[traumahawk99]

let's examine the differences between curriculum and how they impact on the job of nursing, where the vast majority of it is done. the bsn is loaded with courses such as community, family, etc... which really don't impact on the entry level job in a meaningful way. these are the courses that differentiate between the two curriculums.. it isn't that the bsn has a vastly superior technical curriculum. nursing history really isn't all that helpful. in fact, i'd say the value is anecdotal once you hit the floor.

my nursing courses also made me a better critical thinker and more knowledgeable regarding the human body. am i less a critical thinker and less knowledgeable about the body than i would be if i had a bsn? is the average asn? if you're an asn or a bsn, fresh out of school.. you are only qualified to be a trainee, and you're going to start in the same place, cleaning the same poop. again, where is the evidence to show that your education is superior? you imply that it is. i say the difference is immaterial.

i have said that a bsn is worthless to me. that's true. it is. i can't think of a more meaningless waste of my personal educational resources. however, i am not deciding for anyone else. i'm not saying we should dismantle bsn programs. people may choose these for a variety of reasons. i am arguing the question at had.. whether bsn will/should become mandatory to hold the title of rn at the entry level. i don't think that the average entry level bsn is researching the efficacy of evaluating for homan's sign, and i would have infinitely more faith in medical research directed by physicans than bsn level nurses for determining this...

of course, i see evidence based practice as important in all of medicine. i just don't see what that's got to do with requiring bsn as entry level to the nursing profession.

and yes, all arguments are charged with a level of emotion. obviously, yours is as well, else you wouldn't be investing so much energy into this. after all, it's only a thread

if i were here stating that bsn's shouldn't be allowed to become rn's, you'd be hititng the roof yourself. my educational background is the one the bsn only crowd is attempting to deny licensure. and i'm simply calling it as a see it, which is form over substance, and fluff over reality.

[GilaRN]

Originally Posted by traumahawk99

let's examine the differences between curriculum and how they impact on the job of nursing, where the vast majority of it is done. the bsn is loaded with courses such as community, family, etc... which really don't impact on the entry level job in a meaningful way. these are the courses that differentiate between the two curriculums.. it isn't that the bsn has a vastly superior technical curriculum. nursing history really isn't all that helpful. in fact, i'd say the value is anecdotal once you hit the floor.

my nursing courses also made me a better critical thinker and more knowledgeable regarding the human body. am i less a critical thinker and less knowledgeable about the body than i would be if i had a bsn? is the average asn? if you're an asn or a bsn, fresh out of school.. you are only qualified to be a trainee, and you're going to start in the same place, cleaning the same poop. again, where is the evidence to show that your education is superior? you imply that it is. i say the difference is immaterial.

i have said that a bsn is worthless to me. that's true. it is. i can't think of a more meaningless waste of my personal educational resources. however, i am not deciding for anyone else. i'm not saying we should dismantle bsn programs. people may choose these for a variety of reasons. i am arguing the question at had.. whether bsn will/should become mandatory to hold the title of rn at the entry level. i don't think that the average entry level bsn is researching the efficacy of evaluating for homan's sign, and i would have infinitely more faith in medical research directed by physicans than bsn level nurses for determining this...

of course, i see evidence based practice as important in all of medicine. i just don't see what that's got to do with requiring bsn as entry level to the nursing profession.

and yes, all arguments are charged with a level of emotion. obviously, yours is as well, else you wouldn't be investing so much energy into this. after all, it's only a thread

if i were here stating that bsn's shouldn't be allowed to become rn's, you'd be hititng the roof yourself. my educational background is the one the bsn only crowd is attempting to deny licensure. and i'm simply calling it as a see it, which is form over substance, and fluff over reality.

With the current educational system, I tend to agree with your points. For the sake of discussion, let us say we changed the way BSN programs are designed. Let us say the courses were focused on teaching the RN what they need to know when they hit the floor. Let us say the foundation of the BSN program will provide the student with a solid foundation in science, nursing didactic, and nursing clinical education.

I think if things changed, we could argue that the BSN should be a requirement for entry into practice. Then again, in the era of EBM, I suspect good research would be needed. However, from what I have seen and communicated from BSN students, the extra two years are simply not providing quality education in many cases.

[jjjoy]

To say that the additional coursework for a BSN (as opposed to for ASN) is completely worthless and a waste of time is about as useful as someone saying that acquiring a BSN is the only way to acquire adequate critical thinking skills. These aren't all-or-nothing issues.

