lowering standards R/T shortage

Peeps Mcarthur · Nov 14, 2002

llg,

Gobbeldygook obstructing cognition; r/t trying to sound intelligent aeb look of confusion and fear in test center.

Nursing actions,

Have student enroll in science courses to re-orient.

Make sure there are no pipes or turtleneck sweaters in student's wardrobe. Remind him that Birkenstocks are not really shoes, but rather glorified outdoor house slippers for liberal arts majors.

Replace any tea in the household with french roast coffee and provide a french press.

Correct student when he refers to "positive adaptation throughout the life cycle within a multi-cultural society" and coach him to simply say "discharge to social services"

:chuckle :roll

RainbowSkye · Nov 14, 2002

I feel so lucky. I started my diploma program in 1971. Before we were admitted we had two full days of written entrance exams (in addition to taking the SATS) along with interviews with the program instructors and director. About 50 of us were admitted. Yeah, we were all female.

Nope, we didn't have any nursing theory in school, the only theorist discussed with Maslow. And, of course, we learned about Florence, but she was never labeled a theorist. No such thing as a nursing diagnosis back then either. We did have care plans though.

We also did had a twelve full week rotation in OR, care of surgical patients, care of medical patients, OB, peds, critical care, psych (at the local "One Flew Over the Cukoo's Nest" facility), public health and nursing leadership.

I graduated pretty much knowing how to be a nurse (albeit, a novice nurse). Oh, everyone in our program got 600+ on our boards (before the NCLEX test).

Sadly, my school closed a couple of years ago after 100 years of teaching nursing. The end of an era.

And, no, we didn't have to mop floors.

**SKM-NURSIEPOOH, BSN, RN** · Nov 15, 2002

not only are some schools dropping entrance standards, but i hear that some instructors actually "spoon feed" students exactly what they'll be tested on in their classes. some tell students to read this section or that section only as this is will be the only area in which you'll be tested. schools are designing their exams to mimic/mirror the nclex...some no longer are requiring the good old fashion essay/fill-in-the blanks exams anymore...everything is multiple "guess" questions.

i think that a huge reason for the lowering of standards, so to speak, is in direct correlation to the nursing shortage out there. yet look in your nursing journals' job list section. look at all the tuition reimbursement jobs are offering now days...they've even offer to pay part of a master's program. it not uncommon to see $5k sign-on bonuses for gns agreeing to commit at least one year with that company/hospital. in the philadelphia, pa & south jersey regions, hospitals are offering sign-on bonuses/tuition reimbursement between $5k - $10k including gns. they'll even willing to let gns work in that compacity for at least 6 months up to a year before the gn is expected to take their nclex...only catch is...gns are even two chances at taking & passing the nclex...some places will make gns work as nurse externs should they fail it the first time around. today, nurses are needed sooo badly that everyone seem to be lowering the entrance/hiring standards so to speak...just 7 years ago...gns could only work the med/surg floors...now...they have their pick at just about any area including critical care. a nurse had to have at least 3-5 yrs experience before applying to specialized areas. i'm not saying that's a bad thing...i'm just saying desperate times require desperate measures as there seems to be an increase in med errors today...granted...many are d/t the terrible nurse/pt ratio...but many errors are contributed from putting inexperienced nurses in areas that they aren't necessarily ready for...jmho. i'm not saying that more errors are proformed by the novice nurse...i'm not saying that at all...i'm just saying that they have more responsibility today because the care is more acute...adding stress & early job burn-out into the mix....but this is another topic...i'm tired & i've digressed...sorry.

so, it's like what susy said earlier...teaching students how to take /pass the nclex being no hard feat...seems today...many schools' missions are focused on teaching students how to pass the nclex after graduating their program...as their accreditation/reputations are at stake.

i've also heard that many graduate nursing programs aren't requiring the gmats anymore...so not only have the generic nursing programs (adn/bsn) lowered entrance standards...now the universities are doing the same with their graduate level entrance requirements. i see all kinds of enticing offers for getting one's nursing degree using the "fast track method." my school has several in place where if one has a prior bachelor's degree...they can go through an accelerated msn program...where you jump into the junior level nursing curriculum & graduate 3 yrs later with the masters. they've even started a program last june where the student is accepted with a bachelor's degree and will complete the bsn program in one calender year with no prior nursing background either. i can see the rn-bsn program lasting 9 months, but come on...where will it end?

