BSN is a joke

katfish67lpn · Oct 14, 2017

I worked with a new grad RN BSN and I was charge nurse and needed to change a foley. She asked if she could watch because she had NEVER put in a foley.I guess what they don't think BSN's will ever need to place a foley??!?

c27_AEMT, BSN, EMT-I · Oct 14, 2017

I am just a new nurse coming to nursing from a very eclectic past. Here's my two cents; take it or leave it.

If someone has mentioned this, I missed it but to OP: why not consider a RN-MSN program. There are quite a few out there and some are not much longer than BSN if you have a BS in something else like me. That is what I am doing because I have the GI bill and my employer pays for it. I think it is almost common sense that the best nurses are life long learners. I study and read new things almost every day, some of which could be considered "over my head" or "doctor stuff." I don't do this to try to play doctor, but I find that the more clinical knowledge I have, the better nurse I am.

I think one thing that really frustrates people like me is that nurses who have been mediocre nurses for years make the same as nurses who are proactive in their education. I know a few MSN students who have very poor clinical knowledge because they don't sit down and read, don't have an intimate understanding of disease processes, don't know their A&P, etc. Having letters behind your name doesn't mean a whole lot if you do not hold yourself to a standard.

I liked what people said about the CEN and other certifications. These are places to start in your specialty, but ultimately you are the one who will limit yourself. There is no bar on knowledge and if I want to go and read medical texts and get into the hard science more there is no one to stop me. Doing this may help me be a better bedside nurse, but at some point there will be diminishing dividends for knowing these things.

I say all this to point out the following: It is super important to continue learning but along the way you will have to jump through some hoops. It is like the quote attributed to Mark Twain: I have never let my schooling interfere with my education. In the grand scheme of education and nursing practice, the RN-BSN is pretty basic. I consider myself far more educated from my efforts than by the college education and degrees I have. Regarding leadership, the BSN is just a brief overview of it. Leading soldiers in combat and reading stacks of books on leadership, science, medicine, and everything in between have taught me far more than a BSN could and I would wager that many of these RNs with years of experience who are good leaders become good leaders by leading not taking classes.

We are trained to believe that more letters equals smarter and more prepared but I am sure many of you can find that tech who reads the NEJM on the toilet every day, the PA who busts her butt to know more than the residents and attendings she works for/with, or the nurse who saves the patient's life by reading medical texts and being able to catch the occasional zebra. The degrees are just starting points...real education and learning is a lifelong process that is the responsibility of the individual.

klone, MSN, RN · Oct 14, 2017

I worked with a new grad RN BSN and I was charge nurse and needed to change a foley. She asked if she could watch because she had NEVER put in a foley.I guess what they don't think BSN's will ever need to place a foley??!?

I had never put in a foley before I became an RN, either. Not all schools provide that opportunity.

elkpark · Oct 14, 2017

"The data need to show the organization's progress toward 80 percent of registered nurses obtaining a baccalaureate or graduate degree in nursing by 2020. An explanation should be included in the assessment narrative when data do not demonstrate progress toward this 2020 goal." From ANCC Magnet site. Sounds like they require BSN nurses.
http://www.nursecredentialing.org/Magnet2016FAQ

As I posted earlier when someone else posted the same FAQs link:

The FAQs you quote are referring to hospitals that have chosen to set a goal of 80% BSN-prepared nursing staff, and what documentation they need to provide the ANCC once they've met that goal (they need to supply documentation of how they're going to maintain that percentage).
The Magnet program doesn't require any specific percentage of BSN-prepared RNs. It requires that hospitals set a goal for themselves, a goal of their own choosing, that shows they are committed to the ongoing educational development of their nursing staff. A hospital could just as easily set a goal that 75% of their nurses will be certified in their specialties (the ANCC would probably prefer that, actually, since they make money off certifications, and don't make money off nurses returning to school for BSNs :)), or anything else that would show an ongoing commitment to the education/professional development of their nursing staff. Since the IOM report recommending 80% BSN-prepared nursing staff by 2020 got so much attention, lots of hospitals have taken the easy, no-brainer route and made that recommendation their goal. But that is the individual hospital's choice.
Magnet FAQ's | UC Davis Nursing (Scroll down to "Do I have to have a BSN to work in a Magnet Hospital?" Page is copyrighted 2017, so, current info)
There's also a nice fact sheet by the AACC, American Association of Commmunity Colleges, about Magnet designation and ADN-prepared nurses (documenting that the Magnet program doesn't mandate any particular proportion of BSN-prepared RNs), but I can't get the link to work. It shows up near the top when I Google "magnet status and bsn requirements."

nehneh14 · Oct 14, 2017

I had never put in a foley before I became an RN, either. Not all schools provide that opportunity.

