Change in BSN requirements - page 4

I heard that North Dakota once required a BSN to practice. Can anyone tell me if this is true and why it didnt work out?... Read More

  1. by   Otessa
    I know of someone who has a BS in another area and is now going for her BS to MSN/NP out on the east coast(Pennsylvania , I believe

    she didn't need to be an RN first-not sure how it works though...
  2. by   Otessa
    here it is-look at the bold and underlined that talks about any bs to np without rn.

    aanp nurse practitioner program list search


    the aanp’s searchable np program database contains information on approximately 850 np specialty tracks available at over 300 institutions in the u.s. a small number of programs outside the u.s. are also included as “international” programs. as information is received from np programs, listings will be expanded. the information is provided as a courtesy to aanp site visitors. the listings are updated as information is received from the np program administrators or faculty. every attempt has been made to make this list as comprehensive as possible. inclusion of programs does not imply endorsement and omissions are unintended. the information on specific entry/degree options and distance learning components is somewhat limited at this point. users are encouraged to contact program administrators to ask about desired options, if not listed.

    after search criteria have been selected, a list of programs meeting those criteria will be returned. in addition to the parent institution and url, the listing contains information on other specialty tracks offered by the program’s parent institution and any available information on special entry/degree and distance learning options. the information provided has been abbreviated and a key is provided below.

    program tracks:
    a=adult
    f=family
    g=geriatric
    ag=combined adult and geriatric
    p=pediatric
    ac=acute care
    w=women's health
    mh=psychiatric/mental health
    n=neonatal
    ap=acute pediatric
    sch=school
    occ=occupational
    onc=oncology
    er=emergency room
    cv=cardiovascular
    ns=neuroscience
    hh=home health
    woc=wound, ostomy, continence
    ltc=longterm care


    entry/
    degree options*
    rnms=rn to ms option
    pms=post-master's option
    rnbs= rns with non-nursing bs
    nonrn=non-nurse option
    npbs=np without master's (i.e. bsn prepared)
    co=certificate only

    distance
    dl=a significant distance learning component reported




    entry/degree options*--unless otherwise indicated (i.e.“certificate only”), all programs are at the graduate level and result in masters degree. the following table provides a brief description of each option:

    rn to ms—rn to ms programs are designed for nurses whose highest nursing degree is either an associate degree or diploma. the program of study typically includes initial baccalaureate-level coursework, as well as the graduate-level np program coursework. the program is coordinated so that the student’s progression is greatly facilitated.

    post-master’s – post-master’s np programs are designed for nurses who have previously earned a nursing masters degree. the program of study is designed to augment the prior coursework with those requirements specific to nurse practitioner preparation. post-master’s students are generally required to complete all np-specific didactic and clinical coursework, as well as any core or supportive courses not completed in their earlier program. in addition to offering np preparation for nurses who have obtained a master’s degree in some other area of nursing (education, administration, clinical nurse specialist), these programs also offer a means for nps to pursue additional specialization.

    rn with non-nursing bs—programs with this entry option are prepared to accept nurses with an associate degree or diploma who have also earned a non-nursing baccalaureate. the student is accepted directly into the graduate np program, as opposed to the previously described rn to ms program.

    non-rn—a small number of np programs have entry options for individuals with a baccalaureate in a non-nursing discipline and who have no prior nursing experience/education. these programs are designed to aid the progression of a non-nurse through the nursing baccalaureate and master’s degree in an accelerated and coordinated manner.

    np without ms—programs that indicate entry options for nps without master’s degrees are designed to accept nps who received their np preparation through a post-baccalaureate certificate program and wish to complete a related master’s degree in nursing. the program facilitates completion by providing some credit for np coursework and requiring the additional coursework necessary to earn a master’s degree.

    certificate only—only a few programs have a certificate-only option. these programs do not grant graduate degrees, although some have articulation agreements with specific universities. articulation agreements allow students to transfer some or all of the certificate credit towards a graduate np degree, making it possible to complete a master’s degree without repeating prior coursework.
  3. by   karmyk
    Quote from Otessa
    Non-RN—A small number of NP programs have entry options for individuals with a baccalaureate in a non-nursing discipline and who have no prior nursing experience/education. These programs are designed to aid the progression of a non-nurse through the nursing baccalaureate and master’s degree in an accelerated and coordinated manner.
    The thing is: yes, you can start these programs without having been an RN first, but every single one that I've looked into has a pre-licensure and a post-licensure part. The pre-licensure part is geared towards making the student an RN first. You can't progress to the post-licensure part (which is the nurse practitioner part of the curriculum) without finishing the prelicensure part and becoming and RN first. Every program I've considered also requires you to work as an RN for at least several hundred hours before you can progress into the meat of the post-licensure portion...

