A question about Diploma Nurses

[Headhurt]

I was surprised to hear an aquaintance of my family was a diploma nurse. I just assumed she had a degree (not that it makes any difference to me), but she was telling me that a diploma nurse ranked higher than an ADN on the nursing food chain. The also said that programs still exist where you can get a diploma in nursing, but its very rare (I guess you have to know the secret password or something :) )

She often looks down on me because I am "just an ADN" and that she outranks me (not to mention she has 20 years experience on me) but I think a lot of this has to do with my aunt blabbing to her what my salary is (which makes hers look really, really small). Nevermind the fact that she works in little community hospital and I work in a Level 1 trauma center. She's just a miserable woman who cheats on her husband...and wants everyone else to be unhappy as well (we refer to her as the "Human Quaalude"

So, I'm confused about the Diploma nurse thing. I worked with a Diploma nurse (and she is one of the best nurses I know), and she said that to her knowledge, no such programs existed anymore and the DN's were grandfathered in when they required degrees. I was also under the impression that a DN was the same as an ADN...just without the degree. Can anyone clarify this for me???

[marylhyatt]

From what I have gathered, nurses were trained in hospitals and given diplomas upon completion until the 50's when Associate Degree nursing programs were started on a trial basis . .and were so successful that they became the "program du jour" for nursing degrees. Interesting note, I was told that when the military trained nurses who returned from Viet Nam were told they had to go through nursing school to be a civilian nurse, they really balked and that was the start of the Physician Assistant programs.

Nursing has a great history. I am new to the field so still listening and learning about the history of my new profession.

I never really saw one nurse as being better than the other...we are all taught to wipe front to back! :)

Can anyone tell me about the history of DN's and how they came to pass? I know about the ADN's, but DN is something we never really covered in school.

[TheMindVillage]

I am a new administrator in a program that is currently in the process of converting to an AD program. My job is to build the general education component of the new college and create a separate identity from the former diploma program. I have no nursing background (rather a humanities background), but having been engrossed in the diploma school (and a fine one at that), I feel compelled to say a couple of words.

Diploma Schools

In my research, there are less than 90 fully operating diploma schools in the country. Similar to our school, they function very well in the preparation of practical nursing and while no pecking order is established, they do tend to be more patient-oriented, particulary first on, than BSN folks. There is a shift in effectiveness, as research shows, of the diploma nurse versus the ADN or BSN prepared nurse as their careers progress. Typically, there is a decline in job satisfaction and patient care with diploma nurse and an increase in patient care and job satisfaction for the ADN/BSN prepared nurse. The reasons are probably too numerous to cite here, and I am not saying that such findings are gospel truth. However, the diploma nurses graduating from our school are some of the finest in the field and go on to do quite well professionally and educationally.

ADN and BSN

We are converting because of the need to have more highly trained graduates in terms of critical thinking and analysis, and to train them to be adaptable in a rapidly changing healthcare delivery system. That's not to say that diploma nurses lack such skills, but in essence, the thrust of any diploma program is centered on the practical. By re-directing focus and energy into molding well-rounded individuals through an ADN program, we believe our nurses will be better prepared professionally and able to more seamlessly transition into a BSN degree. While I believe diploma nursing has its plusses, I also believe that being so practically-based can create a hindrance when it comes to complex issues related to health care and social issues indirectly affecting health care. BUT - is one better than the other?

I suppose it is what one values. I tend to believe ANY educational attainment and ANY professional in the helping careers is someone to be commended and held high regardless of whether they hold a diploma, a bachelor's or even a doctorate. My main issue with nurses so far is this obsession with degrees. Why not focus more on the edification of individuals in the field rather than worrying about who has the better or worse degree? I applaud the original poster for seeing this person as an individual rather than as someone speaking for the collective.

WHAT A GREAT POST!

TMV

[zenman]

My main issue with nurses so far is this obsession with degrees. TMV

The bickering about degrees would stop with one entry level. Then we could focus on "my school was better than yours!"

