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?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.
In some ways yes. In other ways no. Someone brought up a good point
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
I have seen a trend in some of these newly minted ADN programs towards "dumbing down" the programs curriculum and leaving what I was taught basic assessment is now "advanced assessment" meant only for the "advanced practice nurses". There are programs...more than I care to admit...that do not have micro, pharmacology (real pharmacology), ethics, legalities in their curriculum...my 2 year program had a course on the nurse practice act alone along with legalities and ethics.
There has been a recent concerted effort by some of these schools to churn out quantity and not quality that I find disturbing.
My children's school system recently decided to get rid of cursive handwriting. When I see things that are being changed and examples of the common core in elemetry education....I am very concerned.
and many persons didn't graduate 8th grade....now that all children must attend school the level of performance isn't going to be the same. if you want everyone to graduate HS, than the level of education that is reflected in that is going to be lower...etc,etc.
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....
The first book I read about nursing when I decided to go back to school in my 30's and become a nurse was Echo Heron's book about her experience in nursing school. It was a bit scary for a neophyte to medicine like me to read about nursing school but especially her description of taking her boards. A trip to Sacramento, studying in the hotel room with her best friend, two days of essay-style questions . . .now we have the "dumbed-down" NCLEX multiple choice style test. Which is what I took.
I think having to write out in essay form is a better way of testing. Just my opinion.
Edited to add . . .what kind of tests did you all take? I know we have some nurses here who went to school in the 60's and 70's. What do you think?
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.
I just wanted to quote this because it seems that some of the newer generation nurses-I believe nurses have generations that overlap the general generation discussion-have an almost nebulous thinking they are the "wave of the future" and will be the ones spearheading the profession "intellectually" when if they were paying attention in their Nursing 101 class, (at least I was in PN and BSN programs)-unless they decided to cut that important nugget of information out-nurses have always been a highly intellectual field; it just had to contend with the period of thinking that nursing intelligence was subpar with physicians; it seems, again, certain thought processes are in play, possibly leading to this disconnect; I think there are a percentage of nurses that have no idea what they are capable of.
Esme, I was just getting ready to mention (after reading your post about one level to enter nursing) that I feel that college has been dumbed down... Probably a lot since you went. I have no doubt that the ASN programs of your early 20s were MUCH more rigorous than those currently offered. I think a big part of the disconnect here is that the older ASN nurses really did get a good education, and have lots of experience. And I'm not saying "all modern ASN programs are useless". But it's been my experience that even many many many of the courses taught at universities are basic. Stuff you should have known coming out of high school. I think people who push for the BSN being the minimum requirement know how far education has fallen in this country.
For heaven's sake, have you seen the material one has to know for the TEAS exam? It's 8th grade knowledge, and that's generous. Yet the prenursing student forum is overflowing with complaints about people struggling to pass this basic knowledge test, who still feel that they should be able to succeed in a degree program. Does knowing the layers of the atmosphere mean you'll be a good nurse? No.. But I would hope that one wouldn't be able to attend (much less graduate) a nursing degree program if one could not easily score above a 80% on that Teas exam.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Esme, I was just getting ready to mention (after reading your post about one level to enter nursing) that I feel that college has been dumbed down... Probably a lot since you went. I have no doubt that the ASN programs of your early 20s were MUCH more rigorous than those currently offered. I think a big part of the disconnect here is that the older ASN nurses really did get a good education, and have lots of experience. And I'm not saying "all modern ASN programs are useless". But it's been my experience that even many many many of the courses taught at universities are basic. Stuff you should have known coming out of high school. I think people who push for the BSN being the minimum requirement know how far education has fallen in this country.
For heaven's sake, have you seen the material one has to know for the TEAS exam? It's 8th grade knowledge, and that's generous. Yet the prenursing student forum is overflowing with complaints about people struggling to pass this basic knowledge test, who still feel that they should be able to succeed in a degree program. Does knowing the layers of the atmosphere mean you'll be a good nurse? No.. But I would hope that one wouldn't be able to attend (much less graduate) a nursing degree program if one could not easily score above a 80% on that Teas exam.
Just my two cents.
I agree 100%. At one of the nursing orientation programs for my daughters school...I was dumbfounded at the questions by some of the incoming students...so was my 17 year old daughter. "How long are we going to have to study?" My response...until you know it.
She took her placement tests for English and math etc for her freshman year and was placed in honors in college. I know she went to a good high school but when she came home she was stunned at how easy they were...she wondered how some of the students are going to succeed.
I have seen a difference in the ADN programs but I also wonder why the powers that be approve these programs?
When I took my boards we were tested 3 days. We all had to travel to Indianapolis...stay in a hotel. Our tests were multiple choice but we were tested about Medical, Surgical, Peds, Maternal/child and psych. You have a set time to take the tests. We were all in one room....something like 5,000 of us seated at tables every other seat.
There was a 800 max score EACH TEST and you have to get I believe it was 450 in each and every section. If yo got 600 or above you had automatic reciprocity.....even to California which had a higher min passing score. Fail by one point you returned for that test you were given 2 chances and back to school for that section again. Period. here was NO take it til you make it. I am shocked at the number of posts I see about taking the boards 4 and 5 times and no remediation.
I read this question to be what I have experienced with clinicals asking my preceptors things. They will do a certain thing and I will ask them what the rationale is and they look at me like I'm a lunatic -- and occasionally get short with me and not seem to want to talk to me anymore. Never mind, then. I'm just over here trying to make connections and learn something with my 12 hours. Trust me, I would be happy just going and getting my ADN (I already have a bachelor's -- they're overrated and I don't really need another) and working but I am more concerned about even getting a job in the first place and then just maybe going on to graduate school later on.
