Education of nurses - page 3
Now I know this may upset some but... I think that all nurses should be BSN prepared at minimum, and all LPN, ASN, and diploma programs should be eradicated. My reasoning for this? How many other... Read More
May 20, '12Quote from Asystole RNI was intubating patients and drawing abgs without a BSN in the 1980"s.....The degree dose not delegate what you can do until you get into advanced degrees. Paramedics intubate. The ability/skill to intubate is governed not by the state nurse practice acts but by facility policy and job description. When I think of the stuff I did as a flight nurse with on the job training.....I Am Honored to have had such an opportunity and education on the job. A 12 lead EKG doesn't require a college degree. I have lived through this acceleration of bedside practice to the responsibilities that are now required. It has been an amazing ride and career. As technology has grown so has the practice of nursing......we had to keep up to care for these patients that were receiving such complicated treatments and interventions.I can understand where you are coming from but unfortunately I think you missed the point of a BSN. What I think most nurses miss is that nursing education is divided into two very distinct areas of study; clinical education and professional development.
The ASN, or diploma for that matter, is designed to be 98% clinical education. These degrees are designed to build you into a minimally functional clinical nurse. If all that was expected of the professional nurse was to be a straight forward bedside nurse then that would be enough.
The BSN level of education goes beyond the clinical education and introduces concepts such as statistics, economics, leadership, research, and the like. These "fluff" classes help to develop you professionally, they allow you to view nursing in a more global manner. If you received a quality education you should have walked away from the program with some concept of leadership, organizational structure, professional duty, maybe some nursing history, the ability to read a study and understand the statistical significance, and the ability to understand why education is important.
Although some tasks in nursing have been refocused and some tasks taken away altogether our overall scope of practice has grown by leaps and bounds. Nursing is moving away somewhat from the generalists but that doesn't mean that tasks are being taken away. In reality nurses are being trained into many different specialties instead. Nurses still do intubate in many states, I still get my own ABGs, and I can get my own 12 lead if I wanted to.
You might not think that higher educational improves a nurse's performance but the studies prove that it actually does make a difference.
Many patients that have been saved by TPA/thrombolytics were saved by nurses that probably didn't have a BSN. Those first open hearts were cared for diploma nurses.I remember the first time I hung the new drug Tridil (IV nitro).....we were petrified to drop it for fear it would blowup..... Intra-arterial streptokinase. Intracoronary urokinase. angioplasty......were all probably performed by nurses without their BSN. I had seen the eradication of the common diagnosis of Ventricular aneurysm due to the aggressive intervention of cardiology and the acute MI. I've seen the beginning of the ck-mb bands to troponin and BNP. I remember when we kept acute MI's on bedrest for days. and the were hospitalized for weeks. Many of these patient were sucessfully cared for by nurses that probably didn't have their BSN.
You need to know where you have been to know where you are going.......
May 20, '12Quote from ocnrn63isn't it funny, they are requiring a bsn with barely any pay difference (just the 'joy' of having more responsibility placed on your shoulders whether you want that or not) while they get more money via higher state rankings thereby advertising their hospital as being better because they are a 'magnet' hospital.i suspect that hospitals that are requiring nurses to go back to complete their bsns are really targeting older staff, who probably graduated from diploma/adn programs. it's a great way to weed out staff who are making higher wages as well as getting rid of older staff who may not move as fast as a 22y old. i doubt it has all that much to do with wanting to have a more educated staff. many facilities don't even pay more for a bsn. it does look good if the hospital is going for magnet to have a mostly bsn staff.
May 20, '12Quote from LockportRNThe hospitals don't get anymore money for Magnet status. It's a marketing tool and bragging rights. Medicare,Medicaid, insurance companies......don't reimburse them any higher than any other hospital. They may get more revenue because the general public may gravitate towards them.....but that's it.Isn't it funny, they are requiring a BSN with barely any pay difference (just the 'joy' of having more responsibility placed on your shoulders whether you want that or not) while they get more money via higher state rankings thereby advertising their hospital as being better because they are a 'magnet' hospital.
May 20, '12Quote from Esme12Ok, yes that is what I meant...thanks for putting it so succinctly for meThe hospitals don't get anymore money for Magnet status. It's a marketing tool and bragging rights. Medicare,Medicaid, insurance companies......don't reimburse them any higher than any other hospital. They may get more revenue because the general public may gravitate towards them.....but that's it.
May 20, '12We have certainly all heard this conversation before! I'm an ADN nurse, but do plan on going for my BSN mostly because it will make me more marketable. I like the idea of having my BSN, but I'm afraid that if we push for every nurse to have a BSN, many people would not be able to afford it. It seems like a shame to cut out people who would be great nurses because of the financial factor. I don't think I personally would have been financially able to get a BSN degree in the situation I was in. That doesn't mean I don't desire it!!!
I really don't think one is better than the other. We all study hard, work hard, and care for our patients. Experience is what truly makes the nurse!
May 20, '12Quote from Asystole RNOperative word there is PROGRAMS. OP sounds like she wants to fire all nurses with less than a BSN and take their license away. New programs, whatever, but don't harp on nurses with knowledge. I'm an LPN and and take great offense to that. I know plenty of LPN's that are great nurses and plenty of BSN & MSN nurses who I wouldn't let wipe my ass.No? How many diploma programs are there anymore? What is happening to the masters level NP programs?
The BSN level of education will be the standard entry level of education for registered nurses in the future, just as the ASN is the standard now.