I'd agree that much of the BSN coursework, as it currently stands, ISN'T very relevant to bedside nursing care. Most any extra education or experience will help someone be a better nurse, from having taken extra psych classes to having raised children. The question here is what is the MINIMUM educational requirement, not what could be useful.

And I'd agree that it does seem like many proponents of entry-level BSN are too caught up in issues of "nursing as a profession" as opposed to training students in the PRACTICE of nursing at entry level... instead putting more emphasis education on issues that are well BEYOND entry level... eg research, professional issues, etc. More important is a firm grounding to succeed as a ENTRY-LEVEL nurse. An ideal program would address both to some extent, but training in nursing practice should not be cut back in order to address other nursing issues and pursuits.

[Miss Mab]

This thread continues to be interesting for its diverse, yet strangely predictable, gaggle of opinions. I was surprised and even a bit flattered to have been mentioned by another poster as having contributed some thoughts worthy of consideration.

Seemingly ironic, and the reason I'm posting this AM, because i have ultimately had quite a change of heart in regard to this endlessly debatable topic.

I actually now agree(though i don't quite think anyone ever really said otherwise if you can move past base defensiveness) that a bachelor's degree is not necessary in the least if you wish to practice basic entry level bedside nursing in the US today.

Originally Posted by jjjoy

.

And I'd agree that it does seem like many proponents of entry-level BSN are too caught up in issues of "nursing as a profession" as opposed to training students in the PRACTICE of nursing at entry level.

I quote this because i believe this is quite accurate, at least to my view, and the basis of my multiple arguments for a BSN to entry. I'm actually of the 'you can teach a monkey a skill' crowd and so truly there really is no need for the expanded curriculum of a BSN, or any college level really, education if one wishes to be a technical bedside nurse. And goodness knows we need them!

I've supported the 'nursing as a profession' mantra as I personally am unable to fathom continuing a job where it is almost universally accepted and understood that there is such a striking inequity of power to the workplace.
Quite evident in the endless threads about capricious management abuses, remarkable pay disparities and the documented inabilities to advocate effectively for either patients or our coworkers. Strangely I, and perhaps even a few like minded folks, clearly view a tight tether between 'where we come from' and 'how things are'. That is my reality and it is so strikingly clear to me that I previously couldn't understand why many others weren't doing the same 2+2 equation....Ok, truly i still don't but I digress....

Now, however, I would never encourage anyone to earn what is considered today a standard four year degree in order to work as a nurse in our current healthcare environments. That extra education truly is actually unnecessary and, in fact, dismissed by a quite vocal majority. More power to that contingent! If the mass of bedside nurses choose to emphasize the technical understanding and critical thinking skills needed at that entry level, then I do have to agree that a vocational or technical associate's level schooling is all that is needed. It has proven to be adequate for those functions and I see no reason to encourage anyone to move beyond that level.

What i would suggest is to then either abolish the bachelor's level of nursing education, or perhaps offer a different entry NCLEX style test, that deposits those nurses at a 'higher' level in the heirarchy as most other career paths seem to follow. Given the LVN/LPN differential already in existence, I would instead suggest no BSN and instead perhaps a 'pre-nurse' or 'pre-health' curriculum(similar to the pre-med or better yet, even the same) before pursuing advanced nursing practice, thereby supplanting the whole entry level bedside nursing debate.

I have been won over. 'Basic' nursing education of the kind needed at the immediate bedside can most definitely be accomplished through a narrowly defined vocational curriculum, as has already been proven by the many successful nurses we already have. We should stop this pitting debate and allow more narrowly defined roles and pathways for those who naturally gravitate toward one end of the spectrum or another. We've proven that our patients need all kinds.

[hpcat]

Originally Posted by GilaRN

With the current educational system, I tend to agree with your points. For the sake of discussion, let us say we changed the way BSN programs are designed. Let us say the courses were focused on teaching the RN what they need to know when they hit the floor. Let us say the foundation of the BSN program will provide the student with a solid foundation in science, nursing didactic, and nursing clinical education.

I think if things changed, we could argue that the BSN should be a requirement for entry into practice. Then again, in the era of EBM, I suspect good research would be needed. However, from what I have seen and communicated from BSN students, the extra two years are simply not providing quality education in many cases.

