LPN. or RN

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nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
First of all...of course it's about the money - but there's more to it.

I'm not using the word professional in such a pedestrian matter. I'm utilizing it to make a distinction between a vocational approach where skills-based education is emphasized and a more "critical thinking"-infused approach. I use ""marks around the phrase critical thinking because I realize the common place attitude that many nurses have when they hear this oft-misused phrase.

My comments related to your use of this statement

"Many nursing organizations are striving to change the image of Nursing as a profession and, truthfully, the origin and scope of the LPN/LVN is not a professional one;"

much more than a quibble about the meaning of the word "professional". You made a link between what nursing organizations are trying to do and the LPN scope of practice. That is an untruth.

What exactly is a "critical thinking infused" approach? After you explain that I'll let you know if that "skills-based" LPN program differs significantly. I doubt you will because it's just so much easier to drop a glib line or two that uses one or two catchwords that don't really say anything and evaporate under scrutiny.

You could read the link in my previous post for another barrage of words that at least carry the imprimatur of a respectable think tank. There you will find that they consider the extra education a positive step in areas that have nothing to do with your odds of killing off your post-op surgical patient in PA between 1998 and 1999 or bedside care at all.

Furthermore, the fact remains that there is extent evidence which clearly indicates better patient outcomes when cared for by BSN-prepared nurses. See below.

Do you know what "proof" means? There may be extant facts that co-exist but have no causal relationship. That isn't evidence. You made a mistake that shows you don't really understand research very well. Put simply there are lots of other things that could explain the results. So your Aiken chart review "gotcha" kind of fell flat.

If you employ critical thinking you might ask yourself if the American Association of Colleges of Nursing might have an agenda? Like a keeping their jobs kind of agenda? Just a thought.

Boom: (phhhhffffffffft. . sorry.) :-/

Oakley44

105 Posts

My comments related to your use of this statement

"Many nursing organizations are striving to change the image of Nursing as a profession and, truthfully, the origin and scope of the LPN/LVN is not a professional one;"

much more than a quibble about the meaning of the word "professional". You made a link between what nursing organizations are trying to do and the LPN scope of practice. That is an untruth.

What exactly is a "critical thinking infused" approach? After you explain that I'll let you know if that "skills-based" LPN program differs significantly. I doubt you will because it's just so much easier to drop a glib line or two that uses one or two catchwords that don't really say anything and evaporate under scrutiny.

You could read the link in my previous post for another barrage of words that at least carry the imprimatur of a respectable think tank. There you will find that they consider the extra education a positive step in areas that have nothing to do with your odds of killing off your post-op surgical patient in PA between 1998 and 1999 or bedside care at all.

Do you know what "proof" means? There may be extant facts that co-exist but have no causal relationship. That isn't evidence. You made a mistake that shows you don't really understand research very well. Put simply there are lots of other things that could explain the results. So your Aiken chart review "gotcha" kind of fell flat.

If you employ critical thinking you might ask yourself if the American Association of Colleges of Nursing might have an agenda? Like a keeping their jobs kind of agenda? Just a thought.

Boom: (phhhhffffffffft. . sorry.) :-/

My reply was deleted and I don't have the will to re-write the whole thing so as to continue our rather tenuous war of 10-dollar words.... I will say that my argument was ceteris paribus and leave it at that.

Oh and also your tone is starting to take on a degree of condescension that I wasn't quite expecting but I should give you kudos for the use of the words imprimatur and glib (a la Tom Cruise).

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nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
My reply was deleted and I don't have the will to re-write the whole thing so as to continue our rather tenuous war of 10-dollar words.... I will say that my argument was ceteris paribus and leave it at that.

I actually talk like that, too. Sorry if my advanced vocablulary offends you. :) Whatever. j/k This sucker died about a week ago. Probably had an ADN nurse taking care of it. :lol2: Sorry and yeah I do get a little oh what is that word . now I really am at a loss for a ten dollar word. I'm not upset with you I'm upset about the AACN for a whole lot of reasons. I've been reading their press releases and position statements quite a bit lately and have s bit of residual hostility. :/ Best wishes to you.

