BSN as entry into practice; why we decided against it. - pg.2 | allnurses

BSN as entry into practice; why we decided against it. - page 2

While hopefully avoiding stoking the ADN - BSN debate unnecessarily, I thought I'd share my experience with my state's consideration of BSN as entry into practice, as well as the BSN-in-10... Read More

  1. Visit  nursel56 profile page
    1
    Quote from PRICHARILLAisMISSED
    Not sure how true this is, but the College that I am currently working towards My ADN with claims that they have a significantly higher pass rate of the NCLEX than the 4 yr University's BSN graduates do. So I guess the real question would be "How accurately does the NCLEX test those entering the nursing profession?"

    If ADN nurses were truly less safe practicing nurses BSN-only would certainly be the law in New York and Pennsylvania by now, and North Dakota wouldn't have repealed theirs, the onlyIf the NCLEX is a fair gauge of a new grads knowledge, then I would the imagine that the BSN would not be necessary for an entry level Nursing position.

    It MAY, however be necessary to pick up a management position...
    You bring an interesting point up here, because the concerned parties involved haven't proportionally weighed in to the degree the advocates of BSN laws have. The ANA has had over 40 years to convince state governments to change the law. The state is charged with keeping it's citizens free from harm, which they can do with zest when they are lobbied to death by a special interest group, like azar on your apples. I think it's fair to ask why they haven't, except for North Dakota, who repealed their law.

    To the "entry-level" designation In it's original position paper, the ANA proposed that there be two categories of RN with separate scopes of practice - the "professional" RN and the "technical" RN. Since the NCLEX is still the same for both, there is no evidence-based way to separate the groups by adding questions only the BSN nurse is expected to know earn a separate designation and wider scope of practice.

    We are all subject to the vagaries of the economy and public policy, and intangible judgments and beliefs. Aiken's conclusions (agree it's worth reading) haven't been proved or disproved, so it's possible there is a causal relationship. It's intuitive to believe more education = better. We need to know why and how before changing laws that would have such a profound impact on both the employee and the employer.

    At the present time hospitals prefer BSNs because there is no nursing shortage, and intangibles are acted on just as hard facts are, so going for the BSN will benefit your job prospects and widen opportunities regardless. They just don't want their hands tied legally should the present situation reverse itself, when they don't see much risk with the ADN nurse, having around 60% of working RNs of recent years ADN nurses.
    Last edit by nursel56 on Nov 17, '12 : Reason: bad eyesight typo
    SummitRN likes this.
  2. Visit  anggelRN profile page
    3
    I'm against BSN as an entry to practice. I'm not against getting a BSN in 10 years. I have never understood the uproar about it. 10 years is plenty of time. Community colleges are a cost effective way to get an RN license. I don't think that should be taken away.

    Also, if every "Tom, Dick, and Harry has it these days", then I don't see what the big deal is. In many other professions, you need to get at least a bachelors and even a masters degreee. Nursing shouldn't get left behind.
    Kandy83, citylights89, and SummitRN like this.
  3. Visit  somedaypeds profile page
    0
    The hospital I just signed on with requires a bachelors in 5 years. At their tuition reimbursement rate per year, it may take me 5 years to complete the one year program. After paying for my LPN and LPN to ADN programs out of pocket, I am very interested in having the rest of my education sponsored.
  4. Visit  kcmylorn profile page
    5
    MunoRN- great post. I'm glad some one finally came out with stating an argument against the plausabilty of Akein's recommendation on BSN required. This has shut alot of us out of jobs and in an economy where so many people are going under financially which is making it even more unattainable for alot of us ADN/diploma nurses to get that BSN to get that job to keep the roof over our heads and food on the table. Yes, there are states in this country who have not jumped on this happy crap bandwagon and make BSN the starting requirement for "a Job" But there are states in this country who have! I happen to live in one and have another boardering along side of me which makes it impossible to get a job unless one wants to pull up roots and move to a state where an ADN/diploma can get a freeking job. And like already posted- that is not a relist tatic if one has a home( try selling your old home that needs expensive repairs in this housing market!!) and a bunch of kids in school and a husband with an immovable job. You all may be on the side of road with your pillows and blankets and a "HOMELESS" sign. That is reality!!! The average nurse doesn't have wiggle room for this frivolity of Akein's Ivy league educationals tastes in nursing requirements. Any one look up the cost of tuition in Akein's University of Pennsylvaina Nursing program lately??
    I have said many times on this site that going back for a BSN is all nice, but if one doesn't have the financial means to do so than it remains a fantacy. Give the nurse a job first and then ask them to go and spend the money on an expensive education to keep you friends in academia employed! You can't get blood from a rock. A nurse on unemployment can not afford to forego the food on the table or the roof over the families head for college tuition!! That is pretty much common sense. And with the demands made in Akein's study, it pretty much apparent that woman never had a poor day in her life where she had to make such choices- how nice for her!!

