Do you feel more people are entering nursing only to become APRN's? - page 5

I am not a nurse yet, but I'm an EMT, have worked in and around the hospital, and I am currently finishing my last two prerequisite courses before applying for ABSN programs. It seems like 90% of my... Read More

  1. by   Rekt
    Quote from Susie2310
    BSN level knowledge needed to take care of complex patients at a tertiary care center?? May I ask what you perceive are the components in BSN nurses education that make nurses with a BSN better qualified to take care of complex patients than ADN/Diploma nurses? I ask genuinely, as a nurse with an ADN and a BSN. You do know that nurses with an ADN/Diploma take care of complex patients? Tertiary care isn't rocket science.
    I guess they don't teach sarcasm in ADN school.
  2. by   KatieMI
    Quote from JKL33
    Good thoughts.

    5. We can begin efforts to repair some of the damage done (from within) to the general respect given to the position of bedside nurse.

    6. We do need to figure out what happened to experienced bedside nurses - why they chose to go away or why they weren't wanted, however we want to look at it.
    7. We need to return NURSES to NURSING. Not to "customer service". Not to the heaviest, time-consuming part of their jobs which can be done by less-qualified professionals, but to clinical nursing which implies critical thinking. If it will mean going back to "team nursing", so be it.

    Making pride of getting every patient under her care a bed bath every shift and completing every task right in time isn't good if one of these patients quietly slips into near-code while the nurse is busy with fluffing pillows or calling consults because she has no supporting staff.

    8. Bedside nurses' voices have to be heard and listened to. For this, they have to be actively included in politics of healthcare, research and local management. There should not be such thing as purchasing or implementing equipment for a facility without getting it approved first by nurses if they are going to be the prime users of it. Those nurses who wish to become "testers" should be appropriately compensated for doing so.

    9. All stuff, great and small, which obstructs educational and creative opportunities for bedside RNs must be eliminated. If a facility runs an ICU, they should have money to make all nurses able to reach everything on ANCC site for free. Nurses should be encouraged with more than words for obtaining professional certifications, and more than that $1/hour. Nurses cannot be forced to accept mandatory uniforms, devices, etc. unless they as a group prefer to do so.

    10. All customer service measures which do not have strong evidence of its benefits done by research with no financial "support" must be eliminated at once, as well as all measures that support it, including paperwork. (little secret: there is very little to no such research existing).

    11. Nurses' working time must be audited periodically. If they spend >30% of it doing paperwork/EMR, the facility should be required to implement measures to reduce documentation load or face repercussions in form of $$$$. Same for overstaying shifts or going with no assigned breaks too often.

    12. All managers of units should be required to do 1 shift/month at bedside.

    13. There should be efforts finally made toward solving dillemmas of "lateral violence". If other criminal acts which depend heavily on opinions and impressions of victim/perpetrator/witnesses, such as statutory rape, could be brought to more or less clear definitions of what it OK and what is not, then the border can be drawn between beneficial "constructive critique" and malignant behaviors. The latter ones should be codified and dealth with accordingly.

