BSN minimum requirement

Mito · Mar 21, 2001

I'm tired of riding this bus lets move on to something that unites us instead of divides (some) of us.

Mito · Mar 21, 2001

I'm tired of riding this bus lets move on to something that unites us instead of divides (some) of us.

nursejanedough · Mar 21, 2001

The older I get, the less I seem to know or understand. Charles, I had to look up "dichotomy", but I knew what succinct meant - so I thought, uh oh, if he can't do "succinct" it might be a little long. All I know is this, I can draw blood for labs (Home Health, Geriatrics), do IV's, do catheters, replace peg tubes, insert an NG tube, do wound care (stage 4) to the bone on many sacrums, do Crisis Intervention - "take em down" after they have tried to stab you with a pencil or ice pick (psych nursing & home health psych), give "holistic" home health care to poor people that just need a little education, like, "You need to wash your wound daily." and then educate his caregivers to please FEED, and help WASH your loved one daily, or just delivering a fan because it is 104 degrees!, etc. I am an AD nurse. I have never had a lot of confidence in my nursing career. I was/am always asking questions. Maybe I should have gone further in my education to obtain my BSN. But I will say this, the CNA's in Long Term Care, are still the real nurses in my opinion. I would wager my last year's salary, (that's another post) that none of you that have posted here, would do what they do for the pay that you get now. I am talking one CNA for about 20 bedridden patients - changing diapers, transferring to WC for shower or bath, spoon feeding (you have to shovel in, because you have 8 residents to do in 30 minutes). I could go on and on. I hope none of you reading this are over 60. If you are, you better do some major planning now, because don't count on nursing homes to take care of you adequately. (Yes, I know there are some good (expensive) homes out there.) I have no answers, but I do know that more education can't hurt, it can only help. Maybe I wouldn't have had to look up dichotomy.

nursejanedough · Mar 21, 2001

The older I get, the less I seem to know or understand. Charles, I had to look up "dichotomy", but I knew what succinct meant - so I thought, uh oh, if he can't do "succinct" it might be a little long. All I know is this, I can draw blood for labs (Home Health, Geriatrics), do IV's, do catheters, replace peg tubes, insert an NG tube, do wound care (stage 4) to the bone on many sacrums, do Crisis Intervention - "take em down" after they have tried to stab you with a pencil or ice pick (psych nursing & home health psych), give "holistic" home health care to poor people that just need a little education, like, "You need to wash your wound daily." and then educate his caregivers to please FEED, and help WASH your loved one daily, or just delivering a fan because it is 104 degrees!, etc. I am an AD nurse. I have never had a lot of confidence in my nursing career. I was/am always asking questions. Maybe I should have gone further in my education to obtain my BSN. But I will say this, the CNA's in Long Term Care, are still the real nurses in my opinion. I would wager my last year's salary, (that's another post) that none of you that have posted here, would do what they do for the pay that you get now. I am talking one CNA for about 20 bedridden patients - changing diapers, transferring to WC for shower or bath, spoon feeding (you have to shovel in, because you have 8 residents to do in 30 minutes). I could go on and on. I hope none of you reading this are over 60. If you are, you better do some major planning now, because don't count on nursing homes to take care of you adequately. (Yes, I know there are some good (expensive) homes out there.) I have no answers, but I do know that more education can't hurt, it can only help. Maybe I wouldn't have had to look up dichotomy.

MollyJ · Mar 21, 2001

Originally posted by Charles S. Smith, RN, MS:
...No amount of clinical hours in nursing school doing specific tasks in a specific regimented fashion can replace the ability to think. We seem to be diluting our ranks with individuals who can take instruction well and are efficient at "doing" (all necessary right now, but why do we need to hold onto this model for the future?). We seem to be reducing nursing to a level of mediocrity based on tasks rather than elevating the profession based on purpose and meaning. As long as we are task driven, we are interchangeable with other groups of care-givers who are equally capable of performing tasks.
...I envision one Professional nurse group (educated at the baccalaureate level at the very least) that is prepared well enough to perform the function of integration in the healthcare arena. This Nurse group will know the medical model, will know the technical care models of nursing, but will be responsible and accountable for outcomes of patient care, inpatient, outpatient, whatever setting through the process of integration. The actual tasks that we know of today in nursing will also be taught, but do not have to be done by nurses. We must be responsible and accountable for the outcomes, putting the pieces together for the benefit of all. I truly believe that nurses ought to be the gatekeepers to healthcare. I realize this is a huge stretch for many and I am leaving out many of the blanks. I hope, nonetheless, that you get the general idea. I do not base my performance on a set of tasks, although i am skilled and accomplished having given many years to learning them. What I do in my nursing role, better than any other discipline, is to cognitively process all aspects of the patient situation to enact a meaningful difference for the patient.

