ADN's being pushed out

LadyFree28, BSN, LPN, RN · Jul 22, 2013

Exactly. We're all on the same team, with caring for the patient being the goal. Well said!

^THIS is what it's really all about. :yes:

The only "pushing out" we as nurses should be doing is ANYTHING preventing us from doing what we are supposed to do-provide clinical judgement, data collect/assessment, coordination and collaboration of care; and education. That's the true "bottom line."

S.G. · Jul 22, 2013

I would be more inclined to believe studies saying BSNs have better patient outcomes if the study showed the difference between BSN students who did not have their RN or LPN license before getting their BSN.

Some if the push for a BSN us to lend more credibility to nursing as a profession. There is still a debate about how a professional field can allow so little education. I've worked with diploma, ADN, BSN, and MSN nurses. There have been good and bad in all levels of education. I went back to school for my BSN after 5 years of ADN. The only "new" thing I learned was in my research class. I didn't know how to properly understand the research I sought to improve my practice.

And I agree that we are all on the same team. We all want to help our patients. Much of what I have learned has come from experience. My job is certainly not like school was.

green34 · Jul 22, 2013

As for the BSN students....did it ever occur to you that maybe their program instructs them to shadow the nurse, and not do the CNA's work? In my BSN program, we were specifically told NOT to do the CNA's work for them. Being in our last rotation of advanced med surg, we were to care for our 2 patients and shadow the RN taking care of them. We all know how to do VS and baths.....we (students) shouldn't do the CNA's work...especially when the CNA's and the other staff nurses expect the students to do all the VS, beds, baths, etc for the whole unit. My advanced MS rotation was awful because the CNA's and floor nurses were mad that we didn't let the CNA's sit around and chit chat. Whether a CNA or nurse, and you have students, that patient is still YOUR priority and it is still your responsibility to make sure things get done. You know that stack of paperwork the students have.....med cards, care plans? Those 5-6 pages (or more!) that is due when they leave clinicals? The paperwork they can't do ahead of time because they aren't allowed to? Yeah. That's all due in post conference. Some of those BSN's might have been LPN's for a long time. Transitioning from an LPN to RN isn't easy. I came away from that rotation still confused about my role as the RN, instead of JUST the LPN.

You "shadowed" an RN? What is "shadowing" RN mean? It sounds like you guys worked on paperwork which would have been better spent doing outside of clinical time. Med research? Should be done on your own time before clinical. Those care plans? Should be done the day after and turned in then. It's a waste of clinical time to do it during clinical.

As for shadowing, what did you need to shadow an RN for? You know how to assess or you work with your clinical instructor during first semester to assess a patient. Charting? You get a crash course in charting if you do not know the system and then you chart using the same charting format an RN uses so shadowing wouldn't be helpful here. Giving meds? You give meds on your patient with your instructor (time management anyone? We all managed to give all meds within the acceptable time frame per hospital policy). You also provided care for your patient which involves giving them a bath/shower/etc if necessary on top of the other duties the patient needed.

The only time I "shadowed" an RN was in the ICU and the ER. The ICU was more of us working with the patients and then having them watch and make sure we were doing procedures correctly.

It really sounds like the school was being unfair in taking away your clinical time to work on paperwork that could be done at a later time on the student's own time. It's unfortunate and robbing you guys of experience working with patients. Our care plans were due the next day at midnight.

Oh, and we didn't let the nurses or pcts sit, however we would help out with skills that our instructor thought were important when they were being done on other patients. Someone never did TPN? Ok, this patient has it. Someone never gave a shot? Well, they can do the flu shots for that day. Someone needs an IV? Someone needs a bed bath? Well, that can go to a pct unless we were completely and 100% dead.

allnurses Guide · Jul 22, 2013

NLNAC requires that research be part of a ADN curriculum to be accredited and applies near identical requirements to ADN programs as the CCNE applies to BSN programs in terms of Research base.

Correct me if I am wrong, but I just did a quick read of the ACEN vs CCNE curriculum statements.

The only reference to research for ADN-level curriculum per the ACEN:

"The curriculum and instructional processes reflect educational theory,

interprofessional collaboration, research, and current standards of practice."

Just one part of the CCNE "essentials" for BSN:

"The baccalaureate program prepares the graduate to:

1. Explain the interrelationships among theory, practice, and research.

2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

3. Advocate for the protection of human subjects in the conduct of research.

4. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources.

5. Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes.

6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.

7. Collaborate in the collection, documentation, and dissemination of evidence.

8. Acquire an understanding of the process for how nursing and related healthcare quality and safety measures are developed, validated, and endorsed.

9. Describe mechanisms to resolve identified practice discrepancies between identified standards and practice that may adversely impact patient outcomes."

They don't seem to be near-identical requirements to me.