[CSLee3, ASN, BSN, LVN, EMT-P]

I once worked with a guy that was bridging from LVN to BSN. When he completed the program he scheduled his nclex and was waiting for his testing date. Meantime, he went to HR and made them make a new name tag, just for kicks....it was funny, as he got funny looks and questions from other nurses all the time about his title... Following his name he had LVN, BSN. He did in fact have his degree in his hand, and a lot of people didn't know he had been going to school for several years on the side...He did this for several reasons, mainly because at that facility, they would put BSN, MSN behind you name but not if you were ASN or DN. So he said okay, I have a masters in education, can I put MS Ed behind my LVN, they said no. Anyway....the newly made nametage was only for a couple of weeks and he was happy to finally put RN,BSN behind his name....I saw humor in that story....he wasn't bitter, made, just having fun.

........hope everyone has a great day.

[NotReady4PrimeTime, RN]

I graduated from a diploma program in 1994. It was a two year (20 months), very intense program based within a hospital in Winnipeg, Manitoba. The school's reputation is very highly regarded across the country. The course of study included university classes in anatomy, physiology, psychology, sociology and ethics. We began our clinical experiences in the third month of the program and became very well-rounded. I feel I got an excellent education and can hold my own caring for the most critically-ill pediatric ICU patient.

Last night at work I had a conversation with a recent BScN grad about the differences between programs. She told me that all the way through her four year (30 months actual study time) degree, she and her classmates were continually being pushed toward going directly into the Masters program with a goal of administration, research or education. She said the whole course was geared toward that aim and that most of her clinical skills were learned as an Employed Nursing Student (an Alberta program where nursing students who have completed two years or more of school are employed in various settings as essentially nursing assistants while completing their education). She has no desire at this point to pursue further education, she just wants to become a good bedside nurse and then see what she feels like doing.

In 1995, legislation was passed in Manitoba making a Bachelor's degree in Nursing the entry to practice for all new nurses expected to graduate after December 31, 1999. Our class was the final intake of students into the diploma program at our hospital, and by 1997, all the remaining diploma programs in Manitoba were closed. By 1999, the nursing shortage in Manitoba was reaching critical proportions, and in August 2001, a new 23 month diploma program was established at three community colleges. The wating list is now several years long. Meanwhile, at the University of Manitoba, they've raised the entry requirement bar for the BN program so high (GPA of 3.92) that only a fraction of applicants are accepted. This is a reflection of the shortage of available faculty. So the number of new nursing grads each year still does not approach that of nurses lost to retirement or other avenues. I'm not sure where all this will end, but I know it ain't gonna be pretty.

[flaerman]

I attended a diploma program when I lived in Philadelphia and to the school is still active to date. My first year was rough as we had 4 semesters(3 of which were nursing classes and 1 was college coorifice work during the summer) and only had a few weeks off all year. By the second and third years we were also a campus of Penn State so it wasn't as bad. The education I rec'd was much more clinilcal based than BSN programs and by my senior year I was taking 4-6 patients during my clinical rotations which I feel much more prepared me to enter the nursing profession. One job I had at Einstein Medical in Phila I was an active mentor for BSN students in their final clinical rotations where I was the non-BSN nurse in that program and worked with students in those rotations for 4-5 yrs where I was their sole nurse preceptor. But at school my instructors were very good and a few of them I feel are why I am as good a nurse as I am today. I am going into my 18th year as a nurse and still do not have a degree other my Diploma. I am very happy with nursing and have done it in 3 different states not to mention different specialties along the way and am currently an ER nurse. So thank you to the diploma programs and Frankford Hospital School of Nursing for providing with the essentials to do the job that I love to do and wouldn't trade it for anything. Paul

[TriciaRN]

I attended a diploma program when I lived in Philadelphia and to the school is still active to date. The education I rec'd was much more clinical based than BSN programs and by my senior year I was taking 4-6 patients during my clinical rotations which I feel much more prepared me to enter the nursing profession"... "I am going into my 18th year as a nurse and still do not have a degree other my Diploma. I am very happy with nursing and have done it in 3 different states not to mention different specialties. So thank you to the diploma programs and Frankford Hospital School of Nursing for providing with the essentials to do the job that I love to do and wouldn't trade it for anything." Paul

Hi Paul: I too am a graduate of an RN diploma school. Mine is in Southeastern Massachusetts. In 1991, our school had just started a hybrid program w/a local college to allow an ADN completion at the same time. We were the last class to take the NCLEX in pen and paper format in 1993. Our training was intense. It was a 20 month program and included the summer as well. We all started clinicals in our 2nd month after an intense 1st month in the patient simulation lab. We had over 1500 clinical hours prior to graduation and challenging instructors. Both on and off site clinicals were included. I think diploma schools are wonderful. It helps you to get out there and earn experience and money, so that if you choose to go for your BSN, it is a bit easier. However, I am content without completing my BSN. I worked in a med/surg float pool in a 900 bed hospital and have practiced in 4 states. I am not into management and have no desire to do research. A NURSE IS A NURSE!

