Help Me Understand! UCD Grad Student Reflections

[babaloo8]

I need the help of my fellow nurses to unravel a problem that I am struggling with in our profession. This may be unique to my working world, but I suspect it's not.

After 20 years as a nurse, I have decided to take advantage of a fantastic, grant-funded Master's of Clinical Science and Health Care Leadership program at U.C.Davis. I decided to take the plunge because I am in desperate need of professional inspiration and renewal. I need to step out of my unit as a staff nurse and submerge myself in new ideas and perspectives. Stretch myself beyond my comfort zone. I believe that under the best of circumstances, the pursuit of higher education can be transformative and I, as well as my cohorts, have grown in many unexpected ways this past year. I'm not sure what I will do with this, but if nothing else, I am a stronger writer, public speaker and critical thinker. I know how to look for evidence in the literature to support or enhance nursing practice. I have broadened my understanding of what an exemplary leader is and the ways that I can support and nurture the leadership capability within my nurse colleagues. It's an incredible amount of work, but I feel tremendously grateful for the opportunity. I share my journey (both good and bad) regularly with my fellow nurses in hopes of inspiring, even one, to take advantage of the program.

So...at this point you might be thinking "That's great!" "What's the issue?"

Well...Let me explain.

"So...does this mean you are going into management?"

In general, my nursing coworkers have been supportive of my journey and have in many cases agreed to an adjustment in their schedule to accommodate my educational needs. But, I am struck often by the lack of interest in advancing ones education and by the suspicious tone that permeates the attitudes of many nurses and nurse practitioners to the value of an advanced degree. This seems to include a B.S.N. as well. I find myself deflecting comments about my presumed intention to enter an administrative role or to teach. The latter always comes with a statement about the cut in pay one would incur when choosing to educate the next generation of nurses. This fact is unfortunately true, but illustrates an inclination by nurses to de-value education outside their clinical nurses training.

Recently, a nurse chairing a committee questioned the validity of the Institute of Medicine(IOM, 2010) report on the Future of Nursing. She did so because of its recommendation that academic nurse leaders should work together to increase the number of nurses with a BSN from 50-80% by 2020. She felt the entire document of recommendations was suspect because this aspect is not supportive of the many associate degree nurses who are doing a great job without a BSN. What? Why are we resistant to any efforts to suggest that setting a minimum degree standard(such as is present for a PT, OT, etc) for nurses might result in a greater number of nurses in decision making roles, such as public health policy. Also, within this document are many important recommendations such as, the desire to see nurses to be full partners with physicians and other health care professionals in redesigning healthcare. There is a clear alignment of these recommendations to achieve the ultimate goal of advancing the field of nursing.

The bottom line for me is that our health care system is broken in the U.S. Reevaluating how we deliver health care is essential. Nurses need to have an equal and active voice in the collaborative improvement efforts that are on going in our daily workplaces. Do we need to have an advanced degree to obtain this? Not necessarily. But, I believe it raises the bar of our profession and increases the chance that we will have a seat at the table of important decision-making.

Now, let me be crystal, clear. I do not believe a great nurse is defined by the degree he/she has obtained. Nursing is both science and art. The vast array of skills a nurse possesses is honed with practice, over time. Experience has shown me this time and time again. But, we want nurses to lead us, rather than an MBA without clinical experience. Don't we? If so, nurses need some essential tools that we didn't necessarily acquire in our undergraduate work.

So, what's at the heart of the fear or suspicion I sense from within my fellow nurses?

My hearts desire is to encourage, support and help equip nurses to practice to their full potential and understanding some of these dynamics might help.

So, has anyone had these same experiences? I would welcome your perspective.

[SHGR, MSN, RN, CNS]

OP, I am in pretty much your situation. Been a nurse for about 20 years, finishing my MSN now. The attitudes you are seeing are exactly what I am seeing. Sort of a mix of suspicion and "oh, I would never do that." Our physicians are wary of NPs and their bids for autonomy and independence (I'm in a clinical nurse specialist program), management is wary of anyone who might ever want or try to be a manager, and my peer nurses don't want to spend their free time or money getting further education (some of my coworkers are diploma grads who don't think nursing or health care has changed since the 1970's).

I do however get very positive vibes from our medical assistants, most of whom are either in ADN programs now or doing prereqs. They value education and the chance for increased opportunities and the MAs who have drive think it's inspiring that I'm investing in my own education- it seems real and doable. A rising tide lifts all boats. Maybe they don't feel threatened by me or they think they can have my job when I graduate, I don't know...it's just nice to have a little positivity.

