Education the cause of divisiveness?

  1. Reading the posts on the general discussion board relating to the low down on education for the RN is certainly disturbing...I won't be posting on that thread again and many of you knew well enough beforehand not to do so. It seems that those who are expressing the most anger are ADN-prepared RN's...sure, I can see it from their perspective as I was initially involved in preparing RN's at this level. But, my question is, when will we decide on the entry level to practice issue for the RN? It was proposed in the 50's by the ANA and remains unresolved. What can be done to speed up this process or should we all just let it go due to the nursing shortage? With as much anger as I have read throughout that thread, I wonder how this would not affect patient care? If someone has these issues and works side-by-side with RN's who are diploma, ADN or BSN-prepared and has not resolved their thoughts and do they keep that hidden? Until this is resolved, the professional RN will continue to struggle to define his/her role and feelings of powerlessness.


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    About barb4575

    Joined: Dec '00; Posts: 179; Likes: 24


  3. by   athomas91
    i agree completely....we are the only "profession" that doesn't have a standard...if we want to be seen as a profession, we need to step up to the plate.

    I understand there are those who have AA's and are only a few yrs from retirement...i have no issue w/ grandfathering them in...but there needs to be some reform and incentive for nurses to go back and obtain BSN's and a requirement for new nurses to have BSN's....i have said it before - it doesn't take a BSN to make a good nurse...but a BSN sure makes a good nurse better.
  4. by   barb4575
    I had posted a long reply and was gone. I don't have the time now to retype it, but I will...I agree with what you had posted completely and I love that last statement...I will be repeating it to my students.

    I appreciate the time you took to reply,

  5. by   barb4575

    I agree with what you had said and have decided not to post anymore on that thread as it only seems to upset people...and that definitely was not my intent. It would be healthy if we could discuss this issue of entry level into practice, but as long as we have unequal standards and educational preparation...that won't happen without someone becoming upset. I, too would support a grandfathering clause. The odd part is that the original poster now is writing that he or she does not like the ADN program that he or she attends.

    Of the programs that I have taught, it is still the ADN program in KS that was most effective in my viewpoint. For some reason, in the baccalaureate programs which I have taught, I have been unable to find other faculty who are interested in teaching psychomotor skills at the Foundations level. I don't know why they cannot see that this boosts the students' confidence hence making them a more effective communicator and bedside nurse as well. It seems that the only thing the students want is someone to spend time with them and clarify that what they are doing is either right or wrong...during that time, critical thinking comes into play when the instructor throws real life scenarios into the, I am being faced once again with working in the lab with the students because I know they need it and I also have fun doing it. What I don't have fun doing is when faculty do not prepare them at the Foundations level and send them onto me in Med-Surg and I have to back up with basic skills. Teaching is no different than nursing, it is tough to find faculty that are truly committed. There are always a few.

    I am now teaching the Foundations course and a Med-Surg clinical. I will spend extra time outside of clinical to get some of these other students up to par...I don't mind doing that, but it does seem that some need to work on accountability and commitment to the students. Some things will never change. I wish I knew how to impress upon other faculty that until there is change, these students will not be prepared to face the challenge of today's world of nursing. It is not easy out there in Med-Surg and these students will need all the preparation they can get to be able to cope with the challenge. I used to recommend a minimum of one year on the Med-Surg unit before specialization, but not anymore as many will leave nursing altogether after that experience.

