Ok this may be a rant but.... - page 5

by PNicholas

5,465 Views | 51 Comments

Why does it seem that most people believe that ADN programs are not as good as BSN programs?! Do we not all take NCLEX? Do we not all have the same goals...to be good caring nurses? Why is there such a distinction made amongst... Read More


  1. 3
    Much of this thread has been about bluster, ego, and feelings of adequacy. How about some evidenced based practice?

    I'm a proponent of BSN as entry to practice. Why? They have shown through research that they provide safer patient outcomes. Here's a few quotes pulled from different studies of the subject:


    • "... there were 4.9 fewer deaths per 1,000 patients on intensive care units staffed with a higher percentage of nurses with bachelorís degrees" (AACN, 2012)
    • "The noted nurse researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death" (AACN, 2012).
    • "The findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients" (AACN, 2012)

    These are just a few examples from studies that are listed on the AACN website. Those "extra" gen-ed classes, nursing electives, Nursing Leadership, Community Health, Nursing Theory, and Research have a measurable effect on patient outcomes.

    Reference
    American Association of Colleges of Nursing (AACN). (2012). Creating a More Highly Qualified Nursing Workforce. Retrieved from http://www.aacn.nche.edu/media-relat...sing-workforce


    Luckyyou, zoe92, and L&DRegisteredNurse like this.
  2. 3
    The gen ed prep classes are not the same for both, in many programs. The widely varying reqs are a concern to BONs, in my state there is a mandate to start making the curriula and prereqs start being consistent with each other. I have looked up prereqs for different ASN schools, one accepts a B in high school biology as sufficient. One requires a basic math class, with simple algebra only.

    Now, I've read many posts, and know that some ADN students have a much deeper and better prep than that, many already have a bachelors in another area. But the fact remains, many ADN programs have much weaker prereqs. Some have leadership classes, others don't.

    BSNs do spend more time in school, both in prereqs and nursing classes. I am proud of my ASN students and grads! But I also know how much more I studied for my BSN; from 3 semesters of psych vs 1, to a lot of chemistry and biology, stats and algebra, history, languages, social studies, etc. In the BSN part, theory, leadership and mgmt, an entire semester of community health instead of a shorter rotation....

    No, I am not being "snooty", I am relating my experience. My ASN students are well educated in nursing, and are competent and able RNs. I work with a fair number of my former students, and gladly. The BSN nurse has a broader education in many areas, and education is always a good thing for any person. Any professional benefits from being widely educated.
    nursel56, zoe92, and L&DRegisteredNurse like this.
  3. 1
    Quote from BlueEyedGuy
    Much of this thread has been about bluster, ego, and feelings of adequacy. How about some evidenced based practice?
    It would be more convincing if you didn't get all your studies from a list provided by a group who has an interest solely on one side of the argument.

    I found this excellent article in following my personal interest in the subject matter from what many people would agree is the inception of the argument, the 1965 ANA position statement about education for entry into practice and the difference between a professional nurse and a technical nurse. The authors are generally in agreement with the principles set forth there, but state:

    Quality care is easy to describe but difficult to measure. Because technical and professional nurses write the same licensing examination, hospitals, as the major employers, do not differentiate among the educational levels of staff nurses in patient care responsibilities or salary. Given the educational mix of registered nurses in the care environments, the number of health professionals involved in hospital-based practice and the complexity of care, it is difficult to identify any factor, such as the educational level of the nurse, in studies of health care outcomes. Consequently, the measured impact of professional nursing on patient care is ambiguous and unproven.

    Revisiting the American Nurses Association’s First Position on Education for Nurses

    It's long, but well worth the read.
    Last edit by nursel56 on Oct 2, '12 : Reason: wonky fonts
    Esme12 likes this.
  4. 1
    I am not quite sure if your post about revisiting the 1965 ANA statement is intended to solidify the argument for BSN or refute it?

    It is true the 1965 statement sparked the debate after which the ANA has supported the BSN. The 2002 revisit you linked concludes that nurses are the least educated in the medical field and a new position that reflects changes is warranted. This was prior to the Aiken et al 2003 landmark study that showed significantly decreased mortality with a larger workforce of BSN nurses, findings that were repeatedly demonstrated in the following years spanning hundreds of thousands of patient outcomes.
    Last edit by BostonFNP on Oct 2, '12
    zoe92 likes this.
  5. 1
    Quote from de2013
    I am not quite sure if your post about revisiting the 1965 ANA statement is intended to solidify the argument for BSN or refute it?

    It is true the 1965 statement sparked the debate after which the ANA has supported the BSN. The 2002 revisit you linked concludes that nurses are the least educated in the medical field and a new position that reflects changes is warranted. This was prior to the Aiken et al 2003 landmark study that showed significantly decreased mortality with a larger workforce of BSN nurses, findings that were repeatedly demonstrated in the following years spanning hundreds of thousands of patient outcomes.
    I posted the link for several reasons. I thought it was interesting and contains a timeline of references throughout the decades since the paper was first published all in one place. If someone was interested in pursuing the topic further, there are a wealth of "leads" in it to serve that purpose.