[JoseQuinones]

From the tone of your posting, I think you already suspect this, but let me put this out there: sour grapes. You mentioned that you are in need of some fresh perspective and encouragement after 20 years; so, probably, do your coworkers. But you are taking the step forward to do that and they are not. It is human nature to resent someone else's success, and as irrational as it sounds, many people would prefer to keep someone else down than they would stretch to succeed themselves. I understand your confusion. You want them to be happy with you and for you! Maybe they are not the right people to share your dream with. They are too tired, jaded, and bored to share it. Maybe your friendship with them is an inch deep and is based on nothing more substantial than the fact you work in the same place. When life moves on, these friendships end. Maybe it would be best to ignore their clucking, stop discussing your plans at work, and find another peer group of people who share your passion to hang out with.

[Altra, BSN, RN]

Before I comment on the original post, I'd like to throw out the following :

I personally believe that a bachelor's degree should be made the minimum educational requirement for licensure as a registered nurse, with a grandfathering provision for all currently licensed RNs.

Now ...

None of us here can possibly fully evaluate the OP's experience with comments made regarding her pursuit of an advanced degree. Tone, pre-existing interpersonal relationships with those commenting, etc. ... cannot be captured here. So taking the post at face value ...

The OP is utilizing an unusual opportunity to pursue an advanced degree without financial burden/risk.

She has received some comments from colleagues asking about future career plans. This is not, IMHO, unexpected as working professionals are well familiar with the work and cost typically associated with an advanced degree -- it is not something that many people pursue solely for the sake of personal growth.

OP has extrapolated the tone of these comments to indicate some broad, underlying resistance to higher education.

Is it possible that, instead, these conversations were just curious? Unless OP has broadcasted her unique good fortune in receiving her grant ... colleagues may well assume that she is assuming the cost of her education and therefore has a plan in place to recoup the investment cost. In any casual conversation with an individual who is a student in any capacity -- inquiring about future career plans is a common conversational topic.

[suni, BSN, RN]

I am 60 years old and just finished my MSN, never too old!

[imenid37]

I think it is very positive that you have decided to take your need for renewal and channel it into something really constructive. I woud love to see the very expert bedside RN have an MSN or DNP. Being "management," "academia," or NP should not be the only roles where nurses have furthered their education and expertise. The bedside is more complex than ever. The MSN or DNP could help to mentor the newer staff and consult on complex patients. I think one of the troubles with advanced education is that once the education is advanced, the nurse is often out of the direct care role. I started as an ADN and many felt about the BSN then in 1987, what they now feel about the MSN and DNP...Why get it if you want to do bedside care? Don't take the nurses away from the patients, educate them and given them the tools to really make a difference. The magic of nursing happens when the nurse interacts with the patient and family much more so than from an office. That is not to say we don't need management, NP's, and admin. We do but we also need those highly interested in direct NURSING care to become expert at that aspect of nursing. If we want to make a difference in this healthcare reform, I that that would help us in a big way. I know achieving this high level at the bedside would not and does not have to be for everyone. I think it would be motivating for some. I also take issue with those who disdain curiousity and the seeking of new knowledge. Just my way out there opinion.

[tokmom, BSN, RN]

I agree with higher education. The old adage of "you don't know, what you don't know" holds true. I thought I knew as much as a BSN, until I recently graduated with my BSN. Now I DO see the difference.

Like you, I have a need to understand more. I was ok doing the ADN thing until I chose to achieve my certification. Once I studied and passed the exam, I felt a burning need to understand nursing in a more in-depth manner, so I went back to school while juggling a FT job, committees, kids and life.

When I graduated with my BSN, not one person congratulated me at work, except my MSN manager.

I would like to further my education for my masters, but cannot take on more debt.

Maybe I would teach, but I really like the political arena of the nursing profession. I just need to figure out how to get there, lol.

Nursing needs to get it together and start supporting each other. We need to stop bashing online versus brick and mortar, profit vs non profit, ADN vs BSN and BSN vs MSN.

While we continue spinning our wheels, health care is changing around us and the bean counters are becoming our managers.

[babaloo8]

Altra-I appreciate your comments. I agree that inquiring about motives to further my education is part of common conversations and I am not needing validation from my peers nor kudos for my efforts. But, here is the interesting thing. This grant-funded program is available to 25 students each year.Any of my nurse collegues with a BSN, minimum 3.0. gpa, 3 letters of rec and a few short essays are eligible for this grant covering the entire cost of a UC education. One would think that after a year of 'talking it up' I might have convinced even one to consider it. So..money is a factor, but apparently not the only.

