ADN's being pushed out

Nursing Students ADN/BSN

Published

I work for a large Magnet hospital. As nursing becomes more popular, and nurses not in short supply, I have noticed something ominous has being going on lately. Several of our older and very seasoned ADN nurses are being fired. The excuses for firing are ridiculous. I have sadly seen some excellent nurses lose their jobs. I am wondering if they want to get rid of the ADNs so they can look "better" with an all BSN staff. Or perhaps they want rid of older nurses who have been there longer because they are higher on the pay scale. Either way, it is very scarey. I myself am BSN, and i am not ashamed to say that what I know does not hold a candle to these fired nurses. Any thoughts?

P.S. Linda Aiken is the director of the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research; the organization responsible for this latest published "research". Who in their right mind would believe this is not biased?

Up Vote Up Vote ×

Part of research is being able to replicate results under similar settings. I would like to see it done in a setting where the staff are not being told they participating in a research study. I have a friend who works in a large teaching hospital in the SICU, they have a nurse who brings her laptop to work at night because she can't play bejeweled on the hospital computer when she is in charge. She is in the process of obtaining her MSN and wants to teach at an online school. This is a true story.

Up Vote Up Vote ×
Specializes in SICU/CVICU.
The only thing it builds upon is previous flawed and biased research that was shown to be mere propaganda at best which they tried to pass off as scholarly research for their own notoriety and personal gain. According to this logic we should all be able to walk into a potential employer's office and tell them what great worker's we are and then cite ourselves as job references.[/quote']

Can you please discuss what parts of this research is flawed? Thanks

Up Vote Up Vote ×
Specializes in SICU/CVICU.
The only thing it builds upon is previous flawed and biased research that was shown to be mere propaganda at best which they tried to pass off as scholarly research for their own notoriety and personal gain. According to this logic we should all be able to walk into a potential employer's office and tell them what great worker's we are and then cite ourselves as job references.[/quote']

Can you please discuss what parts of the methodology are flawed? Thanks

Up Vote Up Vote ×

BlueDevil makes a good point. Maybe the BSN/MSN/PhD is not for everybody; there are still many ADN's out there doing excellent patient care and will continue to do so for many years to come. Earning a more advanced degree is a decision each person must make on his or her own. Skip the distractions of "corporate ______"; they are simply distractions and a waste of your time. Run the numbers and decide if spending the money is worthwhile for your own future.

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.
The only thing it builds upon is previous flawed and biased research that was shown to be mere propaganda at best which they tried to pass off as scholarly research for their own notoriety and personal gain. According to this logic we should all be able to walk into a potential employer's office and tell them what great worker's we are and then cite ourselves as job references.[/quote']

Lets be honest here: how many undergraduate research classes have you taken? Graduate level?

Enlighten us on some of the flaws of the study, and please use your own thoughts, rather than rehashing the statement of the AACC.

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.
Part of research is being able to replicate results under similar settings. I would like to see it done in a setting where the staff are not being told they participating in a research study. I have a friend who works in a large teaching hospital in the SICU they have a nurse who brings her laptop to work at night because she can't play bejeweled on the hospital computer when she is in charge. She is in the process of obtaining her MSN and wants to teach at an online school. This is a true story.[/quote']

I think you would have some IRB difficulty with that.

Up Vote Up Vote ×

I don't know what the AACC said but I do consistently see academic elitists paraphrasing previous statement form the AANC, ANA and IOM. As I stated before, it's just like Pepsi publishing a study that those who drink Pepsi cola with experience better health than those who drink other colas.

Bottom line is that this study was backed by the very groups and organizations that stand to benefit from coercing students to go even further into debt by going for BSNs rather than the much lower priced ADN or Associates programs. Increased admission to BSN programs means they can ask for more funding (non-profits must show a need for more funding from the previous year). Of course more funding can mean bonuses for those who run those programs.

Another thought: the ANA (one of the groups committed to the BSN push) along with the AMA and AHA released a report in Oct. 2012 that there could be a loss of nearly 800,000 healthcare and related jobs due to mandated reductions in Medicare spending by the Budget Control Act of 2011 (Nursing Spectrum, Oct. 8, 2012). Oh, I'm sorry, I forgot. According to a previous commenter, Nursing Spectrum is only a credible source if it's expounding the virtues of the Aiken Study and coercing all nurses that they must run back to school. So all nurses who are taking on thousands of dollars of debt for that BSN: I wouldn't expect the ANA or AACN to help you pay those loans back if you lose your job.