    That's how all of the entry level NP programs I've seen so far are designed. You become an RN during the first portion of the program, and you work towards becoming an NP during the second portion. You could probably compare it to someone getting their BSN and going to their NP school directly after they graduate. You don't skip the process of becoming an RN before you become an NP. In the case of the entry-level programs, it's just integrated into the program (if you ever looked at the description and curriculum of any of these programs, it's not that hard to notice).

    What specific school lets their students skip becoming RN's?
    Last edit by karmyk on Jul 25, '06
  4. by   wickman
    Actually here in montana a floor nurse whether a BSN or ADN thy get the same pay. also as leadership roles. I was 1 of the main Charge Nurses on our floor andyes i directd BSN nurses. And the majority said they would not have gotten their BSN if the ADN program had been available to them. some even said "it was a waste" because they really did not do any more or have any greater training in nursing. ADN nurses are in clinical settings from their first quarter til they complete their degree. Learning hands on about diseases meds pt care from the start. W did not sit in a class room for a year or two trying to imagine what they were reading about. Oh, by the way all types of nursing degrees have the same test after school to pass for their liscenses. So in actuality we ADN RN's have the same basic knowledge as other RN degrees. What really matters is what you do with your skills and knowledge.
  5. by   BSNtobe2009
    I disagree. On the same token, you are saying that those that seek a BSN are "wasting their time". Having an ASN only may get you a job at a hospital for the same pay, but statistically, BSN's exceed ASN's in earning power in the long run. It also significantly expands your career options.

    I live in a state where they will very soon be doing away with the 5 year Pharmacy program and making a doctorate mandatory.

    The primary method of obtaining an RN used to be through diploma nursing, and now it's an ASN. Once the nursing shortage begins to curb, and lawsuits in medical malpractice keep rising, and technology and care continuously become more and more advanced, I fully expect that a BSN will eventually become mandatory.

    All healthcare professions are moving in this direction toward requiring higher levels of education, and it's only because of the nursing shortage have ASN programs been allowed to remain the primary mode of training RN's.
  6. by   ZASHAGALKA
    Quote from BSNtobe2009
    All healthcare professions are moving in this direction toward requiring higher levels of education, and it's only because of the nursing shortage have ASN programs been allowed to remain the primary mode of training RN's.
    I disagree.

    The current shortage is not the reason that ADN remains the primary education model or that would have been directly addressed in the 1980's, when the shortage ebbed for a time.

    The reason is two-fold:

    1. Supply and demand.

    There are 3.4 million nurses (2.9million RNs, and 450,000 LVN/LPNs) and only 700,000 doctors, an approx equal number of pharmacists, and less OT/PT, etc.

    Anytime you compare nurses with other healthcare professionals, you face an obstacle to the logic provided: there is simply a need for more nurses than any other health care occupation. That is not related to a shortage. There will always be a need for nurses in greater numbers.

    That drives the education debate far more than the concept of a shortage. Indeed, a credible argument can be made that moving to a BSN model SHOULD create and extend a shortage. That shift in supply and demand is what would serve to make nursing more valuable.

    Of course, you would find, just as pharmacists and PTs, that would mean that more of nursing would devolve to unlicensed assts. So, the question becomes one of balance: at what balance of supply and demand can nurses maximize the benefit of supply without forcing other concessions to demand?

    As it stands, the need for a constant high supply, and not a relative shortage of that supply, defines why those that employ our services are satisfied with an ADN and it also explains why a move to BSN promoted BY those that employ our services is not likely in the cards in the nearterm.

