Latest Comments by BostonFNP

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Joined: Apr 4, '11; Posts: 5,200 (63% Liked) ; Likes: 13,258

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  • 1
    TiffyRN likes this.

    Quote from TiffyRN
    I'm still waiting on the "breaking news" we have been promised for years exposing the conspiracy of nursing academia. I swear I'll send you a Starbucks gift card if it ever comes out and they will verify that "avenging spirit" was their deep throat.
    Now it's time to sit back and wait for the attack.

  • 2
    TiffyRN and elkpark like this.

    Quote from avengingspirit1
    The facts are in the study itself; but you have to know have to sift through all the corporate-speak. Something you don't seem to be able to do. It requires thinking outside the box, which is how most problems in the real world get solved. And by the way I said "backed" not funded. There is a difference which involves simple reading comprehension. Get away from the corporate-speak, learn to think for yourself, then post post me back. And yes, I've seen many other sites and blogs and plenty of nurses are angry. And I will keep pushing till there's more spotlight on this specific topic. There has been much recent news about the expense and nonsense going on at four year schools. Move away from sheltered thought and read about it.
    Cite sources.

  • 1
    elkpark likes this.

    Quote from avengingspirit1
    And I won't stop until I stir more nurses into action. I met with a reporter a coupe of years ago and can do more this time. There are thousands of real working nurses that agree. These are some of the facts I'm putting out there; and I invite anyone to read the study for themselves.
    Do you think you are really "stirring" any nurses into action? Where is the link to the news story from your meeting with the reporter a couple years ago?

    You say you are putting the "facts" out there. What are those facts? Cite them here, as you have been asked to do numerous times before.

    Quote from avengingspirit1
    The authors simply took the template they had for a previous study on nurse to patient ratios and mortality rates and by their own admission, manipulated the data no less than 133 times supposedly without bias to make it fit the mold for the BSN study.
    The 2011 Aiken study which I assume you are talking about used pre-existing raw data from a prior nursing survey; they used this data in a novel way. This is very common in research and it in no way implies the study is invalid. Again, consider the thousands of studies that use NHANES data.

    Cite the paper where the authors say they manipulated the data 133 times. Cite the quote right here.

    Quote from avengingspirit1
    The authors also admitted to excluding hospitals that didn't fit their data set. The criteria for the inclusion of certain data for the study was based solely on the discretion of the "so-called" 'experts' creating the study.
    Here is the actual exclusion criterion:

    "The hospitals included in our sample represent 86% of all general acute hospitals in the four states and account for over 90% of all adult general, vascular, and orthopedic surgical patient discharges in those states. Hospitals not analyzed are primarily small hospitals with fewer than 10 nurse respondents, which we regard as too few to provide reliable estimates of the hospital-level nursing characteristics of interest." - Aiken et al. (2011)


    Quote from avengingspirit1
    And all those 'experts' were backed by those with pro-BSN agendas such as the AACN (American Assoc. of Colleges of Nursing).
    Here is the actual funding information:

    "Funding for this study was provided by the National Institute of Nursing Research, National Institutes of Health (R01NR04513, Linda H. Aiken, PI), the Robert Wood Johnson Foundation, and the College of Nursing, University of Florida. "

    Quote from avengingspirit1
    But they insist that you have to trust their 'independent verification' that the results weren't biased.
    Show us where the bias is; cite the study where you feel that it is biased.


    Quote from avengingspirit1
    They took all this manipulated data and ran a logistics regression model to see what MIGHT happen if they was a 10% increase in BSN RNS.
    You understand what a logistic regression is right?

    Quote from avengingspirit1
    Now if you disagree with those facts which are in the study itself, well that's too bad.
    There are no "facts" here.

  • 1
    elkpark likes this.

    Quote from avengingspirit1
    I can't not publish their name for the same reason you won't reveal your real name. I have published links to the research rebutting Aiken's study on other threads concerning this topic. I work for a living and don't have the time to spend hunting for them now. You may feel free to go and hunt for them.
    I am willing to bet I can spend 5 minutes, look through your post history, and confirm that you have never posted a link to a peer-reviewed study that refutes any of Aiken's work, but that burden is on you.

