Can Someone Be a Nurse Without Jean Watson??

z's playa · Jul 17, 2005

who is that???

Who is who?

Z

Tweety, BSN, RN · Jul 17, 2005

From what I'm gathering in threads like this one is that the opposite is true in nursing. The "technical" vs "engineer" (for lack of a better distinction) starts as equal. Then, after some time, the latter can creep up the chain a bit farther than the former (assuming no additional formal education). In comparison to other knowledge-based fields, it just seems counter-intuitive. One field starts at different levels and converges with years on the job. This one starts the same and (may) diverge with years on the job. I'm not saying it's right or wrong and I know there are tons of reasons why it is the way it is. I'm just noting that I can see where some folks are struck by the logical dissonance.

It does seem a bit odd. Realize that over the years ADN programs have gotten longer, harder and more comprehensive than the "technical nurses" they put out 50 years or so, and have gone way beyond just technical tasks.

But you do highlight what Grinnynurse was saying, those outside the biz of nurse look more favorably on a person with a bachelor's degree than those with an two-year degree. The question is, for us as nurses, do we really care? Does it really matter when ADN programs are as tough and comprehensive as BSN programs?

chadash · Jul 17, 2005

Think your discussion on nurses caring is very interesting and important. Competency in skills and soundness in judgment are nonnegotiable in acceptable nursing practice. These are the fundamentals. I also believe that character qualities, such as integrity, are essential in nursing, more than other fields. In some of the LTC facilities I have worked, character issues have often been the real Achilles heel.

But that nebulous concept of caring... ahh! Can we do our jobs without it?

Whoops! I mean you; I am not a nurse, I am a nursing assistant! But I digress...

Well, the really great nurses I have known have not been lacking in skill, judgment, or character. But they did have a little something extra that set them apart. Yes, they were working to pay bills and care for their families. But I observed one striking quality:

It was never about them, it was always about the patient.

So I guess that brings us to what caring really is. It is not some fuzzy oozy gooey something, it is really a setting aside of ourselves for another's good. Forgetting ourselves, preferring others. Bet you guys do that a lot more than you think.

God bless you for all you do.....

zenman · Jul 17, 2005

I'm still waiting to start NS, so take this as a newbie point of view...
Without delving into the "why's" of a 2yr vs 4yr program resulting in no initial discernable difference in whatever perceived ability or compensation... doesn't it seem just a little..well.. odd? I admit that coming from an engineering field, I've possibly developed the wrong assumptions regarding level of education, but there (engineering) it seems to work totally opposite of what seems to be the norm in nursing.

Yes, we are very odd to other professions. However, there is still a difference between the two programs. This is most easily noticed when you look at the degree plan of the two from a school which has both programs.

I'm just noting that I can see where some folks are struck by the logical dissonance.

Some folks have a clue. However, you might want to be careful with those big college words (logical dissonance) as many people will have to look them up! :chuckle

zenman · Jul 17, 2005

Good idea. It will save a lot of money.

Well, I guess no one got it! :chuckle

Tweety, BSN, RN · Jul 17, 2005

Well, I guess no one got it! :chuckle

Got it, just didn't want to go there.

zenman · Jul 17, 2005

I also cringe when I hear that ADN is a technical education.

If you studied the history of nursing you will see that is exactly what this program was created to be in a misguided, knee-jerk reaction in an attempt to cure the nursing shortage.

1. I'm getting *really* tired of people assuming that those of us with degrees other than a BSN are somehow less educated *or* intelligent. Regardless of what you, or anyone else here, may think, an understanding of theory, professionalism, principles of wholistic care, and any other 'non-technical' aspects of nursing *can* be acquired in other ways. We need only remember the educational background of Albert Einstein to understand that. When I worked in the tech industry, one of our best marketing strategists had a high school education, and had started in the industry as a telephone line technician. He could run circles around any newly-minted MBA that walked in the door.

If you have less credit hours than someone else, then you are less educated than they are. That's a cold fact. I'm more educated than some; less than others. Intelligence is another matter!

Regarding your marketing strategist, we have to develop our degree programs for the masses...perhaps with accelerated programs for the really smart ones.

there is no other profession where the folks in academia have so utterly detached themselves from reality and made their own little world.

I think this covers most professions.

the reason asn should be entry level for the job is because it's the training level that's sufficient to do it. requiring this other load of bull to enter the profession isn't instructing, it's obstructing.

So, should we settle for "sufficient" and not have all the other "bull?"

you can get a bsn and maybe have started one iv and done one foley catheter. the only word i can have to describe a training program with its priorities so misplaced is pathetic.

I've been asked by quite a few MDs to draw blood or do IV pushes, among other things, because "I've never done it."

Studies have shown that diploma, two and four year new graduates generally start on with the same degree of skills. And that after several years, BSN graduates clearly pull ahead of the other two types of degrees. Of course, these studies have been done by those in the ivory towers and are clearly suspect by those with lesser degrees. So be it but the evidence is there, like it or not, accept it or not.

