Entry into RN Practice (Part 1): Associate Degree Nursing (ADN)

I've heard both of these figures, also (the cost of orienting/training new grads and the fact the turnover is now so high for new grads), as well as the factoid that the attrition rate (leaving nursing for good, not just changing jobs) for new grads is now significantly higher than it's ever been before. I attribute much of this to the fairly dramatic changes in nursing education in recent decades. New grads used to graduate pretty well prepared to function as entry level RNs. Now, facilities find that they have to teach new grads practically everything they need to know to get through a shift, they're sick and tired of having to shoulder the expense and effort of doing that, and they're starting to put their feet down (and I can't say that I blame them).

IMHO, nursing education has really thrown the baby out with the bathwater, and I (again, MHO) think we're getting pretty close to a real breaking point -- as seen by the growing reluctance of so many facilities to hire new grads. I believe a big part of the problem is a serious disconnect between nursing academia and the real world. I know that, in the last BSN program in which I taught (a well-repected program in a state uni), the faculty was made up of the tenured, doctorally prepared professors who had been there a v. long time and had little or no contact with the "real world" of nursing in many years, and we "serfs and peons" -- the MSN-prepared faculty who taught most of the undergrad curriculum (much of the theory and all of the clinical). The "grand poohbahs" all believed that we had a great program, a really strong curriculum, and were doing a great job of teaching our students everything they needed to know about nursing. We "serfs and peons" used to hole up in someone's office and vent a lot about how guilty and conflicted we felt about what a poor job the program was doing of preparing the undergrad, pre-licensure students to be practicing RNs and what we could do about it. I, personally, was shocked by how little the students knew about nursing when they graduated. When we tried (on a number of occasions) to bring these concerns up to the high and mighty professors who ran the program and made all the decisions, they just blew us off. I left that position after one year, and it's v. hard for me to imagine a situation in which I'd be willing to take a teaching position again, although I love teaching -- the crap (IMHO) that goes on in much (most?) of nursing education now is just too much for me to put up with.

(And don't even get me started on the NCLEX, haha! )

Vicky, I would love this and I look forward to reading it. I graduated with a B.A. in Ethnic Studies/Public Health in 2008 and I am so torn between doing an ADN, a traditional BSN, an accelerated BSN, or going for a direct-entry MSN program.

I could really use all the advice and insight that anyone has to offer in making the aforementioned decision.

I'm just starting my pre-requisites this fall for an associates program at my local community college. Because I have to spread out my credits (financial reasons) and I'll still be working full time, I'm not looking at actually being able to enter nursing school until 2011. I will be a career changer, coming from a teaching background, and I already hold a Bachelor's and 2 master's degrees.

So, this is very timely information for me as well...I look forward to reading your future installments.

Great post Ms. Vicky...I do disagree with one point though. I work in a hospital that hires ADN nurses with experience as Assistant Unit Managers. The Unit Manager on my floor was the assistant unit manager on the same floor up until the previous UM decided to seek employment elsewhere. My UM was told that if she'd promise to go back to school and get her BSN, they'd give her the UM position. She worked as the UM while getting her BSN degree.

So it is possible for an ADN trained nurse to get a mangerial position if she has an adequate amount of experience.