    What you "have the time" for is:

    1. Making up fake quotes to try and pass them off as the authors.

    2. Peddle hearsay and conspiracy theory.

    3. Make fake claims.

    4. Avoid/dodge questions asking for proof.

  • 0

    Quote from avengingspirit1
    The head of certain state nurse's association said nurses weren't professionals unless they had at least a BSN. That was in no uncertain terms saying that their work, value and contributions are not as respected as other nurses. That was one of the most disparaging comments ever uttered about nurses.
    You didn't cite anything. Cite your sources for us so we can read what you are talking about.

    Quote from avengingspirit1
    The study was implying that patients are in less danger of mortality if they are served by a BSN nurse; and that is simply not true. So if the authors didn't mean to imply that; they should come out and rectify their conclusions.
    You bounce back and forth between numerous studies and seem to refer to it as "that/this study". The study you were discussing above concluded that if hospitals increased the proportion of BSN+ nurses in their work force then mortality would decrease.

    I has been said numerous times but you still seem unable to comprehend: these studies say nothing about individual nurse performance, they do not compare nurse A to nurse B, in fact that is a basic principle to research in general: you need large enough numbers to account for individual variability (statistical power).

  • 0

    Quote from avengingspirit1
    There is much research out there on the many flaws of this study
    Cite them then. Just list all of studies on the "flaws of this study" below so we can all read them.


    Quote from avengingspirit1
    Again, all nurses whether they are Diploma, Associates or Bachelor prepared make valuable contributions every day and have shown they can adapt to changes in the profession. Too bad nurse's associations no longer recognize that.
    Can you cite a state or national nursing association that has stated that they do not value some nurses based on academic degree?

    This just isn't true. All (well, most) nurses make valuable contributions and have demonstrated basic competency to practice. I don't think anyone has stated otherwise. None of these studies suggest that nurse A, BSN is inherently better than nurse B, ADN nor is anyone suggesting that.

  • 8

    Quote from Bakingismylife
    Sure of course, but there is honestly nothing wrong with marijuana.
    The Surgeon General's Warning on Marijuana

  • 0

    Quote from djmatte
    How on earth would it not be more lucrative? There's no better guarantee of a steady student base than pushing someone through some accelerated RN program with the guarantee of advance education regardless of experience. The amount of student loss to the career field goes way down if they lose anyone ever. That's a lot they save on recruitment and improves their bottom line with a steady student population that will be charged more at the specific intervals studies call for.
    You don't have to work in academia to understand there is a huge demand right now for NP programs. The majority of that demand is by practicing RNs not direct-entry: the largest cohort of NP graduates has 2-10 years experience.

    There are also a number of difficulties with DE programs from a student loan perspective that academic programs would prefer not deal with and that don't exist for RN-MSN programs.

    There are diploma-mill programs that probably do try to rope as many students in are are driving by sales numbers on rotating admissions but these are a minority and generally of poor quality.

  • 1
    BCgradnurse likes this.

    Quote from Dodongo
    OH come on. So you have no idea why disclosures are important. You've no idea why bias or conflict of interest matters?

    The source of funding is very important in evaluating research. Especially when the studies are low quality to begin with. There was a thread a long while back where you posted a lot of this "research" you so often cite, and I explained quite thoroughly why all of it was heavily biased towards the null.
    There are no listed financial disclosures for any of these studies. We are not talking about disclosures rather the fact that the authors work in academia and therefore are somehow biased. The majority of research is conducted by academia. Furthermore, I have never seen anyone make a convincing argument that not requiring RN experience is somehow more financially lucrative to academic institutions.

    I have no problem with critically evaluating research, it is very important. In doing so, you must be objective yourself.

    So please, enlighten us, go through each of the studies I posted here and show where the obvious/heavy bias is.