This man did a critique of the Aiken study and I believe every point he makes is true. So here are some of those flaws:

The criteria for inclusion of 'data' is solely based on the 'consensus' of the 'experts' creating the study. And these 'experts': backed by AACN (Amer Assoc of Colleges of Nursing) - An organization committed to BSN-entry and an organization which maintains, on its website, a valiant defense of this study:"

"The original data pool was used for an earlier study about staffing levels and mortality GENERALLY. That data was just copied onto this template for this study. But it wasn't just copied; it was copied with the full assurance of the authors that the results of the first study that used this data could be 'factored out' of this, subsequent study."

"Before analyzing the data, the authors first decided that it would be necessary to 'exclude' hospitals that didn't fit their data set."

"In fact the authors admit to manipulating the data 133 ways! But all of these 'manipulations' were later 'verified' to have produced no bias."

"Try this one: "Patient outcomes were risk-adjusted by including 133 variables in our models, including age, sex, whether an admission was a transfer from another hospital, whether it was an emergency admission, a series of 48 variables including surgery type, dummy variables including the presence of 28 chronic, pre-existing conditions as classified by ICD-9 codes, and interaction terms chosen on the basis of their ability to predict mortality and failure to rescue in the current data set."

"So the data was manipulated 133 ways, excluding some data. But, and this is key: there are SO VERY MANY variables that could effect patient outcomes that you have to adjust for EVERYTHING except for what you're looking to find. Right? This is not only what the authors contend, but they contend that they SUCCESSFULLY adjusted the data, 133 different ways, for just this purpose, and completely without bias. Amazing."

"this study states that experience is NOT A FACTOR AT ALL in pt outcomes. It doesn't merely argue that education is a BIGGER factor; it argues that education is a factor TO THE EXCLUSION of experience."

"It took the data and ran a 'logistics regression model' as to what might happen in a given hospital "if there were a 10% increase in BSN RNs."

"This study doesn't even compare the relative levels of RN education. Let me repeat that: THIS STUDY DOESN'T EVEN MAKE THE COMPARISONS IT PURPORTS TO HAVE STUDIED. This model and, as a result, this study doesn't compare existing situations. Instead, it makes assumptions regarding potential situations compared to current situations. Do you get this: the study wasn't designed to test real conditions. The study was designed to create hypothetical situations and comment on the validity of said models based on highly modified and incomplete data."

Timothy, critique of "Educational Levels of Hospital Nurses and Surgical Patient Mortality", 5/11/06. Allnurses.com

Up Vote Up Vote ×
Specializes in CCM, PHN.

You lost me one paragraph into this rant.

All I see is a wall of text by someone wasting a lot of time and typing trying to angrily justify their own lack of ambition and total denial of reality.

I actually agree that degrees and academia are pretty much a bucket of hooey, but I'm also a realist who has bills to pay. If you don't roll with the punches and keep up with the demands you'll be left behind. If your livelihood depended on getting more education, and your boss said do it or you're out, you better just zip your lip and get to studyin.' What's the point of beating your chest and wailing about it?

And not everyone goes a bazillion dollars into debt, for crying out loud, there's tuition reimbursement, grants, loan repayment programs, scholarships and financial aid out there.

Up Vote Up Vote ×

If hospitals don't want to hire ADN's, then why on earth are community colleges graduating hundreds of them every year? It is kind of douche if you ask me. Setting people up for failure, school debt, time wasted. Then what are they supposed to do, my first guess was a bridge program but if job posting specifically say LPN-BSN and ADN-BSN programs need not apply, then what, and why wouldn't a bridge program "count"?

Up Vote Up Vote ×
Specializes in CCM, PHN.

For the 10000000000th time, HOSPITALS aren't the only place nurses work! Many other places hire ADNs & LVNs. The whole point of this thread is, if you wanna work in the big-time Magnet hospital you'll need a BSN. Period. It works just like any other profession. More education = more $. Big deal!

And the colleges will offer whatever they want, it's the STUDENT'S responsibility to choose their major. No one is hiring new lawyers or art historians either, but colleges continue to graduate hundreds of students with those degrees.....because the students choose that major. It's on the student to pick a program & find the job. NOT the college. If an ADN graduate is too unrealistic to research the job market & stats - and ONLY listen to the school's marketing reps, without ANY critical or independent thinking whatsoever - then they DEFINITELY could benefit from the skills taught in a BSN program.

