Mail Order credential

  1. I have one question: Does any one worry about nursing becoming a mail order credential?

    I am concerned by the trend. And before ALOT of people get angry and hurt, let me tell you where I am coming from. I am less concerned about the RN to BSN "distance studying". I think if we are going to really want a great number of nurses to be BSN's we will have to open creative venues to make that a reality. That said, I would not trade the university based experiences I had in my BSN completion program for anything, but I realize that it is not available or workable to all. So I think that this is acceptable and not the main gist of my concern.

    My concern is the distance learning programs that allow LPN's, EMICT's and other vocations to become RN's. Again, folks, I am not here to defame you all personally. My beef is with the NLN that acredited these programs. I think LPN to RN progression is a pathway that includes skill acquisition, knowledge acquisition and role enculturation that is best accomplished in a school of nursing setting, be it an ADN or BSN or diploma setting. I think allowing EMICT's (bless their intelligent and able hearts) to become Registered Nurses without attending a school of nursing is little more than selling a credential and I am scandalized that the NLN sanctions it. The two paramedics I know who did this no more think like a nurse than my cat does. They think like paramedics and use paramedic constructs (and my cat can't do that).

    I remain concerned that the NLN allowed our professional boundaries to be breached so easily, without a whimper. And I do understand that it's a done deal. I believe our boundaries are permanently breached; we have sold an essential part of our profession.

    Any thoughts?
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  2. 7 Comments

  3. by   P_RN
    Call me naive but no this doesn't worry me.

    I was not aware that there was a track that EMT's could become RN's. What school does this?

    As one who lives waaaaaaay out in the boonies, I have would appreciated the world of the internet in my education. Unfortunately (?) I came along before the "web" was a twinkle in Bill Gates' eye.

    When I finished USC I had 2 kids under 5, I worked 2 jobs and a part time on Saturdays and Sundays typing (yes TYPING not word processing or computering) papers for other students. It was 45 miles one way to school. Some weeks I never saw my children awake. I only saw my hubby on Sunday afternoons and that would be a "howdy" in passing while I was studying.

    I think that the distance learning is an excellent thing. Nurses need to be flexible. I HOPE that all nurses DO NOT think alike.

    No offense to your kitty intended

    The NCLEX is still required for distance learners isn't it?

    Great question though.
  4. by   MollyJ
    Hi P RN,
    Thanks for your reply. Like I said, I have no beef with BSN completion distance learning. Like you, my university was 1 hour away from where I lived and some of my commuting colleagues came from adjoining states (particularly during my MSN). Again, I think BSN completions are a whole different animal, though I repeat, I really liked my university based program. It doesn't take a lot of imagination to figure out why some people would choose and benefit from from a distance learning in this situation.

    I am talking about the entry level. Link to this:
    http://www.regents.edu/nur_admn.htm

    Here you will see that they accept into their ADN, BSN, MSN programs the following:

    Registered Nurses
    Licensed Practical/Vocational Nurses
    Paramedics
    Emergency Medical Technicians
    Military Service Corpsmen (certain classifications)*
    Physicians
    Naturopathic Doctors
    Respiratory Therapists/Technicians
    Respiratory Care Practitioners
    Chiropractors
    Physicians' Assistants
    Licensed Psychiatric Technicians* (CA, AR, KS, and CO only)
    Licensed, Certified, or Registered Lay Midwives*
    Certified Surgical Technologists*
    Any individual who has completed at least 50 percent of the clinical nursing courses in a registered nursing education program*


    I believe that entry level nursing requires a change in knowledge, skills, culture etc that distance learning is poorly suited to provide when you have no previous grounding in the Registered Nursing role.

    Any thoughts?
  5. by   MollyJ
    Originally posted by P_RN

    ... think that the distance learning is an excellent thing. Nurses need to be flexible. I HOPE that all nurses DO NOT think alike.

    No offense to your kitty intended

    The NCLEX is still required for distance learners isn't it?

    Great question though.
    Yes, they take the NCLEX because they are allowed to as grads of accredited programs. I think we can agree that the NCLEX is not a perfect tool for screening out all incompetent practitioners. I think schools of nursing have a responsiblity in that realm, too.

    And, P RN, I don't want all nurses to "think alike" but I do want them to think like _nurses_, you know--identification of nursing needs, forecasting of health care needs and problems etc. The two paramedics I know that completed the program thought in terms of identifying and treating emergent problems using paramedic constructs. It okay. It's what I want from an emergency care provider. But I'd want MORE from a nurse.

