Professionalism and Credentials - page 5

OK, just some thoughts here so early in the morning (after work...) I've been thinking on how we can improve the image of nursing and a couple of thoughts come to mind. First, what do people... Read More

  1. by   nurs4kids
    Mjourney,
    Of course I never intended to imply that all ADN's and diploma's are verbally inferior to BSN's. That would be a slight in my own direction . I do feel, however, that the more education a person has, they increase their chance of retaining information. You make a very valid point that I have pondered throughout this discussion. The fact that many ADN's and diploma's hold other degrees in higher education. If we grasp this whole idealogy that one should be paid by the TIME spent being educated, then does this mean that someone with a BS in physical education should be paid more than myself? I have two years of classes that did not go toward my ASN, does that mean that I, too, should be compensated for that education? I don't really see where a year's worth of electronic classes have enhanced my nursing ability. What has helped me is experience. I spent a few years working in and supervising Central Supply. Learned the ins and outs of sterilization, of supplies, etc. This doesn't necessarily make me a better nurse, so to speak, but a much more efficient nurse. I spent several years in purchasing. Again, made me more
    efficient. A year or so as a Unit Secretary. Definitely made me a better nurse, for obvious reasons. My point in all this..how do we truly define education? Do we define education by years of college attended, by degree obtained or by knowledge retained?? I figure the answer depends on who you are and your level of "education". Heck, while we're at it, why don't we just throw out all the ADN and diploma nurses. After all, we're the ones dragging the profession down. I'm sure that if tomorrow we started the profession anew with nothing but BSN's and above, we'd see an immediate change in the way the public views nursing <note obvious sarcasm>>
  2. by   mattcastens
    Originally posted by KC CHICK
    matt, I'm confused.....how exactly did you not expect the responses to be this way??? There have been many other threads on the SAME subject w/the SAME types of responses. You opened the can of worms again, knowingly or unknowingly.....sorry, but it's true. Not only that, another thread was created out of windfall from this one.....over the EXACT SAME SUBJECT!!

    I think this dead horse has been kicked a few times too many. Please let him be.
    a) I guess I thought that most nurses could distinguish between a discussion that hinged on education and public perceptions and one that focused on skills and abilities. My mistake.

    b) This is not a dead horse. Seeing as how this discussion as been going on for longer than I've been alive, the issue obviously hasn't been resolved.

    d) Why are you so hostile KC? Do you feel threatened by these issues? Here's a radical idea: if you don't like the discussion, don't participate. That's why we have subject lines -- so you can avoid reading things that you can't handle.

    Now then ...

    About the dental hygenists. I did not realize that there were degrees in that field. However, the fact I assumed that it was only a two-year degree underscores my point. There are dental hygenists that have baccelaureate degrees but I assume that they don't. How many physicians and normal folks are assuming that nurses have less education than they do simply because there are so many associate degrees in nursing available?

    Also, why I certainly don't want to belittle anyone's chosen profession, we have to agree that nurses have a huge responsibility -- health and lives are at stake. I continue to maintain that this responsibility in and of itself is the very reason to demand higher education as being the baseline for nurses.
  3. by   canoehead
    Sometimes in these discussions we assume that the implication is that non degree nurses are not as good as degreed. I think the truth may be that nurses that are self starters and committed to lifetime learning are more likely to show up at a degree school eventually. This does not mean that non degreed nurses cannot have those same positive qualities, they may express them differently.

    I think that Chas has hit on a truth when he spoke of the supply/demand issue. If nurses' skills are a challenge to obtain, and we are less available, not just anyone can be a nurse as we all know, then we will be a more valuable commodity. I think the nursing shortage is an opportunity. We can congregate to hospitals and situations where the nursing environment is professional, and constantly advancing, rather than places where nurses are another piece of equipment and a necessary expense.