I did quickly review the top three ADN programs in my state (by NCLEX pass rate) and none of them include a dedicated research class; they all include a dedicated research class as part of the RN-BSN program.

malamud69, BSN, RN · Jul 22, 2013

I work for a large Magnet hospital. As nursing becomes more popular, and nurses not in short supply, I have noticed something ominous has being going on lately. Several of our older and very seasoned ADN nurses are being fired. The excuses for firing are ridiculous. I have sadly seen some excellent nurses lose their jobs. I am wondering if they want to get rid of the ADNs so they can look "better" with an all BSN staff. Or perhaps they want rid of older nurses who have been there longer because they are higher on the pay scale. Either way, it is very scarey. I myself am BSN, and i am not ashamed to say that what I know does not hold a candle to these fired nurses. Any thoughts?

Of course they want to "look better" if you go to any reputable source that discusses magnet status, you will see that there is nothing...Nothing! mandatory about hiring only a BSN nurse...we all know that we take the same test usually make the same pay and for someone to sit in 2 years of communication classes and "theory" vs actual hands on experience-especially if they have years of college under their belt-is ridiculous! They are doing the same thing at a hospital I work at-Big city CT...sad but true.

MunoRN, RN · Jul 22, 2013

Correct me if I am wrong, but I just did a quick read of the ACEN vs CCNE curriculum statements.
The only reference to research for ADN-level curriculum per the ACEN:
"The curriculum and instructional processes reflect educational theory,
interprofessional collaboration, research, and current standards of practice."
Just one part of the CCNE "essentials" for BSN:
"The baccalaureate program prepares the graduate to:
1. Explain the interrelationships among theory, practice, and research.
2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.
3. Advocate for the protection of human subjects in the conduct of research.
4. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources.
5. Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes.
6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.
7. Collaborate in the collection, documentation, and dissemination of evidence.
8. Acquire an understanding of the process for how nursing and related healthcare quality and safety measures are developed, validated, and endorsed.
9. Describe mechanisms to resolve identified practice discrepancies between identified standards and practice that may adversely impact patient outcomes."
They don't seem to be near-identical requirements to me.
I did quickly review the top three ADN programs in my state (by NCLEX pass rate) and none of them include a dedicated research class; they all include a dedicated research class as part of the RN-BSN program.

There are short and long-winded ways of saying the same thing. Both have detailed explanatory statements available, although I don't see them online, and the CCNE's detailed explanation is no different than it's "short" explanation, while NLNAC appears very similar to the CCNE long-version.

More and more however BSN and ADN programs have shared curriculums (ADN programs have adopted their BSN partner's curriculum, either to facilitate the ADN to BSN articulation or because it's actually required by state law), so the accreditation standards don't even really come in to play. There are two consortiums in my state where ADN and BSN take the same classes, I doubt they are getting vastly different educations in research.

Whether or not to make a research class it's own dedicated class or to integrate it into the Nursing program curriculum is up to each program. We have a mix in my state, we have ADN programs that have their own research class, and BSN programs that build it into their core curriculum. All of our RN-BSN programs include a Research "refresher" for those that graduated before Research become a more prominent part of ADN programs.

Esme12, ASN, BSN, RN · Jul 22, 2013

NO one has ever answered me......if a 4 year education makes a superior nurse....why is an accelerated BSN only 2 years to become one....clearly thier courses taken for a previous 4 year degree have no "nursing" focus.

allnurses Guide · Jul 22, 2013

NO one has ever answered me......if a 4 year education makes a superior nurse....why is an accelerated BSN only 2 years to become one....clearly thier courses taken for a previous 4 year degree have no "nursing" focus.

Are you speaking to aBSN programs for individuals with a prior BA/BS degree in another field?

Check out Seifer and colleagues article from 2008, it is an interesting look at LA Ed. The article is not specific to nursing but the results could be extrapolated to explain some of the benefits to nursing.

PMFB-RN, RN · Jul 22, 2013

NO one has ever answered me......if a 4 year education makes a superior nurse....why is an accelerated BSN only 2 years to become one....clearly thier courses taken for a previous 4 year degree have no "nursing" focus.

I take your point however a two BSN is not an accelerated program. The actual accelerated BSN programs are only 12 months long. We have a couple one year nursing schools here in Wisconsin.

allnurses Guide · Jul 23, 2013

Are you speaking to aBSN programs for individuals with a prior BA/BS degree in another field?
Check out Seifer and colleagues article from 2008 . . .

Do you have anything more specific than that? I searched all the common databases and didn't find it. Perhaps the words you were abbreviating with "LA Ed."?

allnurses Guide · Jul 23, 2013

Do you have anything more specific than that? I searched all the common databases and didn't find it. Perhaps the words you were abbreviating with "LA Ed."?

Sorry. Liberal arts education.

Title of the article is "The Effects of Liberal Arts Experiences on Liberal Arts Outcomes". Should be easy to find.

allnurses Guide · Jul 23, 2013

Sorry. Liberal arts education.
Title of the article is "The Effects of Liberal Arts Experiences on Liberal Arts Outcomes". Should be easy to find.

Got it, thanks!