I agree. In an ideal world, requiring a BSN to enter nursing would help raise standards so we might be considered on a par with professionals like OTs PTs etc. But again, I don't think BSN programs now (with the exception of perhaps a few) provide enough real world skills to warrant the extra 2 years. And unfortunately, the lack of nursing educators and clinical slots, especially by me, just add another obstacle. How do you intensify a 4 year program without the people to teach it and the environment to teach it in?

On the subject of respect, here's my 2 cents - I was a patient several times, one of my surgeries was major (10 hrs, 2 weeks in the hospital, 1 1/2 years out of work). The nurses i most respected were the ones who took the time to at least come to me at the beginning of their shift, introduce themselves, and ask if I needed anything. I understood if they were extremely busy or had emergencies and couldn't come check on me very often. But I can't tell you how many nurses I had who treated me like a nonperson or burden by looking right through me or talking to others in the room as if I didn't exist or griping they had to do anything for me; ignored my pleas for pain meds (yes, it happened!); got annoyed with me for needing help with hygiene issues; complained about their jobs to me as I was laying extremely sick in bed, etc. Believe me, I remember those nurses, unfortunately sometimes more than the good ones.

Of course, there will always be patients who are thankless regardless. But If one wants respect from patients, one needs to give it too!

[Ruffles 1]

I agree with Pantheon, she is actually going through the BSN program and it costs her more money than it is worth. And again who is at the bedside taking care of the patients???? Not a nurse with a BSN behind her name.

[Elvish]

Originally Posted by Ruffles 1

I agree with Pantheon, she is actually going through the BSN program and it costs her more money than it is worth. And again who is at the bedside taking care of the patients???? Not a nurse with a BSN behind her name.

Ahem....there are plenty of us with BSN behind our names at the bedside taking care of patients.

[jjjoy]

Originally Posted by Miss Mab

What i would suggest is to then either abolish the bachelor's level of nursing education, or perhaps offer a different entry NCLEX style test, that deposits those nurses at a 'higher' level in the heirarchy as most other career paths seem to follow. Given the LVN/LPN differential already in existence, I would instead suggest no BSN and instead perhaps a 'pre-nurse' or 'pre-health' curriculum(similar to the pre-med or better yet, even the same) before pursuing advanced nursing practice, thereby supplanting the whole entry level bedside nursing debate.

We should... allow more narrowly defined roles and pathways for those who naturally gravitate toward one end of the spectrum or another. We've proven that our patients need all kinds.

Interesting thoughts! I can kind of see where you're going with your thoughts on different educational paths. Given the vast numbers of nurses we need at the bedside (in LTC, at hospitals, dialysis centers, etc), to require a bachelor's degree across the board for all nursing positions that require an RN license seems unreasonable.

A big question is whether or not advanced practice nurses or other non-bedside nursing roles (school nursing, occ health nursing, etc) NEED the same education and training as bedside nurses. If bedside nursing education is going to better prepare new grads to start their practice as bedside nurses, then it should be PRIMARILY focused on bedside nursing issues and not so much on other nursing issues (such as preventive health, community health, etc). Those should be addressed but needn't be the MAIN focus of a bedside nurse's training.

If a student isn't planning to work at the bedside, is it worth it to anyone to require them to complete the exact same program as those planning to work at the bedside?

Maybe in addition to a generic RN license, there should be a further licensure/certification for acute care nursing - or some way to identify between those nurses who are qualified and ready to work at the bedside and/or with acutely ill patients and those who aren't.

It seems to me that the reality is that one's acute care nursing skills aren't NECESSARY to functional successfully as a public health nurse, a school health nurse, an occupational health nurse, a family nurse practitioner, etc. Acute care nursing experience will always be an asset but it would seem that a nurse could function just fine in those other roles without the same kind of intense training that an acute care nurse hopefully has.

[jjjoy]

Originally Posted by Elvish

Ahem....there are plenty of us with BSN behind our names at the bedside taking care of patients.

very true!

it's also true that many BSN programs de-emphasize bedside nursing as the ultimate goal of one's nursing education and strongly emphasize other nursing roles, such as advanced practice. this is especially true of recruitment efforts to second degree accelerated programs and direct-entry MSN programs.

[Ruffles 1]

I think you are right in your thinking jjjoy, why do all nurses who want to take care of patients in acute settings need an advanced degree.
I think if you want to manage the staff okay go for the BSN, but you will probably be missing out on the whole point of being a nurse.