I hadn't either. We had models on which to practice, but we weren't allowed to do invasive procedures, with the exception of wound packing. I don't find this uncommon at all. It has nothing to do with ADN vs BSN, it's all about the particular program. I went to a big 10 school with a well known nursing program.

klone, MSN, RN · Oct 14, 2017

As I posted earlier when someone else posted the same FAQs link:

Thank you for that clarification. I hate being wrong! :)

nehneh14 · Oct 14, 2017

No, but cardiac electrophys and multi-lead ECG are fundamental and broadly applicable from neonates to geriatrics, from tox cases to trauma, from the maternity wards to the ortho floor, from the ED to the ICUs.
Frankly, I'm stunned that anyone is arguing to the contrary.

It's part of the curriculum, sure. But, it doesn't have real world/nursing applications except in certain circumstances. I've worked in several different hospital areas and clinics and the only time I ever looked at an EKG/rhythm was when I worked in clinical research. I'm not quite sure why you would think that reading rhythms is something every nurse would be doing on a routine basis. It's just not. I haven't looked at a rhythm in years and guess what? I'm still out there working. :)

bgxyrnf, MSN, RN · Oct 14, 2017

I worked with a new grad RN BSN and I was charge nurse and needed to change a foley. She asked if she could watch because she had NEVER put in a foley.I guess what they don't think BSN's will ever need to place a foley??!?

No... there is simply a dearth of clinical opportunities for many programs. In my DEMSN program, I put in all of 1 Foley during nursing school. It wasn't that we weren't taught, it simply was that none of my patients needed Foleys except that one. And my first NG tube was 1.5 years into being a practicing ED nurse.

I learned *how* to do them in school but simply had scant opportunity to actually perform the skills.

bgxyrnf, MSN, RN · Oct 14, 2017

It's part of the curriculum, sure. But, it doesn't have real world/nursing applications except in certain circumstances. I've worked in several different hospital areas and clinics and the only time I ever looked at an EKG/rhythm was when I worked in clinical research. I'm not quite sure why you would think that reading rhythms is something every nurse would be doing on a routine basis. It's just not. I haven't looked at a rhythm in years and guess what? I'm still out there working. :)

I don't "think that reading rhythms is something every nurse would be doing on a routine basis" but I do think the knowledge of doing so is something which every nurse should graduate with, particularly when being awarded a Bachelor of Science in the field. That is part of being a properly educated nurse.

Sure, once the person hits the real world, he/she may not end up in a clinical role where that's part of the regular practice and, over time, the details will fade but if you've really learned the fundamentals then the basic skill should remain.

MunoRN, RN · Oct 14, 2017

Definitely NOT in my region. We have ADN programs that take a student from high school to ADN in 15 months -- with no pre-reqs. They are just factories that produce new grads who can take the test (with the bare minimum passing rates to keep the school open). In my region there is a HUGE gap between these programs and the local BSN programs.
We do have some better ADN programs at the community colleges -- but their curricula omit much of the content found in the BSN programs. They may "briefly touch" on some of the topics, but do not go into any depth. (e.g. statistics, research, theory, leadership, community health, population health, evidence-based practice, health policy, education, etc.)
Just because you live near some ADN programs that are ripping students off by requiring BSN level achievement, but only offering ADN level credit ... don't assume there isn't a difference between the degrees everywhere else.
If I were you (or your colleagues who go to these grandiose ADN programs) -- I would feel cheated -- or foolish for having attended such a school. If you are right in your assessment of the curricula, those students should be awarded BSN's not ADN's and those schools who are ripping those students off should be ashamed of themselves.

I'm not really referring to ADN programs just in my area, I was part of a workgroup who's purpose was to make BSN the entry to practice in the state, we had a pretty comprehensive survey of various program, accreditation, and state requirements for programs, and there were none that required no prerequisites. There is some room for variation, but to be accredited and for states to allow grads to sit for the NCLEX, there is a minimum set of pre-requisites as well as program requirements. I still have the review, and while there are 15 month ADN programs on the list they all actually require a previous bachelor's.

I don't really agree that providing ADN students with a quality education is "ripping them off". Generally when you get something of good quality for less money then that is the opposite of getting ripped off.