    Those of us in practice now can help by presenting ourselves as patient advocates and professionals in our own right, not just a set of skillful hands that carry out orders. Get involved in the organization of some part of your hospital's nursing, and in something related to nursing outside the hospital. I know if every nurse became accountable for their own practice, and for hospital decisions about nursing that are made in their names, our professional reputation would improve a thousandfold.
  4. by   KC CHICK
    Matt, I do not believe I am being 'hostile'. I just don't see it.
    I don't feel threatened at all by these issues.

    Here's a radical idea for yourself......if you can't handle the answers you get, don't start a thread over a controversial subject.

    I believe that I've been giving strong answers (reflects my personality) that have been addressed to you.... I have not personally attacked you, as you have resorted to doing to me. (That's too bad too, it just belittles yourself)

    Let me ask you this question, seeing as how you are presently an ADN that is bridging for your BSN: Would you have gone into nursing if you had not been able to complete an ADN program to do so? Would you have been able to do it if a BSN were your only option??

    Seeing as how us ADNs are (and were) non-traditional students, what steered you into an ADN program and not a BSN program initially?? Just curious.

    Anne

    PS
    I'm not driven from a thread that easily....as you can tell.
    Last edit by KC CHICK on Nov 12, '01
  5. by   mattcastens
    Originally posted by KC CHICK
    Let me ask you this question, seeing as how you are presently an ADN that is bridging for your BSN: Would you have gone into nursing if you had not been able to complete an ADN program to do so? Would you have been able to do it if a BSN were your only option??
    Yes, I would have. It would have taken a little longer, but I still would have gone into nursing. The fact is that I am a second-career nurse without a previous bachelor's degree.

    While I obviously made my own decision to pursue the ADN route, I feel that I had some poor career counseling from older nurses I was working with as a nursing assistant. I was told that BSNs were "useless". I now feel that this is incorrect.
  6. by   KC CHICK
    Interesting.
    Seems as though we are very much alike. This, too, is a second career for me.
    I am also a licensed cosmetologist, believe it or not. I chose the ADN route because I was paying my own way in college and living on my own. I am going to BSN bridge starting next summer or fall. (Due to wedding plans for May.) I've already been accepted to UMKC...would have started this fall, but the training for OR is 9 months long and both at once is way too much to handle.
    I didn't want to be dirt poor while going through four years of school. It just worked out better for me this way. I didn't do it because I don't value higher education.

    Anne

    PS:
    Also see that you are engaged to be married next Oct.....Congratulations Matt!!
    Last edit by KC CHICK on Nov 12, '01
  7. by   Stargazer
    I think this dead horse has been kicked a few times too many. Please let him be.
    You know, Anne, my first impulse on seeing this thread title was exactly that. Imagine my surprise and delight to see that this is, on the contrary, one of the most civilized, calm, and intelligent incarnations of this topic that I have seen yet on this board. Could it be that people are finally learning to DEBATE?? Even some new and innovative thinking, as evidenced by the suggestions on the 2-tiered NCLEX (not that I agree with that, and I'll tell you why in a minute---but innovative nonetheless).

    Many great posts here that summarize my thinking. Although I think an MSN entry-level requirement is a pretty big leap to take (and I think Mijourney was using it to exaggerate for effect), she's got a good point that there is a huge untapped resource of nurses who have left the bedside because of poor pay, scary staffing, and lack of respect--and I include myself in this group. While I don't think a BSN entry would completely solve that problem, I do think it would give us a little surer ground in marketing ourselves as professionals, as Chas suggests.

    As far as the 2-tiered NCLEX is concerned--I'm sorry, it's been 14 yrs since I took it, and maybe it's changed for the better--but my NCLEX test was NOT a measure of my nursing knowledge. It was heavily weighted towards OB, peds, and psych, and many of the questions were, not to put too fine a point on it, BIZARRE. I laughed out loud several times during the exam because the questions were so absurd. The NCLEX was basically a measure of how well I took tests, not how much nursing I knew. In contrast, my CCRN exam taken years later was a much more thorough, fair and accurate assessment of my critical-care knowledge. As I said, if the NCLEX has changed dramatically in the intervening years, please feel free to clue me in.

