The 'De-Skilling' Of Nursing - page 20

by TheCommuter 33,137 Views | 240 Comments Senior Moderator

What should be our greatest concern for the future of nursing? We must fear the day if (or when) registered nurses (RNs) and licensed practical nurses (LPNs) will be less needed in healthcare due to systematic de-skilling of the... Read More


  1. 0
    Quote from OCNRN63
    I never "didn't" get it.
    My original statement was facetious, now you get it?
  2. 1
    Quote from Asystole RN
    The level of academic achievement of a nurse however has nothing to do with their clinical practice however.
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it just seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    lindarn likes this.
  3. 0
    Quote from luv2
    Sorry about your wife. I am surprise that nurse did that because most vns do not stay they are usually there for the treatment and other stuff and leave . I am appalled by what the nurse did to you and your wife. However, nursing is more than looking and having a feeling...I am glad you want to learn. I hope you continue down this path to become a R.N or LPN. As a CNA you should NEVER teach anyone anything. "When a patient is having breathing difficulties, who better to work with them until the RN arrives, coaching them to take slow deep breaths and urging the patient to try to relax, the CNA who is there." This exactly what irks me as a RN ...Do you see why we need to organize and start taking back our skills?
    I'm not sure if I'll go one to get my LPN because the hospitals are phasing them out here in Florida (at least where I live). Because of my age, 58, I haven't made up my mind yet. I think you miss understood my comment about"coaching" a patient having breathing problems. I have been in the situation where my wife has gone into respiratory distress and by the time staff got there, I was able to talk her through slow breathing techniques. Not teaching, working gently and calmly with the patient. Those are skill I have learned because of my own asthma and working with respiratory staff. Once more qualified staff get there, let them take over unless I'm asked to continue with assisting the patient. No more, no less. I think my background has given me skills that other CNAs. I've had the opportunity to learn skills outside of schooling that most have not but in a critical situation ( for lack of a better term) doing what you can after calling for assistance makes more sense to me.
    Last edit by animal1953 on Aug 29, '12 : Reason: added to post
  4. 1
    Quote from BrandonLPN
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it ju,st seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    It would depend on what the identified differences are in a BSN program vs an ADN program. Many of them, as has been said, focus on leadership, community health, health care policy, etc. so maybe I don't understand what you mean by "scope of practice"?
    gummi bear likes this.
  5. 2
    Quote from BrandonLPN
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it just seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    I think she's referring to the things that are inherent to all nurses. Common sense/critical thinking, compassion, being able to see the big picture. If you took a cross section of nurses and placed them at a level that all the nurses SOP covered you'd probably get the same results.

    That's what most of the LPN vs RN's miss. I can do MY job as well as an RN can. I'm not saying that I can do her job but if she were to do mine it would be about the same.
    mc3 and Fiona59 like this.
  6. 1
    Quote from Asystole RN
    The BSN nurse predates all other forms of nursing except the Diploma nurse. Many hospitals are actively attempting to increase the ratio of BSN nurses on the floor.

    The level of academic achievement of a nurse however has nothing to do with their clinical practice however.
    I am curious......what makes you say the BSN nurse predates all other forms of nursing except the diploma nurse. What are you saying that ADN programs don't produce nurses? I am unclear......If this is true.....what you are saying is that my ASN program was a figment of my imagination.

    I do however agree that the academic achievement of the nurse in no way influences their clinical expertise and practice at the bedside.
    Fiona59 likes this.
  7. 1
    Quote from Esme12
    I am curious......what makes you say the BSN nurse predates all other forms of nursing except the diploma nurse. What are you saying that ADN programs don't produce nurses? I am unclear......If this is true.....what you are saying is that my ASN program was a figment of my imagination.

    I do however agree that the academic achievement of the nurse in no way influences their clinical expertise and practice at the bedside.
    I believe that BSN programs were developed before ADN programs were that originally there were BSN programs and diploma programs. I know my old college developed the first BSN program in the state and that was back in the 40's. Not sure when associate degrees themselves came about.
    lindarn likes this.
  8. 1
    Quote from BrandonLPN
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it just seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    There are various forms of education. The education you received as a LPN/LVN is what is known as vocational training, not collegiate education. Hence the V in LVN.

    RN education is comprised of two elements, the clinical vocational training and the liberal collegiate education. ADNs mostly receive vocational training with some collegiate education while BSN nurses roughly receive the same vocational training with more collegiate education.

    What constitutes collegiate education is determined by, and certified by, various credentialing organizations that have developed the collegiate educational model. Depending upon the mix of various classes within the educational program will determine if your degree is a science or an art. In fact, the first nursing program at Columbia in the 1890's gave nurses a BA and a Diploma in nursing, only later was the degree combined into the BSN by Yale.

    One can have a BSN without ever being a nurse, one can be a nurse without ever having a collegiate education.
    lindarn likes this.
  9. 1
    Quote from Esme12
    I am curious......what makes you say the BSN nurse predates all other forms of nursing except the diploma nurse. What are you saying that ADN programs don't produce nurses? I am unclear......If this is true.....what you are saying is that my ASN program was a figment of my imagination.

    I do however agree that the academic achievement of the nurse in no way influences their clinical expertise and practice at the bedside.
    Nursing was largely unregulated and unformalized until Nightingale popularized and standardized the occupation in the mid to late 19th century. Towards the end of the 19th century formal programs that gave nurses Diplomas were developed. There is debate as to actual time line of when the advent of the baccalaureate level of education for nursing came to be since some programs offered a nursing program that granted a BS coupled with a Diploma in nursing. Either way, the advent of the BSN degree occurred in the late 19th or early 20th centuries. The MSN degree was developed in the 1940's.

    Following WWII, in order to compensate for the shortage of nurses programs began offering an Associates Degree in Nursing.

    BSN nursing predates ADN nursing, meaning that BSN nursing was invented prior to the advent of ADN nursing.
    lindarn likes this.
  10. 1
    Just for info - the proud history of LPN's (taken from Wikipedia):
    The first formal training program for practical nurses was developed at the Young Women's Christian Association (YWCA) in New York City in 1892. The following year this became the Ballard School of Practical Nursing (after Lucinda Ballard, an early benefactor) and was a three-month-long course of study concerned with the care of infants, children and the elderly and disabled. The curriculum included instruction in cooking and nutrition as well as basic science and nursing. The school closed in 1949 after the YWCA was reorganized. Other early practical nursing education program include the Thompson Practical Nursing School, established in 1907 in Brattleboro, Vermont (still in operation today) and the Household Nursing School (later the Shepard-Gill School of Practical Nursing), established in 1918 in Boston. In 1930, there were still just 11 schools of practical nursing, but between 1948 and 1954, 260 more opened. The Association of Practical Nurse Schools (APNS) as founded in 1942, and the next year the name of the organization was changed to the National Association was changed to National Association for Practical Nurse Education and Service (NAPNAS), and the first planned curriculum for practical nurses as developed.[4]

    mc3
    lindarn likes this.


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