  6. by   VickyRN
    In the varied units in which I practised, it was only an issue if MANAGEMENT made it an issue. In one hospital, the DON simply "gloated" over her "BSN's" and openly made all of us "lowly" ADN's feel so inferior. The BSN's were given higher salary, etc, and offered better learning and professional opportunites. All I remember is the tremendous resentment and low self-esteem and horizontal violence this produced. And, looking back the BSN's did not perform any better at the bedside than the "lowly" ADN's.
    At other facilities, TPTB were just glad to get "warm bodies" to staff their units--whether ADN, BSN, diplomas. In fact, one hospital has an ADN-prepared nurse as DON, and another hospital has an ADN nurse as assistant nurse manager of the popular cardiac unit in which I worked (she does a fine job, BTW). In these particular hospitals, the working environment was much more collegial. One hardly knew (or cared) about the "background" of one's RN coworkers as it really wasn't an issue.
    I may be wrong, but I even suspect that management on these units actually preferred ADN's as many BSN's were trying to get into CRNA school or another nurse Masters program and would leave the unit once they were admitted. The ADN's were more stable and simply content (at least in the first few years) at being a staff nurse.
  7. by   OC_An Khe
    ON the many different threads with regards to this topic, one area that I very rarely seen discussed is the "forces" outside of Nursing that benefit from the current melange of entry level education standards. From politicians, administrators,insurance companies, and MDs and educators running various educational institutions all benefit financially (in their opinion) from this division. They often do work behind the scenes to foster this division. And yes this division does result in large amounts of hrizontal violence within the profession.
    As to when the generations old ANA's position that a BSN degree be the standard for entry into Nursing pravtise, it will probably be generations in the future. Until Nurses decide that it is their profession, and not listen to outside forces, and realize that the Profession as a whole will benefit from this standard it won't happen.
    As to those who educate in the various program levels they should not be teaching that one system prepares better nurses than another but what is best for the future of the Nursing profession. The future of nursing will evolve in ways that many of us would not predict, just as those who started their carrers and were educated in the 1950/60 would not have envisioned todays routine of nursing, nor the scientific knowledge base that is required today. One prediction, that hospital based nursing will continue to decline as the major employers of RN's. Today almost 50% of current Nurses are not employed in hospital settings. Why are we arguing that one level of educational preparation
    makes a better bedside nurse than another when so much of current and probably future Nursing will not be hospital and bedside based. The educational standard should be that which prepares Nurses best for all the vast opportunities that Nursing provides.
    Nursing is a profession that requires a committment to lifelong learning and education in both Nursing and in related fields. The broadest educational bachground and preparation should be the entry standard.
  8. by   orrnlori
    I have a question to this thread that I really really want to understand because I am an ADN who is continuing her education and I want to eventually teach nursing.

    Here it is. In my area, there are 5 BSN programs and a like number of ADN (AAS) programs. If you take two people with no prior college, put one in the ADN program and one in the BSN program, you end up with two people who take the EXACT same number of nursing classes for their degree. The only difference is that the BSN had more literature, art, etc. I want to understand how you feel this makes the BSN a more professional nurse? I could understand if the BSN's took a more difficult NCLEX, took more difficult patient's once becoming a nurse, etc., but they don't. Why would you not consider the ADN who goes on to get either a BA or BS in another humanities area after obtaining her RN the same as a BSN? I don't get this.

    I do understand that once an RN goes for her BSN there are more nursing classes, they couldn't obviously fill the extra 2 years of a nursing degree with only art, history, and literature. The RN-BSN is a much more highly trained nurse than is either the ADN or the from scratch BSN and I don't dispute that. But I do dispute the other scenario. Is Kentucky really that different from other states? I can't believe from reading the other areas of the board that that is so.

    After much research, I found I could get very quickly to a BS in Psychology then go after an MSN. With college costs are high as they are, I have taken that route. Yet, I know I will not be considered equal to a from scratch BSN and this is just very silly to me because my actual nursing hours are exactly equal.

    Please help me understand this.

    Also, once you make nursing BSN only, you will wipe out a huge majority of those older, more stable less childish nursing students in their 30's 40's and 50's. After reading this board and seeing that many 2 year programs take 3-5 years to get into getting pre-reqs out of the way, you've just knocked out the majority of people willing to go into nursing and able to afford it.

    Please, someone, address these issues. I don't think I want all nurses to be 21 year olds with no common sense or life experience to take care of me in my old age.
  9. by   Hellllllo Nurse
    I am an ADN RN, actively seeking to obtain a BSN. I have 127 college credits, all core, nursing and sciences courses. My GPA is 3.69.

    However, it is still going to take at least 66 credits for me to obtain a BSN at every college I have checked in to. By the time I get my BSN, I will theoretically have enough credits for a Masters.

    My husband has a PhD in engineering. He saw what I went through to obtain my ADN. He tells me he thinks that getting an AAS in nursing is at least as difficult as getting a BS in engineering.

    I think it would be ideal for all RNs to have a BSN as an entry level requirement.