    And as far as dental hygienists are concerned--they are now a significant leg up on us, so to speak, as they have just been granted the ability to practice independently of dentists. Maybe we should find out their secret?
    Last edit by Stargazer on Nov 12, '01
  8. by   morghan
    I just wanted to add a comment here. I was a Diploma Grad(so many years ago, I hate to say, ha ha!) let's just say I'm a child of the 60's, OK?! Any way, I kept saying I didn't need that extra degree, but did finally go back and complete my BSN, in an
    accelerated RN to BSN program. Best thing I ever did. You have
    to remember, too, when I went to school, and many currently practicing RN's went, there weren't many BSN programs available, unless you had access to a large metro university, with a teaching environment. I believe, however, that those "extra courses" in the humanities, assist people to be more well-rounded from an education perspective. I also believe that the
    more knowlege you acquire, the better off you are. I can recall when mandatory CEU's first came along, everybody griped about that too, like it was too much trouble to get a little extra info.
    I agree with the Moderator, most environments are seeking BSN
    prepared, and that's in the heart of the Midwest! I recommend
    education for the advantages it offers, in many arenas. Since I am now working on my Master's, I have moved from a Clinical
    Supervision position to Psychiatric Case Manager at my hospital.
    Hope everyone has a great Thanksgiving, too.
    PsychRN
  9. by   Mijourney
    Hi. Well stargazer, actually no, the idea of MSN as entry level wasn't all effect. It's a goal that at this time one would not expect to take effect, but it is a goal that should be continually discussed and strongly considered as an alternative for the future.

    You see, MSNers are the only level of nurses, outside of those with a PhD in nursing that can get credentialed individually as autonomous practitioners in the nursing profession. That does not mean that one will not experience problems that are generally inherent with anyone who has high levels of responsibility and accountability. The debate over increasing the educational standards in nursing has been going on for nearly four decades or more. So far, nursing has not achieved a mandate for establishing a different level of entry, but neither has nursing gained any more respect, wage and benefit fairness, or intellectual political clout from within or without.

    Doctors on the other hand, pharmacists, and now therapists with their increased educational requirements (probably because of their smaller numbers), although not as diverse and flexible as nurses IMO, are able to call many of their shots and make then stick with legislators, insurance companies, the government, the pharmaceuticals and other vendors, as well as the patient. Outside of the relatively small number of NPs and some CNSs, nurses are not able to do this successfully most of the time.

    Nurses are not primarily the helpmate of doctors to carry out orders and to do all his/her bidding. We are a team. There is nursing science and medical science. Both of these are vital and interdependent. Doctors are not qualified to be our supervisors nor to my knowledge is it in their practice act to do so. Nurses are. There is such a thing as nursing diagnosis and nursing orders. I use them all the time when I develop a plan of care for my patients in home health.

    I'm still concerned about the overwhelming focus on skills and abilities as the only benchmark that determines a good practitioner. These are important, but I think it's the reason that nurses are considered technicians but the public and not professionals. We're lumped in with construction workers and the like. Our intellects are not well respected. It's been written over and over that the public does not give a rat's a** about education, but I believe that is untrue. I think that they are confused about nursing because there are so many ways to get into nursing. I also don't think nursing has marketed its image as professionals over the many years well. We've had people representing us and marketing us that probably haven't been at the bedside in years if ever.

    No, education is not the cure all, but then nothing in life is. I think the excuses against moving nursing to the next level are a self-defense, because many of us did not truly get into nursing as a career.