    I did an agency assignemnt yesterday and came in contact with a nursing supervisor in a LTC facility who stated the same thing I have been yelling about in this site for months- many nurses in this economy can not afford to go back to school for that BSN. So I know I am not alone in this sentiment.
    To address the second point of Muno's post- I have sence gone back for my BSN on state aid through the help of unemployment because I cannnot afford it out of pocket.( and what is that doing to the economy Mr/Mrs MBA's) Can I honestly say that these BSN courses are making me a better nurse. NO. are they teaching me anything about Health Assessment I didn't learn in my diploma school and after 32 years of practice experience, NO! What am I learning? "APA format!!!" Which I know all my patients right after surgery and a good boust of diahrrea are really going to ask me about because it is vital to their "outcome"!!!! and eventual discharge to home. The APA police will be transporting them home. I have learned about the readiness of a system to begin a new telehealth program. Here is another must know for a patient who needs to get out of bed to go to the bathroom. if they can click the TV remote, their ready for that ambulation! but first I have to ask all on the unit if they agree a change is needed and then go to the providers and the organization to check and see what level of readiness they are at, because their readiness goals and that of the patient may be different. Happy BSN, ya'all.
    tntrn, MBARNBSN, Spidey's mom, and 2 others like this.
  5. Visit  tewdles profile page
    1
    I have commented before that we have decades of evidence that demonstrates clearly that a BSN is not required to be a competent and effective bedside nurse.

    Should professionals continue their education, surely.
    nursel56 likes this.
  6. Visit  PureLifeRN profile page
    7
    Quote from CapeCodMermaid
    . When I told the woman who asked me I didn't have a BSN and all their ads said it was a requirement, she laughed and said "I'd rather hire nurse who knows what they're doing than hire someone just because they have 3 more initials."
    I cant stand this type of argument. Why is it always assumed that BSN's DONT know what they are doing?!? All these posts from ADN's stating "My ADN school had more clinical hours", "My community college school is sooooo much better than the university." "ADN's know more than BSN's"

    Well how about this? MY BSN school has more clinical hours, better NCLEX pass rate and prepares students to be better nurses than the local community college.....but no, that would be an inflammatory remark.
  7. Visit  BonnieSc profile page
    4
    I've had exactly the same experience. No one wants to hear that in many places, BSN students have the same number or more clinical hours. Not that I think it makes that much difference anyway, a piddling difference in clinical hours. Both an ADN and a BSN get so many more hours in their first month of orientation as to render the clinical hours done during school almost meaningless. Clinical hours are a taste; you learn the clinical aspects of nursing during orientation and during your first year on the job.

    Diploma-prepared nurses are an entirely different ballgame, because their number of clinical hours is exponentially more. In comparison, every BSN and ADN program is effectively the same.

    In the end, I think how successful a nurse is depends on two things: first and foremost, it depends on the person. Second, it depends on the support that nurse gets during orientation and the first year.
    brandy1017, citylights89, sosweetrn, and 1 other like this.
  8. Visit  VICEDRN profile page
    2
    Two things:

    1. The aiken study is one of three major studies on the topic. Each of which conclusively correlated a BSN prepared staff with better patient outcomes. One of the studies was done in Canada which has a universal coverage system so I don't you can argue payor mix for outcomes.