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.
I don't know what the AACC said but I do consistently see academic elitists paraphrasing previous statement form the AANC, ANA and IOM. As I stated before, it's just like Pepsi publishing a study that those who drink Pepsi cola with experience better health than those who drink other colas.

Bottom line is that this study was backed by the very groups and organizations that stand to benefit from coercing students to go even further into debt by going for BSNs rather than the much lower priced ADN or Associates programs. Increased admission to BSN programs means they can ask for more funding (non-profits must show a need for more funding from the previous year). Of course more funding can mean bonuses for those who run those programs.

Another thought: the ANA (one of the groups committed to the BSN push) along with the AMA and AHA released a report in Oct. 2012 that there could be a loss of nearly 800,000 healthcare and related jobs due to mandated reductions in Medicare spending by the Budget Control Act of 2011 (Nursing Spectrum, Oct. 8, 2012). Oh, I'm sorry, I forgot. According to a previous commenter, Nursing Spectrum is only a credible source if it's expounding the virtues of the Aiken Study and coercing all nurses that they must run back to school. So all nurses who are taking on thousands of dollars of debt for that BSN: I wouldn't expect the ANA or AACN to help you pay those loans back if you lose your job.

This man did a critique of the Aiken study and I believe every point he makes is true. So here are some of those flaws:

The criteria for inclusion of 'data' is solely based on the 'consensus' of the 'experts' creating the study. And these 'experts': backed by AACN (Amer Assoc of Colleges of Nursing) - An organization committed to BSN-entry and an organization which maintains, on its website, a valiant defense of this study:”

“The original data pool was used for an earlier study about staffing levels and mortality GENERALLY. That data was just copied onto this template for this study. But it wasn't just copied; it was copied with the full assurance of the authors that the results of the first study that used this data could be 'factored out' of this, subsequent study.”

“Before analyzing the data, the authors first decided that it would be necessary to 'exclude' hospitals that didn't fit their data set.”

“In fact the authors admit to manipulating the data 133 ways! But all of these 'manipulations' were later 'verified' to have produced no bias.”

“Try this one: "Patient outcomes were risk-adjusted by including 133 variables in our models, including age, sex, whether an admission was a transfer from another hospital, whether it was an emergency admission, a series of 48 variables including surgery type, dummy variables including the presence of 28 chronic, pre-existing conditions as classified by ICD-9 codes, and interaction terms chosen on the basis of their ability to predict mortality and failure to rescue in the current data set."

“So the data was manipulated 133 ways, excluding some data. But, and this is key: there are SO VERY MANY variables that could effect patient outcomes that you have to adjust for EVERYTHING except for what you're looking to find. Right? This is not only what the authors contend, but they contend that they SUCCESSFULLY adjusted the data, 133 different ways, for just this purpose, and completely without bias. Amazing.”

“this study states that experience is NOT A FACTOR AT ALL in pt outcomes. It doesn't merely argue that education is a BIGGER factor; it argues that education is a factor TO THE EXCLUSION of experience.”

“It took the data and ran a 'logistics regression model' as to what might happen in a given hospital "if there were a 10% increase in BSN RNs."

“This study doesn't even compare the relative levels of RN education. Let me repeat that: THIS STUDY DOESN'T EVEN MAKE THE COMPARISONS IT PURPORTS TO HAVE STUDIED. This model and, as a result, this study doesn't compare existing situations. Instead, it makes assumptions regarding potential situations compared to current situations. Do you get this: the study wasn't designed to test real conditions. The study was designed to create hypothetical situations and comment on the validity of said models based on highly modified and incomplete data.”

Timothy, critique of "Educational Levels of Hospital Nurses and Surgical Patient Mortality", 5/11/06. Allnurses.com

Was this a serious response?

You ranted about how flawed Aiken's peer-reviewed and published research is and were asked to engage in a discussion about these purported flaws. Your response is to quote and cite an anonymous Internet forum post from 2006? On top of that, the quoted passage is ripe with inaccuracies and offers no data to corroborate its outlandish statements that highlight the lack of academic research education of the writer.

If you have some of your own thoughts on the flaws, I would be happy to discuss them with you.

Up Vote Up Vote ×
+ Add a Comment