Mkue · Nov 15, 2002

originally posted by skm-nursiepooh
..seems today...many schools' missions are focused on teaching students how to pass the nclex after graduating their program...as their accreditation/reputations are at stake.

i've seen many students spoon fed that is very true, a lot of "hand holding". so much is focused on the nclex.

good post!

kelligrl · Nov 15, 2002

Tutored a first semester student a few months ago who asked me, "Will her lecture material be on the tests?" :rolleyes: WTF?? Nah, she just stands up there and talks so she can listen to her own voice. She enjoys that....Yeah, I'd say that they're letting in some real freakin' geniuses... But then again, had they done the whole admissions process based on GPA, I'd never have gotten in. My first time around in college I did as little as possible...Think I had like a 2.76 when I started the program LOL...Pulled it up to really close to 4.0 through the program, but they wouldn't have let me in as it stood...Sounds like you're drowning in psychobabble, Peeps...Didn't we have this discussion regarding the Developmental Psych classes? :chuckle Our modules are based on systems, started with integ, worked all through 'em, ending with cardiac, neuro, and respiratory in the final semester. Orem's Nursing theory was integrated into the curriculum, but was only PART of it....

Pretzlgl · Nov 15, 2002

llg -

I understand your point about ADN vs. BSN. However, what would a "technical" nurse do differently than a "professional" nurse. And how do you tell the 25 year experienced ADN nurse that he/she is now a technical nurse and the new grad BSN will be their professional manager?? And then what becomes of the LPN role?? And on and on. I realize this has been a hot topic - always has, probably always will. Certainly nothing wrong with continuing education; however, I am friends with many RN's who have completed BSN degrees only to find out they aren't better nurses after all. I realize that the degree is a stepping stone to bigger and better things - and definitely more opportunities. I just don't think roles should be established in nursing bases solely on degrees. My current manager is bachelor prepared going for masters and has never worked a day in her life on a floor. HHMMM..... Could that be why she is having so much trouble with critical thinking? It's not the degree that makes the nurse, it's how he/she puts it to use.

Shopgirl2262 · Nov 15, 2002

The program I am in has not and will not get any easier. That's a good thing though. Atleast I know that I will be prepared for the NCLEX.

Angelica · Nov 15, 2002

I am in the third semester of an ADN program, and if there's been any dumbing down of standards at my school I hate to think what students before me had to endure. My class started with 50 students, and we have been dropping like flies ever since. We now have 15 brave souls left. We have four exams per semester, each covering 12-15 chapters. We're never afforded any hints as to what will be on the exam (althought the latent slacker in me wishes we were). I have, until this semester, maintained a 4.0 average. I am now in serious "B" territory, and am grateful for it. My exams are all multiple choice, but as a previous poster alluded to, that does not necessarily make for an easier exam. The exams I have taken have been extremely difficult.

llg, PhD, RN · Nov 15, 2002

Pretzlgl:

Thanks for the thoughtful response -- and for not "flaming" me. I knew my post was a bit provocative, and am grateful for your response that furthers conversation of the topic rather than attacks the writer.

My post was in response to the one by MICU RN, so some of my thinking was "left out" of my post so as not to repeat what he had written. So, anyone getting into this little discussion might want to re-read his original post on the first page of this thread.

I think you raise some great points in your post, Pretzlegl -- and that's the problem -- or rather, the big dilemma for nursing. The ADN degree is probably sufficient for a bedside staff nurse. That causes a problem for the those who want to see nurses respected and paid on the same level as those whose careers require a bachelor's degree. How would you resolve that dilemma? What do you suggest?

One possible course would be to simply stop trying to get people to consider nursing "equal" to those other professions and accept a lower status. Some of us have difficulty with that.

Another possible course would be to differentiate different levels of nursing based upon differing educational levels. That's what the ANA tried to do back in 1965. As it was politically unpopular in non-academic circles, it never had the full support of the nursing world and never actually got implemented. Thus, no one ever created two different roles based on the educational difference (except the military and the Veteran's administration -- who do formally distinguish between the two levels.) Are there any military nurses out there who can enlighten us about how that works?