I would like to know what it is to work as a bedside nurse prior to going to graduate school, for what it's worth. There's no point in being in admin and not knowing what people are really going through on the floor. You can't really affect meaningful change that really helps people if you don't understand the problem. I've worked in retail -- I've dealt with people who never had to work up any ladder. They tend to be pretty horrible leaders with absolutely no connection to the people working under them and with no sense of what is going on. You have to be in it with people in order to lead effectively. When people start at the top with no clue, no one wants to listen to them and the communication breakdown can have some serious ramifications.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Aren't rising expectations for education in nursing a good thing? Don't we want a workforce of smart, educated nurses? Maybe the nurses with high degrees who have never worked a day as a nurse are trying to improve the field of nursing through their knowledge of the extant research.
I'm not sure that a workforce of smart, educated nurses requires rising expectations for education in nursing. An ADN and a passing NCLEX score makes you an RN, a BSN is a nice bonus and makes you more promotable. Beyond that, more education is wonderful -- if you can afford the time and the money. But I'm told that nursing schools today are promoting the idea of an MSN as necessary for bedside nurses and that just isn't so. Nor is the idea of everyone who graduates from a BSN program going on to become a CRNA or an NP. Not that CRNAs and NPs are BAD things, but we need good, smart nurses at the bedside, too.
It would be interesting to see evidence that college is being "dumbed down". I know we may have that feeling....but is it really true??
I have two entirely different degrees earned 20 years apart so I feel I can have some legitimate (although anecdotal) opinion on the matter.
Both of my programs were very rigorous. I wrote many many papers in APA format for both degrees, worked many math and statistic problems and read chapters and chapters of dense information.
What made my second degree easier?? Technology. Seriously. While writing a paper twenty years ago was an exercise in hanging out in the library with a four foot high stack of books reading through abstracts and trying to find research articles on microfiche, for my nursing degree I could hang out in my bedroom searching on CINAHL with "Amazing Race" on in the background.
When I think about my program from the late 80's I picture myself slaving away and imagine it to be much more difficult than my nursing degree.....but I don't think that is really true. It was just more work intensive. Had to be. Google makes life much easier.
Also, as I have been reading through this thread I keep thinking that we need to keep in mind that education does not equal intellectualism. Intellectualism is curiosity and knowing how to take previous experience and knowledge and apply it to new situations. Nurses do this all the time. Education (at least the earning of degrees) is signing up for classes, paying tuition and jumping through hoops. It helps to have "intelligence", but you sure don't have to be brilliant.
I agree that there is an undercurrent of anti-intellectualism in nursing, despite the efforts of nursing educators and researchers to make the field more academically serious. Part of this is due to our lack of educational standards (the entry-level for our profession is much lower than those of our colleagues). But I think the main problem (which no one wants to talk about) is not education. It is class. Physicians and other professionals have historically come from upper classes. Nurses have historically come from working and lower classes. Like it or not, rich kids who are interested in a career with prestige wouldn't dare dream of nursing school. It's medical school all the way. Most nurses seem to come from working class backgrounds, have limited vocabulary/spelling/grammar skills, and speak with lower-class ("redneck" or "Ebonics") accents. I am not trying to insult anyone, but this is what I have observed. If we want respect for our profession, we have to present ourselves with class and professionalism. I'm not saying we have to be stuck-up, but I'm sure you have noticed that the public sees nurses as low class, menial labor, hourly wage workers and not as educated professionals from the upper middle class.
I haven't been in school for a long time, but the BSN program I attended was definitely "dumbed down" in compairson to other science degrees. The biology, chemistry and math. were watered down versions that were used most commonly for AD for ancillary health programs or technical certifications that did not require a degree at all. "Real" science majors took the full strength classes where as BSN students took the light version.
It may be different in academia now-a-days, but as far as clinical care and advanced practice, I still see a lot of "Nursing Diagnosis" kind of science as a foundation.- You know- the fluffy, soft science, touchy-feely sort of learning that has little or no hard science or evidence based research to back it up. The only advanced practice nurses I've talked with that had any serious hard science in thier MS program were Nurse Anesth.
I have been disappointed in the science behind nursing since I entered the field. I've always thought we have no hope of strengthening our position of Nursing as a profession until we decide basic sciences are the minimum foundation for our specialized knowledge base. As long as "spiritual distress" and other such silliness is part of our basic education- we are never going to be respected along with the other science degrees. We may as well change the program to a BA instead of a BS designation.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I'm not saying we have to be stuck-up, but I'm sure you have noticed that the public sees nurses as low class, menial labor, hourly wage workers and not as educated professionals from the upper middle class.
Then again, the overwhelming majority of the US public who supposedly casts these negative judgments about nurses are not exactly what one would call "educated professionals from the upper middle class," either. Look at the source.
Be cognizant that, in 2014, 70 percent of American adults are still without BA/BS degrees.
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Trust me, I would be happy just going and getting my ADN (I already have a bachelor's -- they're overrated and I don't really need another) and working but I am more concerned about even getting a job in the first place and then just maybe going on to graduate school later on. 
Esme12, ASN, BSN, RN
20,908 Posts
In some ways yes. In other ways no. Someone brought up a good point
I have seen a trend in some of these newly minted ADN programs towards "dumbing down" the programs curriculum and leaving what I was taught basic assessment is now "advanced assessment" meant only for the "advanced practice nurses". There are programs...more than I care to admit...that do not have micro, pharmacology (real pharmacology), ethics, legalities in their curriculum...my 2 year program had a course on the nurse practice act alone along with legalities and ethics.There has been a recent concerted effort by some of these schools to churn out quantity and not quality that I find disturbing.
My children's school system recently decided to get rid of cursive handwriting. When I see things that are being changed and examples of the common core in elemetry education....I am very concerned.