    2. There is a definitive reason hospital managers don't like to hire BSNs. The fact is that hospitals certainly do not want to pay more money for a better trained staff (after all, what motivates that? Better pt outcomes and they aren't being paid for that) and BSN nurses are just that much closer to being able to go to grad school.

    Our ICU managers actually had to be forced into hiring BSN grads when the hospital considered a magnet status. Too many BSNs were doing their two years and going to grad school.

    As for conversion, its my experience that ADN programs train their students a certain way. Focusing on skills more than critical thinking and as a result, the nurse's practice is corrupt from the get go. Getting some online BSN so they can bypass "difficult" courses like statistics and college algebra doesn't improve their level of practice.

    Sorry but a finding that disavows the findings of several large studies is unfortunate for our patients and the future of nursing.
    SummitRN and subee like this.
  9. Visit  Skips profile page
    0
    Quote from SummitAP
    Without going on for 1000 words, OP's state is very different than my state on almost every point:
    • Significant prereq differences in BSN favor
    • Large GPA difference in BSN favor as BSN programs are merit based while nearly all ASN programs are minimum->waitlist admission
    • Slightly more to massively more clinical hours in BSN programs
    • Massive hospital BSN preference or requirement, especially for NG RNs
    • Major or exclusive preference for BSN students in clinical placement and internship offerings
    • Accelerated, traditional, and flexible BSN programs for professional and second career students
    • etc etc etc.

    That said, I'd love to see how OP "properly" corrected Aiken's "failed" math and upon what OP based the correction factors?
    My state is similar to this. There are less and less hospital jobs available that are preferring ADN RNs vs BSN RNs. BSN prepared RNs can get a hospital job a lot easier than an ADN RN. However, non-hospital jobs are ready and available for an ADN or BSN RN to take. There are plenty of them, but the hospitals here are pretty picky, since there are about 5 nursing programs in my city alone to choose from (and that doesn't count the city right across the river). Only one of them is an ADN school, the rest are BSN schools. Two of the hospitals won't even hire ADN nurses anymore. I guess it depends on the area.
  10. Visit  Streamline2010 profile page
    0
    I cant stand this type of argument. Why is it always assumed that BSN's DONT know what they are doing?!? All these posts from ADN's stating "My ADN school had more clinical hours", "My community college school is sooooo much better than the university." "ADN's know more than BSN's"
    There was a time that the college / university BSN programs really didn't get much clinical time. My sister graduated with a BSN in 1984 and she said they were woefully ill-prepared for clinical work, and had to learn everything on the job. There still are a few BSN degree programs that look more like a liberal arts degree than a nursing degree. Most have restructured to place more emphasis on clinical experience, probably due to employers were refusing to hire their grads anymore.


    As for conversion, its my experience that ADN programs train their students a certain way. Focusing on skills more than critical thinking and as a result, the nurse's practice is corrupt from the get go. Getting some online BSN so they can bypass "difficult" courses like statistics and college algebra doesn't improve their level of practice.

    This is another problem that mostly been eradicated, at least in the associate degree programs that I looked at. Granted, I never started looking at RN programs until 1Q 2010.

    Western PA still has many diploma schools, quite a few associate degree programs at community colleges and branches of Penn State, and the urban areas have the BSN programs. And all of them have stayed alive by responding to the market. AS RN added critical thinking. BSN upped the clinical instruction hours. And diploma RN requires usually at least 9-10 non-nursing college courses, equivalent to or more than what's needed for associate degrees.

    Diploma RN required nutrition, and algebra or a satisfactory score on their school math exam. Online RN-to-BSN had algebra or some equivalent math as a prereq, and statistics had to be completed beforehand or done concurrently with the BSN courses.