The AACN, NCSBN, ANA, NLN and others have already agreed on this subject and have put into motion long term interventions to make the BSN the standard.
LPNs are a different subject.
May 20, '12Quote from Asystole RNSame could be said about the education I'm receiving now. 20 years it will be also obsolete.You must admit that the education you received in the 80's is not adequate for what registered nursing has become today. No one wants to eradicate diploma nurses, ASNs, or LPNs. The goal is to change the future standard of education to better prepare students for the future as registered nursing becomes more and more advanced.
May 20, '12
May 20, '12I agree with the op. 30 years ago when in a BSN program, the professors repeated over and over again that "soon" a BSN would be required. It hasn't happened, at least not in most places. The community colleges and private for-profitare cranking out a lot of RNs, and we all know that it's pretty difficult to find an entry-level RN position in most of the country.
Pharmacists used to be master's-prepared, and now a doctorate is required. Same thing for physical therapists. To be an SLP, you must have a masters. I do think that there should be a standard entry-level for RNs, and it should be a BSN. This isn't a slam to AD nurses at all, because they can be just as clinically excellent as a BSN-prepared nurse. But we need to do this for the future of our profession.
May 20, '12I don't think an ADN says anything about a person. Afterall, I just finished my ADN, however I also hold a BS in biology/animal science. I have had statistics and probably more science than any BSN prepared student. I have performed my own research, and have used all of my previous education towards my ADN. With that being said, I am going straight to a MSN program so I will have an easier time finding jobs later down the road, not because it will increase my clinical abilities and critical thinking skills. My ADN program kicked our butts, and we are better nurses for it.
You can also go the route of letting students graduate these programs that shouldn't. Many BSN's that work at our hospital only have one patient thier whole entire clinical. I cannot tell you how many I have seen DANGEROUSLY let off of orientation and had no idea (literally no clue) about normal urine or lab levels. Every program lets people graduate that shouldn't in my opinion, whether they are ADN or BSN. What about the age of people graduating and thier maturity factor?? Like another poster said, actually I'll go even further, I'd rather let my 3 year old care for my life than some nurses I've encountered. I honestly think it depends more on the person and their desire to learn and take their responsibilities seriously than where they've graduated from with what degree.
May 20, '12Quote from floridanurse1983I graduated in 1982 from a diploma program one thing we learned quickly was critical thinking skills....a skill that will NEVER be obsolete. We also learned to keep learning throughout our careers. I graduated with the skill to run a unit. I have a Bachelor's degree in English and frankly never saw the point of getting another bachelor degree.I'd put my knowledge,skills, and PROFESSIONALISM up against anyone else's...ADN or BSN.Same could be said about the education I'm receiving now. 20 years it will be also obsolete.
May 20, '12Quote from Asystole RNI learned (and more importantly learned to apply) those concepts in my ADN program.The BSN level of education goes beyond the clinical education and introduces concepts such as statistics, economics, leadership, research, and the like. These "fluff" classes help to develop you professionally, they allow you to view nursing in a more global manner.
Tell me, how does viewing nursing an a more "global" manner enhance bedside nursing?
Please, give me an practical application of the concept in bedside nursing. My BSN instructors couldn't do it yet it was one of the buzz words/phrases in their glossy program brochure.
Quote from Asystole RNI walked INTO my BSN program with all of those skills as I had walked OUT of my AND program with them 17 years earlier.If you received a quality education you should have walked away from the program with some concept of leadership, organizational structure, professional duty, maybe some nursing history, the ability to read a study and understand the statistical significance, and the ability to understand why education is important.
And since it will probably come up...I graduated from a community college in the Pac NW in 1990 that was no different than any other CC program in the state. My BSN came from a well regarded college, where I graduated with a near 4.0. While it's certainly possible I missed the "point" of my BSN program or attended a less than great school, the multiple MSN programs I've been accepted into make me inclined to disagree.
I do agree that standardized education and a standardized level of entry needs to be defined but at this point believe that good ADN programs would fill that need more than adequately. There are many professions (and I'm not using the lay term) for which an Associates is entry level. I don't believe making the BSN the standard for entry does anything but create additional financial burden for those who want to enter the field. Placing nursing education out of reach of the 'masses' and limits the supply, thereby creating some job security for already working nurses, then again, perhaps that is the point.
May 20, '12That is an interesting point kids...one that I hadn't thought of ...
"Placing nursing education out of reach of the 'masses' and limits the supply, thereby creating some job security for already working nurses, then again, perhaps that is the point."
Just because those that would make money from people getting into nursing by advertising a current nursing shortage, does not mean that it is true. Though I don't really think that the average nurse has anything to do with pushing this agenda of limiting the supply of nurses, I wonder who may be direct benefits of this? The only ones that seem to benefit would be the schools. I do not believe that an ADN with a few years under her belt does not know any less than a BSN and after paying so much more for their degrees, a BSN doesn't earn all that much more than an ADN. So what is the point?
It would seem that the average nurse would be better to fight for better ratios that put patients at less risk and their nursing license at less risk than to force this issue. What happens when all these new grads that can't find jobs decide to NOT be a nurse because they can't wait for healthcare facilities to hire. That is when the true nursing shortage will kick in hard...especially when the aging boomers begin to retire enmasse. The schools will have burnt out their credibility with the college age kids to become nurses after a few dozen of their buddies start telling their stories of the years of sacrifice to become a BSN and all the debt they are saddled with while being unable to procure a job to repay these loans. We may just have to go back and allow (or even beg by that time) for kids to go to school to get their LPN or ADN.