    And lets be totally honest here: did you have a preconceived belief that RN experience was of vital importance in NP practice prior to reading a single one of these studies (assuming you have even read them)? What was that belief based on? Direct experience as a practicing NP or via direct experience with NP education? If you had no preconceived belief prior to reading the studies, what it the "heavy bias" in "all" the studies that made you conclude the opposite?

  • 2
    ixchel and elkpark like this.

    Quote from avengingspirit1
    I completely agree about nurse staffing levels being a factor in mortality rates. But the topics of staffing levels and nurse education and their effect on mortality rates are mutually exclusive and should have been examined in that way if the authors really wanted to imply that RN education levels affected patient outcomes.
    They aren't mutually exclusive at all. Hospitals that are interested in improving outcomes can improve staffing ratios, increase the the education of the nursing workforce, and improve nursing work environment all simultaneously. Many hospitals have done this recently as part of achieving Magnet status.

    Quote from avengingspirit1
    I can not trust based on just their say-so that they completely and objectively factored all impertinent data while they factored in only relevant data.
    Of course science is not perfect and it is never possible to account for "all" factors but that is why we have statistics. The authors are able to conclude that the results noted are not due to chance alone. And in this particular case, they also controlled for unidentified confounders and found they were not statistically significant in aggregate.

    Quote from avengingspirit1
    It was not original research. I also must ask why they didn't want to take the time to do a completely original study on nurse education levels. And then looking at who supported the study, I question as to whether it was truly unbiased. Don't know if Aiken is still teaching classroom nursing courses, but I highly doubt she would have accepted a paper from a student that was built on a previous paper handed in. I spoke with a couple of Univ. of Penn nurses and they didn't even know who she was.
    This is original research. It used existing data but the rest of the study was entirely new. The vast majority of clinical research uses databases of retrospective data (like NHANES and WHO). This is very common in research and it covered in 100-level research method courses.

    As far as your "contacts" at UPenn not knowing who she was, she is the Director of the Center for Health Outcomes and Policy Research. I am not sure what you are implying by that other than that your contacts were ignorant.

    Quote from avengingspirit1
    You seem to like the word conspiracy. I really haven't heard the word used much since Oliver Stone's JFK movie. But I am merely saying that there are multiple organizations benefiting from people being driven back to colleges and universities. It's not conspiracy; it's business.
    Look up the definition of conspiracy and conspiracy theory. That's why I use the term.

    Academia is absolutely a business. But this research is consistent across multiple countries and multiple authors, some of which have universal education.

  • 1
    turnforthenurse likes this.

    Quote from djmatte
    On a positive note, you are working for a major corporation that will likely pay a decent wage with benefits reflective of working for such a corporation. If the support and structure is in place, it can be a good place for any NP regardless of being new or not. I wouldn't be worried about being pigeon-holed there because you are still doing some primary care (albeit probably mostly urgent care). All of those skills are transferable to to traditional clinics. If you were starting out in a specialty area then I would be more concerned.
    The MC here pays $55/hr I think plus bonus and good benefits. It has been a great stepping stone to other practices for a number of former students and it also is not a bad career job in a growing field.

  • 3
    ixchel, BCgradnurse, and elkpark like this.

    Quote from avengingspirit1
    The information about using gross estimations and then and then making an estimation about what MIGHT happen if there was a 10% increase in BSN nurses are buried in the body of the study.
    I am not sure you understand the purpose of the study. The study built on previous studies which had identified that improved staffing levels, improved work environments, and increased nursing education were all associated with improved patient outcomes (lower mortality). The design of this study was to take the outcomes data from a large number of hospitals and patient encounters and use that data to build a model. The model could then be used to predict the effect on patient outcomes if the modifiable risk factors were adjusted (staffing, environment, education) while keeping everything else the same.