This is one example of having more education as you learn about research and how it can affect you and your patients (and as a member of a caring profession, this should be high on your list.). And the liberal arts grads are in the most demand by those in the know!!

i suppose it would depend on the program bsn program, to some degree. i think that technical skills are MUCH more important than most programs stress. certainly, there is need to understand theory related to pharmacology and pathophysiology. i have no problem with that. but much of the nursing care plan stuff is fluff, and that's what is over stressed. teaching therapeutic touch theory as fact is pure foolishness. i can name one bsn program where the professors run around thinking that they're good witches who can ruffle and realign your energy forces. i'm not alone in thinking that nursing education has taken a wrong turn and that students are ill prepared for the realilites of the profession.

I would also like to see nursing education revamped, but a BSN still needs to be the entry level, in whatever form it winds up as. Perhaps with one entry level we would not stand apart as a "confused" group of people. And yes, get rid of nursing diagnosis...please.

Become more positive to "therapeutic touch" and other forms of energy medicine as it is the medicine of the future. I also do bodywork and "energy" work. I have left many a physician speechless...or as one did, run out of his office to get all his buddies to "come see this!" Some times all the technical skills mean nothing but a caring touch means everything. Have you considered that modern medicine can't function when the electricity goes out!!

an an entry level to practically taking care of patients, the asn is adequate. i personally don't care if someone wants a bsn. you'll learn something. but to require it as entry to the profession is buffoonery, which is my main point. it's counterproductive to take a profession where there is already a significant shortage and require this to further lower the numbers. what is the real world reason for it?

If you think that the ADN is "adequate," then we should perhaps suggest that other professions, such as teachers for example, also offer a 2 year program as entry level. However, keep in mind that they are not taking care of the more sicker, complex cases that we see in the hospital every day...and they are not responsible for life or death decisions...and they are not part of a health care system that is one of the leading causes of death. They just have to educate kids.

If there is a shortage of medics, do you think we should cut their training? Police shortage, doctor shortage...should we cut their training?

as a medic, i started over 100 iv's in clinicals, even a couple of external jugulars. i did at least a dozen foleys. i gave meds, etc. the education was entirely practical and to the point. i attended a great program, and walked out with a good basic knowledge of cardiology, pathophysiology and pharmacology.

I was a Vietnam era medic, then 91C who challenged the California state boards and passed. So, I basically became an RN after graduating from the equivalent of an LPN program. I went straight into a Level I trauma center and a year later was the nurse manager. Now, that I have a BSN, I much more aware of what I do know versus what I thought I knew. Same with my masters. Now, I hope to know even more as I go for my FNP at 54 years of age and more than 30 years in the trenches.

i don't see that a student with a bsn is any better at assessment than a student with an asn. making a bsn the minimal entry level doesn't have anything to do with the reality of patient care. the people pushing this could give a rat's behind about the severe nursing shortage this would cause in the real world. instead they're dying to be respected. it's more out of ego than anything else. it's pathetic that they care more about their egos than the public health. theories of caring? give me a break! what a joke this is!

As a medic, you learned one level of assessment. I'll bet an LPN learns one level, an ADN another, a BSN another, a masters level nurse another, an NP another, a physician another. Am I correct?

Do all the other professions that have a BS/BA as an entry level suffer from ego problems? "Caring about public health?" When did ADN programs start teaching public health?

"Theories of caring?" I have one, do you? It serves as a guide for how I view people and how I care for them.

It does seem a bit odd. Realize that over the years ADN programs have gotten longer, harder and more comprehensive than the "technical nurses" they put out 50 years or so, and have gone way beyond just technical tasks.

This is one of my big points. The ADN program found out that it "didn't have all that it needs" and is growing into a BSN program. And the LPN is turning into a 2 year program.

amber1142 · Jul 17, 2005

Fascinating question. I believe that caring is an intrinsic part of what nursing is about, much the same as caring is an intrinsic part of mothering. You could do everything technically right and get the job done, but if it's done without the human emotions of compassion, sympathy and caring, you haven't done enough for your patient. Nursing is about touching your patients, and not just physically.

ZASHAGALKA, RN · Jul 17, 2005

But you do highlight what Grinnynurse was saying, those outside the biz of nurse look more favorably on a person with a bachelor's degree than those with an two-year degree. The question is, for us as nurses, do we really care? Does it really matter when ADN programs are as tough and comprehensive as BSN programs?

This is the thing: nobody outside the people reading this thread cares or scarcely notices whether you have a BSN or ADN. What they see is RN.

And rightly so. Nursing is about on the job experience. The things that make you a nurse aren't taught in either program. They are learned in the trenches. It isn't those of us in the trenches that care about this debate: we know better. It's the ivory tower ilk that long ago forgot what nursing is about.

And the only extent to which this so-called debate invades the bedside is the extent to which the ivory towered types have successfully brainwashed the BSN's with thier cult of superiority.

There's a reason why the market doesn't recognize a difference.

3.5 vs 4 yrs of school with the extra 1/2 yr giving you an advantage in management doesn't inpact care at the bedside. Both programs produce equal qualities in bedside nursing: the BSN's advantage is towards 'management' and 'research', not the bedside.

