Education Conspiracy

[Avid reader]

Does anyone see a huge difference between an ADN and a BSN prepared nurse, nursing skills wise? Very little of my BSN coursework have been utilized on the floor and to be honest, experienced Diploma nurses frequently possessed better skills. Sure, there was management and leadership skills, but unless that is your intent, I cannot see the point.

Personally, the nurse with desire and curiousity for her craft have always appeared to me better, at not only practical skills but also interpersonal. I acquired more debt but little else.

Is there collusion between the AACN and learning institutions pushing this agenda? Why is it so few nursing international bodies have adopted very little of this trend?

[Spine_CRNA, BSN, RN]

This is absolutely correct, and a true reflection of the current staff nursing landscape.

When hospitals in desirable areas have hundreds to thousands of applicants for a single opening, how else are they expected to thin the herd?

Being judged, not by the quality of your work, but by the amount of education you have is unfair, but the norm. This is the end result of the 2008 economic downturn in the US, and nursing being branded as a surefire way to make a decent living with minimal commitment. People flock to nursing simply because it is an attainable middle class job.

While I don't believe in an education conspiracy, I do think there is an education bubble at the graduate level. Enrollment in NP, CRNA, MBA, MHA, and other MSN programs has skyrocketed. In the future, the concern will not be the percentage of ADN RNs getting their BSNs, but the percentage of BSN nurses getting advanced degrees and being underemployed.

Where are there thousands of applicants for a single staff nurse position?

Underemployment for APRN? I figured with Obamacare NP and CRNA can provide physician level care but for less money, making them desirable to patients and employers: high demand meets high supply? But perhaps a smaller supply since programs are being pushed to Doctoral-level.

[Spine_CRNA, BSN, RN]

Thank you Horseshoe and Ruby Vee for a little reality orientation. I think one of the notions that brings passion to the ADN - BSN discussions are the insinuations that ADNs are not interested in advancing their careers and settle for "something less" by staying at the bedside. When everyone else does whatever they do, at the end of the day, the lives of the patients are in the hands of those of us who choose to be at the bedside. Can you really top that level of responsibility and reward? Stagnant? Are you kidding me?

I know many a nurse that haven't touched a patient in *decades* because they have offics jobs, sit in meetings, etc. They keep certifications one receives through bedside nursing (like the CCRN) through CE's. I very much trust the care of bedside nurses.

[Spine_CRNA, BSN, RN]

1000 likes! There is such a big push and pressure to continuously advance and obtain the next level degree, which is great....but what would happen if everyone advanced their careers to the NP or administrative roles? You have to have bedside nurses!! It is definitely not settling, especially if you love what you do!

This is just a late night thought experiment but Artificial Intelligence is developing and it's only a matter of time before it is affordable, able to critically think, acquire new knowledge, and teach itself by connecting to the internet in the same way humans learn and teach themselves by going online. Coupled with the physical capabilities of robotics perhaps not even advanced degrees could save -any- nurses role from being taken by A.I.

Clinicians already rely heavily on advances of technology to treat patients: MRI, CT, Lab results... even the iPad they write orders on. Once A.I. connects to the internet, it has vast reaches of information and can teach itself more effectively than any human can. (Sorry. I realize I totally went off topic!)

[smartnurse1982]

I can't comment on adn vs bsn because in my country the only way to be a nurse is with a bsn.

But avid reader I'm really confused with you comment about nurses who just want to say on the floor and don't require as much education as that's all they want to do. doesn't sound like a nurse to me. Sounds like someone that is stagnant and shouldn't be in health care. Someone that's done the bare minimum just to get a job because it sounds like it has all these benefits, then come in sites like this and complain about how awful nursing is.

Nurses in my country not only have to have bsn they also start post grad study when they start there first nursing job. And must continue to learn and do so many hours of professional development each year just to say registered.

life long learning is a requirement of being a nurse. You will never know it all. There's not one nurse out there that has completed all of their education. Health care changes so quickly, you have to say on top of it and continue to learn to be competent.

Remaining on the floor and being stagnant. Not wanting to learn and further themselves and their career is a joke of a nurse. I don't care if you have a bsn or adn. People that work hard, actually like there job and are interested in it, continue to learn and progress are what the profession needs. Not people doing it for the money or only having to work 3 days, which I hear so much with American nurses and it really pisses me off.

Again I don't know the difference between adn and bsn but I do know a good nurse, of anyone's watch nursing channels on YouTube I'm sure you know nurse bass, he has a adn and is exactly what I mean. The right nurse attitude who I would be happy to work with. Or Ashley Adkins who has a bsn that has the same attitude. It's not about your title or letters. Nursing is a career, something to be proud of. Not something that you should complain about or the opportunity to further you self.

But I will say 2 years does seem awfully short to learn everything.

What everyone gets wrong is that ADN's only have 2 years of education.

The actual Adn nursing programs are 3 years in length once you include the pre-req's.