    14. Last but not least: there should be finally a federal law making violence toward medical workers, including nurses, "equal" to one done toward polce. Yelled profanities on a nurse ->> welcome to jail.
  3. by   WestCoastSunRN
    Quote from Susie2310
    BSN level knowledge needed to take care of complex patients at a tertiary care center?? May I ask what you perceive are the components in BSN nurses education that make nurses with a BSN better qualified to take care of complex patients than ADN/Diploma nurses? I ask genuinely, as a nurse with an ADN and a BSN. You do know that nurses with an ADN/Diploma take care of complex patients? Tertiary care isn't rocket science.
    Clinically speaking, you have a point here. But I would argue that being clinically proficient is not enough anymore in view of progressing nursing as a profession and knowing how to play with everyone else in the sandbox is important. And whether we like or not .... or see theoretical applications of nursing as a bunch of hooey ( I know plenty of nurses who think this), we now live in a climate where educational degrees matter in the professional realms of healthcare. And this is not unique to nursing.... it has happened across all disciplines.
    I don't ever question the clinical proficiency of ADN/Diploma nurses based on degree status. In fact, I have known them to be more prepared as new nurses, clinically speaking, than many of their BSN peers. I, also, started as an ADN nurse.
    But while taking care of tertiary level patients in an acute care setting may not be "rocket science", it most certainly demands strong patho/pharm and critical thinking skills along with sharp hands on ability. I have to admit, I don't understand nurses not feeling intellectually challenged by our work. I'm no Einstein -- and maybe those who don't feel challeged are -- they are just too smart. But, for me.... there is always. something. more. to learn. And sometimes it's stuff I already learned 10 years or more ago, but haven't used in a while. The "nursing-isnt-rocket-science" thing just never sets well with me.
  4. by   Susie2310
    Quote from WestCoastSunRN
    Clinically speaking, you have a point here. But I would argue that being clinically proficient is not enough anymore in view of progressing nursing as a profession and knowing how to play with everyone else in the sandbox is important. And whether we like or not .... or see theoretical applications of nursing as a bunch of hooey ( I know plenty of nurses who think this), we now live in a climate where educational degrees matter in the professional realms of healthcare. And this is not unique to nursing.... it has happened across all disciplines.
    I don't ever question the clinical proficiency of ADN/Diploma nurses based on degree status. In fact, I have known them to be more prepared as new nurses, clinically speaking, than many of their BSN peers. I, also, started as an ADN nurse.
    But while taking care of tertiary level patients in an acute care setting may not be "rocket science", it most certainly demands strong patho/pharm and critical thinking skills along with sharp hands on ability. I have to admit, I don't understand nurses not feeling intellectually challenged by our work. I'm no Einstein -- and maybe those who don't feel challenged are -- they are just too smart. But, for me.... there is always. something. more. to learn. And sometimes it's stuff I already learned 10 years or more ago, but haven't used in a while. The "nursing-isnt-rocket-science" thing just never sets well with me.
    No-one is arguing that nurses don't need to be good critical thinkers, and have good knowledge of pathophysiology etc. But "progressing nursing as a profession" has nothing to do with the quality of nursing care a nurse delivers, and "knowing how to play with others in the sandbox" - are you actually suggesting that BSN trained nurses have superior communication abilities to ADN/Diploma nurses? Nursing requires intelligence, good critical thinking abilities, and for bedside nurses, a strong body. I agree with you not understanding nurses who don't feel intellectually challenged by their work, but saying that tertiary care isn't rocket science is simply stating a fact.
  5. by   WestCoastSunRN
    Quote from Susie2310
    are you actually suggesting that BSN trained nurses have superior communication abilities to ADN/Diploma nurses? Nursing requires intelligence, good critical thinking abilities, and for bedside nurses, a strong body. I agree with you not understanding nurses who don't feel intellectually challenged by their work, but saying that tertiary care isn't rocket science is simply stating a fact.
    No. I am not suggesting BSN nurses have superior anything. I am suggesting the world has changed. BSN is quickly becoming the minimum nursing degree. Just a fact. And you're right nursing is not rocket science. That is a fact also. But when I hear that comment, it's usually in a dismissive way... even when it's said by other nurses. I guess we can all have different sensitivities.
  6. by   llg
    Quote from CKPM2RN
    Let's see...enter a BSN program...pay 25-35k for said program...work another 10 years after that. I'd rather not since it doesn't pencil out well. Perhaps I will take the less glamorous job in your step down unit or telemetry. Med-surg sounds good too. (I use the word glamorous as a jest related to other subjects on this forum.)
    1. I don't know why you would pay so much for a BSN. With tuition reimbursement, it can be done a lot cheaper than that in my neck of the woods.

    2. We require new employees to go back to school for all RN jobs, not just the ones in ICU -- unless they have significant experience in pediatrics. They don't need to complete it before hire, but they have to be working towards. So it can be done cheaply if you take a few years to do it using tuition reimbursement. (I work for a children's hospital.)
  7. by   Susie2310
    Quote from WestCoastSunRN
    No. I am not suggesting BSN nurses have superior anything. I am suggesting the world has changed. BSN is quickly becoming the minimum nursing degree. Just a fact. And you're right nursing is not rocket science. That is a fact also. But when I hear that comment, it's usually in a dismissive way... even when it's said by other nurses. I guess we can all have different sensitivities.
    Re a BSN quickly becoming the minimal nursing degree - I know many would like this to be the case. In actuality this appears to very much depend on which area of the country you are in and whether the facility you work at requires this or not. In my area ADN and Diploma nurses are sought after by employers.
  8. by   Julius Seizure
    Quote from Ruby Vee
    Not kidding; not even a little bit. My manager had a call not long ago from an irate father who threatened to "have your job" if Susie wasn't given a pass on working the holidays because it was very important to HIS career to have a hostess for all of his holiday entertaining, and since his divorce, Susie was his hostess.

    Wow. Poor Susie. I wonder if she has any idea how much of a disservice her father is doing to her.

    Quote from llg
    I've had parents call me because they didn't want their precious babies to have to get immunizations prior to employment.

    I've had parents come with their new grads for job interviews and be offended because I wanted to interview their baby privately.

    I've had parents call as THEY tried to fill out the employment application for their precious baby.

    Such parents are shocked when they are told that we need to deal directly with the RN applicant -- and if their precious baby is interested in the job, she should get in contact with me herself.
    Same for these young adults. Whether they asked their parents to help them or not, their parents need to let/make them figure out how to be adults.

