Lowering the Bar?

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    The school Iím going to has always used a 1+1 curriculum this means that to become an RN you have to first go threw an LPN program and get your LPN license. Altogether you have to take 40 credits of perquisites (A&P, Patho, Micro, math for meds, psyche, social science) and about 60 credits of nursing classes to become an ADN. Altogether it takes about 4 years to finish the program 2 years of nursing classes and 1 1/2 Ė 2 years for prerequisites or about 1 semester less then it would to become a BSN. I like most of my classmates choose the A.D.N. route because it has allot more clinical time then the BSN program in our area.

    They have decided to scrap the 1 + 1 curriculum and go to a strait curriculum. A.D.N. students will no longer need to become licensed as LPNís or complete any prerequisites they will instead go threw a 6 week orientation (meant to replace the 40 credits of prerequisites) and then go right into the A.D.N program with no prerequisites and be done with the program in a year and a half. They are also planing to cut about half of the clinical time they currently have and focus more on theory.

    This doesnít effect me I have already finished my LPN year and am registered for the old A.D.N. program in August.

    The school says they are changing things due to the communityís need for nurses. I agree that our city is in desperate need of nurses and that some changes to the current curriculum could get people out faster but cant help feeling that the new graduates will be under prepared.

    I enjoyed my nursing theory classes but they honestly havenít helped much sense I started working on the floor. I feel that most (95%) of useful information I learned was in clinical and that much of my critical thinking is based on the things I learned in prerequisites.

    I live in Colorado and I know that other states have used this type of strait curriculum for some time. What do you think about the strait curriculum?
  2. 48 Comments so far...

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    SORRY I DON'T consider this "LOWERING THE BAR". I was a straight-into-RN school type. I did very well and graduated with a 4.0 and have been a nurse for 5 years. If I wanted to be an LPN, I would have gone to LPN school. I think it is ridiculous to expect one to go there if they don't want to. LPN training is usually vastly different than RN training most places.....I knew I wanted to get an RN degree from the start, and took no detours going there.

    If one wants to be an LPN they should.....but be aware that often if they want their RN later, they will have to go thru a lot of "basics" first to get there. Frustrating for many. The shortage is too great to make it difficult for an LPN or RN to reach his/her goals in the most expedient yet well-prepared way possible. I applaud a program that understands this. IT WORKED FOR ME!
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    Debbie, I think that the main complaint (as I read it, anyway) that Dayray has here is that the vast clinical experience that the old program had is going to be cut; and this is Dayrays' concern.

    I can see the concern; especially since Dayray says she benefitted from this program. However, Dayray, this type of program was a type of ladder program and although it does allow each level of nursing to build on the preceeding level, it does not turn out nurses as fast as a regular ADN program. I'm sorry your school has to change, but give it time before passing judgement on whether it is "lowering the bar" or not.
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    Clinicals are very important...I agree. But if this were the huge concern all along, we should have NEVER ever allowed any RN to enter without graduating a DIPLOMA nursing program. Face it, since most of them have been phased out, how can anyone who graduated BSN or ADN school Say he/she had nearly the clinical exposure that diploma grads did? ( or in rare cases, still do?).

    I say, it will work out. The graduate nurse will need time to orient and learn once in the working environment. But I bet many diploma grads would say the same thing about anyone graduating other programs. IT is not the same, yet we DO WELL once oriented, if we are motivated and learn quickly.
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    I don't care what program anyone comes out of you are still wet behind the ears and you learn as you go. How well a school prepares you is more of an issue I think. I was a LVN first because I wanted to see how nursing is and too my suprise LVN's get as much respect as a Q-tip swab. You are constantly being challenged of your ability to function as a health care provider. But I was smart about it while I was working as a LVN I was still taking my courses for RN and a year and half later I graduated as a RN with an ADN. Honestly, my Lvn training made me a better RN because it was a very difficult cirriculum RN school was a breeze with literally reviewing what we learned in LVN school. I later found out we were using a RN level med surg book and that might be the reason it was so tough. RN school was an extension for me in learning a new role as a RN. Not so much bedside but a critical thinker and supervisor of care for my clients. I say both were great learning tool for me. I don't think it would be lowering anything instead just by pass LVN. If anyone does decide to be a LVN my advice is if you still want to be a RN down the road take your classes for RN so when you are ready that is less time spent in the classroom with prereqs!!!!
    Last edit by Teshiee on Jun 27, '02
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    agree. tshe. I HATE that LVN/LPN's get so little respect. That is unwarranted to me!
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    The largest difference I see is that the LPN education is largely skill based whereas RN programs have more theory. When I was in LPN school, we had clinicals out the wazoo (which, of course, is a technical term). RN school, IMHO, was heavier in patient management and delegation (which is in the scope of the RN).

