Frustrated in BSN program - page 12
So I am tired of getting treated like an ignorant, useless nurse because I only have an ADN and denied employment everywhere because I'm not a BSN. I get into a BSN program and start taking EXPENSIVE... Read More
Nov 28, '12 by MunoRNThere are no doubt advantages to making a BSN the level of entry for Nursing, so the next step is to look at our options. We can't expand BSN programs any further than they already are due to limited clinical placement options. Doubling the cohort size in BSN programs would significantly worsen the quality of a BSN education. So the other option is to turn existing ASN programs into BSN programs, which has largely already been by turning ASN programs into what are essentially franchises of BSN programs, with matriculation plans in place for transitioning ASN graduates to BSN degrees. Basically, this spreads BSN curriculum over a larger area without suffocating the already overburdened BSN clinical placement opportunity. Personally, I don't really see a better way of doing it.
Nov 28, '12 by nursel56 GuideSomewhat off-topic aside . . .the AACN seems to be advocating for a similar approach with respect to existing MSN programs transitioning to DNP as stated in this excerpt from "DNP Essentials" based on the findings of a Task Force that studied the issue for two years. If they've done the same in-depth review with the ADN curriculum I've not been able to find it.
This review indicated that many programs already have expanded significantly in response to the above concerns, creating curricula that exceed the usual credit load and duration for a typical master’s degree. The expansion of credit requirements in these programs beyond the norm for a master’s degree raises additional concerns that professional nurse graduates are not receiving the appropriate degree for a very complex and demanding academic experience. Many of these programs, in reality, require a program of study closer to the curricular expectations for other professional doctoral programs rather than for master’s level study.
Nov 28, '12 by woohOne good reason to go to BSN only: Longer time to create a nurse means fewer new grads being churned out means hospitals/etc. have to actually VALUE the nurses in existence rather than replacing them with cheap and easy to find new grads.
Sure, hospitals are being "choosy" now. But they like that they can say "BSN only" while they know the market is being flooded with new grads every 2 years. Keeps wages low. Keeps respect low. (Not because ADNs aren't "respectable" but because they don't have to give respect to people that are easily replaceable.) If we really gave them what they claim they "want" which is all BSN, they'd have to actually start paying for nurses instead of paying bare minimum and replacing us every two years with someone newer and stupider and willing to put up with whatever BS they want to throw at us.
We have no bargaining power. Don't want to work a ridiculous schedule? There's a bright shiny new grad willing to take anything, willing to do anything, and heck, even Mary Martyr experienced nurses here are advocating for working off the clock. Because it's "for the patients." So is housekeeping, but do you see the housekeepers restocking their carts 15 minutes before they clock in? For a bunch of educated people, whatever education level that may be, nurses are big bunch of IDIOTS. We're too busy worrying about hurting each other's feelings: Lateral violence whining. Eating our young whining. ADN/BSN/LPN whining. Maybe if everyone would grow the * up and quit whining about their coworkers we could at least get as much respect as the housekeeping staff, who isn't expected to work off the clock.
This is all ridiculous. All of it. Don't want a BSN? Don't get one. But as long as nurses are being churned out on a giant assembly line like we are right now, get to be choosy. And ALL of us are paying the price for that.
Nov 28, '12 by MunoRNI think you're conflating length of program with number of graduates when really there's no relationship between the two. Both ASN and BSN programs churn out students once a year, twice a year, or even quarterly. The number of students both types of programs produce are just as controllable if we use the BSN only model compared to the ASN/BSN model.
Manipulating the supply side of supply and demand isn't likely to do us much good. When there's a shortage, it becomes a Nurses' market, right now it's an ' market. Even when we've had Nurses' markets we haven't taken advantage of it all that well.
During the last two shortages our pay didn't even budge. Employers were careful to use signing bonuses, rather than higher pay, to recruit Nurses, this meant that when the market swung the other way they weren't stuck paying higher wages. The shortages were also used, very successfully, to increase Nursing loads. This is why recent Nursing shortages haven't materialized as predicted; the number of patients of various acuities has risen dramatically, yet the number of Nurses hasn't kept pace, we just absorbed that rise in acuity rather than maintaining our same standards for ratios in certain acuities. I've recently heard MBA hospital administrators make the case that we don't really need as many Nurses, some don't see why we can't split up the various tasks of Nursing into tech jobs. Cutting the Nursing supply in half would only help them make a case for that just as it helped them make the case for our "acuity creep" that has occurred over the past 20 years. Basically, we have to be careful about keeping our demand high, while also maintaining our role in the market, if we can't maintain our responsibilities in the patient care market, there are others that will fill that void (look at Physicians and NP's).
