ADN's being pushed out

allnurses Guide · Jun 2, 2014

Again, I posted those sites that refuted the Aiken propaganda over a year ago in a response to one of your posts. Go through your posts and you should find them. That entire body of research you speak of were all spun off from Aiken's 2003 so-called scholarly research. As a matter of fact,you'll see many of the same names listed as sources.
What a bunch of robots you all are if you believe this nonsense. But you do what you feel you must and so will I. I am preparing reports for the news agent and our state representative . Also, a couple of weeks ago, a major report in our area spoke out against the use of PAs and NPs as primary care providers. I completely agree with the report. NPs and PAs are only to used as an extended arm of a licensed physician but never as a replacement or substitute for one. The differences in the education of NPs and PAs as well as the ability to diagnose and treat illnesses compared to that of an MD or DO is like night and day and never to be equated.

You posted "sites" that "refute" the studies? Blog and forums posts do not "refute" anything unless you have less understanding of the scientific process than common knowledge.

Again, you post three paragraphs of hearsay and no evidence. Good luck with your "report" I am sure it will be national breaking news, though I am willing to bet that the "news agent" and "state representative" are going to insist you name all your anonymous "sources" or else call you out on your fabrication.

allnurses Guide · Jun 2, 2014

I no longer engage in the outcomes debate but having amassed a huge list of links to all sorts of information over the years, if anyone is interested here are a few links to articles that include information that can serve as a springboard for further investigation from the standpoint of questioning a cause and effect relationship between BSN vs ADN/diploma and outcomes. Some don't take a position but provide a very comprehensive timeline and history of the BSN ETP argument as a whole.

A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce

Urban Institute: The Nursing Workforce Challenge: Public Policy for a Dynamic and Complex Market

AACC Says Deceptive Study Maligns Millions of Nurses

Associate Degree Nurses Vital to the Nation's Health Flawed Study Unduly Alarms Public

Education for Professional Nursing Practice: Looking Backward into the Future

Nursing Economics: An interview with Peter I. Buerhaus, PhD, RN, FAAN: on hopes and threats for nursing's future; Leadership Roundtable Interview

**mya612, BSN, RN** · Jun 2, 2014

Just curious - there are programs without real live clinicals? HOW?
This is part of the problem. Little standardization for degree conferral.
Edit: Ah - my guess is you mean stuff like Excelsior. But I thought for an ADN with them you had to have hands on experience somewhere in a related field (CNA) or x amount of time of military experience? Just curious.

Yes, you do have to already have a clinical credential (LPN/LVN, Paramedic, Respiratory Therapist, Licensed Midwife) to get into Excelsior's program. A CNA does NOT qualify for their program, nor does a Medical Assistant or Radiologic Technician/ Technologist. In essence, the credential you need to get into the program has to have required you to do some level of clinical assessing and intervention.

MunoRN, RN · Jun 2, 2014

Yes, you do have to already have a clinical credential (LPN/LVN, Paramedic, Respiratory Therapist, Licensed Midwife) to get into Excelsior's program. A CNA does NOT qualify for their program, nor does a Medical Assistant or Radiologic Technician/ Technologist. In essence, the credential you need to get into the program has to have required you to do some level of clinical assessing and intervention.

While "some level" of clinical experience might be required, it's not sufficient to be considered adequate by nursing boards in 15 states.

**mya612, BSN, RN** · Jun 3, 2014

While "some level" of clinical experience might be required, it's not sufficient to be considered adequate by nursing boards in 15 states.

What do you mean by that? I was clarifying the entrance requirements for the poster I previously quoted.

After reading this entire thread, I have a few comments to post of my own:

1. avengingspirit1 and BostonFNP - why can't we all just get along? :)

2. Learning can take place in a variety of venues - brick and mortar, online, traditional, non-traditional - it doesn't matter. We have as many different learning environments as we have learners. No two people will learn information exactly the same way.

3. MunoRN - every state has different licensing requirements. Although there are several states that will not allow licensure by examination of Excelsior graduates, only ONE state will not allow licensure at all and that's California. Excelsior's ADN program has been in existence for a very long time (since the '70s) and the school has been awarded the ACEN (formerly NLNAC) School of Excellence award several times.

All of this push for more education, advanced education, traditional education - when will it end? We still pay more for health care than most other post-industrialized countries and have poorer health outcomes - even with all of this focus on education a technology. I'm not knocking anyone's educational background, but I do think it may be time for the US health care delivery system to start evaluating the care we are providing - from Doctors to CNAs. Everything is becoming top-heavy. Doctors want to be specialists, nurses want to be advanced practice nurses. All of this is leading to higher health care costs and unimproved patient outcomes. Nursing should be extremely cautious with establishing fragmentation within the profession. We can achieve much more collectively than by fighting amongst ourselves. Furthermore, the AMA has always had the stance that no one should do what a physician can do - hence the backlash against independent practice of APRNs. So, while everyone is pushing for "higher education and higher credentialing" maybe we should look at the current curriculums in place and see why we are falling behind other post-industrialized countries when it comes to health care costs and patient outcomes.