Tricia

[Justmeandmycat]

Hi Everyone:

Seeing as everyone is so informed about this degree thing, let me throw one more scenario at you. I graduated in 83 with a BA . In 2002, I decided to enter nursing. I was told that my BA was too old. I would have to take prereqs all over in Bio, Chemistry, Algebra, then apply to a nursing school, wait two years on the waiting list to be considered and then, if I were accepted, get an ADN. Then someone mentioned the state LPN. I tested, interviewed, and graduated after 15 months with honors. I took the NCLEX and got my license in April. At this point I have my license and a history of 800 hours of clinical earned during school on two med surg floors, and 3 subacutes in LTC. I went to apply to the hospital where I did most of my clinical, and the recruiters wouldn't even accept my resume, never mind interview me. They only want ADN or BSN candidates. Same thing at the other larger hospitals in town. I went to an "open house" where the LPN's were seperated from the RNs and the hospital recruiters wouldn't even let us in the room to speak with them. I applied to doctors offices and clinics and they wanted one year Med Surg experience after graduation. How can I get more med surg experience in a hospital if the doors are locked? Now my only option at this point is to move to another state (a state, I should point out, which didn't finance my program) where the LPNs ARE welcomed to work in hospitals. My only option in my state is to work in a LTC facility, not my cup of tea. Now, dear audience, what do I do? I'm considering Excelsior because it's faster but am concerned with the clinical testing aspect and the whole brew-ha-ha over "BSN preferred". I still want to do nursing, but to be shown all these interesting areas during clinical (including OR, ER and the diagnostic testing areas), working my butt off, taking the same NCLEX as everyone else and then being treated like a piece of you know what because I have an LPN is unbelievable. And for the record, to blow a few notions and stereotypes about LPNs out of the water, I happen to be white, in my early 40's, of average weight, married, no children and have a four year college degree behind me for what good that does. Go ahead and have a field day with that last sentence. Just stating the facts. So much for being able to help out with the nursing shortage. I'm ready to tear up my license and send it back to the State Board of Nursing with a note saying its not worth the paper its printed on. I wasted the state's money, my money, and an inordinate amount of effort and time. But we're all nurses, taking care of the sick that need us, right? We're all the same no matter what the letters on our name tag say, right? That's such a nice feel-good thing to say but I'm here to tell you the reality is just the opposite.

[RedBait]

Hi Everyone:

Seeing as everyone is so informed about this degree thing, let me throw one more scenario at you. I graduated in 83 with a BA . In 2002, I decided to enter nursing. I was told that my BA was too old. I would have to take prereqs all over in Bio, Chemistry, Algebra, then apply to a nursing school, wait two years on the waiting list to be considered and then, if I were accepted, get an ADN. Then someone mentioned the state LPN. I tested, interviewed, and graduated after 15 months with honors. I took the NCLEX and got my license in April. At this point I have my license and a history of 800 hours of clinical earned during school on two med surg floors, and 3 subacutes in LTC. I went to apply to the hospital where I did most of my clinical, and the recruiters wouldn't even accept my resume, never mind interview me. They only want ADN or BSN candidates. Same thing at the other larger hospitals in town. I went to an "open house" where the LPN's were seperated from the RNs and the hospital recruiters wouldn't even let us in the room to speak with them. I applied to doctors offices and clinics and they wanted one year Med Surg experience after graduation. How can I get more med surg experience in a hospital if the doors are locked? Now my only option at this point is to move to another state (a state, I should point out, which didn't finance my program) where the LPNs ARE welcomed to work in hospitals. My only option in my state is to work in a LTC facility, not my cup of tea. Now, dear audience, what do I do? I'm considering Excelsior because it's faster but am concerned with the clinical testing aspect and the whole brew-ha-ha over "BSN preferred". I still want to do nursing, but to be shown all these interesting areas during clinical (including OR, ER and the diagnostic testing areas), working my butt off, taking the same NCLEX as everyone else and then being treated like a piece of you know what because I have an LPN is unbelievable. And for the record, to blow a few notions and stereotypes about LPNs out of the water, I happen to be white, in my early 40's, of average weight, married, no children and have a four year college degree behind me for what good that does. Go ahead and have a field day with that last sentence. Just stating the facts. So much for being able to help out with the nursing shortage. I'm ready to tear up my license and send it back to the State Board of Nursing with a note saying its not worth the paper its printed on. I wasted the state's money, my money, and an inordinate amount of effort and time. But we're all nurses, taking care of the sick that need us, right? We're all the same no matter what the letters on our name tag say, right? That's such a nice feel-good thing to say but I'm here to tell you the reality is just the opposite.

