Short Cuts in Nursing

HM2VikingRN, RN · Oct 30, 2007

crawl before you walk walk before you run run before you race.......The point is that knowledge is a spiral. Each experience builds on the next. I am not sure that being critical helps people move on. The general OP had an "icky" feeling in part. I agreed with parts and disagreed with others. I think that in general it would have been more helpful to lay out what skills to develop and how to gain experience to advance your professional skills.

NeuroMedic · Oct 30, 2007

Perhaps I misphrased some points. When I speak of "children"; I am in no way condescending or looking down upon anyone. The context in which I use the term could be more closely related with "children" as it is used in biblical writings, not to say that this is in any way related to religion. As to, "Handing out pity"; empathy and pity are 2 entirely separate things in my book. I understand that psychological & emotional support are important in nursing; arrogance or an, "Im better than you because" attitude was never the intent, and I apologize to those of you who took it this way. However, it angers me when I see so many people wanting to shortcut the nursing process. This is the point I was trying to get across.

PedsED-RN · Nov 1, 2007

I am an ASN graduate, of a pretty intense program, but I am already continuing to my BSN to grad. again this spring. I see many students that get in over their heads and do not make it for some reason or another. I liked my program because it allowed me to start working and getting clinical experience while I get the management/research portion of the education. I eventually want to go Master's as an Educator, along with whatever else I get my mind set on, but this route was a great choice for me. Not all programs are one in the same, but some students are looking for an "easy" degree, saddly. but, even the ones that pass the program to get the degree have to pass boards like the rest of us, so they will find out soon enough.

elkpark · Nov 9, 2007

I did not get the impression that the OP was suggesting that ADN programs produce "short-cut" nurses, or intended to put down ADN nurses (in fact, the post notes that the OP started out as an ADN grad). How often do we encounter on this board people who think that "even" an ADN program is too much trouble and time, and are looking for a quicker, easier way to get licensed? (Also, the people who are looking for quick, easy ways to become advanced practice nurses.) That's what I thought of when I read the original post ... Please, please, please, let's not turn this into another ADN vs. BSN thread -- we have too many of those already! :)

PMFB-RN, RN · Dec 15, 2007

There are no true shortcuts in nursing. As Nurse Practitioner(MSN ACNP/FNP), I have worked my way from the ground up: RN, A.A.S, followed by RN, B.S.N. followed by M.S.N. ACNP/FNP, and I can tell you from experience that taking shortcuts will not pay off.

*** I took a shortcut into nursing. I am an RN who went to nursing school for 9 months and have 32 earned college credits to my name. I work in the SICU of a level I trauma center.

I spent 5 years as a medic with army infantry. When I got out of the army somebody told me that as a medic I could challenge the Ca LVN boards. I did and passed. I then moved to Wisconsin and somebody told me that the Wi technical college system just changed to a 1+1, first year is LPN and second year is RN so those with an LPN could enter the second year of the ADN RN program. I CLEPT'ed all the non RN nursing classes and passed most of them. So in addition to the second year RN nursing classes I had to take Micro, developmental psychology, and freshman english. This made for a 16 credit hour semester x2, No problem. Started nursing school in late August and graduated the following May.

I am now half way through an RN to BSN program at a state university and it seems a great waste of time and money to me. The classes I am takeing all seem like B.S. classes to me and not the least bit useful (except english comp, I am learning tons in that class). I am only doing the BSN so that I can apply to grad school. There is no other financial incentive to do so in my area. I work with staff nurses with BSNs, ADN, and a few MSNs. Most are good, some are great and some are not so good at all education levels.

First of all, I find it funny that some of you still think there is a such thing as a 2 yr RN nursing program.

*** There are. The Wisconsin technical college's ADN prorgam can be done in two years. It's set up to be doable in two years and lots of people do.

