Entry all RN's be BSN's - page 2
:smilecoffeecup: hey fellow nurses... i am in my masters of nursing education program and one of the assignments is to write about the pro's and con's of entry level rn education. there is (and... Read More
Feb 24, '07I think I belong here I've two dachshunds, a poodle, and a malti-poo.. all rescues.
I also have a BA and an MS in unrelated disciplines and I'm working diligently in an ADN program. I'm also working full time, so it's a hat-trick. Why I feel that I can address this issue is based on the long struggle to get into a nursing program of any type. I'm pushing 50 (thirteen day more or less to go). I've also taught electronics in degree programs and vocationally. Amazingly enough there are parallels that we, as nurses, can appreciate.
But first, let me show a little hardness of nose. I remember back in .. 1991 or so... when there was a strong push to make the nursing entry level degree a BSN. There were ads on the radio that, frankly, I found offensive. I'm sure to be inexact, but the message was "If caring were all it took to be a nurse, anyone could be one."
Those ads took the one trait that truly makes a nurse a nurse and made it unimportant. My grandmother was a nurse. I knew that caring was a huge part of the job. Might as well be an engineer as a nurse otherwise.
Professional nursing is a very complex job. Yes, a BS degree is desirable, but the essential skills, attitudes, and behaviors are taught in the ADN programs. Look at most of the RN to BSN programs. There are about six courses that are pure nursing in most programs (Drexel's a good example). There are science requirements that make a lot of sense (real anatomy and physiology instead of NursingScienceMashup 101), and being educated has been pretty cool once in a while if I do say so myself.
Now back to 1991: I remember that being the start of the drive toward the elimination of diploma and a whole bunch of "upgrade" the ADN program fever. So in the middle of a shortage, we make fewer nursing education opportunities available. Brilliant!-NOT. (By the way, this thinking is entering the EMS profession, so in the middle of an acute paramedic shortage, we're going to make them all get a BA).
Now that we've figured out that the profession needs people, we're seeing new and novel ways to get nurses educated. I'm on an on-line hybrid program (don't be afraid, I get full clinical experience, including wearing white uniforms and changing briefs in nursing homes). I could not have become a nurse otherwise without selling my house, leaving my dachshunds homeless, and living in a refrigerator box.
Now the idea of an LPN with an Associates degree is not a bad idea, and here's where I come back to my vocational education roots. Vocational-technical schools produced technicians that had a practical level of knowledge. They got science and math at a more general level, and students that were late bloomers, or had a problem with learning a lot of stuff all at once could become technicians in electronics, or HVAC or any of a number of disciplines where they had a tilt toward routine tasks mixed with troubleshooting and problem solving. They weren't expected to be solo practitioners, and they got a more basic and mostly hands-on learning experience.
Today's automobiles, air conditioners, and even water heaters are run with computers. The simple jobs are simpler, but there's more complexity. Most technicians in auto repair are now getting an associates degree because they're in school two years. They're not considered pre-engineers and its not normally expected that they're going back to school. Is it possible for a practical nurse (LPN/LVN) to be happy at that level? I think so. Would it be better to get the training and education done at a more comfortable pace. I believe so. It doesn't mean that an ADN RN would get less education, but an ADLPN would get better preparation for a more complex world.
The big difference between the ADLPN and ADRN would be scope of practice. Also an AD RN would be seen as being on a path to the BSN and beyond. The AD LPN most likely would have an easier time bridging to the ADRN than our current LPN to RN programs. I don't see any damage to anyone from being in school more.
The problem is that the LPN can work in a year. Adding a year to that would cause shortages over the near term. Perhaps the ADLPN programs would be a place for EMT-Intermediates and Paramedics to bridge into nursing very quickly. This would give them a career path they need since EMS professionals can only go so far in the Fire Service before they have to leave EMS for line firefighting. The Intermediate/Paramedic could bridge in a year or less. Just a thought and not core to the idea.
Okay, I've talked way too much. Sorry :-|
ADNSLast edit by OldPhatMC on Feb 24, '07 : Reason: Typeos
Feb 24, '07You've made some interesting points, OldPhatMC. That's a good correlation about the technicians that would just do the technical end of the job and would never be solo practitioners. If that would be the ADLPN, are you saying that they would be able to do all that RN's can do now? (I've never really understood the big difference between the skill level of an RN versus a LPN, anyway. A LPN doesn't do a few things that an RN does, but she is certainly capable!) If the pay scale for a ADLPN would then reflect what RN's make now, I agree this would be a good way to go. Then, the BSN's could start out at a higher rate. You could work your way up through the levels or start as a BSN.
I have a question for anyone out there. Why is it that for a lot of certifications in nursing, before you can take the test, you need to have worked in that field for a minimum amount of time. IE: Before you can sit for the Society of Gastrointestinal Nursing Association Exam, you must have worked in that area full-time for a minimum of two years. Yet, to get your MSN you don't have to have worked at all in that nursing area! You don't need any practical experience, other than school practicals, before you can become licensed. That's never made sense to me.
Feb 24, '07The VA medical center won't promote you unless you have your BSN. The evidence supports that the higher the education, the better the patient outcomes. As an LVN, I couldn't disagree more on a very individual basis. I think the evidence fails to support my claim.
Feb 24, '07I was a single mother when I decided to go for a nursing degree. I was thrilled when I found out about the ADN program, because I knew that I could get it done in a little over 2 years. ( I took A&P and chemistry prior) I needed something that I could support myself and my son asap. Also, the ADN degree didn't hinder me from getting into managing a 34 bed med/surg unit in a major teaching medical center or becoming a liaison/consultant for a state government department. The professionalism, ability and knowledge of the nurse doesn't lie in the degree, it lies in the abilities of the individual nurse themselves.
Feb 26, '07OldPhatMC - I see what you're getting at with the suggestions on ADLPN. I think about that kind of stuff, too. How to make it all work!! I'd love to toss ideas around with you. Would you like to PM me about it?