Anti-Intellectualism in Nursing

[fakenurse]

I went into nursing because I love science and medicine, and thought working with like-minded people to deliver high-quality care sounded like a great job. Since entering the profession, however, I've discovered that there is widespread mistrust and criticism of education and research in nursing. Nurses who are curious and love to ask questions are sneered at, and nurses who pursue further education are labeled "book smart" and lacking the prized "street smarts", which seems to equate to knowing how to start an IV. I've never heard of any other profession where furthering one's education is seen as a bad thing. I'm feeling so disappointed about this attitude, and really disenchanted with nursing. I loved school, I love learning, and I think more education is always, always, always a good thing. Will I always be an outcast in nursing because of this? If we want to be taken seriously as professionals, shouldn't we be embracing theory and knowledge and intellectual curiosity?

[Mr. Murse]

I just read the OP and not all the responses, so apologies if I repeat anything that's been said, but the only time I've seen education even remotely cast in a negative light is when someone rises to a management position purely through classroom/book education with little or no real world education. This is only frowned on because then you have someone making key decisions in the workplace who have never actually been a part of the workplace, and basing decisions on data and numbers rather than practical experience. This is what often leads to management trying to implement stupid and unrealistic policies, and ridiculous patient to nurse ratios, because the people making them don't know what it's like to actually be "in the trenches", so to speak. Whereas if some of these people had worked along the way and maybe taken some time out of school here and there to actually get those "street smarts" instead of just racing to the top, it would enhance their management capabilities exponentially.

Aside from that, I have never seen anyone look negatively on someone else for furthering their education in the nursing world. We have at least one or two nurses working towards practitioner on my floor, and they get nothing but support. Maybe you work in a toxic, unsupportive environment and are assuming it's that way across the board. Just be assured it's not that way everywhere.

[Esme12, ASN, BSN, RN]

I have to say that in my (very limited) experience, nursing is becoming an intellectual field. Yes, by nature, it is task-oriented, but with the advent of technology, patients being kept alive longer, doctors releasing some responsibility to nurses, a nurse without "critical thinking" skills cannot make it very far.

Nursing is becoming an intellectual field? Becoming? Uhmmm....as far as I'm concerned it has been an intellectual field for years where critical thinking and independent thinking has been prevalent all along.

I'm sorry...I am forever amused/frustrated/angered by these statements. Who does everyone think has cared for all of these patients and technology the past 40 years when technology exploded?

Who does everyone think cared for the open hearts and new transplants? Who does everyone think cared for the first TPA patients? The first portable VAD patients? The new computers? Monitors and drugs to the market. The first invasive cardiac patients? Who cared for the first transplants?

Heck... I remember the first time I hung IV nitro and TPA....I was in no teaching facility and the MD was at home. Our surgeons went home and left the fresh CABG patients in our care with standard orders to use at our discretion, education, and critical thinking process.

Just exactly who does everyone think cared for these complicated cutting edge patients? Considering that the major majority of the workforce were diploma and ADN/ASN grads....IT WAS US! It was this group of highly educated, skilled, and experienced group of R's who are now called/considerd "under-educated", non critical thinking, non intellectual working force of nurses. Nurses.... who are being mistreated and tossed in the trash because we don't have history, English lit, statistics, or other fluff courses to fill the 4 year college requirements.

Really? Task oriented, non critically thinking nurses? I think NOT!

Many of us have our specialty certifications (and they cost a pretty penny by the way) which by far... makes us the most competent in the working force. Yet were are being tossed in the ditch under the guise of being "undereducated" and requiring a BSN. All this just because the facilities want to get rid of the senior nurses because we are verbal, higher paid, and are less inclined to put up with the current treatment by management/administration.

I am NOT against advancing the nursing entry requirement FOR THE FUTURE. HOWEVER...I resent the implication that nurses with years at the bedside have suddenly become complete and utter morons who lack the mental capacity to critically think....

It really chaps my ass at the propaganda perpetuated by the "powers that be" when their true driving force is cutting salaries, selling test books, self promotion, and job security.

I have my BSN...gained after I had a very successful career in critical care and emergency medicine paid in full by my boss. After 35 years...It added ABSOLUTELY NOTHING to my ability to lead, my critical thinking skills, nor my ability to care for critically injured or critically ill patients. There was no advanced pathophys...I had that 35 years ago on my ASN program. What I didn't learn I learned on the job through experience, continuing education, and certifications in my specialties.

There I feel better. I seldom get annoyed but this is one that annoys me.

