[jjjoy]

Originally Posted by Michigangirl

Just a note... I think the reason the ADN has become a 3 year program is the difficulty getting classes when you need them. Credit-wise, it's about 80 credits to get an associates degree (looking quickly at my program including the prereqs). That is doable in 5, maybe 6
semesters. It's just that it is impossible to take the classes in the correct order, apply to the program, wait on the waiting list, and finish up the nursing portion in two years elapsed time. But theoretically, I suppose it could happen.

That's true in some cases. In other schools, though, the pre-reqs themselves take up to year even if you can get into the classes immediately. Now, throw in all the gen ed requirements of an associate's degree, which many programs heavily encourage taking prior to applying for the nursing program. And then there's the nursing coursework. It does seem rather difficult to squeeze it all into just 2 or 3 years!


Here are the pre-reqs for one ADN program I quickly looked up.

Anatomy 1 4.0 units
Physiology 1 4.0 units
Microbiology 5.0 units
Psychology 9 3.0 units
NDEG 50 (Introduction to Nursing) 2.0 units
FECO 11 (Nutrition) 3.0 units

And the co-requisites

Sociology 1 3.0 units
Mathematics 5.0 units
Speech 3 3.0 units
English 1A 3.0 units
History 2 3.0 units
Political Science 2 3.0 units
Philosophy 3 3.0 units

[Tweety]

Originally Posted by Michigangirl

Just a note... I think the reason the ADN has become a 3 year program is the difficulty getting classes when you need them. Credit-wise, it's about 80 credits to get an associates degree (looking quickly at my program including the prereqs). That is doable in 5, maybe 6
semesters. It's just that it is impossible to take the classes in the correct order, apply to the program, wait on the waiting list, and finish up the nursing portion in two years elapsed time. But theoretically, I suppose it could happen.

Once upon a time it was set up that way. There were no "pre-reqs" accept high school algerbra and chemistry (or college level if not taken in high school). We had one student who got in the last minute fresh from high school and it took only two years. The rest of us choose to take it over three years because it was just too hard to take all at once. The poor women had to take Nursing, A&P, English, Sociology and Pyschology the first semester. I can't imagine.

It's only a recent phenom. the last 15 years or so that the era of "pre-reqs" evolved and the "two year degree" is no longer.

[jjjoy]

What are all of these *extra* classes that ADN programs have in addition to the basics? Nutrition? Psychology? Llg, you comment that students should be angered that they have to take 3 yrs worth of classes to earn a "2-yr" degree, but is it really even possible to train up RNs (foundational courses such as micro and A&P as well as core nursing courses) AND include the gen ed requirements for an associate's degree in just two years?

[llg]

Originally Posted by jjjoy

What are all of these *extra* classes that ADN programs have in addition to the basics? Nutrition? Psychology? Llg, you comment that students should be angered that they have to take 3 yrs worth of classes to earn a "2-yr" degree, but is it really even possible to train up RNs (foundational courses such as micro and A&P as well as core nursing courses) AND include the gen ed requirements for an associate's degree in just two years?

You are assuming that the "end product" graduate of the program would be expected to function in the nursing role the same as a BSN grad. But that isn't what the ADN degree was originally meant to be. ADN grads were not originally intended to assume as much responsibility as many now assume. 4 semesters of study was considered enough because they were not expected to perform at a level equal to a BSN.

Also, there are ADN programs now that take only 4 semesters post high school -- and those grads get the same degree and take the same jobs that graduates of longer programs do. In fact, one local program where I live takes people just out of high school and gives them and ADN after 15 months of full time study -- with no college-level prereq's.

[jjjoy]

Originally Posted by llg

You are assuming that the "end product" graduate of the program would be expected to function in the nursing role the same as a BSN grad. But that isn't what the ADN degree was originally meant to be. ADN grads were not originally intended to assume as much responsibility as many now assume. 4 semesters of study was considered enough because they were not expected to perform at a level equal to a BSN.

