Ok this may be a rant but....

Nursing Students General Students

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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 us?? I do not understand why there is not more compassion among nurses!! I just would really like to know what makes one program better than another?

Either way, the BSN is higher nursing education. It in NO WAY makes someone a better nurse. They just spent the extra time/money receiving the bachelor's degree rather than associate's. I would probably go for the ADN rather than BSN, but my parents offered to pay for my BSN (I am only 19 and a traditional student), and where I lived it is easier to find a job with the BSN. I will never look down on someone who has an ADN and does not plan on obtaining any more nursing degrees.

Either way, the BSN is higher nursing education. It in NO WAY makes someone a better nurse. They just spent the extra time/money receiving the bachelor's degree rather than associate's. I would probably go for the ADN rather than BSN, but my parents offered to pay for my BSN (I am only 19 and a traditional student), and where I lived it is easier to find a job with the BSN. I will never look down on someone who has an ADN and does not plan on obtaining any more nursing degrees.
It is NOT higher nursing education. It is higher education overall because of the Gen ed and interdisciplinary study requirements, but I repeat it is NOT higher nursing education. I have used the same leadership/management.... texts as some universities and had tons of research papers due throughout both years. This topic urks me to no end. I can't wait til I'm done with my bsn classes (in which I've already learned this stuff in my adn program) just so I don't have to have people look down on me anymore for only having an adn. Even before nursing school, before my prereqs, I had 94 credit hours from a jc and NIU. I have more education than most graduating BSNs and I don't even have my BSN yet. I'm just SICK of the snooty ones who think they are better because they went to a four year school.

I hope you weren't assuming that I am one of the snooty ones. And when I say higher nursing education, I meant that you have a higher nursing degree with a BSN... which is the truth. It doesn't mean you bring more to the nursing profession.

Specializes in L&D.

My husband holds an ADN. I am currently in school for a BSN. The main difference I have noted is generally the theory surrounding nursing. In my program, we spend a heck of a lot more time learning theory, research, and cultural viewpoints. In his program, they hit the ground running, beginning clinicals 6 weeks after the very first day of nursing school. They were required to care for their own patients. I did not begin clinicals until level 2. The first clinical was shadowing a nurse for the day. After that, we have a partner to take care of one patient for the day for 2 weeks. After that, we are on our own with a patient. It's just different. I'd say the pace is a lot different. He learned the same nursing care that I am learning now, though. Also, there is community health thrown into the mix for me. He did not do any of that in his ADN program. Just different stuff you have to learn on top of clinical skills. (:

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 bachelor's 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-relations/fact-sheets/nursing-workforce

Specializes in Trauma, Teaching.

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.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
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.

Specializes in Adult Internal Medicine.

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.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
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.

Specializes in Adult Internal Medicine.

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?

Specializes in Peds/outpatient FP,derm,allergy/private duty.
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."

Specializes in Adult Internal Medicine.

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.

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