A true RN program is 3 yrs, one year for general education followed by two subsequent years nursing. You are doing yourself no favors by shortcutting as when you apply for that "sweet position in a trauma center" that you've always wanted--your hiring nurse manager is going to take into acct how you received your education. Did you know that most ICU's will not hire Paramedic to RN nurses?

*** I applied at 6 hospitals when I graduated and all 6 offered me jobs. 3 of them offered me a job in their ICUs as a new grad. They seemed to see my medic experience as a plus.

Also, B.S.N. is not a waste by any means. The B.S.N. nurse is prepared to accept roles in clinical education as well as to pursue higher education with regards to faculty positions. In addition, the B.S.N. nurse is further trained in patient assessment, critical care interventions, as well as nurse management.

*** Maybe or maybe not. I don't think all BSN programs are created equal.

New opportunities are becoming available all the time for B.S.N. Did you know that most aeromedical transport services will accept a B.S.N. nurse over an A.A.S./A.S.N./A.D.N. nurse any day of the week?

*** I did not know that but you also said most ICUs won't hire paramedic to RN grads but that has certainly not been my (limited) experience.

I am afraid my days of sympathizing with the uninformed are over. We must wake up! The simple fact is: Nurses who take shortcuts, kill patients! Period.

*** Maybe, but I have seen a few MDs kill patients and their education is far more extensive that your average BSN or ADN RN.

Haunted · Dec 16, 2007

Shortcut RN here, plus I am in a rotten bind trying to get licensed here in TN since I am 1 elective short of my ADN. Lot's of holes in the OP's statements, maybe he has never practiced out of State? When I first started out in nursing I was offered a sweet position with Life Flight. The offer was on the table and I had to decline due to the hours required to be on call (had a child at home who needed me to be available) . Why would they offer me, an non grad RN this position if everything the OP says is true?

Also, I never killed or injured a patient but knew of a few "advanced degree" co workers who made some fatal or harmful errors. It can happen to any of us, degree or not.

AND!!!! Now I'm Jonesing for a cheeseburger. DANG!

alphadog0228 · Aug 29, 2008

I have noticed that alot of you out there are looking for transition programs, shortcuts, and the "easiest way".
There are no true shortcuts in nursing. As Nurse Practitioner(MSN ACNP/FNP), I have worked my way from the ground up: RN, A.A.S, followed by RN, B.S.N. followed by M.S.N. ACNP/FNP, and I can tell you from experience that taking shortcuts will not pay off.
First of all, I find it funny that some of you still think there is a such thing as a 2 yr RN nursing program. A true RN program is 3 yrs, one year for general education followed by two subsequent years nursing. You are doing yourself no favors by shortcutting as when you apply for that "sweet position in a trauma center" that you've always wanted--your hiring nurse manager is going to take into acct how you received your education. Did you know that most ICU's will not hire Paramedic to RN nurses?
Also, B.S.N. is not a waste by any means. The B.S.N. nurse is prepared to accept roles in clinical education as well as to pursue higher education with regards to faculty positions. In addition, the B.S.N. nurse is further trained in patient assessment, critical care interventions, as well as nurse management. New opportunities are becoming available all the time for B.S.N. Did you know that most aeromedical transport services will accept a B.S.N. nurse over an A.A.S./A.S.N./A.D.N. nurse any day of the week?
Also, for those of you with non-nursing degrees seeking nursing education--please be aware that it will benefit you to use the general education you already have and to attend a traditional RN training program. Don't try to enter critical care M.S.N. coursework with a 4 yr degree in social studies.
The majority of level 1 trauma centers will not even hire a nurse practitioner into a direct care position without that practitioner having at least 3 yrs experience as a non-master's RN.
Undergraduate registered nursing is the foundation on which you build the framework for practice and develop a solid footing in the practice of nursing.
I am afraid my days of sympathizing with the uninformed are over. We must wake up! The simple fact is: Nurses who take shortcuts, kill patients! Period.
If I have offended some, then maybe you should step back and reassess why it is you want to become a nurse in the first place.
To those who wish to put in the hours and earn their degree's,
good luck in your studies. It is only when we seek to set about change within ourselves that we seek to set about change in our communities.
- NeuroMedic RN, M.S.N., ACNP, FNP, CFRN, CCRN, ccNREMT-P, CF-P, & all the other $2 titles

