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BostonFNP Guide 45,298 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 4,878 (62% Liked) Likes: 11,892

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  • 3:34 pm

    Check out last night's 60 Minutes segment on the cozy relationships between Republican lawmakers and the drug distribution companies. I don't think that Jarrod gonna be able to fix this one.

  • Oct 15

    Quote from BostonFNP
    What is the crux of the issue? That neither ASN or BSN programs are preparing students adequately for the role?
    It would be interesting to me to see what a BSN program would look like if it were developed de novo rather than slowly evolving along the diploma to ADN to baccalaureate continuum.

    Personally, I think engineering education provides an excellent model (admittedly, I'm biased). In the first year, the student is immersed in rigorous science education - in the same classes as the students for whom those are their major classes. The students begin basic lab practica to get exposure to the tools and environs of their field. In the second year, the hard sciences continue but are now joined by applied sciences based on the the core topics already studied. Each of these includes a practicum component (which includes writing on a professional level). In the second and third year the students study applied topics from other disciplines which overlap with their own. In the third year students begin to work more independently and are expected to produce original work and to have fundamental skills to utilize the tools of their trade. The students begin to take electives toward specialization within their field. By the fourth year, the applied sciences have become specialized and dependent on multiple prerequisites. Often times the students will begin taking selected graduate-level classes. By this time it is expected that the faculty are serving more as mentors and guides rather than as instructors. The expectation is that the students have developed the skills and core knowledge to educate themselves utilizing resources. The students are spending many hours in practica and are performing independent, original work - projects and/or research. Upon graduation, students are expected to have basic competence and to be ready to be productive staff engineers - albeit at a basic level.

    Throughout all years of the program the students take all the GE classes like music appreciation, anthropology, poli sci, history, English, etc.

    While I can only speak for my personal experience, my engineering program prepared me much better than did my nursing program. The engineering program (and the years of professional experience) prepared me greatly for both my nursing education and my professional work as a nurse.

    I will also point out that engineering school was much more difficult that was nursing school. There were no multiple choice tests and homework could take hours and hours, sometimes on only a problem or two.

  • Oct 15

    Quote from lonewolfiern
    "Don't hang around any physician forums, but I have to wonder if they are in the habit of disparaging education the way I often see nurses doing.. ************************************************** *****************
    Quote from lonewolfiern
    MD's are the worse! What are you talking about! LOL!

    My hubs is a Simulation Manager. Every physician specialty has to come to the Simulation Center to perform their scenario to prove competency. The MD's hate it, as they already know how to do it!
    Well, hello there... You know, when you respond to someone and add a "lol" it might give the impression that you are mocking what the person you responded to said.. Frankly, it sounds a bit snooty & superior.

    Also, if you want to make sure that your reply actually makes sense, it's helpful if you include the entire paragraph you were responding to, instead of just half of it. LMAO!

    This is how it went...

    Oh, and remember... the title of this thread is "BSN is a joke"..

    OP wrote this...
    Quote from nurseguy22
    Yet here I am getting trained in areas I have no interest in, and will never ever use in my career. And for what? So I can say I have 3 letters behind my name and the school and hospital can make more money? Its a joke.

    My response to the above quote was...
    Quote from macawake
    I don't hang around any physician forums, but I have to wonder if they are in the habit of disparaging education the way I often see nurses doing.. While degrees aren't the be-all and end-all of our earthly existence, I guess I don't understand the negative attitude towards them.
    See, what I was commenting on doesn't have much, if anything, to do with what your "hubs" teaches. I was obviously talking about academic degrees. ROFL!

    Okay, I've had my fun The rest of the post is a serious response.

