Entry into Practice

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Ethics Column: "Ethical Grounding for Entry into Practice: Respect, Collaboration, and Accountability"

Online Journal of Issues in Nursing.

Silva, M. and Ludwick, R. (August 30, 2002).

http://www.nursingworld.org/ojin/ethicol/ethics_9.htm

"Moral questions are raised that must be answered . . . because the status quo in nursing practice, licensure, and education is morally unacceptable" (Hess, 1996, p. 289).....

The authors ask:

Should the shortage be used as rationale to jump start diploma programs that have in the last 20 years taken a back seat to ADN and BSN programs?

Can we ethically justify to society and to ourselves three educational routes with differing costs and time frames for completion and then "use" those nurses interchangeably and expect the same level of service provision?

To be accountable as individuals and as a profession, do we not need to resolve this issue in a more timely fashion than the past 35 years?"

Let the debate begin and consensus reign.

Well yes, it would be good if we as nurses could have resolved this issue in a more timely manner than 35 years! Even, worse, there is no conclusion for this debate in sight.

I am originally a diploma graduate, and no offense to graduates from any other program, I believe these programs offered the best preparation for bedside nursing. Despite this, I don't know what we gain by bringing them back at this point, simply because I don't thing adding yet another entry level will serve to advance the status of nurses as a whole.

As far as ADN vs BSN - many people who want to go into nursing are women with children at home, or people beginning a second career- many of these potential nurses might view 4 years of college as a financial and time burden that they can't afford to take on.

For years I have thought that making the BSN the entry level for all nurses would help to advance the perception of nursing as a profession. Now I feel that the issue goes more deeply than entry level. Where I work, the OR, staff nurses are not viewed as professionals for the most part by surgeons, nursing management and the hospital administrators, regardless of entry level, and I know that this is true in other hospital departments as well.

Why do nurses have such low status in the eyes of other healthcare professionals, and in the eyes of the public??? We need to resolve this problem FIRST, and then come to a consensus on entry level.

Sorry, NRSKaren, I don't have any answers, only more questions. Hopefully, someone in Allnurses land will have some answers!

Can we ethically justify to society and to ourselves three educational routes with differing costs and time frames for completion and then "use" those nurses interchangeably and expect the same level of service provision?
You know, I've never seen the question phrased in quite this way, and I think it's a very interesting point. i'll have to think about this and come back, but I'm also interested in what others have to say in viewing this problem from a different angle--fairness and ethics.
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