Graduate degrees as entry-level for other healthcare professions

  1. You all are probably aware that PT requires (or will soon require, can't recall) the masters degree for entry into practice. Pharmacists need the PharmD. Etc., etc. Did any of these other non-nursing professions have a lot of controversy over adopting these standards? Or any standards, for that matter. Nursing doesn't agree on what the standards should be, unless you consider the multiple points of entry a "standard".

    The debates in nursing over proper entry-level have been going on and on for years. North Dakota (and Canada, yes?) has adopted the BSN as the entry-level. How did this come about? What did it take for the legislators to sit down and say, "this is how it's going to be, no ifs ands or buts"? How is nursing affected in these areas due to the BSN being required?
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  2. 93 Comments

  3. by   Enright
    This is one of the old chestnuts in the nursing world....the debate over entry level education. I think it is an embarrassment to all of nursing in the US that we still allow the 3 entries to the RN. I sit on the State Medical Society board in my role as a nurse consultant to a state agency...you can't believe how often I hear "gee, a lot of these nurses only have 2 years of college!". I think it is a tremendous issue in terms of respect and autonomy. On the same note, I think there should no longer be advanced practice nurses grandmothered in who do not have master's degrees. They should sunset the ones who are out there.

    I think you should need an ADN for your LPN and a BSN for the RN.
  4. by   renerian
    LGood question. I am in my graduate program now.......hard.....but in science not nursing. Same with my BS. Wanted to focus on something besides nursing. My major is nutrition. I love it........doing distance education which is even harder as there is no one to bounce stuff off of. This could be the reason our profession is so divided........one of them at least. LOL>

    renerian
  5. by   shannonRN
    Originally posted by Enright
    I think you should need an ADN for your LPN and a BSN for the RN.
    i agree 100%. changing the entry level of nursing may help obtain that higher level of respect that nursing deserves. i'm not saying that it is the only way to get the respect, just that it will help.

    waiting for the debate to begin....
  6. by   Dr. Kate
    In the late 70s, early 80s I had a friend who was a PT and the discussion of making the entry degree as master's was active then. In fact it sounded to me like pretty much a done deal. It took >20 years. These changes do not come easily.
  7. by   SmilingBluEyes
    not AGAIN! jeeze there are so many threads on this.....and so on it goes. Hats off to those w/advanced degrees, but requiring entry level be graduate (or even BSN) sure won't do much to abate the shortage...esp in rural areas where BSN programs are 100s of miles away. If I wanted to be an LPN I would have attended vocational school and done so. The only program to prepare me to be an RN was an ADN. The nearest BSN was at the State University 100 miles away, not very doable for an adult learner with a family to care for....that is the reality of many situations..... I not sure if there is a similar shortage of pharmacists and physical/occupational therapists......Anyhow, make the BSN more universally accessible, and I might personally agree on this entry level requirement. Til then, I just don't see it happening universally.
    Last edit by SmilingBluEyes on Oct 9, '02
  8. by   SharonH, RN
    Originally posted by Enright
    This is one of the old chestnuts in the nursing world....the debate over entry level education. I think it is an embarrassment to all of nursing in the US that we still allow the 3 entries to the RN. I sit on the State Medical Society board in my role as a nurse consultant to a state agency...you can't believe how often I hear "gee, a lot of these nurses only have 2 years of college!". I think it is a tremendous issue in terms of respect and autonomy. On the same note, I think there should no longer be advanced practice nurses grandmothered in who do not have master's degrees. They should sunset the ones who are out there.

    I think you should need an ADN for your LPN and a BSN for the RN.

    I agree.
  9. by   dianacs
    Hey, this isn't intended to be a debate about what the degree should be. I'm only seeking info on how the process went for the other professions and how the situation is for those places who have adopted BSN as entry-level. I'm not advocating anything one way or the other.
  10. by   SharonH, RN
    Originally posted by dianacs
    You all are probably aware that PT requires (or will soon require, can't recall) the masters degree for entry into practice. Pharmacists need the PharmD. Etc., etc. Did any of these other non-nursing professions have a lot of controversy over adopting these standards? Or any standards, for that matter. Nursing doesn't agree on what the standards should be, unless you consider the multiple points of entry a "standard".

    The debates in nursing over proper entry-level have been going on and on for years. North Dakota (and Canada, yes?) has adopted the BSN as the entry-level. How did this come about? What did it take for the legislators to sit down and say, "this is how it's going to be, no ifs ands or buts"? How is nursing affected in these areas due to the BSN being required?

    My husband and I were just discussing this(he had a question about respiratory therapists). IMO, nursing and respiratory therapy are at the low end of the totem pole in regards to respect in the healthcare setting as compared to PT, OT, and even Dietary. The difference is that those disciplines have been able to establish their specialties as separate from medicine with their own standards for treatment and their own plan of care. It was not that long ago, that I can remember the docs coming in and writing out specific orders for PT(I want this done and that done, etc. ) I can also remember that pharmacy merely filled medication orders, no more. Now the docs come in and write PT consult or OT consult; they come in, evaluate the patient and recommend a plan of care. Same thing for pharmacy; the doc writes RX consult for gentamycin dosing, Vanco, etc. whereas that used to be strictly the domain of the physician. As a result, they are seen as collaborators in the care of the patient instead of merely taking orders that the physician writes. Not coincidentally, they have also seen enormous rises in their salaries and increased autonomy within the healthcare system, as well as increased respect. IMO, this started with standardizing and elevating their entry level for practice.