Hi,

I find your post misleading particularly when you call out the BSN for their 'advanced skiils" in assessment and critical care interventions. I have worked with many RNs during my career and I know the 'rungs in the ladder' very well after being trained in a hospital setting and progressing on to the graduate level. A BSN is typically BEHIND the curve when they start their initial job. My Diploma and ADN trained nurses come to the job ready to 'hit the ground running' while most of the time we spend way too much time having to re-train our 'better educated' BSNs who have performed each nursing skill one time in a clinical setting during their 4 years of education and that's IF they were lucky. When a patient is crashing, no one is going to ask the BSN who their theorist was and what her documented care plan says to do next. Most of the arrest teams where I work have mostly Diploma trained RNs because they are the most capable and in many instances end up training the residents on what to do during a code. I have seen many a bumbling BSN get themselves into a bind more often than not when they are calling attention to their observations when discussing a pt with a doctor. It usually ends up with the BSN running for the break room after they have been dressed down by the doctor. BSNs also have the highest rate of those leaving the profession after the first year. They simply have not had the clinical training they need and the subsequent 'tempering' to deal with the often harsh reality of working in a hospital. You mentioned your days of 'sympathizing with the uniformed are over'. Try being a new grad's manager and having to listen to them while they burst into tears when they finally come to the realization that this was the wrong career choice - after 4 years and tens of thousands of dollars in student loans. Nurses who 'take short cuts' do not kill patients. Nurses who have not had the theory and clinical experience they need to function with confidence kill patients. Count the hours the diploma, ADN and BSN grads have when they graduate. If you were acutely ill, which one would you want taking care of you?

I am a strong advocate of enhancing the level of education in our workforce. I am also a strong advocate for new grads to be TRAINED on what they need to do when they begin their careers. The core issue in our profession today is that there is no REAL career ladder for those of us in healthcare which would allow progression from basic patient care to post graduate studies for those who are capable and willing to further their education.

I find it interesting that the debate over diploma, ADN or BSN continues to go on and on. I do not think we will ever get to a point where BSN is required for entry practice. Here's why: With the projected shortage of 100,000 nurses by 2010, some organization will have to step in and find more efficient methods of training RNs. This was the case during WWII which prompted the Nurse Training Act, the Cadet Nurse Corps etc where the Fed goverment funded nursing education. Many of the 3 year programs were reduced to 24-30 months to get people through the program and on the job because the shortage was so great. Fast forward to 2008 where we have a more acute (and growing) gap of trained RNs to what is needed. Eventually (when hospitals start closing and people are dying as a result), the government will have to step in. My thought would be they would sponsor entry programs at their own facilities (maybe VA hospital programs) to get more people through the program as quickly as possible. In Canada a few years ago, they closed all their diploma programs and went to strictly a BSN framework. What they ended up with was an acute shortage driven by more demand but also because people were not going into the field because of the time required. As a result, hospital schools starting to open AGAIN just to address the shortage which had been created by the BSN requirements. At the end of the day, I believe it is a supply v. demand problem. When we get to the point where demand really outstrips supply(on the brink today), there will be a outside force (Fed Government, private training school, hospital programs to create the staff they need - they have to train new grads anyway for a year - why not do it from the beginning and get the skills built into the program they need?) that will cause a change in the market dynamics to address demand. My thought would be we will revert to a 2 year program and perhaps if the governing bodies could ever agree on anything, a REAL and comprehensive nursing career ladder will be put in place to allow caregivers who are qualified to progress from CNA to LPN/RN to BSN to MSN(for NP) to PhD. Everyone in the field knows the shortage is already acute. When a well known public figure dies because of poor or a lack of care, someone will act because the problem enters the public realm and then most people will become aware.

