BSN is a joke

[nurseguy22]

I am a nurse at a major hospital where I have worked over a year after gaining my ASN. I have returned to get my BSN. What I'm not understanding is why there is such an ENORMOUS disconnect between what I do at work and the class work I need to do. It doesn'y apply at all. I have to take family care classes and informatics with very little practical application. I have to memorize all the rules of APA. My patients don't care if I can wrote a wonderful APA formatted paper. They just don't. It's like there is no appreciation in BSN education for what nursing is really about. At no time will I EVER do a CFIM on my patient or a PEEK readiness assessment. Get real. Where is the disconnect? Everyone I talk to say's the same thing about their BSN program, that it is completely useless. Who decided that nurses needed extensive training in social work and paper formatting?!?! I don't deal with social work. I have a team of social workers for that. At no time will I ever be in a patients home trying to improve the communication between family members ect. There are family counselors ect for that. It isn't my job! Yet here I am getting trained in areas I have no interest in, and will never ever use in my career. And for what? So I can say I have 3 letters behind my name and the school and hospital can make more money? Its a joke. I'm learning nothing of value. I would drop out and find a new school, but everyone I talk to has the same opinion about where ever they went. Basically healthcare has become obsessed with accolades, but forgot that those accolades were supposed to represent a level of expertise.

Why is there such an enormous disconnect between real life nursing and nursing education??!?!?

[klone, MSN, RN]

Klone, with all due respect I don't understand what you're saying here. That someone in the 5th year of a formal, ongoing, post-baccalaureate educational process which is focused on the minute details of the human body and its functioning is on the same footing with regard to role preparation as a BSN RN, respectively?

I'm saying that a newly minted physician is about as prepared for independent practice in his/her role as the newly minted RN is in his/her role.

[BostonFNP, APRN]

I think this post really expresses the crux of this whole discussion.

What is the crux of the issue? That neither ASN or BSN programs are preparing students adequately for the role?

[bgxyrnf, MSN, RN]

I've often heard nurses complain about stupid APA formatted papers and research, but I've never heard a physician whine that they had get a higher academic degree in order to practice as physicians. Have you ever heard a surgeon witch and moan that s/he had to do all this APA garbage, when all s/he is doing all day long, is cutting people up? I mean, that's one heck of a task-oriented job. Who cares if they know the difference between a high quality randomized trial, case-control design or a retrospective comparative study?

Word.

Whence long ago I needed to obtain the services of an expert neurosurgeon, I did my best to do due diligence. It turns out that he was nationally renown which was immediately revealed by the extensive publications that he'd authored.

My only gripe about APA, beyond being somewhat hard to read due to the embedded parentheses, is that it is the preferred format from a soft science - psychology. I'd prefer to use AMA and more closely align nursing with medicine rather than seeking to distance ourselves.

[bgxyrnf, MSN, RN]

What is the crux of the issue? That neither ASN or BSN programs are preparing students adequately for the role?

It would be interesting to me to see what a BSN program would look like if it were developed de novo rather than slowly evolving along the diploma to ADN to baccalaureate continuum.

Personally, I think engineering education provides an excellent model (admittedly, I'm biased). In the first year, the student is immersed in rigorous science education - in the same classes as the students for whom those are their major classes. The students begin basic lab practica to get exposure to the tools and environs of their field. In the second year, the hard sciences continue but are now joined by applied sciences based on the the core topics already studied. Each of these includes a practicum component (which includes writing on a professional level). In the second and third year the students study applied topics from other disciplines which overlap with their own. In the third year students begin to work more independently and are expected to produce original work and to have fundamental skills to utilize the tools of their trade. The students begin to take electives toward specialization within their field. By the fourth year, the applied sciences have become specialized and dependent on multiple prerequisites. Often times the students will begin taking selected graduate-level classes. By this time it is expected that the faculty are serving more as mentors and guides rather than as instructors. The expectation is that the students have developed the skills and core knowledge to educate themselves utilizing resources. The students are spending many hours in practica and are performing independent, original work - projects and/or research. Upon graduation, students are expected to have basic competence and to be ready to be productive staff engineers - albeit at a basic level.

Throughout all years of the program the students take all the GE classes like music appreciation, anthropology, poli sci, history, English, etc.

While I can only speak for my personal experience, my engineering program prepared me much better than did my nursing program. The engineering program (and the years of professional experience) prepared me greatly for both my nursing education and my professional work as a nurse.

I will also point out that engineering school was much more difficult that was nursing school. There were no multiple choice tests and homework could take hours and hours, sometimes on only a problem or two.

[JKL33]

I'm saying that a newly minted physician is about as prepared for independent practice in his/her role as the newly minted RN is in his/her role.

I agree with you and I think many agree with us, which is why their formal training is not complete at the end of MS4.

[JKL33]

What is the crux of the issue? That neither ASN or BSN programs are preparing students adequately for the role?

I would say that's possible, or part of the issue, yes.

