BSN is a joke

labordude, BSN, RN · Oct 12, 2017

I think there are also two disparate pieces to this: 1) requirement/recommendation that currently licensed non-BSN prepared RNs get their BSN and 2) BSN as a requirement for NCLEX examination. I am fully in favor of #2, let's just set a date and go for it. #1 is a bit more nuanced and probably serves less benefit to the profession in the long run. Part of this discussion is focused on the individual nurses who may or may not be interested in going back to school. That is a short-sighted view of the situation. One of the hallmarks of a profession is a single defined educational entry point. For years, the argument has been that the NCLEX is the entry point and the education doesn't matter, but I disagree. Just as other professions have defined and elevated their requirements to better cope with the increasing demand for knowledge within their specialty area, nursing must also adapt. It is not enough to be a good clinician, we have to able to better understand and integrate evidence beyond what is simply passed down as best practice from a professional organization. The non-nursing courses that exist in good BSN programs (believe me, there are plenty of crap ones out there) also better prepare us to handle social, cultural, political, etc issues that impact healthcare. I am looking far beyond the individual nurse level (there are fantastic diploma prepared nurses and terrible doctorate prepared nurses) to the aggregate level and at that point the evidence supports additional required entry level education for nurses.

Libby1987 · Oct 12, 2017

Delete

JKL33 · Oct 12, 2017

While you are busy passing meds your higher ups are making decisions that changes processes within your facility because they have these skills.

Please. You must be joking. Shall I become indignant or simply fall out of my chair with laughter.

This is one of those times where I would love to be at liberty to describe in detail some of the mind-bogglingly-devoid-of-intelligence "process improvements" I've seen in recent years - the worst of which have directly led to patient harm. Directly. No exaggeraton. Suffice it to say that I myself do not agree that intelligence, ethics, or skills are required in order to become a quasi-"leader" nor that any of those things are what separate the "higher ups" from the "med passer."

JKL33 · Oct 12, 2017

I think there are also two disparate pieces to this: 1) requirement/recommendation that currently licensed non-BSN prepared RNs get their BSN and 2) BSN as a requirement for NCLEX examination. I am fully in favor of #2, let's just set a date and go for it. #1 is a bit more nuanced and probably serves less benefit to the profession in the long run. Part of this discussion is focused on the individual nurses who may or may not be interested in going back to school. That is a short-sighted view of the situation. One of the hallmarks of a profession is a single defined educational entry point. For years, the argument has been that the NCLEX is the entry point and the education doesn't matter, but I disagree. Just as other professions have defined and elevated their requirements to better cope with the increasing demand for knowledge within their specialty area, nursing must also adapt. It is not enough to be a good clinician, we have to able to better understand and integrate evidence beyond what is simply passed down as best practice from a professional organization. The non-nursing courses that exist in good BSN programs (believe me, there are plenty of crap ones out there) also better prepare us to handle social, cultural, political, etc issues that impact healthcare. I am looking far beyond the individual nurse level (there are fantastic diploma prepared nurses and terrible doctorate prepared nurses) to the aggregate level and at that point the evidence supports additional required entry level education for nurses.

Okay, this I can agree with a bit more. My question to you, though, would be: Is it your belief and opinion that healthcare administrators and nursing administrators are prepared to step up and treat BSN-prepared "med passers" like professionals? I'm all-in 100% in favor of requiring professional degrees (so long as those degrees represent a course of study that produces advanced bedside skill as well as a well-rounded educational experience) - but then, continuing to treat bedside nurses as menial "workers"/"human capital"/basically thorns in administration's side isn't really going to fly. And honestly, I don't think anyone is prepared to do any better.

Wuzzie · Oct 12, 2017

I think there are also two disparate pieces to this: 1) requirement/recommendation that currently licensed non-BSN prepared RNs get their BSN and 2) BSN as a requirement for NCLEX examination. I am fully in favor of #2, let's just set a date and go for it. #1 is a bit more nuanced and probably serves less benefit to the profession in the long run. Part of this discussion is focused on the individual nurses who may or may not be interested in going back to school. That is a short-sighted view of the situation. One of the hallmarks of a profession is a single defined educational entry point. For years, the argument has been that the NCLEX is the entry point and the education doesn't matter, but I disagree. Just as other professions have defined and elevated their requirements to better cope with the increasing demand for knowledge within their specialty area, nursing must also adapt. It is not enough to be a good clinician, we have to able to better understand and integrate evidence beyond what is simply passed down as best practice from a professional organization. The non-nursing courses that exist in good BSN programs (believe me, there are plenty of crap ones out there) also better prepare us to handle social, cultural, political, etc issues that impact healthcare. I am looking far beyond the individual nurse level (there are fantastic diploma prepared nurses and terrible doctorate prepared nurses) to the aggregate level and at that point the evidence supports additional required entry level education for nurses.