As for pay, there's really no reason to believe a BSN-only workforce would cause our pay to go up. Employers already don't "have to start paying" for BSN nurses, in fact they can get them often at the same price, maybe sometimes a dollar more an hour.
In terms of leverage for a new grad RN, it's unlikely that the new grad with $80,000 in loans is going to less desperate than the new Grad with $10,000 in loans.
Nov 28, '12 by Susie2310MunroRN, in reply to your post:
"I've recently heard MBA hospital administrators make the case that we don't really need as many Nurses, some don't see why we can't split up the various tasks of Nursing into tech jobs."
I don't doubt that some administrators do think nursing care can be divided up into tasks that techs can perform. But presumably those same administrators want good patient outcomes, not increased patient deaths or readmissions. I believe studies show that when the number of RN's providing patient care is decreased patients experience significantly greater mortality rates and complications. So I'm not sure how your making this statement lends weight to your notion that depend on the market being saturated with nurses.
"In terms of leverage for a new grad RN, it's unlikely that the new grad with $80,000 in loans is going to less desperate than the new Grad with $10,000 in loans."
This comment doesn't make sense. Of course an employer is going to have more leverage over me if I owe close to $100,000 versus a fraction of that amount.
Are you a manager?
Nov 28, '12 by woohQuote from MunoRNYou really think as many people would go into nursing if it took four years versus two? Read the boards. An argument against BSN is frequently, "I'd have never become a nurse if I had to go to school for four years."Both ASN and BSN programs churn out students once a year, twice a year, or even quarterly.
Nov 29, '12 by MunoRNQuote from Susie2310The availability of Nursing jobs doesn't depend on the market being saturated with Nurses, it does however depend on Nursing to fulfill it's roles at some minimal level to at least maintain Nursing's share of the healthcare delivery pie. Take PICC insertions for instance. As demand for PICC lines grew, hospitals were having a hard time making PICC placement available during off hours. They could have tried to lure more Nurses into these off hour positions with better pay, but instead they just shifted this role to RTs in a number of states.MunroRN, in reply to your post:
I don't doubt that some administrators do think nursing care can be divided up into tasks that techs can perform. But presumably those same administrators want good patient outcomes, not increased patient deaths or readmissions. I believe studies show that when the number of RN's providing patient care is decreased patients experience significantly greater mortality rates and complications. So I'm not sure how your making this statement lends weight to your notion that nursing jobs depend on the market being saturated with nurses.
If all of your administrators are mainly focused on good patient care then consider yourself lucky. More and more administrators' backgrounds are shifting from a patient care background to an MBA background, there are some of these administrators who could really care less about patient outcomes so long as it doesn't affect the bottom line. With reimbursement tied to some outcomes, even the more callous administrators will see the importance of good care. But you have to remember that these people often see this in terms of HPPD, not RN ratios. HPPD can be anybody, and if it can be anybody, why not use lower paid people. In other words, if pressure ulcer rates go down because there are more RNs to turn patients regularly, then the same result could be had by hiring more CNAs to turn patients regularly (I think there's more to it than that but this is how an MBA will often see it).
Quote from Susie2310I'll rephrase that; "In terms of leverage for a new grad RN, it's unlikely that the new grad with $80,000 in BSN loans is going to less desperate than the new Grad with $10,000 in ASN loans.""In terms of leverage for a new grad RN, it's unlikely that the new grad with $80,000 in loans is going to less desperate than the new Grad with $10,000 in loans."
This comment doesn't make sense. Of course an employer is going to have more leverage over me if I owe close to $100,000 versus a fraction of that amount.
Quote from Susie2310In a previous career I worked my up to a management position only to realize I hated doing that, plus salaried pay is for fools. I've successfully avoided management in Nursing, although as punishment I get stuck serving on many committees, boards, and work groups, which I actually do like.Are you a manager?
Nov 29, '12 by MunoRNQuote from woohThere will be those who will get turned off by a BSN requirement, although there are plenty more to take their place in line.You really think as many people would go into nursing if it took four years versus two? Read the boards. An argument against BSN is frequently, "I'd have never become a nurse if I had to go to school for four years."
Whether Nursing programs produce 20,000 grads a year split half and half between ASN and BSN programs, or if all 20,000 come from BSN programs, the effect on the market for Nurses is the same.