    These kind of BSN vs ASN threads pop up on a regular basis and I am always saddened by them. It's funny how I've never seen a thread started by someone with a BSN, MSN or DNP saying how bad diploma or ASN nurses are (simply because I don't think the vast majority of nurses with those degrees hold that view, I know that I don't), but I've seen many where BSN's are disparaged. I do think that it's counterproductive to voice contempt against professional degrees in your chosen profession. It's the exact opposite of promoting yourself and your profession. You are telling the world that the education you have or the education that your peers have is crap. How does that reflect on us all? Does anyone think that will strengthen the position and image of our own profession if we loudly and publicly badmouth the educational requirements?

    I stand by my original post. I've often heard nurses complain about stupid APA formatted papers and research, but I've never heard a physician whine that they had get a higher academic degree in order to practice as physicians. Have you ever heard a surgeon witch and moan that s/he had to do all this APA garbage, when all s/he is doing all day long, is cutting people up? I mean, that's one heck of a task-oriented job. Who cares if they know the difference between a high quality randomized trial, case-control design or a retrospective comparative study? Just give'em a scalpel...

    Quote from BostonFNP
    The more I read posts on this debate the more I think the crux of the issue really has nothing to do with degrees, coursework, application, or outcomes but rather with one group either feeling or being made to feel they are 1. left on the outside or 2. less of a nurse. It becomes so personal that way that implicit bias trumps any logical argument or data to the contrary.
    I think you hit the nail right on the head.

    These discussions almost always feel very emotionally charged, and not always rational/fact-based. Since I have never thought of any nurse as "less than" based purely on level of academic accomplishment, I am always a bit surprised when a poster feels the need to launch a seemingly unprovoked broad-brush attack on every single BSN-holder (or rather the quality/value of their education). I'm sure that some schools are academically more demanding and others are somewhat lower in quality, but that isn't in my opinion a good enough reason to designate a BSN degree, a "joke".

  • Oct 15

    Quote from BostonFNP
    Would you take the "shrewd, experienced, capable" nurse with and ADN or the same "shrewd, experienced, capable" nurse that has also finished a MSN?
    This, exactly. People are comparing the "20-year veteran bedside ADN nurse who probably trained Jesus in the healing arts" to the "brand new wet-behind-the-ears BSN nurse who is also socially awkward".

    They should be comparing themselves to themselves. Anyone who doesn't believe that more education would make THEMSELVES a better, more well-rounded nurse, is either lying to themselves or ignorant.

    If you have more nursing education and theory, you will become a better nurse. It's as simple as that. Further, as with most anything else in life - you will get out of your education what you choose to put into it.

  • Oct 15

    Unless the OP's employer mandated a specific RN to BSN program, they should have put some effort into finding a good program. Since I live near San Diego, I'll use the San Diego State University (SDSU) RN to BSN, a typical public university, curriculum as an example:

    For RN to BSN students, the nursing courses taken upon entering the SDSU School of Nursing include
    (schedule of courses subject to change):

    NUR 307: Nursing Research & Evidence-Based Practice (3 units – offered Fall 2016 and Spring 2017 Semesters). Note: prereq is Math Quantitative Reasoning.

    NUR 312: Nursing Professionalism (3 units – offered Fall 2016 Semester) Concepts in professional nursing practice including stress theory, therapeutic communications, values clarification, and legal issues.

    NUR 320: Health Assessment and Health Promotion for RN to BS (4 units – offered Fall 2016 Semester). Expands RN's ability to measure and interpret physical physiologic and psychosocial functioning. Clinical presentation of disease and disability. Evidence-based guidlines for health promotion and disease management. Lab and lecture.

    NUR 415/415L: Community Health (5 units – offered Fall 2016 and Spring 2017 Semesters) Assessment and utilization of community health concepts and delivery with emphasis on promotion of health, prevention of illness and group teaching techniques. Clinical experience in caring for clients in the community. Public Health Nursing is a very respected RN function and is the foundation for NP practice. Lab (clinical hours) and lecture.

    NUR 458/458L: Leadership (5 units – offered Fall 2016 and Spring 2017 Semesters) The US healthcare system and healthcare economics. Theories and functions of nursing management in the healthcare system. Lecture and lab.