    I remember when I graduated college and moved out of state to start my first job as a nurse. (A job that I had found and interviewed for all by myself). It SUCKED for the first six months and my mom knew I was miserable when I would cry on the phone. She said I could just come home. What?? I told her, "No! I'm not running back home! This is my job and my life, and I'm not moving back!" I think I might have actually hurt her feelings a little - oops
    Last edit by Julius Seizure on Sep 15
  9. by   llg
    Quote from Susie2310
    BSN level knowledge needed to take care of complex patients at a tertiary care center?? May I ask what you perceive are the components in BSN nurses education that make nurses with a BSN better qualified to take care of complex patients than ADN/Diploma nurses? I ask genuinely, as a nurse with an ADN and a BSN. You do know that nurses with an ADN/Diploma take care of complex patients? Tertiary care isn't rocket science.
    I'm not going to continue this aspect of the discussion beyond this post as I don't want to hijack this thread into yet another ADN/BSN debate. But when another poster suggested that hiring ADN's would solve the turnover problem because ADN's are less likely to want to leave the bedside (his/her idea, not mine) ... I brought up the fact that my hospital prefers BSN's at the bedside. We expect our staff to have the following knowledge and skills that are more common in BSN programs than in most ADN programs.

    1. Understanding research, exploring the literature, evaluating research for practice readiness, etc.
    2. Experience with evidence-based practice -- able to be a useful member of an EBP committee
    3. Community health basics -- to include a consideration of community health when thinking about inpatient health for patient and familty
    4. Intro to leadership, management, etc. -- prepared to step into front-line management roles after gaining some experience
    5. Familiar with basic teaching/learning principles -- prepared to move into front line staff and patient education roles after getting a little experience

    Of course, there are exceptions to the rule ... but most BSN programs include more depth on the above topics than do most ADN programs.

    Switching to a predominantly ADN staff will not help us move forward in our nursing practice. We need to attract and retain the BSN's at the bedside.
  10. by   Julius Seizure
    Quote from KatieMI
    That sounds very unfair. (and regarding calling parents... there I truly feel sorry for you.)

    BTW, it is also not likely to lead to much results. I can only speak from the point of "too smart" person, but what would hold someone like me in place would be chances to develop as a clinician, not working schedule my way. Free subscription for AANC classes for the first year, for example. "Perks" like you describe have little to no attraction for really smart people who know for sure what high-rank nursing grad school entails.

    Did anyone of your administration actually try to speak with or poll recent new grads or students in local schools to know what their expectations, beliefs and preferences and make correlations by their experiences and educational achievements? If no, that could be a nice capstone project for some in Ed/Leadership program and results can be used by your facility.
    I know from my experience, one of the things that was very disappointing to me as a beginner nurse (say, 1-4 years of practice) was that I didn't see opportunities to make a difference at my workplace beyond my patient assignment for 12 hours. I wanted to get involved, join committees, help with quality improvement projects for the unit, etc. There was nothing like that available for me to sink my teeth into. Some might say it was because a beginner nurse shouldn't have those opportunities yet, I guess, but it was disappointing to me and was one of the things that led me to apply to a different hospital system eventually.
  11. by   Julius Seizure
    Quote from Susie2310
    But "progressing nursing as a profession" has nothing to do with the quality of nursing care a nurse delivers, and "knowing how to play with others in the sandbox" - are you actually suggesting that BSN trained nurses have superior communication abilities to ADN/Diploma nurses?
    I took this to mean that the "sandbox" of healthcare professions is quickly starting to be filled with careers that have a bachelors degree as the minimum standard of entry. Therefore, if nursing wants a seat at the table, we may need to play by those rules.
  12. by   RNperdiem
    I believe nursing is a gentrifying profession. It is embracing advanced degrees and distancing itself from its female, working class origins. Barriers for entry get raised higher and higher.
    It remains to be seen where this leads.
  13. by   Dodongo
    Quote from SurfCA40
    I am not a nurse yet, but I'm an EMT, have worked in and around the hospital, and I am currently finishing my last two prerequisite courses before applying for ABSN programs. It seems like 90% of my current classmates in nursing prerequisite courses, along with other prospective nurses I've worked with, are entering the nursing profession with the goal of become a Nurse Practitioner or CRNA.

    Do you, especially those already working as nurses, feel a lot of new graduate nurses are entering nursing for the sole purpose of becoming an APRN? I feel like since APRN's are gaining more popularity, people are entering the nursing field to become an APRN and not a "nurse", in lieu of becoming an MD/DO or PA. I'm not saying more education is bad, but it seems like people want to be an NP, not a nurse, if that makes sense. Which leads me to believe (and I know it's been discussed before) a huge over saturation of APRN's is in the near future.

    Thoughts? Again, I'm not a nurse yet, so I could be completely off base.
    Not everyone who enters nursing is able to matriculate into, and graduate from, an APRN program. These "barriers" serve as a rate limiting step in this process. Now, of course there is the problem with 100% online, no requirement NP programs letting anyone with the ability to take out a loan enter the profession. However, for the most part, the vast majority of those who enter nursing are *not* becoming advanced practice nurses, and are therefore, remaining bedside nurses - see the statistics provided in earlier posts. If the profession ever does reach this critical max, market forces will swing us in the opposite direction soon enough.

    Plus, simply being on this forum reinforces an inherent idea called the availability cascade. You read constantly on this forum that there will be an over saturation, and over time, the more your read that, the more plausible it becomes, and the more people start to believe it. That does not mean it's true. NPs need to do a better job of policing who is able to become an NP by eliminating a handful of bottom tier programs, but overall, there are way more people applying than are granted entry, and there are more jobs than there are graduates.

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