~faith,

Timothy.

Tweety, BSN, RN · Jul 17, 2005

This is the thing: nobody outside the people reading this thread cares or scarcely notices whether you have a BSN or ADN. What they see is RN.
And rightly so. Nursing is about on the job experience. The things that make you a nurse aren't taught in either program. They are learned in the trenches. It isn't those of us in the trenches that care about this debate: we know better. It's the ivory tower ilk that long ago forgot what nursing is about.
And the only extent to which this so-called debate invades the bedside is the extent to which the ivory towered types have successfully brainwashed the BSN's with thier cult of superiority.
There's a reason why the market doesn't recognize a difference.
3.5 vs 4 yrs of school with the extra 1/2 yr giving you an advantage in management doesn't inpact care at the bedside. Both programs produce equal qualities in bedside nursing: the BSN's advantage is towards 'management' and 'research', not the bedside.
~faith,
Timothy.

I agree, and even if people think about it, I don't care what they think.

I'm take exception your last statement. My RN to BSN program is going to help me at the bedside. My RN to BSN courses in pathophys., pharmacology, health promotion and assessment, aging in society and community health etc. are not necessarily going to help me in research and management, and I find that last statement a bit to general.

But otherwise, we're on the same page. :)

chadash · Jul 17, 2005

This is the thing: nobody outside the people reading this thread cares or scarcely notices whether you have a BSN or ADN. What they see is RN.
And rightly so. Nursing is about on the job experience. The things that make you a nurse aren't taught in either program. They are learned in the trenches.
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++
I am not sure I understand this lively discussion on nursing as a "profession". Guess I don't know a BSN from an ADN. But as someone who knows nothing of the hierarchy in academia, I want to express my humble observations. (Heck, why let a little ignorance hold you back?)
Out here with the great unwashed, the word professional is applied to how one performs in their discipline. If the individual is consistently striving for excellence, and is continually deepening there knowledge in theory and in practice, that person is deemed "professional". Back to the "caring" philosophy: if you are in a care giving profession, it would follow that your insight into what constitutes caring as a health giving attribute would develop as a result of your experience as well as academic research and sharing with others in your profession. So theory and practice go hand in hand, how ever you get it. Keeping the balance is the key. Might be that it is not the type of degree as much as how the person develops in these areas. Or am I missing something?
May be you need a nurse-meister classification: someone judged by their peers to have mastered the attributes essential in their profession
:)

ZASHAGALKA, RN · Jul 17, 2005

I'm take exception your last statement. My RN to BSN program is going to help me at the bedside. My RN to BSN courses in pathophys., pharmacology, health promotion and assessment, aging in society and community health etc. are not necessarily going to help me in research and management, and I find that last statement a bit to general.

I'm all for education. Of course your bridge program is going to help you. But. That's because, as a RN, you have the experience to apply the knowledge.

I think in general, I was referring to how well a BSN program vs. an ADN program prepares you to begin nursing: and at the bedside, they are almost (not quite but almost) equivalent. Why? Because what really makes you a nurse is experience. School gives you the the background to learn, but experience is the teacher.

Look at it this way: Doctors have 7 real years of medical education: 4 in med school and 3 as interns/residents (you can get your original bach in just about anything - but even so - add 2yrs of med school basics: 9 yrs).

A BSN has 4 yrs of school and ADN 3.5.

But neither is prepped to be a full fledged, independent nurse until they have experience under their belt. The difference between Doc and RN is the Doc has to be prepared for independent practice: in most cases, RNs start thier careers with a cadre of experienced nurses to turn to. So, after about 2 yrs of experience, a nurse wakes up one day and realizes that more often than not, (s)he gets it. That's a 6 yr education for BSN and a 5.5 yr education for ADNs - with the real education being the last 2 yrs for both.

9yrs MD vs. 5.5-6yrs RN. In fact, as an RN, you ARE highly trained in comparison to MDs no matter how you got ur degree. And in fact, by comparison of 5.5-6yrs, it's the extra learning experiences and opportunities that distinguishes the individual nurse at that point - not the type of program they attended.

After nursing school, I went to college to get my BA-Biology. I'm CCRN certified in critical care. I take approximately 35 ce's a year to maintain my CCRN. I go to the national conference. If somebody wants to tell me that I'm less of a nurse because I have an ADN - I'm gonna get defensive: hence the passion that this debate normally engenders.

Is there a difference between that BSN or ADN with 2yrs experience: marginally but the learning curve for both nurses is identical.

I've said I could be sold on a BSN-entry for the right reasons: professional image, justification for higher salaries and more autonomy, etc.

But. The idea that BSN is so superior to ADN as to make the ADN programs 'diminish' RNs in general, as has been posted, is absurd. Which one of you would prefer a BSN 2 weeks out of school to an ADN with a year's experience to take care of your parents?

The problem with this debate is that many BSN-entry proponents cannot seem to argue for their cause without arguing that ADNs are inferior. BUT THAT'S NOT AND NEVER WAS THE RATIONAL FOR BSN-ENTRY!

~faith,

Timothy