ADN's being pushed out

Nursing Students ADN/BSN

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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?

Specializes in Adult Internal Medicine.
Not accepting a study's methodology and/or conclusions due to standards of research and/or statistical procedures, does not equate to believing in a conspiracy theory, as many people have good or excellent knowledge of research procedures and statistical procedures. Also, not everyone who refutes a study, with good reasons, will feel a need to debate with you.

Conspiracy theory: "a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators"

My comment about conspiracy theory is directed at the flat disregard for every published study (there are now more than a half-dozen) on the grounds that they are invalid due to the international influence of a collaboration of nursing academics and the US government. At least as far as I am concerned that is a classic example of conspiracy theory.

There is no problem with challenging the methods of a study, in fact it is encouraged. There are some legit problems with the methodology of some of these studies, at least from my critical read, but that is not what has been debated here. In a myriad of threads on the same topic I have seen but one legitimate critical appraisal of a single study, and even that does not refute the entire body of work on the topic. As I mentioned above, I have some issues with some of these studies, but they are all consistent across nations, academic systems, healthcare systems, and researchers. There is a compelling argument in that.

True not everyone will be confident enough or have the motivation to critically discuss these studies, but one would think more than one person would given how passionate people are on this forums about the topic. Rather we get people slinging hearsay and conspiracy theory because they "have heard" they are right.

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Specializes in Adult Internal Medicine.
.... based on one study that was proven to be flawed (I posted that information in a response to you months ago)

First off it is not a single study, it is a half dozen major studies at this point.

If you can produce a single published study that refutes the results of the 2003 Aiken study, post the link here.

The only "evidence" you ever posted was a link to another post by a user of this site. That does not "prove a study to be flawed".

Again, post some evidence not just opinion if you want to "refute" a single study yet alone an entire body of research.

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Specializes in Critical Care.

We seem to end up in these arguments over who is/isn't more likely to kill their patients which is pretty ridiculous when you remember it serves absolutely no purpose.

For the sake of argument, let's say there is no doubt that BSN's are better nurses, what do we do with that information? How do we make all nurses like BSN nurses? How do we do something productive with that information?

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Specializes in Adult Internal Medicine.
We seem to end up in these arguments over who is/isn't more likely to kill their patients which is pretty ridiculous when you remember it serves absolutely no purpose.

For the sake of argument, let's say there is no doubt that BSN's are better nurses, what do we do with that information? How do we make all nurses like BSN nurses? How do we do something productive with that information?

If I were the one making decisions (and clearly I am not and will never be) my goal would be the following steps:

1. Follow up large scale study of nursing education at the associates and bachelor levels to determine exactly what components of the curriculum have the largest impacts on outcomes. Develop standards of education for bachelor prepared nursing.

2. Set a standard for entry to practice. Require all program to meet this standard: consider all of those program bachelor-level programs regardless if they were traditionally associate programs or bachelor programs.

3. Evaluate the components of extant associates and bachelor programs an eliminate extant associates and bachelor programs that do not meet this standard.

4. Control entry to these programs based on current market and need.

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If I were the one making decisions (and clearly I am not and will never be) my goal would be the following steps:

1. Follow up large scale study of nursing education at the associates and bachelor levels to determine exactly what components of the curriculum have the largest impacts on outcomes. Develop standards of education for bachelor prepared nursing.

2. Set a standard for entry to practice. Require all program to meet this standard: consider all of those program bachelor-level programs regardless if they were traditionally associate programs or bachelor programs.

3. Evaluate the components of extant associates and bachelor programs an eliminate extant associates and bachelor programs that do not meet this standard.

4. Control entry to these programs based on current market and need.

You are also in favor of independent nurse practitioner practice, as well as BSN for entry into practice, and have argued vehemently on AN that studies support these events. From other posts you have made on AN, and now here, it appears to me that your primary intention is to set the bar higher for nursing education, so that entry to the profession is limited and wages/salaries are more on a par with physicians. This would certainly have the effect of making access to nursing care/NP care for patients more expensive, and you would have more job security. Who do you think would take care of patients in long term care facilities? Would it be the BSN educated nurse with $60,000 in student loans? You are saying that LVN's have no place in providing nursing care.

I

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Specializes in Adult Internal Medicine.
You are also in favor of independent nurse practitioner practice, as well as BSN for entry into practice, and have argued vehemently on AN that studies support these events. From other posts you have made on AN, and now here, it appears to me that your primary intention is to set the bar higher for nursing education, so that entry to the profession is limited and wages/salaries are more on a par with physicians. This would certainly have the effect of making access to nursing care/NP care for patients more expensive, and you would have more job security. Who do you think would take care of patients in long term care facilities? Would it be the BSN educated nurse with $60,000 in student loans? You are saying that LVN's have no place in providing nursing care.