    NUR 400/400L: Nursing Care of the Complex, High Acuity or Critically Ill Patients (6 units – offered Fall 2016 Semester) Lab and lecture
    NUR 437: Transitional Care of Populations (6 units – offered Summer 2016 and Summer 2017) Lab and lecture. Both courses focus on care management of patients of all ages who have complex health concerns that require coordination of care across disciplines and transitions between care settings.

    I don't see how any of these courses can be deemed "fluff."

    In addition, the student must complete some GE requirements to earn the BSN. A BSN is a Bachelor's degree. A bachelor's degree is not a skills-based degree. It is meant to provide a well-rounded education.

    Evidently, some programs require Healthcare Informatics. This is extremely important. A lot of RN job postings specify the candidate must have experience with EMRs and some even specify the name of the EMR. And a BSN-prepared RN should know more than just how to use an EMR. Health Info Tech (HIT) also encompasses how to use the data in such systems for data analytics purposes - QI, budget, legal requirements, etc.

    The OP, and many other posters, lack an understanding of the definition of a profession versus a trade From Merriam Webster: an occupation (as medicine, law, or teaching) that is not mechanical or agricultural and that requires special education. Professions also generally command higher pay and status. If RNs want more pay and to be treated better, then they also need to put in the time for a professional education, beyond skills training.

    Finally, I have never seen a profession disregard a college education! Military officers, with few exceptions, must have a college degree. MDs are required to obtain a 4 year college degree before med school. Allied health professions, such as physical therapist, etc are required to have at least a master's degree! If we want the nursing profession to have more respect, then we need to have the educational credentials!

    The benefits of higher, more abstract education are generally NOT immediately apparent. Nursing is NOT just skills - it goes way beyond that. Nursing is a science and discipline. Florence Nightingale did not just write about skills and provide an instructions manual - she had to advocate for the improved practices and care she developed, and go in front of Parliament to get budget for the care of soldiers in the Crimean peninsula. Her writings are also focused the the reasoning behind the practices she pioneered.

    The American dream has been for young people to get the best education possible. My mother was an immigrant and she sacrificed a great deal to make sure I got a college education. I've never heard a good parent say they don't want their kids to get a college degree!

    OP, part of being a professional is sometimes doing things you don't like or find boring. In fact, that's true of any decent job. It's on you that you did not make the effort to find a good RN to BSN program. And if it bothers you that much to have to get a BSN, then go find a job that doesn't require it. You should be grateful for this opportunity, as I bet your employer is paying for part or all of it.

  • Oct 13

    Quote from nurseguy22
    EKG's are done on my floor all the time. Would be nice to be able to read them a bit better than my limited knowledge. Obviously I can read overt rhythms in lead 2. But why not teach the other leads and rhythms or how to measure intervals? I see it everyday and have to wait for someone more qualified to look at them for me. It would be great to get that with my BSN. I need it. It's important.
    Should they also teach you advanced fetal monitoring and care of a 24-week preemie in your BSN program?

    The purpose of the BSN is to teach generalized theory that can be translated into any specialty. How to read an EKG strip is not that.