    However, with all the hoop-jumping I am still being put through to try and obtain a BSN, I am doubting it is worth it.
  10. by   orrnlori
    Oh, and one other thing I have noticed. I precept nursing students and have done so for several years sometimes for several weeks, sometimes for only one day, but I almost always have a nursing student with me during any given week. I love to teach, I work in a teaching hospital, I even do some teaching to surgical residents and keep their behinds from being singed on a regular basis. Here is a casual observation that I have come to look at much more critically in the last year. I get BSN students, I get AAS students. And I work in the OR so I teach the planning and care of surgical patients and let my students follow a patient from beginning to end. My BSN students never seem to ask questions. I can rarely get them to the field to look. They don't even seem to have a cursory knowledge of basic anatomy or even passing base knowledge in drugs as common as epinepherine or solumedrol. They never bring anything with them to write on. They don't even seem to have any concept of why they are there other than to observe. On the other hand, my AAS students come with notepad in hand, write down things, ask about nursing care plans, look at instruments, etc., etc.

    Is this a difference in objectives from a BSN program and an AAS program. When I was in school, we had preprinted objectives, and they best be met by the student during their observations in ICU, OR, or whatever. The only BSN students I can get engaged are those who know they want to be advance practice nurses, like FP, CRNA, etc. What's up with that?
  11. by   athomas91
    well the first problem is generalizing....not all BSN students have no drive...and not all ADN students are first we mustn't generalize...

    i will stick w/ my doesn't take a BSN to be a good nurse - but it can ONLY make a good nurse better. and as for BSN students wanting to move on to adv. practice..when i got my BSN i had no aspirations of CRNA - that didn't come until later.

    I have worked w/ nurses from all educational levels and agree that higher education alone doesn't neccesarily make them better. However IF nursing wants to establish themselves as a profession and be on equal standing w/ other professions - there cannot be 80 different ways to do it.
  12. by   llg
    One of the problems seems to me to be that so many ADN programs keep adding requirements to the point where they approximate a BSN program. That fuels the fires of discords because it decreases the difference between the academic degrees. The original intent of the ADN degree was to prepare a basic, beginner-level nurse for the bedside in 2 years -- no higher expectation and no more requirements.

    However, as ADN requirements and expectations have increased, it is no wonder that their graduates are angry when they are not considered to have an education equal to that of the BSN's. I think the anger is sometimes being directed at the wrong people -- the BSN's. That anger should be directed at the ADN program administrators and faculty who keep lengthening their programs and trying to establish a set of unrealistic expectations for their students and graduates.

    I don't think the different level are the main problem -- it is that the different levels have been blurred. If the levels were kept distinct, with clear sets of requirements and expectations of each level, there would be far fewer problems.

    Last edit by llg on Mar 5, '04
  13. by   gaulkari
    Maybe everyone should go back to the reason we are here at all. Most of us want to be nurses in some capacity. Nursing schools try to prepare their students for what will face them when they are on the floor faced with real life people who depend on them. ADN programs get harder and harder because if they don't the nurses turned out from their programs will not become RN's. Both BSN and ADN turn out grads that are excellent and some that are not. I respect the education and ability combined of all different levels of nursing. I personally have my ADN and will be starting on my BSN. I do it because I feel in our field if we don't continue our education we are letting our patients down and ourselves. Each day we need to work together to gain the respect we deserve.
  14. by   orrnlori
    I don't believe I used the word drive, I used the word engaged. And my question was more in asking how the criteria was set up for the BSN in clinical observation as a rule. Most of my AAS nurses come with a set of structured observations in writing they need to involve themselves in, the BSN's don't seem to do that unless they are motivated beyond their BSN.

    I also don't see nurses who work side by side having a problem with their so called levels and I agree that much of that comes from outside, but it also comes from above.

    So are you advocating that ALL nursing schools have one curriculum for the BSN. I can tell you from looking at BSN programs from all over the country, they come in every color and size. Some emphasize strong science content, some are very strong in the arts, some have religion classes attached. But I can guarantee you that all are different from each other so as to be quite obstructive in getting to the goal.

    And HelloNurse, I agree with you, it's a very long way around the barn with most programs and they are highly inflexible. It is what it is. If the goal is to have an educated graduate then the education should be valued above a rigid set of classes whose very nature changes depending on what school one looks at.

    I found a decent number of master's programs however that are quite flexible in what you come to the table with as long as you are a practicing registered nurse, thus, why I chose the BS route rather than extending my education and additional two years just to get to a master's program.

    I would propose that until WE decide what we think a nurse is and needs, that schools will not be inclined to assist easily in our education. Education is afterall a business.

    And llg, I agree that the ADN programs have become much more than 2 years. The very very least you can do most two year programs in is about 2 1/2 years taking a suicide load of classes. But is the answer to cut back at the ADN level or extend at the BSN level? And what about the question of the same number of nursing hours in each degree?