BSN as entry into practice; why we decided against it.

Students ADN/BSN

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nursel56

7,078 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I'm pretty sure that your definition of "in depth" when it comes to research studies and my definition of "in depth" are nowhere near the same.

You are here arguing a point of view, yet stated that,

I haven't done a lot of in-depth research or determined what factors may have impacted any study regarding this topic whether it's in favor or against. Why? It's time consuming so it has to be something that's not already obvious in order to dedicate any time to it.

If your definition of "in depth" is what is already obvious to you as an individual or has an abundance of evidence on the surface (whatever that means) then I'm sure we won't agree. I'll submit that what the committee Muno was part of did compares quite favorably in even a lay person's estimation of the meaning of the phrase "in depth", when even a cursory look was declared by you to be too time consuming --yet you stated "ADN advocates" were sweeping pertinent information under the rug just to support a predetermined conclusion, even though many of them have BSNs themselves.

In fact, there's a pretty wide variety in the time it takes to get an overview of a study without going deeply into their models, but if you never look at them because you assume your opinion trumps their research, again, there's no real point in your jumping in.

Ntheboat2

366 Posts

You are here arguing a point of view, yet stated that,

If your definition of "in depth" is what is already obvious to you as an individual or has an abundance of evidence on the surface (whatever that means) then I'm sure we won't agree. I'll submit that what the committee Muno was part of did compares quite favorably in even a lay person's estimation of the meaning of the phrase "in depth", when even a cursory look was declared by you to be too time consuming --yet you stated "ADN advocates" were sweeping pertinent information under the rug just to support a predetermined conclusion, even though many of them have BSNs themselves.

In fact, there's a pretty wide variety in the time it takes to get an overview of a study without going deeply into their models, but if you never look at them because you assume your opinion trumps their research, again, there's no real point in your jumping in.

Again, I'm pretty sure our ideas of "in depth" are very different.

If you knew a lot about how to analyze a research study then you would know exactly what I meant by "on the surface."

When all posters are required to do in depth research on a topic before there's a point in "jumping in" then I will refrain from doing so. However, the day that is required will be the day the discussion board all but dies.

Until I see every opinion followed up with evidence that includes measurement reliability and validity (including the degree) and also provide values (p-value) as well as effect size...

Then I will assume that this is a discussion based upon opinions and references are made based upon casual reading of reliable articles rather than "in depth research."

MunoRN, RN

8,058 Posts

Specializes in Critical Care.
If I was talking about my theory then I would've said, "If it goes along with my theory." The word 'your' is the keyword.

Ah, thank you for explaining the complexities of personal pronouns . My lack sentence structure knowledge allowed my to think your statement could have just as easily been applied to you, now I see that your statement could not have described your position in any way.

Do you honestly think that there's no difference between the programs other than the names?

So, students spend "45 more credit hours" doing nothing for a BSN? That's funny because my final semester practicum was spent answering to several ADN nurses as to why I was spending over 200 hours on the floor getting hands on training when they claimed that they, "went a day or two."

If experience is the best teacher then the difference in hours spent doing direct patient care could be just one piece of the puzzle. We're not comparing an ADN nurse with 2 years of experience to a new grad BSN. We're talking about an ADN graduate and a BSN graduate side by side doing the same job.

Take the name of the degree out of the equation. Who do you think would be better at...let's say...making balloon animals? Someone who spent a few hours practicing how to make them, or someone who spent a few hundred hours practicing how to make them? Who would you hire for your kid's party?

I really don't see the big mystery here. More education is always better in my opinion...no matter who the subjects are. People are just too close to the situation to see that. I bet if you ask random people off the street who have no emotional involvement who they would rather have caring for them, they'll pick the person with more education every time. Again, we're comparing new grads.

So just to clarify, it's your impression that the Nursing program portion of an ADN program is 45 less credits than that of a BSN?

And you're also under the impression that an ADN practicum is "a day or two" long?