  • Oct 13

    Quote from nurseguy22
    No i think a lot of you missed my points. Maybe I wasnt clear.
    1. i want to learn things I know I will use and will advance my practice. I want to be more competent. For example a co-0worker and I were looking over a patient's chart the other day. My co-worker who is an MSN knew so much more than me about the labs and tests. I want that knowledge.
    2. I am required to get my BSN to keep my job.
    3. I expect a BSN program to be advanced nursing. Not the exact same social concepts covered in my ASN.
    4. Not many nurses work in public health or research. Why are we focusing so hard on preparing nurses for research when almost none of us work in that area? I mean sure we need to use EBP. But we don't need to be trained to the extent, or in the fashion the BSN trains us.
    5. No language. We need languages. We deal with all sorts of people. Why doiesn't nursing curriculum have language? Seriously we spend all this time on a skill like APA formatting or in home family dynamics which we will rarely use or see, but no language. No advanced lab values study, etc.
    6. After a year of working I think another pharm class wouldn't be terrible. Combine it with the lab values class or something, or like advanced assessments. Heck even a class on medical equipment would be great. I run into stuff all the time I'm not quite sure about, but am responsible for.
    7. Why doesn't BSN have useful things like certifications? Like med surg or ACLS?
    8.Honestly the skills in most BSN programs dont apply to most positions nurses fill. Nurses who actually do home visits or work in demographics or research are relatively rare. Why don't we focus on what most nurses do and need to know?
    9. Not everyone gets a terminal degree like me. The number one thing new nurses need is how manage time and be efficient. Why don't we work on that?
    10.I really think there is an enormous diufference between what I actually do day to day, and what BSN programs teach. If you want to go in public health save it for a masters specialty. Most of us never will.
    It seems as if you were hoping that the BSN would be more like an MSN (at least, your description of what you were hoping to get out of the BSN is more in line with the offerings of an MSN)? The advanced sciences that you are looking for are found at the graduate level. If you are not interested in being an APRN, MSN programs such as clinical nurse leader and nurse educator provide advanced patho/pharm/assessment. BSN programs typically provide the introductory/entry-level patho, pharm, and assessment courses (many ADN programs do not include dedicated coursework in those areas, instead covering similar content in the clinical nursing courses). The dedicated courses in the sciences found in BSN programs presumably would provide you more depth, however certainly not at the advanced practitioner level.

    As far as research, many clinical nurses do indeed perform research, EBP, and QI projects. I personally am part of a research fellowship for clinical bedside nurses which is a joint endeavor between the medical center and the affiliated nursing school. Although I do use the principles I learned in my BSN research and statistics courses, I rely heavily on my PhD-prepared faculty mentor, as the BSN research course is nowhere near the rigor of the research preparation found at the graduate level.

    If you are looking for "advanced nursing", you need to look at the graduate level. Not sure why you would expect the BSN to do so.

  • Oct 12

    59%. I guess it has gone down a lot in the past few years.

  • Oct 11

    This article shows me that nurses do not understand addiction either by most of these comments. It's not the simple, oh it started with a pain medicine prescription for a toothache. The problem of addiction is much deeper. By placing the problem squarely on the pills, it's leading to much bigger problems.

    Everybody thinks, lets just stop prescribing. Hold the doctors responsible for this mess. No, that's not the answer. The addicts simply then turn to the street and start up on Heroin. I saw this happen to a community I used to live in. Our government patted themselves on the back for shutting down three doctors. The Heroin epidemic is now in full swing. Needle exchange stations have popped up. HIV is on the rise...... because nobody wants to take the actual time to understand and try to fix addiction.

    Meanwhile those with chronic pain are ostracized. Cancer is not the only painful condition out there.

    I strongly encourage nurses to attend an NA meeting. I did years ago and it opened my eyes. These people have problems that started way before taking a Percocet. Most were addicted cited to something else, the percocets were just cheaper. Their addictions often weren't any type of drugs, nonetheless they were an addiction. Pills were easier and cheaper.

    We need to fix why these people don't find everyday life satisfying. I feel that is a societal issue as well as the message is given everywhere that our lives have to be fulfilling and meaningful. People compare their lives to what they see from their friends on social media. They get depressed when they think they don't have as much or don't have the perfect life that all their coworkers and former classmates have. There's too much to put into words on here. But you can see where I'm going.

    We are not the pill pushers. The doctors did not create this. Acute care is not the place to fix this. I'm not treating the pain I see on my unit with an ibuprofen. And while I explain to each patient that their pain will not fully be gone even with narcotics, I do my best to get it under control.

    I'm tired of the evening news doing shows on it every night. Those people understand the least and the pendulum is getting ready to fly in the wrong direction 100% with people who are in horrible pain getting a Tylenol and ibuprofen which is laughable, to say the least. I've never had a Tylenol do anything for pain. It helps with fever. Too many ibuprofen will destroy your stomach.