[Esme12, ASN, BSN, RN]

The "anti-intellectual" feelings and opinions here are vented by nurses just like me who resent the implication that they are now somehow suddenly unworthy to be a nurse. It comes from these poor frustrated new nurses (who by the way pass the same exact test that the BSN nurse passes) as entry level nurses...incur thousands of dollars of debt...and are suddenly told they aren't good enough when their competency has already been judged as sufficient by passing the boards.

They are being lied to from the very beginning only to find out in some markets their hard earned education isn't "enough". If the "powers that be" really felt that the ASN grad was inferior... why are they still approving all of these ADN programs to graduate and test new grads as entry level nurses. If the powers that be really felt that the BSN was absolutely necessary for entry level...why don't they get a spine and get rid of the ADN programs.

For me this is just typical passive aggressive behavior to self promote their own agenda...frankly I feel it is bullying and lateral violence (to use to new buzz phrase) against an entire group of nurses as not belonging to the group. IMHO just another clique.

I'm all for making ONE LEVEL entry into nursing. If only to stop this incessant bickering

Against education? No. I am proud and support ANYONE who seeks to gain advanced education. I have a good friend and mentor just got her DNP at Rush in Chicago! And I and VERY PROUD OF her and honored she was my mentor.

Having it stuffed down my throat? Yes I resent that. Being looked down upon as inferior when I have the experience to back it up? Yes...I resent that. To be considered less because I really like being a bedside nurse. I mean I REALLY love it! I don't want to be an APRN. I no longer want to be "The Boss". I'm happy at the bedside with the patients. Am I tired of being asked about ambition, or my lack thereof, to further my education when my ambition is to be a bedside nurse and certified and an expert in my field.

My daughter is getting her BSN outright because that is where the profession needs to go as it moved forward. I am, however, against the discrimination against nurses that have proved competency by experience and by passing the same standard entry licensing exam.

I pray I am alive when all the BSN nurses are told get a masters or get out when they are 50 with 30 years experience.

Thank you I feel better.

[trishmsn]

Nursing is becoming an intellectual field? Becoming? Uhmmm....as far as I'm concerned it has been an intellectual field for years where critical thinking and independent thinking has been prevalent all along..........Who does everyone think has cared for all of these patients and technology the past 40 years when technology exploded?

I think you have brought up an excellent point, not only about nursing education, but about education-PERIOD-in the US over the last fifty to sixty years.

In the years before WW II, a high school education (and diploma) was rigorous, and young adults with this credential were considered perfectly well educated for most careers. [if you doubt this, look on the 'net for the EIGHTH GRADE graduation test from the around 1910-1915. It has elements that challenged both myself and my husband, and both of us are professionals with seven degrees and fifteen years of college/university between us!]

As the curriculum in high school became "dumbed down" in most of public education, the value of the HS diploma fell, to be replaced with an A.A. or "junior college" degree, and then the bachelor's degree in many, many fields of employment. This led to a general belief that a college degree was the hallmark of someone in the middle class (at least for men....women could still join the party if the husband had a degree and she stopped with her "M.r.S." degree after a year or two as a "coed".) The GI bill sent waves of vets to college, ending centuries of a college education being available only to the wealthy.

Concurrent with overall change in education, nursing started to morph from a technical skill taught to single young women into a college major readily available in many universities and colleges. The entry to practice debate goes back at LEAST until 1951, when the associate degreed RN was created to produce "technical nurse" who would work under the supervision of a BSN. I think the distinction lasted about 20 minutes, due to supply and demand!

Add on to this the feminist movement of the 1970's, when "nice girls" could become something OTHER than a nurse, teacher, or secretary....and in part thanks to combat medics, men could become nurses without being immediately labeled as "gay".

So, the turf wars began and rage on, as some see nursing as a possible major for people who are going to college, regardless, and others see nursing as a technical skill one "trains" for, rather than being educated for. And the conflicts will continue due to this dicotomy....

[Ally082]

I wholeheartedly agree that people should gain experience, start at the bottom and work their way up the career ladder.

I agree that shortcuts to management will lead to nothing good but I don't think that most people who earn a BSN are walking around calling nurses who have an ASN "incompetent". If that actually happened to anyone that's shocking. I just don't know any BSN or MSN nurses that would say these things, they respect people because of work ethic not what degree they earned.

Do most people feel this is generally a management attitude or is this actually happening with your peers?

[LadyFree28, BSN, LPN, RN]

As for the whole critical thinking vs task-oriented debate....

Bedsdide nursing will always have a "tasky" componet in the sense that the nurse will spend most of his time performing tasks such as administiring medications, administering treatments, personal care and performing focused assessments based on the established medical diagnosis. These patients are here because they need a qualified, skilled nurse to monitor their symptoms, to update the physician of any changes in condition and to carry out the physican's orders. Of course all this requires critical thinking, but it also requires skill, experience, speed and the ability to hit the ground running. For schools to put an emphasis on the tasks of nursing isn't a bad thing. For schools to hammer home the basic skill sets of nursing is not anti-intellectual. It isn't mutally exclusive with teaching scientific rationale and critical thinking. Schools really could (and should) teach vocational skills along with theory.