And you also believe that typically BSN's graduate with more direct care clinical experience than ADN's?

Ntheboat2

366 Posts

Ah, thank you for explaining the complexities of personal pronouns . My lack sentence structure knowledge allowed my to think your statement could have just as easily been applied to you, now I see that your statement could not have described your position in any way.

So just to clarify, it's your impression that the Nursing program portion of an ADN program is 45 less credits than that of a BSN?

And you're also under the impression that an ADN practicum is "a day or two" long?

And you also believe that typically BSN's graduate with more direct care clinical experience than ADN's?

Uhh....I specifically quoted "45 credit hours" because YOU said the only difference between ADN and BSN is 35 general credits and 8 core credits. Okay, so that's 43 hours. You're right, I was wrong!

Which ADN practicum? I was talking about ONE practicum. One in which actually was "a day or two long" in comparison to a couple hundred hours long. You know that the entire sum BSN clinicals is much more than a couple hundred, and I wasn't implying that the entire sum of ADN clinicals is a day or two long. I was speaking of ONE clinical rotation and yes there was a huge difference.

Yes, I believe that BSN's graduate with more direct care experience than ADN's because...well...they do.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

My questions were admittedly rhetorical, so I'll just go ahead and answer them.

ADN and BSN credit and clinical hours are largely standardized, in my state ADN and BSN programs have to meet the same requirements minus 8 credits, clinical hour requirements are state mandated and the same for both types of programs. Aside from just having similar programs in terms of numbers, affiliations between BSN and ADN programs are becoming more common which has led to the two often sharing curriculum.

I googled "top ranked BSN programs", and UPenn, Columbia, and Johns Hopkins came up frequently. I couldn't find curriculum information for the first two, but I did find a breakdown of Johns Hopkins clinical requirements. Their final semester practicum is 168 hours, the minimum for practicum clinical hours in my state for an ADN is 180 hours for a quarter system, 220 for a semester system (more than your BSN required).

In terms of clinical experience, there's a reason my hospital stopped hiring BSN new grads for two years. While all RN graduates in state need the same number of clinical hours, not all clinical hours are equal. BSN programs often struggle with limited clinical placement opportunities as compared to more dispersed ADN programs, as a result it's not unusual for ADN grads to come out of school closer to being able to take a full load. That's not an observation specific to my Hospital, from an online article "Diploma and Associate Degree RNs will clearly tell you that they can run rings around BSN program graduates when it comes to patient care. Theyll explain that they have more actual clinical experience and patient care know how in their little finger than a new BSN grad, and 99% of the time theyre right about that!" It may just be a myth, but it's a frequently stated myth. As an aside, I don't think time-to-full-load is all that important, potential to progress should be more important.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.
Uhh....I specifically quoted "45 credit hours" because YOU said the only difference between ADN and BSN is 35 general credits and 8 core credits. Okay, so that's 43 hours. You're right, I was wrong!

A bachelor's degree (any bachelor's degree) includes your major program, typically about 2 year, and 2 years of general electives. ADN programs typically have about 45 credits of pre-reqs (including the pre-reqs' pre-reqs). So that leaves about 45 credits of electives (art history, english lit, etc). The programs themselves are pretty similar, in my state the only difference is 8 credits of leadership and community health.

To put that another way, ADN and BSN programs are not nearly as different as they used to be. These days the main difference between the two is a year of art history, english lit, etc. While I'm all for a well rounded education, I'm skeptical that an ability to expound on pointillism significantly contributes to better patient outcomes.

Ntheboat2

366 Posts

Where did you get the idea that 220 hours is more than I did? That's not even true...so I'm sure I didn't say it.

Between you making things up, forgetting what you even say in your own posts (ex: 45 hours is the difference), and people not answering questions while wanting theirs answered, this is getting boring.

I'm going to use my awesome critical thinking skills I developed through my totally useless education and bow out now.

Peace!