    Two different programs, both turn out nurses. My $0.04, adjusted for inflation.
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    Associate Degree Nurses DO get a lot of clinical, and an even amount of theory...IMHO...and I can't for the life of me figure out how any school got away with that 1+1curriculum...how can they MAKE people become LPNs before becoming RNs??? What nutcase allowed that curriculum to become law in that state??? Maaaaaaannnnn.....the older I get...the more floored I get...some laws never cease to amaze me! :chuckle
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    I'm a LPN and I'm enrolled to begin a RN program in the Fall. The LPN program that I attended included 24 hours of clinical per week(2-12 hour days) and we attended class the other three days from 8am-3pm. That went on for 11 months.

    The ADN program that I am going to attend has just made revisions in their program structure. The program is still 4 semesters of actual nursing (you are required to have the math, A&P one, and Psychology pre-req's).....however, the first 2 semesters are considered PN portion and you have the option to exit then and take the NCLEX-PN and make that a career or continue on to 2nd year ADN level. If you elect to take the NCLEX-PN and plan to CONTINUE....you must not fail the NCLEX...otherwise you are out.

    LPN's that have one year of work experience are admitted as accelerated ADN students and sit out the first year.

    I was suprised to learn that be doing only 6 hour clinicals twice per week. WOW! That is a vast contrast to the program I attended before. I'm curious to see what the NCLEX pass rate will be for this program. It is a NLN accredited program and I'm sure that much of the students success depends on how much they prepare themselves.

    The whole thing about diploma programs is this....no denying that they are immersed in nursing care much of their time. It's a shame that academia felt that is where nursing was best learned....at college/university level. I agree that there must be a "balance" in theory and clinical...but clinical is where you APPLY the theory. Todays health concerns are no longer textbook cases much of the time. People are often living with many disease processes and on many medications. The level of nursing care needed by the clients of today requires nurses to be "hands on" from the beginning. This is where we develop our acute senses for knowing when a patient has taken a turn for the worse because we might be able to detect the subtle signs NOT emphasized in a text book. I can read all day long but what really sticks with me is learning to apply what I have learned.

    I am NOT knocking any program. I just kinda think that "floor time" helps us become comfortable in our surroundings and maybe better prepared to take on the roles that we are learning to fill.

    Thanks for the the thread and I look forward to your (polite ) comments.

    Happy Nursing~Angie

    BTW...I have never made below a B in any course and I passed boards first time up with minimum # of questions(85). I am not bragging...I feel that my nursing program did an excellent job on their part to prepare me is all.
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    I appreciate all your comments. I think its important to point out that Iím not really passing judgement on the program, simply wondering what other people think. I have to say that it does beg the question (are we lowering the bar?) when 2 years are cut out of a program and clinical time is reduced.

    I think one of the reasons Colorado used the 1 + 1 or ladder program is that the LPNís scope of practice is pretty large here. As an LPN I take patients (I am their Nurse). I take fresh surgeries can give all PO, IM and Sub Q meds, under my IV certification I can start IVís hang electrolytes, vitamins, and premixed antibiotics. I chart just like an RN.

    The differences in practice between an RN and LPN are that an LPN cannot hang fluids (other then the ones I mentioned) cannot manage or maintain central lines, cant do IV push meds and arenít allowed to circulate in surgery. Some facilities place further restrictions on LPN's (mostly for insurance reasons) in my hospital LPN's cant except verbal orders cant hang blood (but can mange it) and cant complete certain parts of initial patient assessment.

    In my area LPN's do basically what RNís do for less money. The reasons for becoming an RN over an LPN are more money, more autonomy, not having to ask an RN to call a doc for you, not having to ask an RN to hang a bag, manage your epideral or do an IV push and of course the knowledge and additional skills you will be able to apply to your patient care.

    I understand that in some areas LPNís are treated like aids that can pass meds and perhaps in those situations forcing an RN student to get licensed as an LPN would be frustrating. In my area becoming an LPN is defiantly a big plus in the learning curve and in my opinion will allow me to get more out of the RN year of my program. For this state the LPN program is defiantly relevant to the RN program and in the past was seen as essential for A.D.N. programs. In fact, most BSN programs now allow if not require that student sit for the LPN state board in their 3 rd year.

    I also have to wonder if by not allowing A.D.N. students to become licensed and work, as LPNís (not to mention cutting out prerequisites and huge portions of clinical time) will result in lower quality nurses.

    Stop and ask your self who you would rather have taking care of you or your family. An RN who had gone threw 2 years of prerequisite biology and math, had been required to prove competence in many clinical areas over many hours of clinical exposure an had worked as an LPN for a year prior to becoming an RN.
    Or the nurse that went to school for a year and a half with no Biology or math foundation, had experienced only half the clinical time and had never set foot on a floor other then as a student?

    Once again thank you all for your comments and I hope I havenít offended anyone.


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