Thinking out of the box re: Nursing education

  1. a nurse attorney stated during a presentation that Associate Degree Nurses should be awarded a Bachelor's degree b/c of all the work involved in becoming an RN.

    This was a EUREKA!!! moment for me.

    have often thought of how much work it was to become an RN. all the assessments, writing, and care plans, etc. -- EVERY WEEK! and one to two full days each week in clinical.

    i myself started out in an ADN program -- and it was a lot of work!!!

    and what other professionals work THIS hard and then look forward to working weekends, holidays, summers, and rotating shifts.

    and when was the last time you heard that a chemical engineer, teacher or a lawyer was sued for malpractice?

    so . . . why can't the 2 year student be awarded a Bachelor's degree? (and by the way, who really completes a "2 year program" in 2 years?)

    i've done some research into course requirements (and "clinical") for chemical engineers, teachers and lawyers. the total number of hours required are less than those required for nurses.

    a close relative graduated law school a year ago. law school is 3 years beyond a bachelor's. the first 2 years are intense. the 3rd year is considered a "waste" by many. Some law schools are toying with the idea of doing away with that 3rd year. others are offering a doctorate degree (J.D) at the completion of the 3 years.

    my point really is -- why shouldn't the degree be COMMENSURATE with the amount of WORK (again consider all the time, written assignments, care plans, clinicals, etc.) that it takes to beome an RN??

    a 4 year program could award a Master's or a doctorate. WHY, given the amount of work involved in becoming an RN, should we restrict ourselves to the traditional notion of 2 years equals an ADN, and 4 years equals a BSN???
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  2. 20 Comments

  3. by   llg
    I"m not against the consideration of new and/or radical ideas, but I can't support this one as stated because:

    1. It's not the "hours of work" that merit a degree. The content of that work is also a big consideration. ADN programs do not include much statistics, research, nursing theory, education, community health, leadership, etc. plus a basic liberal arts foundation of general courses. If the schools lengthen their programs to include these things (commonly found in BSN programs), they yes ... they should be awarding BSN degrees. But if that were the case, it would take 4 years.

    The whole idea of creating the ADN degree was to create a 2-year entry level program that would prepare a nurse for entry-level positions in a 2-year program. As some schools have lengthened their ADN programs, they have corrupted that basic purpose. The mistake is in the lengthening of the ADN programs and the "muddy-ing of the waters" over the difference betweeen the two degrees. That's the problem -- and the solution is to return ADN programs to what they were originally intended to be, not continuing to muddy the waters by narrowing the gap between the degrees.

    2. If academic degrees were awarded based on hours of work rather than the contents of the work ... then any field that required hours of practice to learn (e.g. automechanics, welding, plumbing, sports, art, music, etc.) would be awarding bachelor's degrees to people who had practiced that profession for many years. I have nothing against those other fields, but spending a lot of time working at something is not the same thing as academic accomplishment. Academic degrees are awarded for ACADEMIC achievement and should not be awarded for anything else.

    3. Awarding BSN's to people who had not met the academic requirements for a BSN degree (and taken ALL of the required coursework) ... would lead to an upgrading of all of the other degrees. There would be a "trickle up" effect, with an effect much like grade inflation. BSN's would become MSN's, MSN's would be awarded doctorates, etc. And in the end, it would all be pretty silly as our nomenclature had changed -- but the underlying academic preparation and skills would not have changed.

    I suspect that lawyer knew her audience ... and was "sucking up" to it by making a proposal that she would never really support if it meant that all the BSN nurses in the world were suddenly to be considered to have a degree equal to her own and therefore would command similar treatment and compensation. If she had to pay "lawyer fees" every time she was treated by a nurse, she would soon be arguing that the nures's education was not so high as her own and should not be compensated as if it were.
  4. by   AnnieOaklyRN
    How 'bout this instead... we keep our associates degree and get rid of care plans because that would cut the work almost in half.


    swtooth
  5. by   psalm_55
    SWtooth -- that was my original thinking. how can we reduce the workload of student nurses without sacrificing the quality of RNs produced?? (BTW, i'm all in favor of getting rid of nursing diagnosis -- they were invented for a healthcare system that hasn't existed for 20 years -- but that's another thread.)

    i don't have the answers -- but i do think that something radical needs to be done. given the amount of work, responsibility, and lack of cache as compared to other degreed individuals / professionals, well -- focus groups need to be formed.

    Ilg -- well-stated. but reflects the traditional view of academia. nursing is so unlike other jobs / professions. i just think we need to re-think the whole thing -- like having summer internships that count toward the degree -- and leave nothing off the table.
  6. by   txspadequeenRN
    LOL..... you have just created another multi page thread of ADN -vs- BSN...
  7. by   marilynmom
    Oh boy.....

    Haven't you learned anything about lawyers?
  8. by   UM Review RN
    Quote from psalm_55

    my point really is -- why shouldn't the degree be COMMENSURATE with the amount of WORK (again consider all the time, written assignments, care plans, clinicals, etc.) that it takes to beome an RN??
    Actually, this is where some good old-fashioned American snobbery comes in. The more physical labor and the less intellect a profession demands, the more it will be considered a trade and not a profession. Nursing has evolved into being much more intellectually demanding than it used to be.

    Nurses really had to fight to get the profession recognized as such, and we're just coming out of the Dark Ages beyond the doctor's handmaiden image.

    Many of my patients don't even realize that nurses have to go to college nowadays. People hear the word "nurse" and automatically think "hiney-wiper," not "college grad" equipped with a brain.