    2. The debate is fundamentally polarized.

    If our employers are not interested in promoting a concept that will cost them more in money and concessions, then the only way to bring about that concept is from within.

    The ANA, in 1965, fundamentally polarized the debate with its 'technical' insult. The debate remains basically unchanged and unmoved for 40 yrs as a result.

    Until BSN can be presented in a light that brings all nurses along, rather than an 'us vs. them' strongarmed insult, there will never be a consensus to move to BSN.

    BSN will require a consensus of all stakeholders. Period. Others won't move this issue along because it is not in their interests to do so, and nursing cannot move it along so long as it serves to polarize us.

    That will require a retraction of the insult and a realistic approach to the concept of differentiation. Education should rightly be a key factor in such differentiation of practice. But so should experience.

    This debate normally comes down to two assertions: 1. Education is all important, and 2. Experience is all important. Both positions are half right, but because of their polarizing influence, both positions are completely wrong.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Oct 26, '06
  7. by   BSNtobe2009
    I still disagree. I can't understand how anyone can actually believe that moves to states requiring BSN's for an RN will NEVER happen.

    It's already happening on the LPN level. It used to be that if you could not complete the RN program, and got at least 3 semesters in, you could sit for the state exam for the LPN boards, but some states are no longer accepting this. LPN's are also, in some areas, finding it more difficult to find work, this is also a shift in requiring more education/experience.

    This also happened with Medical Techologists. This used to be a diploma program, and now requires a 4 year degree (which is different from a Medical Technician). Why? Increased technology.

    There is a magnet hospital here, and I just saw another one advertised in the paper, that are only hiring BSN's for RN positions. When a few hospitals start this trend, and if they achieve great success at it, word gets around. I seriously doubt, in my area, if this is something unique, and I would wager it has been done with success in other parts of the country and the hospital here is just modeling.

    There has always been a critical shortage of teachers, however, the requirements for teaching has steadily increased for many years, despite the massive need and increasing population, school and classroom over-crowding. There are some top-notched public school systems that are now requiring Masters level and some private schools are moving towards this trend as well.

    Sheer numbers of a profession is never the reason to "dumb down" the requirements in order to increase numbers. Healthcare lawsuits are on the rise, the level of technology is increasing in the hospital setting, more and more experienced nurses are leaving the floor. That's like saying, that beause of the shortage, all hospitals will just start going back to the diploma based programs when students were used for a huge amount of their labor that basically eliminated the need to hire full-time CNA's at all. Hey, that can be alot of employees that you don't have to provide benefits for. However, they are not doing that.

    It's not an "80's" thing, and just because they didn't address it in one decade, they are never going to address it again? The trends in healthcare, show a much different picture, and in this aspect, nursing is no different than any other healthcare profession.

    You have to look at the WHOLE picture to see what is going on.
  8. by   RN34TX
    Quote from BSNtobe2009
    It's already happening on the LPN level. It used to be that if you could not complete the RN program, and got at least 3 semesters in, you could sit for the state exam for the LPN boards, but some states are no longer accepting this. LPN's are also, in some areas, finding it more difficult to find work, this is also a shift in requiring more education/experience.
    LPN's being employed/utilized in hospital settings has always been a cyclic thing. Once you have been in nursing long enough, then you will have seen the trend for yourself come and go. It's not a new concept that has never been tried before.

    The shift toward more education/experience is dictated by the job market and applicant pool, not solely because of increased technology. My first LPN job originally intended to hire only BSN grads, but there simply weren't enough RN's period, so LPN's were employed.

    If a hospital believes that they are in a position to be choosey enough to only hire RN or BSN grads, then they may attempt to do so. But when the RN applicant pool runs dry or they start getting too expensive, the LPN's come back into acute care once again. It's a cycle.

    My hospital is a large university teaching hospital that churns out nothing but BSN grads year after year, and even they cannot staff all BSN's on the units, so how are the other hospitals going to do it?

    Also, the reasons for some states no longer allowing RN students who didn't complete their programs to sit for LPN boards is because 1/2 or 2/3 completion of an RN program is not always the equivalent of an LPN program.
    LPN grads have completed their theory and clinical rotations in all of the required areas. An RN student who did not complete their second year may still be deficient in certain areas such as psych, OB/Gyn, peds, etc. so their incomplete education may not be enough preparation for the LPN role.