[babaloo8]

Thank you for your comments tokmom! I am so glad to hear that you are interested in the political arena. Through my graduate program, I attended 'Legislative Day' where we heard from those involved with public health policy and they stated over and over again that they desperately need more nurses and those with direct patient care experience to step into the public health policy arena and help them solve problems, give our perspectives as patient advocates. Apparently, the method of getting involved starts with talking to your legislators about issues that are important to you, sharing your view points on proposed bills with committee members and then after a period of time, they then know you and will call on you for a professional opinion on a subject. It's a networking process in politics.

[tokmom, BSN, RN]

Altra-I appreciate your comments. I agree that inquiring about motives to further my education is part of common conversations and I am not needing validation from my peers nor kudos for my efforts. But, here is the interesting thing. This grant-funded program is available to 25 students each year.Any of my nurse collegues with a BSN, minimum 3.0. gpa, 3 letters of rec and a few short essays are eligible for this grant covering the entire cost of a UC education. One would think that after a year of 'talking it up' I might have convinced even one to consider it. So..money is a factor, but apparently not the only.

I certainly didn't need kudo's for my efforts, however, everyone knew I was going to school and they knew when I finished. I thought it was odd, that nobody said anything. I do believe it shows that education isn't highly coveted in my co-workers and some think there is no difference in the ADN vs BSN, so what is the big deal (?).

I work with folks that can have a certification course paid for, but only a handful of us took advantage of the offer. Many don't want the commitment that it takes to further their education either through obtaining a cert, BSN or MSN. I gave my life away for 16 months, whilst going to school, spending close to 20 hours a week on homework, easily. For some, that is too much of a sacrifice.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I have a 'friend' whom I've known for 12 years. We were agency LPNs together. She went on into an ASN program. At the time, I had no desire to go any further. But I later graduated from the same ASN program as she did, exactly 4 months after she did. However, I managed to pass boards before she did because she failed her first attempt. She was licensed one month after I was. But as soon as I began my BSN pursuit, very casually mind you, she stopped speaking to me. When life threw up its hurdles and caused me to pull out, she became my 'best friend' for the entire year that I was 'out'. We have conversations occasionally now, but only if it's not pertaining to advanced degrees. Being that I'm a little more than 5 weeks out from completing my degree, she is going to be SICK when I'm done.

I personally find her behavior to be very immature (given that she is 55 years old!!!) and insulting to the profession. But, my decision to continue on was what I needed to do because this BSN is the only role in nursing that was MY choice. The LPN was my dad's decision when I was just coming of age with NO MONEY (he paid for it), and the ASN was the decision of a failing economy, as it forced many changes in how my hospital viewed LPNs in regards to getting the most bang for the buck.

As as one poster said, it may be sour grapes or perhaps it's a severe case of being green with envy. Whatever the case, you know the desire for challenge that is burning within. There are a lot of us who do not settle for complacency and eventually move into other areas of nursing. This is why I've been a Float Nurse for many years even during my LPN days. So keep going until YOU want to stop. Those who are worth your while will be happy for and supportive of your efforts.

[JPCummings]

There is no definitive answer as to why some individuals respond negatively to advanced education. Education should empower nurses, the more you know the better off the patient. Unfortunately in this instance education appears to be divisive. I'm almost certain if there was a medical school program that took half the time to train an individual to become a physician, and demonstrated favorable results that physicians would have this same dialogue. The best thing to do is not over-think the why. As many other colleagues posted, surround yourself with positive like-minded individuals.

The wonderful thing about nursing are the multiple pathways an individual can choose once their career has started. While 90% of nursing occurs at the bedside, there are opportunities beyond bedside care, if an individual is interested. To attain such positions, advanced education beyond basic nursing school is usually needed. For example, a nurse I know was offered a job as director of research and development for a pharmaceutical company because she was pursing a PhD in nursing research, she has to fly to France 10 times a year as a job requirement.

The point is that nurses can have a much greater impact beyond the bedside, not just one patient at a time. Nurses have the ability to have more influence, if they choose to take advantage of those opportunities.

[babaloo8]

BSNINTHEWORKS-congrats on the near completion of your professional goal! You beautifully illustrate the type of behavior or attitude that I was drawing attention to in my article. We need to support one another and see each nurses advancements as enhancing the professional as a whole.

Thanks for sharing!