Of course, you took the NCLEX-PN, not the NCLEX-RN (taking the same NCLEX as everone else), but I wonder what state has so many nurses they can exclude LPN's?

As for "stereotypes" for LPN's, I work for the fed gov at a military hospital and LPN's there are of every description. I did not know there was a type.

I am an RN, I work ICU, I have a diploma, no degree of any kind, I have 22 years of ICU experience, I work with LPN's, but we do not do exactly the same job.

[Justmeandmycat]

Of course, you took the NCLEX-PN, not the NCLEX-RN (taking the same NCLEX as everone else), but I wonder what state has so many nurses they can exclude LPN's?

As for "stereotypes" for LPN's, I work for the fed gov at a military hospital and LPN's there are of every description. I did not know there was a type.

I am an RN, I work ICU, I have a diploma, no degree of any kind, I have 22 years of ICU experience, I work with LPN's, but we do not do exactly the same job.

Hi. Thanks for responding and at least listening. I wrote before to vent, not to get into any debates about scope of practice, and the differences between RNs and LPNs in terms of theory, nor do I want to get into the whole education versus experience thing. I'm in the northeast where LPNs are seriously outnumbered by the many schools here that graduate RNs. Since there are not many of us, I prefer to maintain anonymity. I didn't realize there were stereotypes about LPNs, (yes, they are or race, sex,and class type) until I became one. Perhaps because you work for the government and not out in a civilian atmosphere you are not as sensitized to the perceived differences between LPN and RN. The army is a great leveler of individuality and differences. But out here its a different scenario. I envy you to be able to work in the ICU rather than to be shown the door to the local nursing home. My advice is that you better stay there in Honolulu, at least you've got the type of job you want. As for me, I have to decide whether I want to start all over again to get the coveted initials, or whether I should settle for the nursing home or leave the state all together. None of these options are very attractive to me for different reasons. I guess I could take my frustration to the NFLPN or the nursing board but I don't have the energy right now to lobby and be an advocate for my group. Right now I just need income. Society and politics will have to wait. It's been a disappointing trip. I thought I had achieved something by overcoming every hurdle put in front of me. The thought that I wouldn't be welcomed as a hospital nurse never even occurred to me. Somewhere in the thread I think there was a story of a fellow who was pleased to finally get RN/BSN on his tag. The person writing thought it was humorous. Actually it's pretty sad that he had to go through all that. I applaud him. I know what he faced. Kudos, friend.

[traumaRUs, MSN, APRN]

Redbait - was perusing this thread and just curious to know what you meant that in "20 years I might feel the same way?" Since I'm pushing 46, hopefully in 20 years I'll be retired - lol. BTW - my avatar does look like me - 20 years ago - tee hee hee!

[fireangel]

The reason being that I have been an LPN since I was 23 years old, I'm white, less than 110 lbs, considered attractive, happily married with children.

Stereotypes suck....:chuckle

Of course, you took the NCLEX-PN, not the NCLEX-RN (taking the same NCLEX as everone else), but I wonder what state has so many nurses they can exclude LPN's?

As for "stereotypes" for LPN's, I work for the fed gov at a military hospital and LPN's there are of every description. I did not know there was a type.

I am an RN, I work ICU, I have a diploma, no degree of any kind, I have 22 years of ICU experience, I work with LPN's, but we do not do exactly the same job.