allnurses Guide · Jun 3, 2014

I no longer engage in the outcomes debate but having amassed a huge list of links to all sorts of information over the years, if anyone is interested here are a few links to articles that include information that can serve as a springboard for further investigation from the standpoint of questioning a cause and effect relationship between BSN vs ADN/diploma and outcomes. Some don't take a position but provide a very comprehensive timeline and history of the BSN ETP argument as a whole.
A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce
Urban Institute: The Nursing Workforce Challenge: Public Policy for a Dynamic and Complex Market
AACC Says Deceptive Study Maligns Millions of Nurses
Associate Degree Nurses Vital to the Nation's Health Flawed Study Unduly Alarms Public
Education for Professional Nursing Practice: Looking Backward into the Future
Nursing Economics: An interview with Peter I. Buerhaus, PhD, RN, FAAN: on hopes and threats for nursing's future; Leadership Roundtable Interview

The first paper does a compelling job arguing for the value-per-dollar of ADNs in the workforce, which is not something I fully agree with (for the profession), but is an important counter-point in discussing education. Also the diversity piece is compelling and if there were changes to the education system this would need to be addressed.

The other papers are op-ed pieces that don't bring any new evidence to the table, and certainly none "refute" any studies.

The third paper (the rebuttal statement from the AACC) and the form letter from the AACC PAC simply make statements without any substantiating evidence at best and demonstrates a misunderstanding of research at the worst.

All in all they (aside from that AACC statement and PAC form letter) do a good job at highlighting the "good" side of ADN education and make important points about the value of ADN education, but ignore the best outcomes discussion.

MunoRN, RN · Jun 3, 2014

If we're looking for best outcomes, it would seem likely that we can figure out what nursing school produces the nurses with the best patient outcomes, once we figure that out why not just close down every other nursing school and only use nurses from that one school? That's how we would get the best outcomes, right?

allnurses Guide · Jun 3, 2014

If we're looking for best outcomes, it would seem likely that we can figure out what nursing school produces the nurses with the best patient outcomes, once we figure that out why not just close down every other nursing school and only use nurses from that one school? That's how we would get the best outcomes, right?

We certainly could try and identify the best program by outcomes and try and mimic it in standardization, but that's a tough job in aggregate, but is potentially feasible.

Obviously you meant this as a joke or some sort of insult implying that what I am discussing is somehow irrational, but I would much rather debate the issue at than that participate in games.

MunoRN, RN · Jun 3, 2014

We certainly could try and identify the best program by outcomes and try and mimic it in standardization, but that's a tough job in aggregate, but is potentially feasible.
Obviously you meant this as a joke or some sort of insult implying that what I am discussing is somehow irrational, but I would much rather debate the issue at than that participate in games.

I didn't mean it as a joke. There are some obvious reasons why limiting nursing education to only the school that produced the very best outcomes would be unfeasible and would be harmful if not disastrous to the nursing profession. It's those same reasons why we don't just limit nursing education to BSN programs.

I, and actually most of the nursing education community, agrees with you that we should mimic what produces the best outcomes in all programs, which is why we're already doing that, so what else is there to change that wouldn't produce the same problems that closing all but the best nursing school would?

allnurses Guide · Jun 3, 2014

I didn't mean it as a joke. There are some obvious reasons why limiting nursing education to only the school that produced the very best outcomes would be unfeasible and would be harmful if not disastrous to the nursing profession. It's those same reasons why we don't just limit nursing education to BSN programs.
I, and actually most of the nursing education community, agrees with you that we should mimic what produces the best outcomes in all programs, which is why we're already doing that, so what else is there to change that wouldn't produce the same problems that closing all but the best nursing school would?

Transitioning to a BSN entry and limiting nursing education to a single school are two vastly different things.

After all we wouldn't want to worsen the nursing shortage by losing a few bad ADN or BSN programs.

allnurses Guide · Jun 3, 2014

The first paper does a compelling job arguing for the value-per-dollar of ADNs in the workforce, which is not something I fully agree with (for the profession), but is an important counter-point in discussing education. Also the diversity piece is compelling and if there were changes to the education system this would need to be addressed.
The other papers are op-ed pieces that don't bring any new evidence to the table, and certainly none "refute" any studies.
The third paper (the rebuttal statement from the AACC) and the form letter from the AACC PAC simply make statements without any substantiating evidence at best and demonstrates a misunderstanding of research at the worst.
All in all they (aside from that AACC statement and PAC form letter) do a good job at highlighting the "good" side of ADN education and make important points about the value of ADN education, but ignore the best outcomes discussion.

I appreciate that you took the time to check those links, but as I said in my first paragraph I wasn't intending them to rebut your argument or really to affect opinion one way or the other. Seeing as how it is highly unlikely nurses will come to any sort of consensus here, and the behavior of other stakeholders in reaction to market forces will tend to move things to a favorable conclusion for your side of the issue I don't see the point in rehashing all of it over and over.

I posted them simply as resources that contain lots of areas for further investigation. Perhaps someone will have their curiosity piqued or otherwise have use of the information. Thanks for the response.

klone, MSN, RN · Jun 3, 2014

All the "quotes" around "random" words are making me want to spork my "eyes" out.