    I don't see what the big deal is with nursing students and math and statistics. Both of them are easier than nursing courses.
    Last edit by Streamline2010 on Nov 17, '12
  11. Visit  trueblue2000 profile page
    7
    The biggest advantage of a BSN requirement in my opinion would be higher wages and a higher degree of respect for nurses as professionals. Nurses are the least educated of the health care workers if you think about it. I think this a big reason why we are treated like crap by physicians, administration and patients. A two-year junior college degree will never command the wages, recognition and respect we deserve.
  12. Visit  MunoRN profile page
    0
    Quote from VICEDRN
    Two things:

    1. The aiken study is one of three major studies on the topic. Each of which conclusively correlated a BSN prepared staff with better patient outcomes. One of the studies was done in Canada which has a universal coverage system so I don't you can argue payor mix for outcomes.
    You hit the nail on the head there, Aiken correlated BSN prepared staff with better patient outcomes, she did not show causation. If causation exists then we should be able to what specific factors produce better outcomes, which she has not shown.

    Quote from VICEDRN
    2. There is a definitive reason hospital managers don't like to hire BSNs. The fact is that hospitals certainly do not want to pay more money for a better trained staff (after all, what motivates that? Better pt outcomes and they aren't being paid for that) and BSN nurses are just that much closer to being able to go to grad school.
    Our review was based only in our state, and very well may not translate to other states, but in my state increased pay is not the reason for reluctance to hire BSNs. For the most part, BSNs make the same as ADNs. Some hospitals pay an additional $1 per hour, although that additional dollar can be obtained through other means as well such as specialty certifications.

    The reluctance to hire BSN's is cost related however. New Grad training is extremely costly. Hospitals have experienced a shorter orientation period for ADNs as a higher percentage of ADNs finish school having taken a full load of patients for the majority of their preceptorship. This will likely be different in areas where BSN programs have sufficient access to clinical spots, however in my state our BSN programs are too concentrated to allow for the same amount of clinical experience that the more dispersed ADN programs can provide.

    Quote from VICEDRN
    Our ICU managers actually had to be forced into hiring BSN grads when the hospital considered a magnet status. Too many BSNs were doing their two years and going to grad school.

    As for conversion, its my experience that ADN programs train their students a certain way. Focusing on skills more than critical thinking and as a result, the nurse's practice is corrupt from the get go. Getting some online BSN so they can bypass "difficult" courses like statistics and college algebra doesn't improve their level of practice.
    At one time this was the case, however except for two "old school" ADN programs that were being phased out, we found no difference in critical thinking emphasis. Even the "old school" ADN programs required college level algebra, and they were the only two that did not require statistics. Most of the ADN and BSN programs required pre-calc and statistics (typically psych dept statistics), however there were ADN programs that required calculus and statistics for math majors.

    Quote from VICEDRN
    Sorry but a finding that disavows the findings of several large studies is unfortunate for our patients and the future of nursing.
    I don't think the current situations is as unfortunate as you would suggest. Since the ANA made it's recommendation on BSN education 40 years ago, ADN programs have essentially become BSN programs, just without the name. So clearly everyone agrees that in large part the BSN model is the better model, it's just not as accurate as it was 40 years ago to claim that ADN and BSN programs are significantly different.
  13. Visit  tokmom profile page
    1
    Quote from VICEDRN
    Two things:

    1. The aiken study is one of three major studies on the topic. Each of which conclusively correlated a BSN prepared staff with better patient outcomes. One of the studies was done in Canada which has a universal coverage system so I don't you can argue payor mix for outcomes.

    2. There is a definitive reason hospital managers don't like to hire BSNs. The fact is that hospitals certainly do not want to pay more money for a better trained staff (after all, what motivates that? Better pt outcomes and they aren't being paid for that) and BSN nurses are just that much closer to being able to go to grad school.

    Our ICU managers actually had to be forced into hiring BSN grads when the hospital considered a magnet status. Too many BSNs were doing their two years and going to grad school.

    As for conversion, its my experience that ADN programs train their students a certain way. Focusing on skills more than critical thinking and as a result, the nurse's practice is corrupt from the get go. Getting some online BSN so they can bypass "difficult" courses like statistics and college algebra doesn't improve their level of practice.

    Sorry but a finding that disavows the findings of several large studies is unfortunate for our patients and the future of nursing.
    Oh yes, let's not forget the "My brick and mortar school is better than your online school argument"
    mya612 likes this.


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