You say that ADN grads were not originally meant to assume as much responsibility as they do. Presumably you are speaking of bedside nursing? Could you be more specific? Not caring for such complex patients as they do now? Not having to coordinate so many different services for patients? What was supposed to be the differentiation in roles between ADN-RNs and BSN-RNs at the bedside and how was the BSN education supposed to support that? And as many argue, if there are to be such different roles between ADN-RNs and BSN-RNs why do they have the same licensing exam? And who was defining these different levels of practice? ANA? Was it a vision for the future (that never came to be) or a reflection of current nursing needs (that has since changed)?

Also, there are ADN programs now that take only 4 semesters post high school -- and those grads get the same degree and take the same jobs that graduates of longer programs do. In fact, one local program where I live takes people just out of high school and gives them and ADN after 15 months of full time study -- with no college-level prereq's.

VERY interesting! Are these students who took specific pre-nursing coursework while still in high school, such as micro and A&P and chem? Those usually are intro level courses and could easily be taught at the high school level to motivated students. If that's not the case, then I'd be very curious to hear more about those programs!

[Hopefull2009]

Originally Posted by llg

To say that an ADN plus BS in another field = BSN is like saying that a Associate's Degree in Physics plus a BSN is the same thing as a BS in Phyics. "It just ain't so."

It's simply bad logic. I have a PhD in Nursing. Had I gotten an Associate's Degree in Physics, my PhD in Nursing would not make me qualified to take the place of someone with a PhD in Physics.

My sister has a degree in Sociology and is currently enrolled in an ADN program in another state. The hospitals in her area told her that they recommended that she get her BSN as soon as possible (mainly because she too, wants advance practice nursing), but because her prior BS is in a Human Relations field, that she could apply and most likely get hired for, BSN-preferred positions.

I agree with you to an extent. But I think what you have that other degree in matters. Something like Fine Art, Broadcasting, etc...those aren't even going to come close to being the same. However, let's say you had a BS in Psychology, and were employed as a psychiatric nurse with an ADN...you have had WAY more Psychology with that degree, than anyone else with a BSN.

[dzadzey]

From what I can see in the clinical setting, there's really not much practical advantage to having BSN over ADN. After even a few months of work experience, any RN is worth a newly minted BSN.

The bachelors, and higher degrees, really only come into play in management, nursing education and advanced practice. And even then, management doesn't require a Bachelor's degree. My institution is now requiring management positions be staffed by BSN's, which is cutting a huge number of people with a great amount of experience and institutional memory out of the running for those positions. A sheepskin doesn't automatically grant the knowledge and wisdom needed to be a successful manager. Believe me, our unit manager is a perfect example...She has a Master's degree and and is a terrible manager.

[Tweety]

Originally Posted by jjjoy

You say that ADN grads were not originally meant to assume as much responsibility as they do. Presumably you are speaking of bedside nursing? Could you be more specific? Not caring for such complex patients as they do now? Not having to coordinate so many different services for patients? What was supposed to be the differentiation in roles between ADN-RNs and BSN-RNs at the bedside and how was the BSN education supposed to support that? And as many argue, if there are to be such different roles between ADN-RNs and BSN-RNs why do they have the same licensing exam? And who was defining these different levels of practice? ANA? Was it a vision for the future (that never came to be) or a reflection of current nursing needs (that has since changed)?



VERY interesting! Are these students who took specific pre-nursing coursework while still in high school, such as micro and A&P and chem? Those usually are intro level courses and could easily be taught at the high school level to motivated students. If that's not the case, then I'd be very curious to hear more about those programs!

ADNs have stepped into many roles away from the bedside to include managers and other things. People in my RN to BSN programs had an amazing variety of non-bedside jobs. The intent of the ADN was bedside nursing and that's it.

The only pre-reqs those students probably needed was like my program: high school chemistry and algerbra. A&P, Micro. etc are not pre-req courses to nursing, but co-reqs that can be taken alongside nursing. As I noted above, ADN programs have switched to 3-year status and made those courses pre-reqs in many programs. But the original intent, as is the intent of most associate degree programs, was for it to take 2 years, or four semesters. Most people don't complain because it's too hard to take all of those courses at once, there's waiting lists, and many are older with children and/or jobs, and other responsiblities, aren't 18 year olds fresh out of high school that can devote many hours to school/study.

