Implementing BSN as entry to practice

subee, MSN, CRNA · Jul 1, 2013

Maybe the market will make the determination.

green34 · Jul 1, 2013

I think a five to ten year plan would be more fesible where you need to get your BSN within five years to ten years. The ones who currently have a license will be grandfathered in.

Most community schools are working on pairing up with local universities to ensure their plans fit with their RN to BSN programs.

PMFB-RN, RN · Jul 1, 2013

I think a five to ten year plan would be more fesible where you need to get your BSN within five years to ten years. The ones who currently have a license will be grandfathered in.

*** That seems very reasonable and prudent. As such it is unlikely to ever be adopted by the BSN as entry to practice crowd. Mainly cause it would not acomplish the goals they are trying to achieve with BSNAETP.

PMFB-RN, RN · Jul 1, 2013

We seem to go around and around in this discussion about the premise of BSN as the level for entry to practice, yet the bigger question of whether or not that is even possible seems to get ignored. The ******* contest (quantitative comparison of micturation velocity and accuracy) that these threads seem to devolve to would seem to be a futile exercise since we're discussing a goal that is arguably moot.
For those that think this is a viable option, how do you see this working in practice?

*** We could alwasy do what some of the other countries that require a BSN have done. Simply pronounce all the ADN programs 3 year BSN programs without changing them. That however would not acomplish the goals they have in mind.

DoGoodThenGo · Jul 1, 2013

*** We could alwasy do what some of the other countries that require a BSN have done. Simply pronounce all the ADN programs 3 year BSN programs without changing them. That however would not acomplish the goals they have in mind.

Think you'll find in many countries with a three year BSN that the education system is controlled by a central state government such as in France. The United States OTHO presents a challenge because each of the 50 states have control over their educational system. The federal government does have some powers via the DofE but not sure how far that goes towards higher education.

DoGoodThenGo · Jul 1, 2013

We seem to go around and around in this discussion about the premise of BSN as the level for entry to practice, yet the bigger question of whether or not that is even possible seems to get ignored. The ******* contest (quantitative comparison of micturation velocity and accuracy) that these threads seem to devolve to would seem to be a futile exercise since we're discussing a goal that is arguably moot.
For those that think this is a viable option, how do you see this working in practice?

Personally think the market should sort things out unless you intend to create some sort of standard for BSN education. I mean certain programs are more theory heavy whilst others favour clinical/lab experience.

If it had to be done the "BSN in Ten" approach is probably best. Let those already enrolled in a program as well as current RNs to be exempt as well as those who have graduated but not yet received a license. Everyone else needs to be well informed upon entry into a program what the rules are going forward.

Because nursing still is a profession dominated by females some sort of extension scheme should be given for those who need more time due to stuff creeping up in life (marriage, having babies, taking time off to care for infants/children ,etc....) Indeed just make the extensions available to all newly graduated/licensed nurses under the scheme with proper documentation for cause.

MunoRN, RN · Jul 1, 2013

Maybe the market will make the determination.

That's actually the one thing we don't want to happen. "The Market" is focused on immediate, short term costs, which makes Nursing care in general high on the list to be cut. Unlike nearly every other patient care service in health care, Nursing doesn't generally bill for it's services independently, which means we are just folded in with other set costs, the result is that unlike other services where cuts in that service produce lost revenue, cuts in Nursing Services increases revenue.

"The Market" has been more than happy to take advantage of our recent "Nursing Shortage", or at least to take advantage of the perception of a shortage to pile on acuity and shift ratios to more economically favorable numbers.

Cutting our New Grad output to 1/3 of it's current output would likely completely change Nursing's current stake of the healthcare delivery pie. As Hospital administrations continue to be populated more and more by MBA's we'll continue to hear them wonder aloud why we even need RN's, "The Market" it itching to replace RN's with techs who work their way through computer generated 'to-do' lists and reducing our presence by more than half would be more than sufficient to trigger that change.

MunoRN, RN · Jul 1, 2013

*** We could alwasy do what some of the other countries that require a BSN have done. Simply pronounce all the ADN programs 3 year BSN programs without changing them. That however would not acomplish the goals they have in mind.