    There is a magnet hospital here, and I just saw another one advertised in the paper, that are only hiring BSN's for RN positions. When a few hospitals start this trend, and if they achieve great success at it, word gets around. I seriously doubt, in my area, if this is something unique, and I would wager it has been done with success in other parts of the country and the hospital here is just modeling.
    The catch here is "If they achieve great success at it".
    My hospital is also Magnet. If a large university teaching facility with it's own built in pool of BSN grad candidates year after year cannot achieve this, then I'm interested in seeing who can.

    The only way I see this happening is in job markets overflooded with nurses such as Minneapolis/St. Paul who may be in a position to choose BSN only applicants.

    Sheer numbers of a profession is never the reason to "dumb down" the requirements in order to increase numbers. Healthcare lawsuits are on the rise, the level of technology is increasing in the hospital setting, more and more experienced nurses are leaving the floor. That's like saying, that beause of the shortage, all hospitals will just start going back to the diploma based programs when students were used for a huge amount of their labor that basically eliminated the need to hire full-time CNA's at all. Hey, that can be alot of employees that you don't have to provide benefits for. However, they are not doing that.
    You bring up the level of technology increasing as a reason for wanting BSN prepared nurses. BSN programs do not teach any higher tech level of nursing than do ADN or diploma programs. They are taught the same level of bedside nursing and have the same competency expectations (hence the same licensure level) and therefore, will not decrease lawsuits because they do not graduate with additional "high tech" skills or knowledge with respect to acute care hospital nursing.

    This is not to degrade the BSN program. BSN programs do include a considerably increased amount of well-rounded liberal arts and science studies, as well as additional nursing coursework such as public health/community nursing, case management, nursing research, etc. but this additional coursework does not by any means provide any additional "high tech" nursing that's not taught in ADN programs from a hospital standpoint, so it most likely won't save hospitals from lawsuits.

    In addition, diploma programs are not being brought back because of the same reason that they have diminished over the years. They were not cost effective for most hospitals. So the reason for not bringing them back is not an attempt to upgrade educational standards.

    It's not an "80's" thing, and just because they didn't address it in one decade, they are never going to address it again? The trends in healthcare, show a much different picture, and in this aspect, nursing is no different than any other healthcare profession.

    You have to look at the WHOLE picture to see what is going on.
    It has been addressed, many times over. North Dakota is the most recent example of it being addressed and it failed miserably.

    Nursing needs to learn from it's mistakes instead of continually trying over and over what never worked in the first place.

    Once you have been in nursing long enough to see trends come and go such as the rise and fall of LPN's in acute care or the push for BSN minimum entry, again and again, I believe that you too, will be able to "look at the whole picture to see what is going on".

    If it worked, ND would still be doing it.
  9. by   ZASHAGALKA
    Quote from BSNtobe2009
    Sheer numbers of a profession is never the reason to "dumb down" the requirements in order to increase numbers.
    Quote from RN34TX
    If it worked, ND would still be doing it.
    It can work someday, but not by strong arm tactics.

    And not by quotes such as ADNs 'dumb down' nursing. An astounding lack of nursing history goes into that statement.

    Indeed, ADN programs provided the link that BSN programs could not meet in the '50's and 60's to move nursing to college level prep. The goal of nursing to remove nursing education from doctors and hospitals and to put it into the hands of nursing with science based backgrounds was finally met: by the ADN program.

    ADN programs represented the CREATION of college level prep for bedside nurses. Until that point, the fledgling BSN programs were so small that they were only creating educators and not bedside nurses. The ADN programs were so successful, that diploma programs either folded, or adapted as a result.

    The result: today's bedside nurse is a science based, college prepped expert. Far from 'dumbing down' nursing, ADN programs advanced nursing to meet the new advanced times.

    And so long as the debate about minimum entry revolves around comments like 'dumbing down', there will never be a consensus to move it forward. BSN entry can work. But, this is why it won't: comments like this just keep the debate fundamentally polarized.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Oct 27, '06
  10. by   BSNtobe2009
    Quote from ZASHAGALKA
    It can work someday, but not by strong arm tactics.