    Quote from avengingspirit1
    Funny, one of my former nursing professors , who did have a doctorate left my nursing school to help run a dept at a four year nursing school. She had always been one to defend 3 year nursing diploma education. But when I went to see her at the university, she did a complete turn-around and even quoted a statement from the March 2011 "It's Academic" article in Nursing Spectrum. I understand she had to tow the company line and we both nodded to each-other as I told her I understood. I understand it's a business. And I would respect those pushing it if they would come out and admit instead of this phony nonsense about elevating the profession.
    Or maybe, rather than her being involved in a multinational conspiracy from "BigNursingAcademia" she read the data and changed her mind. And maybe your assumption that support for 3-year diploma is mutually exclusive to also supporting advancing nursing education: it's not. These studies (and Aiken's are only a part of it) suggest that more education makes individual nurses better nurses: I feel like you think these studies suggest that nurse A, AN is a worse nurse than nurse B, BSN and they absolutely don't.


    Quote from avengingspirit1
    If I had solid proof that taking courses such as "Sociology of Nursing", "Theoretical Foundations of Nursing" would help heal patients, then I would agree that having a BSN could help patients.
    There are numerous studies across many countries that have shown consistent results.

    Quote from avengingspirit1
    This may be hard for you to believe, but I am about helping people and doing what's best to accomplish that. My mother died a few months ago because I believe the staff did not recognize the early signs of Sepsis. When I visited her the first day and saw her vital signs, I asked if she was being evaluated for Sepsis protocol. They just told me they were working within hospital parameters. How about a BSN program to teach nurses how to better recognize early signs of sepsis, diabetes complications or new wound healing methods or new methods to accelerate healing and speed recovery. Give me those things instead of just writing more APA format papers and I'll agree that a BSN is worthwhile and needed.
    I am sorry about your mother.

    I would argue that education does help. While going from and ADN to a BSN might not directly teach a specific thing (like early recognition of sepsis) it does (in theory, and supported by data) contribute non-directly. Increasing nursing education does many meaningful things for the profession including increasing nursing research, critical clinical thinking, EBP, etc which sum up to improved outcomes, and in the end, your mom maybe could have been in that reduction in mortality the studies have suggested.

    We should improve nurse staffing levels. We should improve nurse working environments. We should improve nursing education. These are all modifiable risk factors or patient mortality that nursing can impact.

  • 3
    KelRN215, BCgradnurse, and elkpark like this.

    Quote from avengingspirit1
    Everything I said about the Aiken study was true and in the study itself; which I'm starting to doubt you even read through.
    You were called out for posting "quotes" from the study which do not appear anywhere in the study.

  • 2
    mma22664 and BCgradnurse like this.

    Quote from NHGN
    Well, consider it. Columbia has a well-known DE program, right? Why wouldn't we be as scrutinizing of their results as we are of studies funded by drug companies?
    There's no need to sensationalize my comment with a "fake news" follow-up.
    All studies can and should be critically evaluated. That is completely different from assuming a study which hasn't even been done yet is somehow biased or useless or "fake".

  • 1
    mma22664 likes this.

    Quote from Dodongo
    Without RN experience, I think PAs will see they easily have the upper hand in their education, and physicians and legislators will also make our education an easy target.
    A few things here:

    1. The "RN experience" thing is not new; many of these programs have been around since the 1970s-1980s. All the extant data out there on NP outcomes includes graduates with no RN experience. Now if the argument is that there are more of these graduates or that the programs now admitting these graduates are poorer in quality, than that is a topic for discussion, but the solution isn't to mandate RN experience in either case.

    2. NPs are educated to be independent providers and PAs are not. The educational structure is very different given one is based on block schedules in the medical generalist model and the other is in the nursing model on semester schedule. I am not sure one is any better than the other overall, having worked with students from both types of programs.



    Quote from Dodongo
    And, hopefully we all can agree that studies funded by nursing organizations, for nursing organizations, are not high yield evidence. Anyone can immediately dismiss them simply for that fact.
    That is not the scientific process. The sources of the funding should not matter if there is good scientific rigor.

    Quote from Dodongo
    We need to do better for ourselves. PAs are adding on more education - see the PA doctorate at Lynchburg and the DMS at LMU - while we are lessening ours?
    How is APN or nursing as a whole "lessening" itself? At least academically the DNP and consensus push was many years ahead of PA changes towards doctorate degrees.


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