[apple400]

Full disclosure - I didn't read all these comments, but wanted to point out there is actually peer reviewed literature on this topic. I certainly did not do an exhaustive search, and I don't have access to full articles, but here are some links and highlights.

Baccalaureate Education in Nursing and Patient Outcomes : Journal of Nursing Administration

"RESULTS: Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay."

Nurse Experience and Education: Effect on Quality of Care : Journal of Nursing Administration

"Results: Controlling for patient acuity, hours of nursing care, and staff mix, units with more experienced nurses had lower medication errors and lower patient fall rates. These adverse occurrence rates on units with more baccalaureate-prepared nurses were not significantly better."

ADN to BSN: Lessons from Human Capital Theory - ProQuest

"Using the Human Capital Theory, a model was created to evaluate if increases in earnings achieved by ADNs when they earned a high degree outweighed the cost of their education....However, after projecting net lifetime earnings an internal rate of return model (IRR), the model revealed that for more than half of the ADN-to-BSN graduates, the costs of education were greater than the salary increase. Younger nurses were more likely to experience a positive IRR due to the longer term of the investment."

[Horseshoe, BSN, RN]

I know many a nurse that haven't touched a patient in *decades* because they have offics jobs, sit in meetings, etc. They keep certifications one receives through bedside nursing (like the CCRN) through CE's. I very much trust the care of bedside nurses.

But even working bedside nurses need to stay current with continuing education. Health care advances and research that shows the need to change practice is ongoing. No one should stay "stagnant"- an earlier poster suggested that some nurses could be okay to be "stagnant," and I disagree with that stance.

[Avid reader]

Apple, just exploring an alternative viewpoint. Look at the author's credentials, tell me if there couldn't possibly be a conflict of interest? Such credentialing has to have justification ie why so many and how can she possibly be objective, also the publication goals?

I took a mechanic's course because I was tired of being fleeced by my local mechanics. Thought I could do my own tune ups etc. Change plugs, air filter, plug wires etc. Aced the theory, very physics inclined. Cannot do anything practically, it's daunting! You can put in a catheter all day on a DOLL? How do you think Ms Blegen would do? Reality, different scenario. Theory is one thing, practical is as advertised.

Unless studies are done by independent objective individuals? Everything comes down to the individual's desire. Nursing is primarily a practical profession and passing the NCLEX proves you have the intelligence for the theory of whatever comes next re assessments and problem solving etc. Also, why haven't the majority of European countries except for the UK which is an American lackey, eg Project 2000, which have been demonstrably shown to produce less competent nurses, adopted our approach?

[Leedeedee]

Also, why haven't the majority of European countries except for the UK which is an American lackey,

uh huh

[apple400]

Of course, these are clearly not perfect studies, I didn't intend to present them as such. Nor do they even all point to the same conclusions. But I personally find it interesting to read the research on this topic. My guess is that some studies came out that showed that hospitals with more BSNs have better outcomes and then everyone jumped on board because it looks good. I'd be interested to dig up those studies and see what sort of conflicts of interest or even confounding variables they have. Perhaps hospitals with a greater proportion of BSNs also have larger budgets or better allocated resources overall, and this what actually is the greatest contributor to the "better outcomes"? I clearly don't know the answers!

All I know is I am getting my BSN because it is the only way I'll be marketable as a new grad in my area. It's what makes sense for me. I'm under no delusions that I'll be any better than any other nurse with an ADN, and I'm definitely down to complain with everyone else about how stupid it is that we keep having to pay more and more for education to do the same jobs and get paid the same. This seems to be a pervasive problem across many disciplines these days.

[Spine_CRNA, BSN, RN]

But even working bedside nurses need to stay current with continuing education. Health care advances and research that shows the need to change practice is ongoing. No one should stay "stagnant"- an earlier poster suggested that some nurses could be okay to be "stagnant," and I disagree with that stance.

Yes, I think the consesnsus is that bedside nurses need to continue their education. But the debate is C.E. via CEU or formal graduate degrees.

[Avid reader]

Apple, so you should. Unfortunately marketability is the only way to leverage. The discipline will assist you as well. I'm all for further education but as online further education demonstrates, conventional avenues can be modified. Personally, I think the market should dictate and not corrupt board officials and other institutions who knows full well that more income can be derived with more qualifications re licencing fees etc. Can you possibly explain why compact States haven't been adopted? It's only so that individual States can levy fees and benefit politicians coffers.

[delilah1010]

I will be perfectly honest that I don't see a big difference in performance between ADN level nurses and BSN nurses. I am old enough that I remember the hospital trained diploma nurses. They were my mom's generation, and they were excellent nurses. But consider this. In my mom's generation, nursing was one of about 2 college level options for women, the being teaching. Now intelligent women have lots of choices. Back when I was starting college, the 2 year RN was the thing, which was offered by the local community college. Only about 20%of the med school class was female back then. Now it is 50%, and there are a large number of mid level options as well, to say nothing of other doctoral level non medical career options, like engineering and research scientists. Back when mom was raising kids, women weren't even allowed to work if they were pregnant, let alone if they had small kids.