HermioneG, BSN, RN · Oct 14, 2017

Different strokes for different folks. If BSN isn't your thing that's totally fine! It doesn't mean it's a joke though.

Susie2310 · Oct 14, 2017

Continuing education requirements are, IMO, a red herring. My father was a physician and, back when I was in high school, long before I ever imagined I'd end up in healthcare, our state instituted a requirement for continuing ed hours for physicians for license renewal. My father thought this was a stupid idea and I recall debating that with him at the time, making the same point -- isn't it obvious that requiring continuing education will ensure that practitioners stay current and fresh with their knowledge? His explanation to me at the time was this: The physicians who are active, interested, committed to professional growth, are already doing more continuing ed than the state requires. The people who don't care aren't going to magically start caring just because the state requires some number of hours. They will find the "path of least resistance" to meet the hours requirement, and there will be companies and individuals who will be happy to step forward to make money off enabling them to do that, but it's not going to make them any better practitioners, or more interested in personal/professional growth.
Years later, as an RN (a CNS, actually), I was living and working in a state which instituted a new requirement for continuing ed hours for nurses for licensure renewal. It didn't affect me because I was already doing more hours than the state required just because I wanted to and felt it was a professional responsibility. However, I remembered the long-ago conversations with my father and was interested in seeing how this would work out in the state. What I saw was that all the hospitals in my area immediately instituted a system of monthly nursing continuing ed programs (the state requirement was 24 hours of education for two-year license renewal, so one hour a month met the minimum requirement), free, offered multiple times on multiple shifts so it was easy for everyone to attend. My service was tasked with providing a few of the presentations, so I was a presenter for a few of the inservices, and I also attended a few others because they were topics that interested me. What I observed was many nurses showing up, sitting in the back of the room, literally reading a magazine (this was pre-"everybody has the internet in their hands at all times") or chatting with their friends throughout, clearly making no effort whatsoever to even pretend to be paying attention to the presentation -- and, at the end, they got their certificate for their hour of continuing ed, and they would have 24 hours by the time their licenses were due for renewal. Was that exercise contributing to their professional growth? Was that making them better, more knowledgeable nurses? Of course not.
I get mailings at home periodically now, from a company that specializes in doing this, a magazine of "self-study" continuing education for nurses that I can use to pay a fee, complete the ridiculously simple "post-tests" (which are obviously written so that people can complete them without even reading the articles, or just casually skimming them) and get the number of continuing hours I need to renew my license in my state. It is simply an exercise in selling CE hours. They make money, nurses get their continuing ed hours, the BON apparently doesn't really care, and everyone's happy. Does that actually make anyone a more knowledgeable, competent clinician? Of course not. As my father noted decades ago, people who care are already making an effort; people who don't will find the cheapest, easiest way to meet the requirements. The requirements don't change anything (except that a lot more organizations are making money from selling CE hours, of course).
As the old saying goes, "You can lead a horse to water, but you can't make it drink."

True, some nurses won't/don't care about making an effort with CE courses, just as some nurses won't/don't care about making an effort with BSN course work. But I don't see how this makes my point in my first post on this thread that you replied to a red herring, i.e. a distractor from the OP's topic of the BSN being a joke. I could however say that your reply to my post is something of a red herring.

The fact is that, as I mentioned in my earlier post, at my last reading fairly recently, 26 states didn't require ANY continuing education units for license renewal, while some states require 30 CEU's in a two year license renewal period. We are talking about a huge variance in continuing education requirements for license renewal; surely this affects the quality of nursing care. However, nursing leadership appears not to be interested in this. Why? My perception is that this is because there is not enough in it for them. Nursing leadership has embraced the notion that pushing/forcing/requiring nurses to obtain a BSN is necessary for the "good of the profession," and this provides a pipeline of students en route to graduate school to give more "credibility/legitimacy" to the nursing degree (since it hasn't yet been possible to make a BSN the universally required degree to enter the nursing profession). Their objective is for nurses to achieve a more professional status - some would like nurses to achieve a status closer to that of physicians (let's not forget the push to increase the numbers of Nurse Practitioners and the push for NP's to be able to practice independently).

There is a faction that exists in nursing that in order to better their own career and job prospects/salaries are imposing and seeking to impose, by a variety of methods, higher education on nurses regardless of nurses individual nursing/life experience, education, abilities, career interests/goals, career achievements, financial situation, etc.