academic credits to have very light course loads.

But in all honesty, at my age the way the bridge is set up it is just something I don't want to do. Three more years of school (and not even full time school due to my credits), three more years of clinicals and dealing with class politics. Three years of student loans. I'd probably have to work full time for five years to pay it off.

There has to be a better way to allow PN's to bridge to RN but it seems that the idea of a "professional" nurse is too closely tied to academia. PN's in my province are governed by the "health professions act" so the government considers us professionals.

I understand the need to raise the academic bar because in all honesty you really have to wonder how some of the people who made it through PN programmes did it (poor written and spoken English, lack of general knowledge on world events, etc.).

But having said all that I'm at the point of my life where I would rather spend my energy working on a History degree and in my union promoting better pay for PNs.

[S.T.A.C.E.Y]

I think the idea of bridging BScN students to RPNs while still in school would be an awesome idea! I would have loved to gave written the LPN exam after my second (or even third) year, then been able to work somewhere and make a decent wage. I heard somewhere that Georgian College or George Brown College (Ontario) has a program where you can do that, get your RPN after X number of years of your BScN. Sadly, I've never heard anything more about it and I was unable to find anything about it.

A few weeks ago I remember reading about a Nursing School in New York (?) that had a program like that. 1 yr for your LVN, another year for your associates degree (RN), and then another two years for your BScN (RN). Not a bad way to do it, in my opinion.

[janfrn]

Originally Posted by Fiona59

I understand the need to raise the academic bar because in all honesty you really have to wonder how some of the people who made it through PN programmes did it (poor written and spoken English, lack of general knowledge on world events, etc.).

Right now we have a fellow in our PICU who has such a poor command of English that her notes are essentially nonsense. She's from South America and they obviously do things very differently there than they do in Canada.

On the subject of bridging, it's really quite a sensible method of allowing people to decide how far they want to climb, don't you think? I have been proposing something similar for orientation of new grads in our unit, a sort of building-blocks approach that would let them get comfortable with the basics then add onto the foundation until the nurse is up to speed... And now we have an educator inthe unit who agrees with me. We'll have to see how far it goes.

[traumaRUs]

THis is the kind of program I attended in Las Vegas. I started the program in 1990, did pre-reqs that year, did the LPN year in 1991-1992 and would have then completed the third year for the ADN portion, but hubby got transferred, so I did a bridge program in Indianapolis.

I thought it was fine - easily prepared me for both LPN and RN boards.

[Fiona59]

Jan that is actually what many PNs in Alberta thought the bridge would be. An honest assessment of our skills and then coursework in developing the skills that we lack in order to permit the transition from PN to RN. More indepth A&P, courses in IV medication preparation and admnistration, courses in human resource management and communications.

But it seems that those in the Ivory Towers of Academia decided that we have to go the BScN route.

It would make sense to say for example if a PN has three (just a number) years working experience and a solid knowledge of her job to be assessed and have some sort of governing body determine if they could do a transition programme to develop the skills required.

I know you work in Alberta, so you know how the PN is utilized by Capital Health. In all honesty can you say that their role is that different on certain units? Post-partum, the main difference is the administration of IV meds and the use of Mag Sulfate. On surgical and medical units, again the main difference is the IV skills/meds (many units have to check and see what skills Capital Health don't permit PNs to use). Dialysis the main difference is RN's can push Eprex and the Dialysis Assistants can't (but can mix and hang IV antibiotics). Public Health utilizes PNs in the school programmes and provincial laws permit PNs to only work with children over the age of five, while student RNs can work with younger children. We won't even go near LTC where the PN is the workhorse and only permitted to utilize the skills that the employer permits (some don't allow PNs to administer anything via injection including insulin).

I think the bridge programme as it exits was built by people with the intention of making it very difficult for working PNs to make the transition.

[janfrn]

Fiona I agree that the pointy heads of academia have made things very difficult for both PNs wanting to advance their careers, and for diploma nurses like me to do the same. When I looked at what it would cost me, on every level, to do a post-diploma baccalaureate, I decided that it would never be worth it.

As for knowing what Capital Health allows PNs to do, we don't have PNs in our unit and the ones who work out on the peds floors are indistinguishable to me from the others. I know they're out there, but not who they are. Scope of practice is such a fluid thing, don't you find? We do a lot of things that aren't usually done by nurses, and then there are others that usually are, but we can't do them. It's very confusing. Even when it comes to grad nurses and what they're allowed to do and not allowed to do, when I precept I often have to consult my orientation list.

Alberta isn't the most friendly place for nurses of any stripe, but we have hopes that it will get better... changing of the guard and negotiations all at the same time!