    I also posted it because it appeared to not be one of the many drum-beating lists of resources intended to prove a point the person or persons tailors to suit that pre-decided agenda. A good example of that would be the way the AACN cherry-picks studies and predictions made by people like Peter Buerhaus.(that is usually done to buttress their claim that we are still in the midst of a nursing shortage though)

    As far as I know every factor mentioned in the excerpted paragraph from 2002 was still true a year later. It's easier to say "correlation does not equal causation". Believing that nurses are undereducated compared to other professions doesn't change the rules on what constitutes "proof". I found the article to be informative and fair. Others may agree.
    Last edit by nursel56 on Oct 2, '12 : Reason: clarify
    Esme12 likes this.
  6. 0
    Quote from nursel56

    I posted the link for several reasons. I thought it was interesting and contains a timeline of references throughout the decades since the paper was first published all in one place. If someone was interested in pursuing the topic further, there are a wealth of "leads" in it to serve that purpose.

    I also posted it because it appeared to not be one of the many drum-beating lists of resources intended to prove a point the person or persons tailors to suit that pre-decided agenda. A good example of that would be the way the AACN cherry-picks studies and predictions made by people like Peter Buerhaus.(that is usually done to buttress their claim that we are still in the midst of a nursing shortage though)

    As far as I know every factor mentioned in the excerpted paragraph from 2002 was still true a year later. It's easier to say "correlation does not equal causation". Believing that nurses are undereducated compared to other professions doesn't change the rules on what constitutes "proof". I found the article to be informative and fair. Others may agree.
    What is your interpretation of the line directly preceding the cited text and directly following the cited text?
  7. 0
    Quote from de2013
    What is your interpretation of the line directly preceding the cited text and directly following the cited text?
    It's unclear to me what you're asking for. By "the line" do you mean the sentence in the preceding paragraph that refers to registered nurses as "undereducated members of the health care team when compared with physicians, etc"?

    I would say it's probably true. The benefits of higher education span across the totality of everything a nurse (or anyone for that matter) does.

    However that is not to say that there is a proven causal relationship between better patient outcomes and what type of education a registered nurse has had. Linda Aiken's first study is not universally accepted as proving that where there are better patient outcomes, every other factor that could possibly account for the improved outcome has been ruled out, or that within the category of "BSN" and "ADN" prior experience or prior nursing education was taken into consideration.

    I don't see how you're arriving at the idea that if one is true the other can't be, and apparently neither did the authors of the article. If you think the article is outdated the 2010 IOM Report on the Future of Nursing: Focus on Education contains most of the points made within this article in terms of the overall need for and benefits of a more educated workforce, it also states: "The causal relationship between the academic degree obtained by RNs and patient outcomes is not conclusive in the research literature."
    Last edit by nursel56 on Oct 4, '12
  8. 0
    The causation vs correlation debate is one of study design. There is no possible or ethical way for a randomized placebo-controlled study to be conducted so a correlation is the best insight we will ever get. Aiken did control for other parameters which showed significant associations; perhaps an argument could be made for the uncontrolled parameters, in aggregate, created a confounding parameter which is the downfall of the study design. I don't notice any blatant confounders.

    And I was referring to the statement following the quoted text that (paraphrasing from memory) that nurses lacking liberal arts education struggle with the application of knowledge.
    Last edit by BostonFNP on Oct 4, '12
  9. 1
    Quote from Esme12
    This debate will contine Ad infinitum while there is a two tiered entry levels.
    I'm Australian and I find it interesting that there are 2 different RN entry level degrees that result in the same responsibilities and pay (is that right?). Here we only have a (BSN) RN degree undertaken at university for 3 years or an Enrolled Nurse (like LPN) diploma which takes 18 months.
    Can anyone tell me the history behind having 2 RN pathways? I'd be interested to know
    Esme12 likes this.
  10. 0
    Quote from Anoetos
    I think you saw my post in the other thread.

    If the idea is that a nurse is someone who assesses patients, communicates with doctors and administers medications from the bedside (along with all the other necessary and wonderful things bedside nurses do), then yes, you're right, these classes are superfluous.

    But if the idea is that a nurse is someone involved in the care of the whole person, family, population and community, including their responses to treatment, stress, their environment and all the many things that effect their health and health behaviors in every place where they find themselves, then a broader classroom preparation becomes necessary.

    Where this gets muddy is when assumptions get made, that, for example a two year degree nurse can't do all these things, or, on the other hand, that BSN prepared nurses are clinically inadequate. Neither is true. Clearly, ADNs get a grounding in holistic and collaborative care, and clearly BSNs get the same amount of clinical preparation as ADNs.

    Frankly, I am for a broadening of the profession. I would like every nurse to be as well prepared as he or she can possibly be. If doctors go to school as long as they do, why should the people carrying out their orders not be at the very least baccalaureates?

    I am for independent nursing as well, for the practice of nursing as a separate discipline, a profession where it's practitioners are prepared as highly as they can be, who can work autonomously.

    I would encourage everyone to go and get their bachelors if they have not, and to go on to graduate degrees if they have and are so inclined. It only improves the profession itself and it's perception. It means better opportunities for a greater number of people. It means elevating the profession.

    I am really sorry if this sounds snooty. It isn't my intention.

    Is a bachelors degree better than an associates degree? Does the question even need to be asked? Of course it is.

    Is a BSN prepared nurse a better nurse than an ADN prepared nurse? Does the question even need to be asked? Of course not.

    But it remains that the former is better prepared upon graduation to embrace nursing as a complete profession in every environment.

    You're welcome to disagree.
    I could not have written a better post. Love this!


Top