I

True. There is plenty of evidence to support the outcomes if both bachelor prepared RNs and NPs in "independent" practice; if there wasn't we wouldn't be having this conversation, as I wouldn't support either.

Absolutely none of this debate revolves around the salaries of myself or other nurses. None of it is motivated by wanting to promote my own job security, that argument doesn't even make sense in this case.

I haven't mentioned LVN/LPNs at all; in fact I think they have a role in the future or nursing. This debate is about ADN vs BSN (or bachelor-prepared RN).

Even if the transition from ASN to BSN added $15k to student loans: The average salary for RNs nationwide is $68k which is on par with OT/PTs, which are doctorate degrees. I think that RNs could handle a little student loan debt given their salary and the importance of their role in the healthcare system.

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True. There is plenty of evidence to support the outcomes if both bachelor prepared RNs and NPs in "independent" practice; if there wasn't we wouldn't be having this conversation, as I wouldn't support either.

Absolutely none of this debate revolves around the salaries of myself or other nurses. None of it is motivated by wanting to promote my own job security, that argument doesn't even make sense in this case.

I haven't mentioned LVN/LPNs at all; in fact I think they have a role in the future or nursing. This debate is about ADN vs BSN (or bachelor-prepared RN).

Even if the transition from ASN to BSN added $15k to student loans: The average salary for RNs nationwide is $68k which is on par with OT/PTs, which are doctorate degrees. I think that RNs could handle a little student loan debt given their salary and the importance of their role in the healthcare system.

The "evidence" is unfortunately not universally accepted, and not just by people who believe in conspiracy theories, but by educated people.

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Specializes in Adult Internal Medicine.
The "evidence" is unfortunately not universally accepted, and not just by people who believe in conspiracy theories, but by educated people.

I think we should not use the "quotes" around evidence as it has been demonstrated consistently in the literature without a refuting study. If you was to cite a study and discuss, that would be welcome.

Let's use "quotes" around "educated" as that is truly the crux of the matter.

I am sure there are "educated" folks that disagree, but I have seen few "educated" critiques of the the extant data.

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I think we should not use the "quotes" around evidence as it has been demonstrated consistently in the literature without a refuting study. If you was to cite a study and discuss, that would be welcome.

BostonFNP, you will have to accept that not everyone, with good reasons, accepts what is said to be demonstrated in multiple studies. Some of those people have posted on this thread. Hence the use of "evidence."

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Specializes in Adult Internal Medicine.
BostonFNP, you will have to accept that not everyone, with good reasons, accepts what is said to be demonstrated in multiple studies. Some of those people have posted on this thread. Hence the use of "evidence."

Yet none have posted any scientific reason why they don't accept it regardless of how "educated" they are hence why quotes around evidence are not required. Anyone that chooses to not "accept" it is welcome to that opinion: they can choose to "accept" anything they like, for instance almost 1 in 3 Americans don't believe in evolution or 1 in 10 believe the moon landing wake faked.

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If ADN nurses are being pushed out, there is a community out there that needs them in home health and private duty; a specialization IMHO that needs MORE experienced nurses to help with complex pts living at home and in the community.

The ADN is in a unique position.

For example,when i was in South Carolina,private duty Lpn's and Rn's were paid the same hourly.

Some companies refused to hire Rn's for LTC,saying that we cost to much and that we do the same things as the Lpn but get paid more. Why pay an Rn when you can pay an lpn less for the same work?

I think the biggest problem in nursing is not only educational level but also there is no cohesiveness.

Different states have different Nurse Practice Acts and different scopes of practice.

I guess it is just going to be Bsn Rn's and Lpn's going forward.

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First off it is not a single study, it is a half dozen major studies at this point.

If you can produce a single published study that refutes the results of the 2003 Aiken study, post the link here.

The only "evidence" you ever posted was a link to another post by a user of this site. That does not "prove a study to be flawed".

Again, post some evidence not just opinion if you want to "refute" a single study yet alone an entire body of research.

Again, I posted those sites that refuted the Aiken propaganda over a year ago in a response to one of your posts. Go through your posts and you should find them. That entire body of research you speak of were all spun off from Aiken's 2003 so-called scholarly research. As a matter of fact,you'll see many of the same names listed as sources.

What a bunch of robots you all are if you believe this nonsense. But you do what you feel you must and so will I. I am preparing reports for the news agent and our state representative . Also, a couple of weeks ago, a major report in our area spoke out against the use of PAs and NPs as primary care providers. I completely agree with the report. NPs and PAs are only to used as an extended arm of a licensed physician but never as a replacement or substitute for one. The differences in the education of NPs and PAs as well as the ability to diagnose and treat illnesses compared to that of an MD or DO is like night and day and never to be equated.

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