I agree with you on one hand and disagree on the other. Yes, we need one entry point to nursing and yes, it should be at the BSN level. However, forcing people to go back to school after years of experience is nonsense. If a nurse wants to stay at the bedside why should the be forced to get their BSN or MSN? So what if it opens up other opportunities...there's absolutely nothing wrong with staying at the bedside. Let them make that decision for themselves. I also don't believe that an experienced nurse must get a BSN to be able to properly understand and implement care based on EBP, nor does not having a BSN preclude them from writing a scholarly paper. I was published and taught nationally in my area of expertise as a Diploma nurse of all things. Nobody cared one bit about the letters after my name. They cared about my expertise and knowledge that was being imparted to them. I've also participated in major research projects that have impacted what all of you do on a daily basis. I learned the research process from my colleagues. It really isn't rocket science. But because I participate in these kind of activities it makes sense for me to further my education however the nurse who intends to stay at the bedside would be better served, as a previous poster mentioned, by becoming certified in their area of interest and making sure that they choose high-quality and pertinent continuing education.

WestCoastSunRN, MSN, CNS · Oct 12, 2017

Okay, this I can agree with a bit more. My question to you, though, would be: Is it your belief and opinion that healthcare administrators and nursing administrators are prepared to step up and treat BSN-prepared "med passers" like professionals? I'm all-in 100% in favor of requiring professional degrees (so long as those degrees represent a course of study that produces advanced bedside skill as well as a well-rounded educational experience) - but then, continuing to treat bedside nurses as menial "workers"/"human capital"/basically thorns in administration's side isn't really going to fly. And honestly, I don't think anyone is prepared to do any better.

JKL33, you always ask good and thoughtful questions and provide valuable input in discussions. My experience of inpatient nursing is not the same as yours, so admittedly that probably makes it easier for me to lean towards the idealistic. That said, I'm going to sincerely ask you what I asked earlier in the thread: Will NOT requiring BSN help the nursing profession gain better footing and representation in the healthcare setting?

Personally, I don't think it's going magically change anything, but I also don't think we are going to be able to get to where we want to be as a profession without advancing our education.

There's been great commentary here in the state of nursing ed to begin with and as with any field of study, there will be good and bad programs. But by all means, let's do what we can to shut down the ad ones.

I also am a huge proponent for continuing education and professional certification, but I have to agree with another poster that even that only produces what the consumer puts into it.

And as for RockNurses comment, I think she was simply pointing out that it is easy to get micro-focused on what we do at the bedside. Heck most days that's really all I have time to think about! But we have to engage in the world beyond the bedside if we hope to impact how the best care is produced at the bedside.

I have never held a solely utilitarian view of education, a bias I readily admit. Also, others have done a better job than myself describing some of the concrete benefits of the BSN. But aside from that, the professional working world of full of advancing degrees.

labordude, BSN, RN · Oct 12, 2017

Okay, this I can agree with a bit more. My question to you, though, would be: Is it your belief and opinion that healthcare administrators and nursing administrators are prepared to step up and treat BSN-prepared "med passers" like professionals? I'm all-in 100% in favor of requiring professional degrees (so long as those degrees represent a course of study that produces advanced bedside skill as well as a well-rounded educational experience) - but then, continuing to treat bedside nurses as menial "workers"/"human capital"/basically thorns in administration's side isn't really going to fly. And honestly, I don't think anyone is prepared to do any better.

I think the way your question is phrased makes it more difficult to answer as it sounds like it has some experiential bias in it. I have worked for institutions that had some of that mentality and others (like my current one) where the CEO of a 10+ hospital, multi-billion dollar system is an RN and the nurses have a great deal of respect within the system. I would argue that the goal of any educational program is to give people a foundation with which to start from and then their experiences, additional learning, and on the job training take them from there. There will always be cases where people don't understand the value of educated nurses to the organization, but I will continue to say that nurses are their own worst enemies when it comes to garnering institutional respect. My perception from listening and observing over the years is that there are a non-miniscule number of nurses who believe that anything moving us from direct patient care lowers one's status as a nurse("oh, they've been away too long, they have no idea what goes on", "they couldn't possibly understand", "do they even know how to take care of patients"). Note that it become an us vs them mentality with respect to bedside nursing and management. It does not have to be this way. The biggest problem in my opinion is ineffective middle management in clinical nursing. I've met far too many nurse managers who "fell into the role because no one wanted it." This is not the way to develop effective nurse managers and it certainly isn't good for nursing's place within the organization. Until we work in partnership to ensure good representation at the manager and director level, we will have little voice.

NutmeggeRN, BSN · Oct 12, 2017

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??!?!?

I fought with my mom bitterly as she wanted me to do a diploma program, but I knew (in 1978) that I wanted a BSN and was fortunate enough to be able to get a great education. That said, I think a program that incorporated more clinical (summer extenrnships?) or a fifth year clinical externship might be better all around. How feasible that is, I don't know.

You are a little over a year into your career, Further down the road you may begin to see the benefit of a higher education.

The first class of my Masters program I learned quickly to use an APA formating program, easy peasy! No problem there and WAY better than the portable typewriter I used in college!!

Frankly, I find the title to your thread distastful. I would never post or want to see a thread stating "ADN nurses are a Joke". I am very proud of my education, as I have worked very hard at it. I finished by BSN porogram in 5 years with a husband and child (not on the original plan, LOL!) and went back at 50 to get my Masters degree.

