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??!?!?

[mushyrn, BSN, RN]

Also, let me just point out - hopefully getting a Bachelors degree will improve the writing of many of the nurses I see. Nurses SUCK at writing, even if English is their primary language. Some of the medical records I read that nurses wrote... I just laugh at the thought of that going to court and the nurse having to defend whatever he/she was attempting to communicate. So many nurses can barely speak correct English (it is so bad to the point of not even being able to communicate effectively in English in the USA).

If anything, hopefully advanced education will help our communication skills so we at least APPEAR as intellectually capable as our colleagues.

[tridil2000, MSN, RN]

I am so sorry you think educating yourself above the level of a technician is a waste of your time. You must understand evidence. You must understand that nursing is a scholarly profession, worthy of people who can read and write a college level paper.

Someone once challenged the associate program too you know. 70 years ago, nurses said the same thing about that. Think about that.

You are no more educated than the ultrasound tech or the surgical tech without a bachelors degree.

[Wuzzie]

You are no more educated than the ultrasound tech or the surgical tech without a bachelors degree.

And people wonder why Diploma/ADNs get a little defensive. Well, here you go.

[Ms.UndastoodRn]

I agree with @nurseguy22. I'm just a "Regular Nurse" and I have no desire for a BSN for the simple fact that it doesn't help you as a floor nurse, has nothing to do with patient care and informatics should not cost $14,000 bucks. If I wanted to be a manager or educator, I'd definitely recommend furthering your education or if I was younger just starting out.

[Susie2310]

To be clear, numerous studies have demonstrated statistical significance not just "a correlation".

And the level of evidence for the studies? Qualitative?

Do we have a Randomized Control Trial yet?

[CKPM2RN, ASN, EMT-P]

If you ever do home care, you will be there when SHTF, and it won't hurt to have a few techniques you can whip out to try to diffuse the situation...

I became an RN after 28 years as a paramedic. I have bucketloads of experience in the home health care family dynamics diffusion arena.

[BostonFNP, APRN]

I have no desire for a BSN for the simple fact that it doesn't help you as a floor nurse..

What makes you think it doesn't help you as a floor nurse?

And the level of evidence for the studies? Qualitative?

Do we have a Randomized Control Trial yet?

The data has been consistent across numerous studies and numerous countries. Given the extant data I am not sure a RCT would even be approved by an IRB as ethical (even if you could find a way to fund it). Lets be honest, even if there was a RCT with 3 million participants, would you believe the results if they didn't agree with you?

[MunoRN, RN]

I am not sure I really follow this argument: do you consider all of the extant studies invalid and obsolete because there have been recent changes to curriculum? That would make just about every study on every topic invalid.

Aiken's landmark study in 2003 used data from 1998-1999. Aiken's JAMA study in 2011 used data from 2006-2008 (which is fairly contemporary in research terms). Aiken's Lancet study in 2014 used data from 2009-2010. There are consistent multinational studies using rather contemporary data.

When were these major curriculum changes done?

The studies look at recent data of outcomes to evaluate the quality of nursing education these nurses received, those educations were on average from the mid 80's or even earlier for her 2003 study.

I don't think it's obsolete, the full body of research is a very good evaluation of nursing education 30 years ago, but it's not accurate to suggest it's just as reliable for evaluating current programs.

Most of the transition to partnering with BSN programs began around 2005, and it's a process that is still occurring, I would like to see states continue to mandate an adoption of BSN curriculum and content for ADN programs.

[MunoRN, RN]

Where is your evidence? Do you have any evidence? Can you find any evidence? Apparently not.

Maybe you could clarify what evidence you're requesting.

I have yet to see a single piece of evidence indicating that ADN nurses have better skills upon graduation.

And I haven't promoted the claim that ADN nurses have better skills upon graduation, as far as I know there is no reliable evidence to support this. I have heard managers claim that in their experience ADN nurses require less initial training to take a full load of patient independently, and I have worked at a facility that had intermittent freezes on hiring BSN grads when they didn't have the extra clinical education staff they felt they needed to take these new grads on, but I have never seen this quantified in a reliable way.