    I don't think we as a profession will get anywhere until the public's perception of nurses changes to reflect what it takes to become and remain (don't forget those internships, orientations, specialized certifications, licensure qualifications, and CEUs!) a nurse.
    Last edit by UM Review RN on Jan 22, '07
  9. by   Tweety
    Great response llg.

    Part of me agrees that the ADN has become so labor intensive it seems a shame that we are awarded "just" an Associates Degree for all that time and hard work.

    But in the end, colleges and universities have requirements for awarding Baccalaureate Degrees above and beyond the labor.
  10. by   Tweety
    Quote from psalm_55
    Ilg -- well-stated. but reflects the traditional view of academia. nursing is so unlike other jobs / professions. i just think we need to re-think the whole thing -- like having summer internships that count toward the degree -- and leave nothing off the table.

    Then we might be considered elitist. Respiratory Therapists, Radiology, and Dental Hygenists, and even vet techs who have programs just as hard has nursing and receive associate degrees will be upset at this idea and would want Baccalaureate Degrees also.

    Interesting idea and I'm not totally closed-minded, but very skeptical.
  11. by   Tweety
    Quote from txspadequeen921
    LOL..... you have just created another multi page thread of ADN -vs- BSN...
    We moderators are not going to let that happen. There are a few open threads on ADN vs. BSN and those are the only ones allowed to go on and on. This topic is a little different, and we do allow for discussions that ask specific questions. If it goes on page after page in a similar vein to existing threads, we'll close this one. If it stays on topic, no problem if it goes page after page.
    Last edit by Tweety on Jan 22, '07
  12. by   RNsRWe
    This is reminiscent of a thread I had started a few months back, when someone (who should have known better) referred to my nursing degree as "just" a two-year degree--equating it with a liberal arts degree because it, too, was "just" two years.

    I seem to remember the general consensus of that thread was that perhaps the time had come for a three-year degree specifically for nursing: recognizing that the credits required were generally more than any other Associates degree demanded, yet not so much as what a Bachelor's demanded.

    Not only do many nursing programs already require MORE credits than the typical A.S., but there are not NEARLY enough credits given for the work actually done: I got not a single credit for any of my clinical work; the additional lecture time and skills lab lecture time was ALL that got additional credits. Why not recognize the academic efforts that go into those clinical assignments? And, therefore, accept that a new level of degree is long since past-due?
  13. by   fleur-de-lis
    I would be offended if someone gave an Associate's student a BSN without them completing the required coursework. I am having to take courses in nursing research, community health, discipline and practice of nursing, nursing management, etc. and write tons of 2500 word essays, have extra readings, tests, assigments etc. IN ADDITION to all the hours of care plans and the courses that are required for an ADN. It would be totally unfair to award a degree that has not been earned.

    I also don't think you can equate nursing education to something like the training for an attorney. I would want my nurse to have had more hours of training, since he or she could very easily kill me or save my life. In normal circumstances, an attorney has no one's life in their hands. (You could make the argument for death penalty cases, but that is not usually their everyday line of work).

    I don't know what the answer is to the nursing education problems, but I cannot see it solving anything to hand out honorary bachelor's degrees.
  14. by   llg
    Quote from psalm_55
    Ilg -- well-stated. but reflects the traditional view of academia. nursing is so unlike other jobs / professions. i just think we need to re-think the whole thing -- like having summer internships that count toward the degree -- and leave nothing off the table.
    Thanks for not getting ugly in your response. I would like to think we can have this discussion without forcing the mods to close the thread. :wink2:

    I am quite open to the idea of exploring possible radical changes to our nursing education. I just think that awarding degrees based on clinical hours alone is not the answer. As I said in my first response, I think the answer is in scaling back some of the work in the ADN programs -- taking it back to what it was originally intended for: the preparation of a safe, entry-level nurse who would return to school for a BSN if he/she wanted career advancement. They were originally meant to take 4 semesters of full time study after completion of high school (or longer if the student attended school only part time.)

    If the ADN programs had stuck to that original purpose and set of expectations, we could have avoided many of the problems we have today. Everyone would know what was what and there would be fewer misunderstandings and resentments. Unfortunately, ADN programs discovered that they could add to their requirements and people would still pay come. People would still pay for the local community college ADN even if it took longer than 2 years to complete. So, they added the requirements, and made money off the students who paid to take the extra courses.

    Out of pride, wanting their grads to be the best they can be, the ADN programs started squeezing in as much from the BSN programs into their programs as they could get away with. There is nothing wrong with wanting to be the best ... and for a school to want to produce the best graduates it can ... but they kept adding to the students' workload (and expense) while still offering the same "2-year" degree. I believe that trend was morally wrong and unfair to the students who keep doing more work and paying more money for a degree that is supposed to take 4 semesters. The people who should be most angry about it should be the ADN graduates who went to such programs.

    But the answer is not to award academic credit for BSN courses not taken. The answer is to curtail the ADN programs. Encourage them to scale back to their original lengths and workloads so that the degree they award matches the work and expense they require.

    Now as for incorporating more "experiential learning" into all types of nursing education ... I am all for that. Experiential learning is one of my favorite topics that I teach as a staff development educator. Learning how to do it well is difficult -- and it is very labor intensive and expensive to use as a teaching method. Lectures, simulations, etc. are easier and cheaper to provide. Many schools also have problems scheduling clinical time in local hospitals as it already is. That would be a real challenge for some schools. But if people can do it WELL (and not just have the time be spent in clinical without a lot of learning going on) ...then I would be all for it.

    llg

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