(I learned the word imprimatur in 2nd grade - if we Catholic kids read something without it we were doomed to the fire pit of hell no questions asked)

AJPV

366 Posts

It is kind of funny, actually. The people who make up the AACN seem to talk out of both sides of their mouths. On the one hand, many of these very same people are NCLEX question writers. They dazzle us by telling us that the NCLEX is one of the most psychometrically validated exams in existence. They tell us that the exam items are rigorously tested to ensure accuracy and validity. They tell us that they routinely survey grad nurses to ensure that the exam represents the most relevant patient safety issues a new grad nurse will face. All of this fan-fare about their wonderful NCLEX. But now, since it has become evident that ADN students have virtually the same NCLEX pass-rate as BSNs (with many ADN schools significantly out-scoring BSNs), they must come out with a bunch of distraction "studies" claiming that BSN's are safer nurses. They can't have it both ways. Either the NCLEX really is a valid indicator of a grad nurse's competence with respect to patient safety or it is not valid. They either such at test writing and validation, or their supposed studies suck.

There are a few red flags that immediately strike me with their "studies." First, a careful examination of the language used reveals that they are lumping together all graduates with a BSN OR HIGHER degree and comparing this lumped together group against ADN grads. In other words, they are throwing MSN grads, NPs, and anyone else they can find into their "baccalaureate or higher" pool. It goes without saying that many of the nurses with these higher degrees have years of nursing experience behind them. Even many of the "new" BSN grads have many years of nursing experience (nurses who work for years as an ADN before completing a bridge program). So what exactly is it that makes this pool of nurses safer? Is it the years of experience they have? Or is it the wonderful $300/credit hour BSN courses in management, statistics, Western Civ, and Music History that the ADN students "missed?" It doesn't take a doctorate in statistics to figure out that the BSN schools are claiming for themselves the safer practice that individuals gain through personal nursing experience. This is why the "BSN is superior" indoctrination so strongly permeates the curriculum of BSN programs. It is why this very subject is assigned for research papers.

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nursel56

7,078 Posts

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

It's all BS. The fact that they continue to peddle that crap to unsuspecting people just strikes me as willful. Or they made up something new like they did with NANDA - "nursing research" Nursing research consists of people who want you to believe that a voluntary email survey of their own members actually tells you something other than complete garbage.

Getting a little deeper into it you find that they want to split the RN workforce into two tiers even after both have passed the NCLEX with a more limited scope and the title of "technical nurse" for ADNs and "professional nurse" for BSNs.

Since there is no proof of better outcomes they have come up with the most insulting things imaginable couched in the garbled jargon laden "nurse-speak". They use the phrase "ritualistic practices" and "rote memorizaiton" to claim a rationale for their agenda. I read yesterday they consider RN to BSN programs a hopefully temporary stopgap method of earning your BSN.

AJPV

366 Posts

The sad thing is that BSN programs COULD produce vastly superior graduates if they WANTED to! They have almost double the time that ADN programs have, and they absolutely fail to produce graduates that are superior in clinical knowledge or skills. If they really wanted to, they could equip their students with the same level of education that you currently can receive only by going to NP school. The problem is that the "extra" courses in the BSN program that are "missing" from the ADN program are completely irrelevant to clinical nursing practice. Let me tell you, I'm soooooo impressed when a BSN nurse standing at the bedside whips out her notes from her Nursing Management, Statistics, Western Civ, or Music History class. The problem is that universities have no motivation to make the BSN courework more practical and relevant. Why would they when they can tell you that you'll need to come back for a masters and pay more tuition? The equal success that ADN grads have achieved proves the irrelevance of the extra BSN coursework.

Specializes in Anesthesia.

New grad ADN here in California. I had a total of 3 job offers within 1 month of passing boards. 2 were in acute care (one was ER). I had LVN experience though. A lot of my classmates had job offers a few weeks after graduation too. Some of them had offers for ICU, ER, step-down, NICU, you-name-it. 85% of our last graduating class had jobs within 6 months after graduating. ADN grads CAN get hired, but it depends on the school's reputation, the applicant pool, the current need for the position, your ability to network and sell yourself, etc. There are a lot of variables, but ADN grads ARE getting hired. You just have to network network network.