I find your achievements impressive. I think you might benefit from a rotation in a med/surg or critical care unit to see just how much has changed with staffing in hospitals in the last 5 years. We need our advanced education RNs to recognize the contributions of RNs who graduate from the 3 educational paths. We are our own worst enemy when our advanced trained RNs start picking apart the foundation of our profession. While the BONs are busy worrying about how much more respect a BSN will give us because they have had one research course and a single management course, we arent educating enough new grads to take care of our patients. We wont need nurse managers and executives if we have no one doing the job of caring for those who are ill which I thought was the reason we all chose this profession.

Miss Mab · Aug 30, 2008

Hi,
It usually ends up with the BSN running for the break room after they have been dressed down by the doctor. BSNs also have the highest rate of those leaving the profession after the first year. They simply have not had the clinical training they need and the subsequent 'tempering' to deal with the often harsh reality of working in a hospital. .

This post was unintentially humorous to me, I believe it was unintended anyway, and I thank you for that....

It seems you've also unintentially offended the non-BSN RN's out there with your descriptive examples of our BSN grads apparent 'shortcomings'.

If by the "tempering" that they lack, you mean the general acculturation process that many HCF's and educational instituitions rely on that ingrains the idea that nurses are the all encompassing scapegoat 'low man on the totem pole', there to be seen and not heard and those who should be perfectly accepting and open to the idea of being regularly "dressed down" in a professional workplace environment then yeah, those particular college educated nurses probably did miss out on some of that ages old curriculum.

As to them having the highest rate of leaving after the first year? Well, statistically I don't know the veracity of your claim but I certainly do understand one of the main reasons why they might leave in greater numbers than non-BSN grads.

BECAUSE THEY CAN.

That's the beauty of attaining the accepted standard collegiate education in the US today. It affords you options. The option to move laterally in the work force and change careers entirely, participate in a new economy or even expand on opportunities available in their current one. The option to leave an unhealthy or toxic environment, for example, where one is expected to be "tempered" and 'play nice' no matter what ridiculous demands or mandates are heaped upon the 'lowly' staff because that's just how it's always been and is financially beneficial to those in 'charge' and so therefore not likely to change anytime in the future. Read=so don't try or you know the whole thing about don't let the door and all that...

So, you see why I think the post was funny. Sure, nurses of every degree are equally free to leave a failed system but it's a little disengenuous to think someone with an associate/vocational degree focused solely on nursing can jump ship with a likely chance of equaling the pay and benefits in another field that healthcare facilities will afford them.

Yeah, every degree produces an adequate bedside nurse but no question earning a bachelor's degree translates into holding far more options when any situation demands a change. So I repeat your statement. More BSN grads leave nursing after a year simply because they can and, therefore, managing a workforce of nurses, many of whom are held 'hostage' simply by their lack of viable employment alternatives is not a supervisory situation I would so happily and handily embrace.

But that's just me.

alphadog0228 · Aug 30, 2008

Thanks for your reply.

I am all for people who cant handle the demands of providing care

for mulitple, acutely ill patients leaving the hospital environment to go

shuffle papers at an insurance company, be a case worker or some other clerically related role. Frankly, if they cant cut it and have an attitude of superiority toward their fellow nurses, I would rather have them leave the team. They arent worth the negative impact they have on morale.

When I mentioned being 'tempered', I was referring to being emotionally and psychologically prepared to work in an often difficult

and very demanding work environment and still be pt focused and

provide a high level of care. This maturity can only be obtained by a great deal of clinical experience which they hopefully received during their nursing education. Without this, nurses graduate and come into the hosiptal setting with 'pie in the sky' attitudes about how the system should be instead of prepared to deal with what it actually is today.