What I see some posters imply here is that it doesn't matter if a new grad nurse never inserted a Foley or successfully started an IV, because "they'll learn it on the job anyway". As if spending time on manual skill takes away from valuable class room time. There's time for both. New nurses hitting the floor lacking practical experience IS a danger. And an expense. Yeah, sure, they'll "catch up" eventually, but do you want to be one of their patients in the interim?

"Vocational" shouldn't be such a dirty word. It seems to mean "stupid" or "poor" to a certain, shall we say, "privileged" segment of the population. There's really just is a huge chunk of being a bedside nurse that is vocational in nature. Moreso than most other healthcare careers. We can add more theory and EBP to the nursing education model, sure. But I fail to understand the drive to eradicate the vocational, hands-on aspects of the profession. As though it was something to be ashamed of.

As for nurses supposedly putting you down for asking questions or for having more education..... maybe. I'm not you so I don't know what you've experienced. But I do know that whenever a new nurse, for any reason, say that most of the experienced nurses are picking on them or have an attitude toward them, I'm skeptical. Maybe it's your approach. If you go around implying that RNs who don't pursue their BSN are holding the profession back, well, that's pretty passive-aggressive. Your LPN and ADN co-workers will label you as a snob.

You being up great points, but as the poster who used "tasky" as an example, who was a LPN for 7 years I still did "critical thinking" along with "tasks" as a LPN, even created policies prior to entering and completing my studies as a BSN. The only difference was a very narrow scope of, shall I say, "tasks".

My point is, you can't have one without the other; if you only have one, take your pick, thinking versus rote mechanics, without consummating the two, there will STILL be a disconnect; the majority of nurses function with both; the thought process can and should promote both; unfortunately, what you see at least on the boards is the undercutting of both camps that believe : 1. Tasks can be taught by anyone so nursing is not a "profession" and 2. More thinking is needed to "elevate" ( ) the profession, or

1. Tasks are important and 2. "critical thinking is fluff" but then reach an impasse on that narrow thinking without embracing both-the application-"task"-based skills, or rather the assessment and interventions-and the "critical thinking"-the nursing diagnosis, the planning, the evaluation. You can't have one without the other, IMHO.

Most nurses realize this; unfortunately again, as I have stated, the attention is focused on the ones who do the bare minimum and care less, which is a very small minority.

[LadyFree28, BSN, LPN, RN]

I pray I am alive when all the BSN nurses are told get a masters or get out when they are 50 with 30 years experience.

.

I plan for THAT not to happen...I'm all for grads roots activism-educational reform, tweaking and no more "goal post moving"

[fakenurse]

I just wanted to jump in here quickly and thank everyone for participating. I'm also very pleased that there have not been any personal attacks here; it's good to know we can have a passionate, interesting conversation without dragging anyone through the mud.

[SubSippi]

I think people would feel a little differently about advancing their education if they were compensated adequately for having done so. I've never heard of someone making more than $1/hr for having a BSN, and often times there is no pay raise. So employers are saying you HAVE to get this degree to keep working here...but it doesn't make you any more valuable. In my area, RNs make almost exactly the same hourly as other Associate's degree only jobs (respiratory, ultrasound). So they are trying to get out of paying for Bachelor's level educated employees and paying them the way they pay others with an Associate's. And I find that incredibly insulting.

[fakenurse]

Those of you who have brought up the historical context of nursing-- I think that's an important piece to consider. I'm wondering if my frustration may have something to do with generational differences. There has been a lot of work done on studying the differing work attitudes and behaviors between generations in nursing. Perhaps the issue is not inherently baked into the field of nursing; maybe it's just a clash of values.

[Esme12, ASN, BSN, RN]

I plan for THAT not to happen...I'm all for grads roots activism-educational reform, tweaking and no more "goal post moving"

You and I both know that it will happen....some facilities are already pushing it....I have seen it here.....sigh

[LadyFree28, BSN, LPN, RN]

You and I both know that it will happen....some facilities are already pushing it....I have seen it here.....sigh

Doesn't hurt to fight to keep it from happening...if LPNs and ASNs are supposed to be phased out and the "white paper" for BSN entry is close to 50 years old and it hasn't successfully happened heck, it will stay around for another 50 years, and by then another cycle of a nursing shortage will happen, and it won't even matter anymore, except for a few that have issues with equating degrees to professionalism.