A third course would be to encourage an entire culture change throughout society in which we would totally re-think the role of education, knowledge, and skill required by different jobs and the functions those job holders perform and re-align our assignment of status and benefits based on that new way of thinking. Nursing might come out ahead under an entirely new way of assigning value to things. I kind'a like that idea, but think it is unlikely to happen in my lifetime.

So ... back to the drawing board. What do you suggest we do about the inherent problem nursing faces? We would like to have our value recognized and rewarded on a level similar to professions that require bachelor's and graduate degrees ... yet we only require an ADN, which seems to be sufficient for the entry-level practitioner. Hmmm.....

Finally, about the truth you wrote about some ADN nurses being terrific and smart and expert, etc. and some BSN (and higher degree) nurses being idiots in the practical world .... That's true of any educational system in any field. There are always individuals who perform either better or worse than "expected" for their level of formal education. But general policies and guidelines designed for the larger world can not be based on the performance of those individuals. General guidelines and policies must be made on the basis of the "typical" performer ... whatever that is.

I find it helpful (and accurate) to think of the different educational levels in terms of overlapping bell curves. The people at the high end of the ADN curve out-perform people at the lower end of the BSN curve, etc. ... NOT on every dimension, of course, but only on those dimensions that distinguish the two levels of programs. On some dimensions, there is no difference and on other dimensions, the average ADN grad may outperform the average BSN grad, with the overlapping bell curves reversed. Also, there are also great schools and terrible schools at both levels. Some ADN programs are excellent and rigorous, etc. and some BSN programs are not. The discussion makes sense only when you start thinking in terms of thousands of programs, millions of nurses, etc. and focusing on the averages instead of looking at individual cases.

You also have to think what the focus of the varying programs are. Most ADN programs focus on producing good bedside staff nurses and many BSN programs focus on producing managers, teachers, researchers, case managers, etc.

Again, thanks for the productive discussion. I'm sorry this post got so long.

llg

Q. · Nov 15, 2002

Finally, about the truth you wrote about some ADN nurses being terrific and smart and expert, etc. and some BSN (and higher degree) nurses being idiots in the practical world .... That's true of any educational system in any field. There are always individuals who perform either better or worse than "expected" for their level of formal education. But general policies and guidelines designed for the larger world can not be based on the performance of those individuals. General guidelines and policies must be made on the basis of the "typical" performer ... whatever that is.

I thought that was very nicely put.

llg, PhD, RN · Nov 15, 2002

Thanks, Susy K. I was trying to be both tactful and truthful. As a few people on this bulletin board may know, I have a PhD and work in a hospital. My boss is 1 year older than I am and has a nursing diploma. We get along great because we respect each other as PEOPLE and acknowledge each other's strenghts and weaknesses openly. Neither of us is embarrassed or ashamed of ourselves and therefore neither gets defensive.

Her clinical background and front-line management experience are far greater than mine. Also, she is one of those people who has read a lot, gone to lots of conferences, etc. and has independently moved far beyond her basic nursing education. She has taken responsibility for her learning and actively sought knowledge throughout her career -- earning her DON job and my respect.

However, she openly acknowledges that there are aspects of nursing (e.g. academic stuff, evaluating research, education, etc.) that she is not terribly strong in and she hires people like me to bring that expertise to our hospital. Her self esteem is sufficiently intact that she doesn't hesitate to admit that she needs our help sometimes. We make a great team.

If we are ever going to make any progress in this "educational level" issue, we need more people like her and more teams like ours. Too often, people get all defensive and sensitive about their own education and their own abilities to have a good, clear-headed discussion of the real issues.

llg

quackers · Nov 15, 2002

:roll I have heard that some states want to lower the standards to accommodate the influx of nurses from other countries. These nurses are having a hard time in passing their boards here in the states. Since the nursing shortage is such as it is no one is looking at the longterm picture in lowering the standards. My school was tough and still is. We need to made sure that not just anyone is allowed to practice no matter how bad the shortage gets. I presently work with nurses that really give the rest of us a bad name, but they work and will continue to work because they are an extra pair of hands and management needs the bodies.