JKL33 · Oct 12, 2017

JKL33, you always ask good and thoughtful questions and provide valuable input in discussions. My experience of impatient nursing is not the same as yours, so admittedly that probably makes it easier for me to lean towards the idealistic. That said, I'm going to sincerely ask you what I asked earlier in the thread: Will NOT requiring BSN help the nursing profession gain better footing and representation in the healthcare setting?

Personally, I don't think it's going magically change anything, but I also don't think we are going to be able to get to where we want to be as a profession without advancing our education.
There's been great commentary here in the state of nursing ed to begin with and as with any field of study, there will be good and bad programs. But by all means, let's do what we can to shut down the ad ones.
I also am a huge proponent for continuing education and professional certification, but I have to agree with another poster that even that only produces what the consumer puts into it.
And as for RockNurses comment, I think she was simply pointing out that it is easy to get micro-focused on what we do at the bedside. Heck most days that's really all I have time to think about! But we have to engage in the world beyond the bedside if we hope to impact how the best care is produced at the bedside.
I have never held a solely utilitarian view of education, a bias I readily admit. Also, others have done a better job than myself describing some of the concrete benefits of the BSN. But aside from that, the professional working world of full of advancing degrees.

Thank you for the discussion. Regarding the two ideas bolded above:

1. BSN entry-to-practice holds every promise of giving the bedside nurse a better standing! I'm in favor. At the same time, if the idea is to simply churn through bedside BSNs who are there temporarily while on their way to "bigger and better" things, well then, no. Just as we don't expect our child's 5th grade teacher to be someone merely biding his/her time in the "menial" work of teaching children until s/he can "advance" into something more self-important, we should aim for a situation where bedside nurses are prepared as professionals and then treated as such, with the importance of their daily contributions acknowledged not with candy and the adult equivalent of sticker charts, but a real place at the table.

2. I absolutely agree.

Kooky Korky, BSN, RN · Oct 12, 2017

A BSN is a Bachelor of Science in Nursing. You've already got the nursing stuff in your ASN. (Much of it, anyway.) Now you have to complete the requirements for a Bachelor of Science degree. If you don't want to complete the educational requirements for a Bachelor's degree, you're free to deem in useless and not complete them. If you want the Bachelor's degree, you must complete the requirements.

But what is the answer to his question?

JKL33 · Oct 12, 2017

I think the way your question is phrased makes it more difficult to answer as it sounds like it has some experiential bias in it. I have worked for institutions that had some of that mentality and others (like my current one) where the CEO of a 10+ hospital, multi-billion dollar system is an RN and the nurses have a great deal of respect within the system. I would argue that the goal of any educational program is to give people a foundation with which to start from and then their experiences, additional learning, and on the job training take them from there. There will always be cases where people don't understand the value of educated nurses to the organization, but I will continue to say that nurses are their own worst enemies when it comes to garnering institutional respect. My perception from listening and observing over the years is that there are a non-miniscule number of nurses who believe that anything moving us from direct patient care lowers one's status as a nurse("oh, they've been away too long, they have no idea what goes on", "they couldn't possibly understand", "do they even know how to take care of patients"). Note that it become an us vs them mentality with respect to bedside nursing and management. It does not have to be this way. The biggest problem in my opinion is ineffective middle management in clinical nursing. I've met far too many nurse managers who "fell into the role because no one wanted it." This is not the way to develop effective nurse managers and it certainly isn't good for nursing's place within the organization. Until we work in partnership to ensure good representation at the manager and director level, we will have little voice.

1. Yes. Of course it does. I combined my experiential bias with all the various implications you made with your statement about med-passers and higher-ups. :) The bulk of my experience (including remote up to present) is within a system every bit as big and sprawling as that which you mention. I'm not talking about some rinky-dink behind-the-times place. I've been watching this for a long time.

2. I don't believe that at ALL, and I don't form my opinions about nursing management in this way, but rather almost solely on willingness and ability to act with intelligence and ethics. It is very possible to make good decisions without currently "doing the job" about which decisions are being made if one is committed to ethics and careful thought. I actually don't think the problem of "us" vs. "them" is the real problem; that is something that is an effect of this constant spoken or unspoken belief that the bedside is something to be moved away from in order to gain respect and "standing."

WestCoastSunRN, MSN, CNS · Oct 12, 2017

JKL33, great point about the BSN too often being merely a stepping stone. You and I have been a part of past discussions regarding the appeal of bedside nursing as an end-goal as opposed to a check in the box. You are preaching to the choir. I hear ya and it's completely relevant to this discussion. And it's something our diploma and ADN colleagues understand very well. You are right -- THAT kind of nurse -- the expert bedside nurse is a dying breed.

And it seems reasonable that ADN and Diploma nurses would be grandfathered into practice though a current or near future requirement would be BSN for new nurses. But how to bring the same passion and expertise that diploma and ADN nurses have historically brought to the bedside will continue to be a challenge.

As with anything we can't throw the baby out with the bathwater.