    Nursing can and should be doing this; we have our own models of care that we should be able to carry out without asking the doctor or being under the doctor's supervision. Instead, we continue to act as taskmasters in the healthcare system while everyone else tells us what to do. The problem is that many nurses do not see it that way and choose to take the debate over A.S versus B.S. personally. It's not about that. How would it affect the shortage? I think if people see nursing as a profession with a lot of respect and autonomy as well as higher salaries, that could only help the shortage. JMHO.


    How did the other disciplines arrive at this? How did they figure out what we realized out decades ago but could never put into place? I don't know. I wish we did know, I think it could improve things for all of us.
    Last edit by SharonMH31 on Oct 9, '02
  11. by   NurseMark25
    Okay. My turn. Education does not necessarily equal respect. I agree with Sharon MH31, it's not the education, it is the breaking away from being taskmasters to being a separate profession. But unlike PT/OT/RPh, nurses MUST work with physicians because of our wonderful nurse practice acts. Also, those professions have something that our does not... oodles, and oodles of people applying to their schools. Nursing could do something about the salary, it's called a union, but females seem to have a lack for sticking together, and most nurses are still female. Am I being an anti-feminist pig? No, just stating the facts. I have tried to start unions and received plenty of support from male RN's and virtually no support from female RN's. As a result, I nearly lost my job, and still have to put up with the incessant whining of the unhappy RN's. They complain of the "what about the patients?" and "what about my job security?" Well, here's the answer... join nursing agencies while on strike to make the income, and hold out until the hospital cannot afford to pay the expensive agency nurses for months at a time. No one said it would be a walk in the park. The other professions mentioned earlier simply took a look at their situation and did something about it. Ours stands idle. You want respect? It comes from making people respect you. It comes from nursing speaking as a collective voice. That's what PT/OT/ and RPh's did, why can't we? Also, the other schools increased the requirements to prevent field saturation. Nursing NEEDS people, and making the requirements tougher will not help the presen shortage. Also, I heard someone mention "Most of these nurses only have two years of educaton".
    Well, it took me 83 credit hours to get my ADN. That's one year of general education and 2 years of nursing school. The big, bad BSN has two years of general education and two years of nursing school. Wow, I'm impressed... a whole extra year of gen. ed. and courses on community/public health nursing and nursing research. That makes those BSN's way better than myself. Those people that say ADN's have only two years of education know not what they talk about... perhaps they ought to do a little research. Furthermore, when is the last time you've seen an RN program only require 60 credit hours to become an RN?
  12. by   ricquet
    well i believe we should have the BSN as entry level also nursing needs some public boost so as to gain respect.
  13. by   SharonH, RN
    Originally posted by NurseMark25
    Okay. My turn. Education does not necessarily equal respect. I agree with Sharon MH31, it's not the education, it is the breaking away from being taskmasters to being a separate profession. But unlike PT/OT/RPh, nurses MUST work with physicians because of our wonderful nurse practice acts. Also, those professions have something that our does not... oodles, and oodles of people applying to their schools. Nursing could do something about the salary, it's called a union, but females seem to have a lack for sticking together, and most nurses are still female. Am I being an anti-feminist pig? No, just stating the facts. I have tried to start unions and received plenty of support from male RN's and virtually no support from female RN's. As a result, I nearly lost my job, and still have to put up with the incessant whining of the unhappy RN's. They complain of the "what about the patients?" and "what about my job security?" Well, here's the answer... join nursing agencies while on strike to make the income, and hold out until the hospital cannot afford to pay the expensive agency nurses for months at a time. No one said it would be a walk in the park. The other professions mentioned earlier simply took a look at their situation and did something about it. Ours stands idle. You want respect? It comes from making people respect you. It comes from nursing speaking as a collective voice. That's what PT/OT/ and RPh's did, why can't we?[/i
    To a certain extent, I agree with this. I don't think there is anyone who can refute that nurses don't stick together. I'm not sure that unions are the answer, I think we need to try to form private practices and seek status independent of the hospitals but that's for another topic. But I do agree that as a profession, we suffer from our lack of unity.


    [i] Also, the other schools increased the requirements to prevent field saturation. Nursing NEEDS people, and making the requirements tougher will not help the presen shortage. Also, I heard someone mention "Most of these nurses only have two years of educaton".
    Well, it took me 83 credit hours to get my ADN. That's one year of general education and 2 years of nursing school. The big, bad BSN has two years of general education and two years of nursing school. Wow, I'm impressed... a whole extra year of gen. ed. and courses on community/public health nursing and nursing research. That makes those BSN's way better than myself. Those people that say ADN's have only two years of education know not what they talk about... perhaps they ought to do a little research. Furthermore, when is the last time you've seen an RN program only require 60 credit hours to become an RN?

    Now this is what I was talking about earlier in my post. It seems to me that you took the comments about making the BSN entry-level personally. Why?
  14. by   Peeps Mcarthur
    But if we get rid of one year LPN, nursing won't have any transitories like me who will use it for pt contact hours and experience to pursue a higher degree in a field that will give me the pay and respect that level orf education deserves. Staffing will get worse(if you can believe it) and "licensed" nurses won't have anything to be puffy about and prop up thier egos everyday............"It" will no longer "flow downhill" and they will leave for the shame of it all as they are treated to some of thier own medicine.....................................Uhm.. ...wait a minute.........................Great idea!
    Last edit by Peeps Mcarthur on Oct 9, '02

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