I'm not convinced that BSN grads are better than ADN grads. I see a lot of students from a lot of different schools doing clinicals where I work, and there is no difference. If anything, I've noticed A LOT of the BSN students are younger and have less life experience. IT SHOWS. I hate to generalize though.

I'm now working as a new grad RN, and I'm set to start my BSN program next month. I WISH I finished my BSN right away, but it just wasn't financially feasible for me. Get your BSN out of the way if it's financially feasible.

Whatever you do, DO NOT attend one of those BSN programs with tuition that is > $60,000. If you can't find a job, you're STUCK paying all of that off. If you can't find a job with your ADN, you've lost a LOT less money.

allnurses Guide

nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
The sad thing is that BSN programs COULD produce vastly superior graduates if they WANTED to! They have almost double the time that ADN programs have, and they absolutely fail to produce graduates that are superior in clinical knowledge or skills. If they really wanted to, they could equip their students with the same level of education that you currently can receive only by going to NP school. The problem is that the "extra" courses in the BSN program that are "missing" from the ADN program are completely irrelevant to clinical nursing practice. Let me tell you, I'm soooooo impressed when a BSN nurse standing at the bedside whips out her notes from her Nursing Management, Statistics, Western Civ, or Music History class. The problem is that universities have no motivation to make the BSN courework more practical and relevant. Why would they when they can tell you that you'll need to come back for a masters and pay more tuition? The equal success that ADN grads have achieved proves the irrelevance of the extra BSN coursework.

Yes - and a good deal of the problem results from nobody on the same page about what makes a BSN graduate so superior to the ADN. I guess that's bound to happen when there is no evidence in their evidence-based arguments that attempt to make their case. Sometimes it's strictly patient safety (ie bedside). That is normally the point you will be ceremoniously referred to the "landmark" work of Linda Aiken in 2003. Most of them have never actually read it. I do so wish they would.

Some state the extra time is essential because it "introduces students to a wider range of competencies in such arenas as health policy and health care financing, community and public health, leadership, quality improvement, and systems thinking" I wonder if that BSN person who thought a "veteran nurse" was someone who works at a VA hospital really gets systems thinking.

Lastly there is the "well-rounded" argument that has nothing at all to do with nursing practice. That's where the class in the ethno-musicology and art history courses come in -- but really? Most people have passing familiarity with those from general (non-nursing major) coursework, or have had life experiences that pale next to a textbook. I do agree that no knowledge is ever wasted, it's the way they frame that excludes other ways of becoming well-rounded or as a student once said a BSN has "a certain polish" compared to their ADN counterparts. A 20 yr old who was raised in an affluent gated-community who took a course in Comparative Cultures is not more well-rounded than someone who lived in one of those comparative cultures.

There are personality characteristics you could generalize about - but it's likely that they were present before the person was in a BSN program.

At the end of the day though - whatever the reason may be for employers to request that only BSNs only need apply we have to face the reality or stay home and ***** about it all day long.

AJPV

366 Posts

Ahh, yes... The same Linda Aiken who brought us the wonderful "disturbed energy field" nursing diagnosis in her NANDA handbook. That instills such confidence in me that her research is "evidence-based."

Please,how many hours will be used to write the LPN exam and what happens when you fail the exam?

cavmedic16

51 Posts

There will always be ADN nurses! They have been talking about phasing out ADN nurses for 20+ years and the majority of RN's are ADN's.Also with a nationwide shortage of RN's to exceed 500,000 by 2020 they are not going anywhere. I would recomend the LPN route if you need income then bridge to ADN,then online BSN become a phoenix like everyone else.

Oakley44

105 Posts

...

At the end of the day though - whatever the reason may be for employers to request that only BSNs only need apply we have to face the reality or stay home and ***** about it all day long.

Exactly (...and I make my way back into the fray).

That's more or less my impression of the current climate, and though I agree with others on this thread that there's a great deal of bs to the BSN (insomuch as the archetypal "Leadership" class), I do believe that even the vague implication of a better-equipped workforce is worth the a clumsy transitional phase.

I imagine there will be RNs with Associate degrees (and even Diplomas) for a decade or two more but after that, for a slurry of both well and poorly thought-out reasons, they will become a single-digit minority.

And don't think a shortage = increased hiring only increased demand.

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