Specializes in Cardiac.

If we are assuming education is progessive, would a new ADN be more up-to-date than a BSN acquired 10 years ago?

B in the USA

6 Posts

Some people don't consider minimal education and the inability to spell anything as diversity or strength.

Embarrassment? Maybe.

Rude.

Ok...I've looked at some of the suggested sites, as well as done a little research of my own on this matter. This is what I've found so far...

There are quite a bit of papers that suggest that the BSN should be the starting point of entry. Yet, none offered a solid reason why it should be. It just seems like-to me, anyway-that they suggest the BSN as entry simpy because it can't hurt, or because "More education is always good." I just couldn't believe how so many "Independent studies" support the BSN yet can't find a reason to back their support up. Or if they do have a good reason, they are reluctant to share it. (BTW, I didn't include the sites here, but all you really have to do is google ADN VS BSN and they will pop up). One of the sites provided by another poster did indeed have one line that claimed that surveys showed that ADN Nurses (didn't specify new grad here) were more than 9x more prone to violations than BSN Nurses. Again though, nothing was offered to back that up. they just say "Surveys of disciplined nurses state that ADN trained Nurses are more likely to screw up." In fact this was everything that long article said that directly condemned the ADN Nurse "The survey also revealed that nurses who had only an associate degree as their basic preparation were more than nine times as likely as those with a bachelor of science degree to be charged with violations." This was the total of the "evidence" used to back up the ADN being incompetent as an entry point claim. And not that I'm just looking to pick apart anything that does not agree with my stance, but even if these surveys do exist, they were filled out by Nurses who were considered "Disciplined-meaning that they were at least having twice as many violations as the average-and were likely looking for whatever excuse they could think of to take some blame off of themselves. Not saying this is absolute, but does deserve consideration.

To be fair, The article did say that BSN grads were better versed in Critical thinking, but when I looked up the BSN degree sheet online (UNLV) I saw no real classes that I would think would help my critical thinking skills. At least not anything that wasn't covered by my school's ADN program. But then again, one thing that ALL the Pro BSN articles did have in common was that the BSN grads were better critical thinkers. So is it true? I dunno, maybe. But I'm just not seeing it by looking at the degree sheet. Perhaps a combination of their classes leads to these better critical thinking skills? It's possible.

Specializes in Med/surg, Quality & Risk.
Ok...I've looked at some of the suggested sites, as well as done a little research of my own on this matter. This is what I've found so far...

One of the sites provided by another poster did indeed have one line that claimed that surveys showed that ADN Nurses (didn't specify new grad here) were more than 9x more prone to violations than BSN Nurses. Again though, nothing was offered to back that up. they just say "Surveys of disciplined nurses state that ADN trained Nurses are more likely to screw up." In fact this was everything that long article said that directly condemned the ADN Nurse "The survey also revealed that nurses who had only an associate degree as their basic preparation were more than nine times as likely as those with a bachelor of science degree to be charged with violations." This was the total of the "evidence" used to back up the ADN being incompetent as an entry point claim. And not that I'm just looking to pick apart anything that does not agree with my stance, but even if these surveys do exist, they were filled out by Nurses who were considered "Disciplined-meaning that they were at least having twice as many violations as the average-and were likely looking for whatever excuse they could think of to take some blame off of themselves. Not saying this is absolute, but does deserve consideration.

I wonder if that might have anything to do with ADN nurses spending more time at the bedside instead of sitting behind a desk? The risks of sitting behind a desk are rather low...

Oh, not that it's extremely relevant, but another thing that EVERY report I researched had in common was that the MAIN factor in high mortality and violation rates was ALWAYS MOST affected by ridiculous Nurse to Patient ratios. The way they made it sound (and It is likely to be true) is that just adding 2 Nurses per shift would be a tremendous help. If this is true then I just don't see why it isn't being done. I percentage wise, how badly would this hurt most hospitals bottom lines?

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