For those who wish to practice bedside acute care they may fare better "professionally" if they aren't dependent on their employer to provide them with the remainder of the essential training required to do their role. Being better prepared for the bedside may, first and foremost, actually improve patient care. It also may help some new nurses to feel grounded enough to stay longer in the role without overwhelming stress that makes them immediately want to leave or declare themselves "burned out" after only a matter of months. Better preparation may enable and empower new-grad nurses to not have to agree to costly financial contracts, which, from what I'm hearing on AN and elsewhere, are used by employers due to the high cost of onboarding and properly precepting a new RN, combined with high turnovers. We can write as many papers and study as much nursing theory as anyone wants to, nothing wrong with that, but in my mind it's not really acceptable to come out of school and not really how to differentiate rales from rhonchi and know the implications of each. The point where the paper-writing meets its beneficial limits for the soon-to-be bedside RN is when the hands-on bedside skills are lacking, regardless of educational path.

These are just a couple of thoughts; just musing. There has been a good discussion here about "what else" one can do with the BSN, but the original topic was about bedside functioning. Patients are sick. They're sicker than patients who used to spend time in the hospital. Surely an RN with a baccalaureate degree could emerge from college with more than a very basic understanding of how to take care of sick patients.

And I will concede that educational opportunities are what one makes of them, but that doesn't mean the curriculum itself isn't an opportunity for either a strong foundation or a shaky, bare-bones foundation. It doesn't mean the curriculum couldn't benefit from being re-focused. Many of the learning opportunities that nursing students have are only available through the school experience itself. You can study thousands of hours extra on your own and even write extra papers if you want, but you can't independently waltz into a hospital and say you'd like some extra experience with nursing care above and beyond your clinical experiences.

[elkpark]

It would be interesting to me to see what a BSN program would look like if it were developed de novo rather than slowly evolving along the diploma to ADN to baccalaureate continuum.

That is not the developmental pathway, and BSN programs didn't "slowly evolve" from ADN programs (which didn't "evolve" from diploma programs). It's ADN programs that were a relatively recent development. Baccalaureate programs in nursing have been around since the 1920s. The first diploma programs, based on the Nightingale model in the UK, were started in the US in 1872. The first collegiate nursing program, which wasn't a true BSN degree program, but was a diploma program plus three years of college (general education), was started in 1919 in Minnesota. Yale had the first independent collegiate school of nursing in the US and offered the first true baccalaureate degree in nursing in the US in the early 1920's. Both diploma programs and BSN programs flourished for many years, with plenty of support for both models of nursing education. ADN programs didn't come along until after WWII. During the war, there were difficulties with supplying enough nurses for the war while also adequately staffing hospitals in the US, which stimulated great interest in developing a mechanism for cranking out large numbers of RNs quickly (i.e., with less education). The first ADN programs started in 1951.

[Wolf at the Door, BSN]

222 post....can we close this thread...I have seen other topics that are actually good get passed on because of this... time to close.

[bgxyrnf, MSN, RN]

222 post....can we close this thread...I have seen other topics that are actually good get passed on because of this... time to close.

Or, perhaps it's simply time for you to unsubscribe.

[MunoRN, RN]

My Spanish minor was very useful in Brooklyn.

As is my first bachelor's in biology, a minor or previous bachelor's can often be very useful, yet the majority of students entering a nursing program with a previous bachelor's are going into ADN programs not BSN programs, so then question is why we allow BSN grads with only those 4 years of undergrad work practice at the same level as ADN grads with a previous bachelor's who have 6 years of undergrad schooling.

[MunoRN, RN]

The more I read posts on this debate the more I think the crux of the issue really has nothing to do with degrees, coursework, application, or outcomes but rather with one group either feeling or being made to feel they are 1. left on the outside or 2. less of a nurse. It becomes so personal that way that implicit bias trumps any logical argument or data to the contrary.

I would agree that people often take this debate as a personal attack, seeing an implication that because they are an ADN nurse that they want harm to come to their patients or that they want to degrade the nursing profession. And if there was any truth to the idea that nursing would be better off without ADN nurses then I'd say they've got no valid complaint, the problem is that doing away with ADNs would pretty well destroy what nursing currently is.

I was assumed that transitioning to BSN as entry to practice was the obvious progression, at a quick glance BSN only seems like a good idea.

To make BSN the entry to practice would effectively cut the output of nurses in half, which would force nursing to alter it's role in healthcare, it's not clear we would even continue to exist. We could fix this problem by doubling the number of students in current BSN programs, which would drastically worsen the quality of education in those programs due to overloaded clinical sites, particularly when the recent progression in nursing education is to better synchronize didactic and clinical experience, which requires more clinical flexibility, not less.

Then there's the problem of how the demographics of those going into nursing would change. One of the supposed advantages to that extra year of electives that BSN grads take is that it makes them 'more rounded' (I would argue that the year of sailing and greek mythology that I took as electives do little to make me a better nurse), but what does far more to make a nursing grad more rounded is previous life experience, and by far the majority of second career nurses come from ADN programs.

I'm all for moving towards what provided a better education and better nurses that provide better nursing care, but a BSN only system clearly isn't how to achieve that.

[MurseJJ]

Thought you'd all like to know, I'm about to do the reference slide for a symposium presentation I'm doing, I just did my every-couple-months reminder of APA format, and I thought of this thread.