In some ways ADNs have been given the advantage that they can move into "BSN preferred" positions based on experience (and often who they know) and get good jobs, responsiblity and money.

On the other hand we are asked to take co-req courses, and other courses that fall just short of getting an actual BSN and that's a rip off in some schools in my opinion.

[llg]

Originally Posted by jjjoy

You say that ADN grads were not originally meant to assume as much responsibility as they do. Presumably you are speaking of bedside nursing? Could you be more specific? Not caring for such complex patients as they do now? Not having to coordinate so many different services for patients? What was supposed to be the differentiation in roles between ADN-RNs and BSN-RNs at the bedside and how was the BSN education supposed to support that? And as many argue, if there are to be such different roles between ADN-RNs and BSN-RNs why do they have the same licensing exam? And who was defining these different levels of practice? ANA? Was it a vision for the future (that never came to be) or a reflection of current nursing needs (that has since changed)?



VERY interesting! Are these students who took specific pre-nursing coursework while still in high school, such as micro and A&P and chem? Those usually are intro level courses and could easily be taught at the high school level to motivated students. If that's not the case, then I'd be very curious to hear more about those programs!

See Tweety's post above. It says a lot of what I would say on the topic of what I meant by the fact that ADN grads have been given more responsibility than they were originally intended to be prepared for. The original idea was to prepare nurses for the bedside only -- where they would be following orders and/or following policies that were developed by nurses with higher levels of education. That's why the original programs did not include topics such as research. They were also not supposed to be doing much education or management. Nor were they supposed to be working with the type of independence typically found in community health roles. The idea was that there would be other people (e.g. nurses with BSN's and MSN's, etc.) who would be in the work setting who would be developing the policies and providing the leadership -- and the ADN grads would be working within the guidelines established by those other nurses.

However, ADN's with experience have been promoted into positions of leaderships over the years. I'm not saying they were not good people -- but one of the consequences of that fact is that people began to think of the ADN as being "the same as a BSN minus the general education courses" as opposed to being fundamentally different in it's intended scope of practice. Also, ADN programs wanted to help their graduates be more qualified for those more advanced positions and began adding course requirements to their programs -- which was popular with the ADN school administrations because it brought in more money for the school. Thus developed the mess we currently live with in which some schools are requiring almost as much for and ADN as other people take for a BSN.

As for schools that only require 4 semesters post high school or less -- there are lots of them. A few require a couple of pre-reqs, but it's nothing like the 3-year programs that you write of.

[jjjoy]

I appreciate everyone's input and perspectives!

Hmmm... ADN training as intended only for bedside care... if that's the case, things really haven't followed as planned, have they?

I've questioned the idea before of having more distinctive nurse licensing - such as "Acute care nurses" and "non-acute care nurses." Here, I can see all nurses first learning about chronic disease, geriatric issues, health promotion, human development, and basic skills (injections, dressings). With this training, they'd be qualified to work in LTC and other non-acute settings. From there, nurses could continue on to learn about acute conditions to qualify for "Adult acute care nurse." Finally, nurses could specialize in critical care, L&D, pediatrics - areas you can't easily transfer general acute care experience to. Or nurses could choose to follow a different non-acute track, taking further studies in "community nursing" - school nurses, public health, occupational health.

Any of these nurses could also choose to earn a bachelor's degree with a focus on nursing. These bachelor's programs would cover research and management perhaps. But in this scenario, would bachelor's nurses have to be qualified as acute care nurses? Or would non-acute training be enough?

I think that's a good question all on it's own. Currenly, BSN programs include all that ADN programs do. That is, they train up nurses for bedside care. AND they also train them in public health and the basics of research. But do BSNs *need* that much training in acute care? If BSNs aren't necessarily going to work bedside, why so much emphasis on it? Why not have acute care be just one of several different tracks BSN students can choose? Instead of training them all in so many different areas, why not have BSN-acute care, BSN-community health, BSN-chronic care, BSN-management... or something like that?

I hope I'm not coming across negatively. I find this stuff very interesting and enjoy tossing ideas around. I'd love to find a local nursing conference on nursing education to attend, but haven't yet found one.