If you read my post carefully, you would have seen my comments about a true clinical ladder which provides all nurses the ability to pursue advanced education. To may, the time required and the cost of an 'accepted standard collegiate education' is prohibitive which it has become for all many students regardless of they plan on studying in school. As for BSNs leaving BECAUSE THEY CAN, I would submit to you that a larger number of entry level RNs remain in a hospital enviroment BECAUSE THE CHOOSE TO STAY and

madwife2002, BSN, RN · Aug 30, 2008

A very interesting and enlightening thread thank you to the OP for starting it.

Most of The 18 month students I have been meeting recently have frightened the life out of me by their lack of knowledge and experience, I am not finding them particularily educated in any area, and their practical experience is lacking, and whilst I do believe that the practical side develops post graduation, I do not believe they are getting the adequate training post graduation to develop these skill well.

My hospital only gives 8 weeks supervised practice to new grads so that is 24 shifts to become fully functioning and then sent off on their own to manage.

Yes we help out our new fledglings but we are so bogged down with an increased heavy workload because these nurses are now counted in the numbers but cannot manage the acutely ill.

I believe all new grads should have a 6 month preceptor program available to them.

alphadog0228 · Aug 30, 2008

Thanks for your reply.

I am all for people who cant handle the demands of providing care for mulitple, acutely ill patients leaving the hospital environment to go shuffle papers at an insurance company, be a case worker or some other clerically related role. Frankly, if they cant cut it on the front line and have an attitude of superiority toward their fellow nurses, I would rather have them leave the team. They arent worth the negative impact they have on morale.

When I mentioned being 'tempered', I was referring to being emotionally and psychologically prepared to work in an often difficult and very demanding environment while remaining patient focused and providing a high level of care. This maturity can only be obtained by a great deal of clinical experience which they hopefully received during their nursing education. Without this, nurses graduate and come into the hospital setting with 'pie in the sky' attitudes about how the system should be instead of prepared to deal with the reality of it.

If you read my post carefully, you would have seen my comments about a true clinical ladder which provides all nurses the ability to pursue advanced education. To many, the time required and the cost of an 'accepted standard collegiate education' is prohibitive which it has become for many students regardless of their field of study. As for BSNs leaving BECAUSE THEY CAN, I would submit to you that a larger number of entry level RNs remain in a hospital enviroment BECAUSE THEY CHOOSE TO STAY and provide the care for those who are ill which was the reason they chose this profession.

Again, we need our RNs with advanced education to recognize the contributions of RNs who graduate from all three paths of education. We are our own worst enemy when RNs with advanced education start picking apart the foundation of our profession, demean those who passed the same board and have they same license as a BSN. And by the way, being respected by their peers and partners in healthcare is a function of performing their job well, having confidence and speaking from an informed position - not because they have a BSN or higher degree and can spout nursing theory to those who have years of experience as a physician or registered nurse.

I do not find your response laughable at all. It is truly sad and indicative of those in the "nursing" profession who have lost sight of fact that providing care for PATIENTS, not stroking their EGOS, is the foundation of the profession. As long as this visible infighting continues between peers and our governing bodies, the respect which we deserve as professional will elude us. Why would anyone respect us when we don't even have respect for each other?

madwife2002, BSN, RN · Aug 30, 2008

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I do not find your response laughable at all. It is truly sad and indicative of those in the "nursing" profession who have lost sight of fact that providing care for PATIENTS, not stroking their EGOS, is the foundation of the profession. As long as this visible infighting continues between peers and our governing bodies, the respect which we deserve as professional will elude us. Why would anyone respect us when we don't even have respect for each other?

I commend your enthusiasm and I agree with the majority of your post, however you must refrain from getting personal and remember if all RN's were like you we would not be facing the majority of the problems we face in nursing today. Everybody is entitle to their opinion, and it opens a healthy debate if we refrain from getting personnal

Everybody Remember the TOS and keep your arguments professional