Although they're now becoming rare, the last wait-list-entry program in my state had an average wait of 2-3 years to get in before it went to competitive admissions a few years ago. The local ASN program typically has more than 200 applicants for 30 spots, if even 100 of those wouldn't pursue Nursing if they had to get a BSN, that's still 100 applicants for 30 spots, which means no drop in enrollment. Plus, there are plenty of people with bachelor's degrees who are either out of work or working at Starbucks, for these people a BSN requirement is essentially meaningless since it will take them just as long to graduate with either an ASN or BSN. The profile of Nursing students would likely change though, we'd likely have fewer second career Nurses and more students who go straight into Nursing programs out of high school.
Nov 30, '12 by godivaI got my BSN in an accelerated program at a respected nursing school in my state. If you have a bachelor's, in ANYTHING, you are eligible for the program. That means that basically it was an ADN course with a few classes in management and public health thrown in. It was very competitive and it took me two tries to get in, even with a high GPA.
What really ticked me off was that my pharmacy courses weren't good enough as prereqs. I have completed all my coursework for a PharmD, but I didn't do my residency. (My BA was in philosophy, quite by accident... I took the classes for fun while in pharmacy school to boost my GPA.) I didn't finish pharmacy school for a number of reasons. Politics, bankruptcy, divorce, depression... what can I say.... life happened. I took very intensive anatomy, physiology, and pathophys courses for pharmacy, but because they weren't taught the same way that they are taught for nursing, I was required to retake them.
I'm not dogging nursing school as it had its own challenges, but it was incredibly easy compared to pharmacy school. I'm not even thinking of all the advanced math and chemistry... it was simply much more academically rigorous. The nursing school, on the other hand, didn't seem to care if you could write very well or do complex analysis with proper citations. The exams were 50 questions tops and were very simple. In pharmacy school, exams were often 100 questions and included essays, even for basic courses. The medicinal chemistry courses were hell on earth!
My nursing school integrated pharmacology into the courses and I think it was detrimental. Many professors were teaching outdated information and in some cases, misinformation! When classes are integrated, not as much time is spent on the details and complexity of a subject. When they are addressed in a separate class devoted to a subject there is a much greater opportunity for learning. You can learn the basics of pathophys and pharmacology when they are taught together along with a general systems review, but you can learn so much more when they are addressed separately and then treated as assumed knowledge in a higher level course that teaches how disease states are managed. I suppose I am biased on this topic, but I do think that nurses should take more in depth pharmacology.
I really don't see a lot of difference between ADNs and BSNs in practicality, but if you are going to speak the language of academia or work in a hospital, you should have a BSN. It is unfair that ADNs are not treated with the same respect as BSNs, if you can call what a BSN gets respect. Personally, I think the entry level degree should be the ADN. BSNs should be reserved for management or jobs that require more paperwork (like case management). I also think the BSN program should be noticeably more rigorous than the ADN, and at present, it obviously is not. There is a reason doctors and pharmacists look down on nursing.
Dec 1, '12 by Susie2310No doubt pharmacy school was much more academically rigorous than nursing school. I agree also that I would have benefitted from a good course in pharmacology. I do think that nursing today really needs a longer period of study than two years, and I believe more space in the curriculum should be allotted to the law as it affects nursing practice.
But nursing school is only the beginning. If one wants to apply oneself rigorously, there is room to do it. There are many areas of nursing: If one is too easy there is always another. I studied for a board certification, and greatly increased my knowledge and improved my practice. I learned a lot more about nursing and medicine in the process. But I had to do it myself: I put the time in, made the effort, and it was worth it to me. So I would encourage anyone to look at a nursing degree as the beginning, with plenty of room for more rigorous study ahead.
Dec 1, '12 by godivaThat is a great perspective, Susie. I do think a course covering healthcare law would be beneficial as well, but I hate to contribute to the problem of credential creep that seems to plague healthcare. I'm not sure a BSN is needed to do most types of nursing, especially considering it doesn't offer any more clinical knowledge or advantage in a clinical setting. A BSN should be noticeably different from the ADN... moreso than it is now. It should require more advanced clinical and scientific study.
I guess I'm of two minds on the issue. I can see the benefits of making the program more rigorous-- namely respect from the rest of the medical professions and a broader range of career opportunities. But on the other hand, some people just don't want to do anything other than bedside nursing, and they shouldn't be required to take all those superfluous classes. I guess the way it is now is pretty adequate, all things considered. I still think it is awful that hospitals require a BSN these days, and offer no benefits for having spent an extra two years in college. As another poster has said, these debates have been going on for decades now. I don't see it being resolved anytime soon, especially since there are so many options for nurses wanting to advance their education. The workplaces will eventually see how dumb it is to require a BSN and start allowing LPNs and ADNs to work at the bedside again.