    Let's actually deal with the problem. It's going to take a lot of money and work, but let's actually get the government and mental health professionals to deal and fix the problem.

    I'm not going to at my level, nor do I want to. I don't have the resources nor do I have the time at the acute care level to do it. I'm treating their pain by the number I'm told.

  • Oct 4

    I went to RN school with the hopes of NEVER going to any more school as long as I lived. Family demands of time and hours led to my advanced practice. Getting up or home for those "12s" in a hospital setting at 4 am or 3 am respectively, working every holiday ...not conducive much to family life. I was an RN for 6 years before my MSN and I even worked some as an RN after my grad degree and licensure - certain settings the money was equal for years or was easy to squeeze in a shift here or there. But I notice a lot of my classmates and students that I precept now, in psychiatry, have never worked in psychiatry before. How can an APRN program (and I've seen online AND B&M) admit for a specialty you have never even worked in!?
    I think a lot of young'uns are in for a rude shock when they hit the APRN and it's not all scrooge-mcduck money pits and doctor status and an easy life. I work harder in an office than I ever did at the hospital - including the asylum. And the docs, at least in my restricted state, treat us like garbage and we earn peanuts compared to what we can bill medicare/medicaid. Most experienced RN in a hospital make more than I do, too.

    Think about why you want to be an APRN ,the cost of the education, and consider what state you plan to reside in also.

    And the only reason I left my RN employer when I became an APRN is because they told me "we don't have room to hire you." Well, ok, see you.

  • Oct 1

    Set up the PCP office for your next semester!!!! I already have students lined up for Spring and Summer 2018.

  • Sep 26

    Quote from KatieMI
    So, do you think that people who moved across the country, speak with an accent, survived traches and other manipulations on their vocal apparatuses, ect., etc. are all sounding like idiots just because they pronounce some words differently? It is quite an interesting point of view for someone who dedicated life to caring for others, I must say.

    One so-called "nurse" who targeted and tortured me all my first year because she somehow found my accent "offensive" and "detrimental for safety", later survived a complicated surgery on her throat. She lately learned to speak again but her speech is still more "accented" and less understandible for strangers than my own and it will likely stay like this till the end of her life. I still refuse to even say "hi" to her although she spent time looking for me and then cried and asked to forgive her for being a cruel and ignorant fool that she was.
    I've moved across the country several times, and I was HAPPY to have someone in Massachusetts explain to me that "Comber" was a "coma," that "an elastic" is a rubber band and that "cah" was my automobile. "Angina" is pronounced different ways in different parts of the country -- nice to know these things before some surgeon (and it's always a surgeon) lambasts me for stupidity. Or just walks away thinking I'm stupid or ignorant.

    If it's just correcting pronunciation, I'm happy to be corrected as are most people I know. If it's something else again -- surviving a trach or throat surgery, speaking six languages and occaisionally mispronouncing one in English, etc -- probably it's more than one word that's getting mangled. Personally, I think it's a kindness to correct someone politely and privately.

  • Sep 26

    Quote from jessimee
    FolksBtrippin, I was asking. I wasn't sure if there were legalities involved in making an assumption of an established provider-client relationship. There is some assumption of liability when giving advice to your neighbors...
    I'm not sure how that is having a provider relationship with anyone. I often post pro vaccine things on Facebook and tell people to get their kids vaccinated. I'm very passionate about vaccines.

    It's no different than all those websites telling people lies and crap about vaccines. Nobody is establishing a provider relationship.

  • Sep 20

    Loved anesthesia. Reapplied to another NA program and didnt even get an interview. Opted for the medicine route and now I am a 4th year. No regrets.

  • Sep 20

    Thank you again for your help! You input has helped me a great deal! Wish me luck! I have applied for an FNP program and now I am in the process of the dreaded wait! I hope you have a great day!