    And not by quotes such as ADNs 'dumb down' nursing. An astounding lack of nursing history goes into that statement.

    Indeed, ADN programs provided the link that BSN programs could not meet in the '50's and 60's to move nursing to college level prep. The goal of nursing to remove nursing education from doctors and hospitals and to put it into the hands of nursing with science based backgrounds was finally met: by the ADN program.

    ADN programs represented the CREATION of college level prep for bedside nurses. Until that point, the fledgling BSN programs were so small that they were only creating educators and not bedside nurses. The ADN programs were so successful, that diploma programs either folded, or adapted as a result.

    The result: today's bedside nurse is a science based, college prepped expert. Far from 'dumbing down' nursing, ADN programs advanced nursing to meet the new advanced times.

    And so long as the debate about minimum entry revolves around comments like 'dumbing down', there will never be a consensus to move it forward. BSN entry can work. But, this is why it won't: comments like this just keep the debate fundamentally polarized.

    ~faith,
    Timothy.
    During the 50's and 60's, BSN's were extremely rare and taught at precious few colleges.

    ASN's were not created because the BSN program "didn't take off". I would encourage you to check your history on that one. ASN's were created when hospitals slowly stopped offering diploma nursing programs that were offered directly through the hospital.

    Since you copied my post, please interpret it accurately. I never said anything about "dumbing down" NURSING, as you conveniently and inaccurately added in.

    Your ARGUMENT was that there was NEVER (ever!) going to be a requirement of a BSN because of the SHEER NUMBERS of nurses needed for the HEALTHCARE profession.

    I said, "Sheer numbers of A PROFESSION (not specificaly nursing, ANY PROFESSION IN WHERE LARGE NUMBER OF EMPLOYEES ARE NEEDED) is never a reason to "dumb down" the requirements in order to INCREASE NUMBERS".

    Then I WENT ON to LIST SEVERAL PROFESSIONS, where large numbers of employees are needed, BUT THE EDUCATIONAL REQUIREMENTS HAVE BEEN STEADILY INCREASED OVER THE YEARS, despite marked shortages.
  11. by   RN34TX
    Quote from ZASHAGALKA
    It can work someday, but not by strong arm tactics.
    I agree, so let me clarify my comment:
    If it worked by way of the methods used by ND and some of those currently being proposed, they'd still be doing it.

    I agree that it can work but one of the first things we need to, IMHO, is to stop making very poor comparisions of nursing to other professions such as teachers or pharmacists.

    What one profession is doing does not justify what we should be doing.
    We should be looking within, not "following the leader" and copycat what another profession is doing that has nothing to do with nursing.
  12. by   np_wannabe
    Quote from Ali G.
    Up until last year ND only offered BSN programs and you had to have a BSN or prove that you were working towards a BSN if you were an ADN that moved here. Our great NDNA and legislature thought that they would "help" solve the nursing shortage if they allowed ADN programs. I personally think it was a step backwards for our state that was the only one to require a BSN. Nursing is a profession-not a technical career. While other health care professions such as PT and OT are moving towards a mandatory masters degree nursing takes a step back.
    It looks like I am among the few that have to agree with Ali G. The reason is this: although ADN and BSN training are very comparable, I think there is something to be said for demanding more--raising the bar--of the profession as a whole. I think of it this way: I can be a "C" student and still receive a High School Diploma, or I can demand more of myself. Why not???
  13. by   txspadequeenRN
    This is so very true. We go back and forth here in my area.. I never know when I can work again at certain hospitals...


    Quote from RN34TX
    LPN's being employed/utilized in hospital settings has always been a cyclic thing. Once you have been in nursing long enough, then you will have seen the trend for yourself come and go. It's not a new concept that has never been tried before.

    The shift toward more education/experience is dictated by the job market and applicant pool, not solely because of increased technology. My first LPN job originally intended to hire only BSN grads, but there simply weren't enough RN's period, so LPN's were employed.

    If a hospital believes that they are in a position to be choosey enough to only hire RN or BSN grads, then they may attempt to do so. But when the RN applicant pool runs dry or they start getting too expensive, the LPN's come back into acute care once again. It's a cycle.

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