In the 40+ years this idea has been around, this is the only solution that's come up as an actual possibility; just take ADN programs and rename them as BSN programs (and add about 8 credits of community health and leadership).

BSN programs cannot currently expand, and ideally they need to spread out geographically to produce more clinical opportunities and flexibility if we want to move RN education forward in the manner Patricia Benner and others advocate. So in reality BSN programs can't absorb the orphaned ADN potential students, and ideally they'll put through fewer students than they do currently.

If the rationale is that a BSN education is completely different from an ADN education, then it would seem just renaming ADN grads as "BSN" grads would make no difference.

So I guess my question is, would just changing the letters on an ADN's diploma to "BSN" achieve our goals?

llg, PhD, RN · Jul 1, 2013

So I guess my question is, would just changing the letters on an ADN's diploma to "BSN" achieve our goals?

No. It wouldn't.

Personally, I have always been in favor or keeping the 2 levels of nursing education (ADN and BSN) -- but making a more concrete and clear differentiation between the two.

An Associate's degree should take no longer than 4 semesters: that was it's original intent and that's how it is in most fields. But ADN requirements have been allowed to "creep" upward over the years so that ADN grads would be better prepared to function at higher levels in today's health care system (without having to get a BSN). (In reality, I think the creep is also due to the school's wanting to require more courses to make more money.)

I say "shorten the ADN programs." Make them shorter, easier, and cheaper. As for the BSN programs, make them more academically rigorous with a solid liberal arts and science foundation followed by a professional nursing education -- upgrade them and enforce high standards. (I think it can be done in 4 years -- 8 semesters of full time study.) My plan would create 2 distinct levels of nursing. The ADN and BSN grads would take separate NCLEX exams and hold different licensures, with their scopes of practice clearly distinct from each other, though with some overlap of content.

Under my plan, the ADN would remain available as an entry into practice for those who can't do a BSN at the start -- or who choose not to for some reason. It would give them a decent job and provide a large workforce adequately trained to do basic care at the bedside for many acute care patients and LTC residents. The BSN's could also provide care at the bedside, but have additional career options based on broader & more indepth education provided by the BSN. The market would then influence (but not totally decide) how many of each an employer (or society in general) would need.

Under my system, everyone would know their role in the system from the start. It's the lack of clarity that is the source of many of the conflicts and tensions that exist. If things got clarified and codified, everyone could then choose what educational path best met their personal needs.

Just my $.02

llg

PMFB-RN, RN · Jul 2, 2013

If it had to be done the "BSN in Ten" approach is probably best.

*** Oh no. That would never fly. Those who advocate for BSN as entry to practice would absolutly be aginst anything like BSN in Ten. It simply would not acomplish the goals they have in mind. It would still allow people to recieve their training in low cost community colleges and graduate with no or little debt. It would also continue to attract the undeirable types of students to nursing. Single moms, laid off factory workers, farmers wives, military vets, etc. Hardly the kind of people who will rub elbows with physicians and administrators socialy at the country club and golf courses.

subee, MSN, CRNA · Jul 2, 2013

*** Oh no. That would never fly. Those who advocate for BSN as entry to practice would absolutly be aginst anything like BSN in Ten. It simply would not acomplish the goals they have in mind. It would still allow people to recieve their training in low cost community colleges and graduate with no or little debt. It would also continue to attract the undeirable types of students to nursing. Single moms, laid off factory workers, farmers wives, military vets, etc. Hardly the kind of people who will rub elbows with physicians and administrators socialy at the country club and golf courses.[/QUOT
It's the plan New York is proposing. It actually would allow single moms, laid off factory workers, farmers wives, military vets, etc., more time to have a chance to stay in the game as the market dictates more requirements for BSN. Your kid's piano teacher has more academic requirements than the nurse who cares for your vented child. However, I know it's more complicated than that because there are many jobs that can be done by ADN (OR nursing comes to mine) and ADN would allow many to get their foot into the "profession". What I don't know about the New York plan is whether it puts ADN programs out of business or allows them to stay open and then give grads. 10 years to complete BSN. I'm mystified how you compare BSN with the ability to mix socially with country club types. I completed BSN while getting food stamps- not while polishing jewelry.