    Someone mentioned the big picture. I do feel that we will miss the boat, by not once and for all making a move in that uncomfortable direction. It won't be all of us, but many of us will do. We're still numbered in the millions after all.
  10. by   Lausana
    To me the only way to be considered "professionals" is to be professional and regard each other that way. As far as how we are perceived by the "outside world" is understandable--to someone not familiar with what each degree covers it would seem unusual that you can receive an RN from an ADN or BSN, so most likely until there is a formal standard of a BSN for new grads this will be the case. As far as pay compensation I'm still unsure how that will be resolved-here there is no educational pay diff only for addition certifications, which I disagree with, I think there should be a pay difference by degree, but also by experience even a BSN grad couldn't hold a candle to the knowledge of an experienced nurse-I just don't think you guys are paid enough! Amoung ourselves, it is up to us to treat each other with respect as NURSES not ADNs or BSNs. I love the positive and creative ideas I've heard on this topic rather than the usual bickering-how many threads like that have we read and has any good ideas come out of the which is better argument?? I think eventually the BSN will be required for new grads and I love the idea of the 1 year preceptorship, think what great new nurses would be joining the workforce! I am going to become an ADN RN but plan to continue to BSN-although I do believe this will not make me better at actual patient care-but instead will make me better equipped if I chose to move to management, etc. It is also necessary for advancement. I can't wait to have my ADN and get out there and get my hands dirty-but I also feel that when the time comes to begin on the BSN it will only build upon the science that the first 2 years provided. (BTW there is a choice on what "humanities" one can take, rather than bowling I will probably take a foreign language, a WWII history class to help me relate better with those who lived through it that I may come in contact with, etc.--it is our education so we might as well make the most of it as we see fit for ourselves because we know in the end we will be a nurse.)
    Sorry for all the rambling-I just get a little tired of the arguing I see here! Please more positive ideas everybody!!
  11. by   Stargazer
    Sorry, Mijourney, didn't mean to put words in your mouth. And I agree with pretty much everything you've posted.

    Like it or not, the trend in medicine IS towards more education. Most pharmacists now have doctorates, registered dieticians have bachelor's degrees--even urology residencies were expanded a few years ago to include an entire year of nothing but research. You don't hear urologists saying, "Well, since I am basically just a glorified Roto-Rooter man, that extra year of education was completely useless and irrelevant."

    I think a lot of the "respect" issue is going to come down to 2 issues: independent practice, and independent billing/insurance reimbursement. As I said, the dental hygienists now have independent practice status. How did that happen? Do dentist not have as strong a lobby as the AMA does, or did the hygienists somehow manage to get the dentists on their side?
  12. by   Mijourney
    Hi. Lausana, when you write about a BSN grad holding a candle to those of us who have years of experience in nursing, do you also mean to include experienced BSNers?

    The point I'm trying to make is that we seem to be benchmarking educational credentials and experience off of new BSN graduates which IMO doesn't make sense. If you looking to make years of experience as a more valid indicator of a good nurse then education, then you can simply match the knowledge, skills, and abilities of all the levels of high performing nurses who have worked in the same area with equal years of actual nursing practice. For instance, you can find measurable ways to compare the performance of an LPN, ADN, diploma nurse, and BSN after each has practiced nursing for five years.

    Years of experience unfortunately is not always the best indicator that someone has matching skills, abilities, and knowledge. Work ethic as implied in the topic on professionalism and credentials I feel is one of the best determinants of whether a nurse is meeting his/her potential. We may not feel it's necessary to expand our education beyond the basics, but with a good work ethic, I feel that more formal education can only be a plus.

    Stargazer, I agree with your comments about independent practice. So, the dental hygientist are recognized as autonomous practitioners? Do you believe this is another way for dentists to get more money very much like doctors do with PAs or NPs? They can bill not only for the work they do but they can bill additionally for the dental hygienist? How ingenious.
  13. by   nurs4kids
    Actually, I've not heard the bit about the dental hygenist. They are also state regulated, so that may not be the case here yet. BUT, that will hurt them more than help. Before when the dentist was not physically in the office, the hygenist could not see patients. Now they will be forced to work when they normally would have been off or at least, off their feet. I don't see where this benefits them, but I don't know the specifics of it either.

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Professionalism and Credentials