And I have yet to see a single piece of evidence that ADN nurses have the same outcomes as BSN nurses.

And I've yet to see any evidence that shows the changes that have been made in response to these differing outcomes were not at all effective, do you know of any? If you believe that having ADN programs essentially become satellite BSN programs does nothing to address the problem, what else needs to change?

You just criticize Aiken, but you clearly did not even read the article I provided. Why do people keep saying the Aiken study uses 1985 data? Aiken has continued doing further studies for over a decade.

Aiken - 2014 in The Lancet - data from 2009-2010 in NINE European countries found better outcomes with increased RN education

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62631-8/fulltext

Aiken - 2011 based on data from 2005-2007

The Effects of Nurse Staffing and Nurse Education on Patient Deaths in Hospitals With Different Nurse Work Environments

Aiken - 2016 based on data from 2008 in South Korea

Effects of nurse staffing, work environments, and education on patient mortality: An observational study

Yakusheva, Lindrooth & Weiss (2014) based on 2011 data

Nurse Value-Added and Patient Outcomes in Acute Care

I haven't criticized Aiken, to use the same study as an example, the study looked at patient outcomes based on the type of schooling a nurse received, the average time since graduation for these nurses in 1999 was 14.5 years, 1999 minus 14.5= about 1985, this means the programs that are being evaluated by this research are programs that on average were in the mid 80's.

[bgxyrnf, MSN, RN]

I am so sorry you think educating yourself above the level of a technician is a waste of your time. You must understand evidence. You must understand that nursing is a scholarly profession, worthy of people who can read and write a college level paper.

Someone once challenged the associate program too you know. 70 years ago, nurses said the same thing about that. Think about that.

You are no more educated than the ultrasound tech or the surgical tech without a bachelors degree.

Apparently you do not realize that ADN programs include the entire breadth of GE requirements. Upon earning an AS/AA, one no longer has to take GE classes when pursuing a BA/BS.

An ADN is not a technical/technology certificate, it's a college degree, and requires all of the educational breadth of the BSN. Where it lacks, of course, is the depth.

[MunoRN, RN]

Which I think we all agree isn't the case.

Do you have some data on that? Any plan for BSN entry would require a lead in period to allow ADN programs to expand into BSN programs perhaps with a small drop in output. I would worry more about what the implications on diversity would be.

The most obvious fix would be to transition current ADN programs into BSN programs, however only a minority of states currently allow community colleges and other non-4 year institutions to grant bachelor's degrees, and those that do often require partnering with a university bachelor's program. In general, current BSN programs aren't interested in offering their BSN through a CC, they prefer their current arrangement which is to have them continue to graduate as an ASN, and then offer an RN to BSN program.

Doubling the number of students in BSN programs won't fix the problem and it may make it worse. There are a lot of other factors at play here, and I think/hope everyone recognizes that (poor quality BSN bridge and BSN programs, post-bac ADNs, increasing education costs, etc).

Agreed, that's a big reason why the current pathways still exist, despite BSN as entry being a goal for the last 50 years.

I've never seen that data, and if that's the case it makes an interesting argument. Do you have access to it/can you share it?

As of 2009, just over half of ADN students were second career students, often with previous degrees, this comes from research put together for a 2009 committee on making BSN the entry to practice, it says I'm not supposed to "re-publish" any of it, I'll see if that is still the case.

I am not sure if you agree there is/ws a difference in ADN vs BSN outcomes or not? If you think there is/was, then how have ADN programs changed to address it, and how did they know what to change?

I agree that the research has shown different levels of education in programs a couple of decades ago resulted in differing outcomes. There was no delineation of what exactly these outcomes resulted from, but the best guess seems to be that it was the differing content and curriculum, it could be due to other factors are less obvious but seem unlikely, for instance it could be because BSN students are more likely to live in a dorm, I tend to doubt that having ASN students live in a dorm for a year would necessarily improve the outcomes of their patients down the road.

It's not feasible to move nursing students to BSN programs, what makes more sense is to move BSN education to them. If there are other aspects of a BSN education that has provided better outcomes in past research then I'm not sure what that would be.

[Ms.UndastoodRn]

I second that!!!!