    Can the folks here identify what they do and how they think that makes them nurses? (I hope.) That is what a nursing education imbues you with, or should.

    Please, I am not banging on distance learner, BSN completers. A profession protects who enters and how they enter the profession. I think the NLN was a poor steward of our boundaries when they allowed that list of people who likely DO have things to bring to nursing to enter via a distance learning tool that has little control over the learners clinical sites.
  6. by   rnshallind
    I am in total agreement in regards to the problem with correspondence nursing. I have a friend that is a MICT/EMT-P and we do think differently when it comes to medical issues based on our training. I am an EMT I/D as well as a nursing student and can say that there are pros & cons to the training and the application thereof, that each of these professions uses to care for patients.
    Moreover, I recently met an individual, who is a MICT and in this program for nursing completion,and I had to show her how to "think" like a nurse in order to study the NCLEX-RN review materials and obtain a correct answer. This should tell you something about being in a nursing program verses correspondence!
    Furthermore, I recently had an opportunity to come into contact with an individual, who is a MICT and a RN-BSN from a school in Kansas and he related that he is proud to be able to say to his patients and others that he graduated from a "real" school of nursing!
    Finally,the two largest reasons I hear, that these folks give for using these programs, is "time and money." Absolute rubbish! In my opinion, coming from someone who's "been there and done that" as,I have been climbing the mountain of degree completion and struggling both with both the time and money issue.Therefore,I have no sympathy,absolutely none what so ever!, with these "mail order nurses!" Nope, I really don't want these folks taking care of me or my patients,now or in the future. Thank you! In fact I'm considering leting my favorite professional nursing associations know how I really feel about this issue!
    Just a FYI: I did in fact, contact the "regents school" and did for a second or two, consider their offer but, declined due abnormally high costs!
  7. by   catlady
    Just one quibble with your post, Molly. The list you describe is only for the ADN and BSN programs. Regents (now Excelsior; can't you just picture a box of packing materials???) has been cranking out nursing graduates for years. I have heard that their clinical exams are deadly. I wonder how a paramedic who doesn't think like a nurse could pass it.

    I was interested in their MSN in informatics, but was told that because my bachelor's and master's degrees are not in nursing, I am not eligible to apply, despite my pretty good credentials.

    I have looked at distance programs myself, and actually completed three courses at Graceland before deciding it was a waste of my time and money. I think distance programs are ok for theory classes, as long as you have a nursing background. I can't imagine doing a generic program this way. We had clinicals the first week of nursing school.
  8. by   P_RN
    Gosh MollyJ that regents site has changed completely since the last time I looked at it. It really tells nothing does it? Not very encouraging as to the quality and program. The old one really looked like a university site. A gal at work did the Graceland degree.....the army paid for it totally! She had like 2...2week clinicals there and had to do her "local classes" with a preceptor at home......hmmmm.

    Sorry I didn't mean to imply I disbelieved you....
    And *I*didn't take the NCLEX . We took the old State Board Exam....5 tests in 2 days. THAT was an EXAM.

    P
  9. by   Charles S. Smith, RN, MS
    [QUOTE]Originally posted by MollyJ
    [B]I have one question: Does any one worry about nursing becoming a mail order credential?

    MollyJ...yes, there are others of us out here who are equally concerned about the trend. Funny thing is, we must not have learned from our own nursing history! Nursing in the US was originally a mail order service! Any one could order a license and practice as a "nurse". When our ranks were flooded with incompetent, alcoholic, immoral ne'er-do-wells (the Sairy Gamps), the "trained nurses" rose up and stopped the onslaught of these folks by basing "training" in hospitals, by requiring high standards of moral fiber, and then by licensing through the state governments. The twist today is that our accrediting bodies, pressured to put more numbers into the workforce, are falling prey to exactly what we railed against early in the last century.

    Now it seems we are back to training again...learning skills rather than educating nurses. Rather than increasing the standards for education of nurses to control the numbers (the supply) of well prepared practitioners in order to increase the demand in the marketplace and thus increase wages, benefits, etc., we are flooding the market. This flooding will ultimately reduce the demand for our services and put us back where we were in the 70's...glut of nurses with no leverage in the marketplace. In turn, with no leverage, our profession is diluted once again with no forward momentum toward establishing a true profession.

    I truly love alternatives to tradition, but we can not afford to sacrifice quality for the sake of numbers.

    best regards
    chas

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