Well, I will reread this in a bit after I have fully awakened..I may make some revisions once i have had my second cup of coffee... thanx again, Molly

regards
chas

I agree that nurses often get snarled up in the day to day tasks that we, too, are too busy to look at the overall picture (integration). Why is this patient repeatedly admitted? Why are they non-compliant with the med regimen? Why did the complication occur? I actually did case management for a while and found myself having an opportunity to attend to just those kinds of questions. Case management, no doubt about it, is a real nursing job. [unfortunately, all too often, your boss is an insurer and they measure outcomes along one parameter only--money]. But I really have to pause and agree with the previous poster, just before me. Who will do the care tasks? What training do we want them to have?

Again, the contradiction is that when an extremely well paid nurse is placed at the bedside to do bedside care task, she is in the best possible position to assess sensorium, skin, function, activity tolerance etc. But it is an expensive model of care; it burns people out (ie their identity becomes "pooper scooper"); they spend the bulk of their time on tasks that anyone could do and a fraction of their visible time on tasks only they can do (assessment and integration of facts with the patient and families reality). When we have gone the other way and taken nurses away from the bedside, then they often lack the knowledge of the patient's particular circumstance to be good integrators of information. So what about your model will avoid some of these previously visited pitfalls?

Additionally, as a new grad, I worked with a nurse who probably graduated in the early 1940's. She said that hospitals hired very few RN's. The RN's were charge nurses. Most RN's were employed outside of the hospital in private duty nursing. The bulk of the hospital work force was--ta-da--the diploma nursing students. (And boy, did the hospitals believe in getting their money's worth!) As all of us will agree, a good NA is above rubies--the one who will tell you that your BP's are concerning, tell you when there's too much or too little drainage in your Foley's gomco's CT's etc or that the skin is reddened. This entity is so rare that many of us don't often meet one. This is alot of informational processing coming from someone who is minimally educated (in a formal way in nursing and often otherwise).

I understand they why and I even think I understand the how of your model, but my questions are who will do the care and why should the hospitals bite? How will we avoid the problems of reduced bedside care quality? By the way, I don't doubt your assertion that we have a great tradition of task teaching and can teach anyone anything. My CM clients were tech dependent peds clients and we had really pretty academically unspectacular parents doing bang up trache-vent care on their kids. Their motivator for sacrifice was that it was their kid. What will motivate the bedside care giver if they do not identify with a profession or a calling?

Keep going, I am intrigued.

MollyJ · Mar 21, 2001

Originally posted by Charles S. Smith, RN, MS:
...No amount of clinical hours in nursing school doing specific tasks in a specific regimented fashion can replace the ability to think. We seem to be diluting our ranks with individuals who can take instruction well and are efficient at "doing" (all necessary right now, but why do we need to hold onto this model for the future?). We seem to be reducing nursing to a level of mediocrity based on tasks rather than elevating the profession based on purpose and meaning. As long as we are task driven, we are interchangeable with other groups of care-givers who are equally capable of performing tasks.
...I envision one Professional nurse group (educated at the baccalaureate level at the very least) that is prepared well enough to perform the function of integration in the healthcare arena. This Nurse group will know the medical model, will know the technical care models of nursing, but will be responsible and accountable for outcomes of patient care, inpatient, outpatient, whatever setting through the process of integration. The actual tasks that we know of today in nursing will also be taught, but do not have to be done by nurses. We must be responsible and accountable for the outcomes, putting the pieces together for the benefit of all. I truly believe that nurses ought to be the gatekeepers to healthcare. I realize this is a huge stretch for many and I am leaving out many of the blanks. I hope, nonetheless, that you get the general idea. I do not base my performance on a set of tasks, although i am skilled and accomplished having given many years to learning them. What I do in my nursing role, better than any other discipline, is to cognitively process all aspects of the patient situation to enact a meaningful difference for the patient.

Well, I will reread this in a bit after I have fully awakened..I may make some revisions once i have had my second cup of coffee... thanx again, Molly

regards
chas

I agree that nurses often get snarled up in the day to day tasks that we, too, are too busy to look at the overall picture (integration). Why is this patient repeatedly admitted? Why are they non-compliant with the med regimen? Why did the complication occur? I actually did case management for a while and found myself having an opportunity to attend to just those kinds of questions. Case management, no doubt about it, is a real nursing job. [unfortunately, all too often, your boss is an insurer and they measure outcomes along one parameter only--money]. But I really have to pause and agree with the previous poster, just before me. Who will do the care tasks? What training do we want them to have?

Again, the contradiction is that when an extremely well paid nurse is placed at the bedside to do bedside care task, she is in the best possible position to assess sensorium, skin, function, activity tolerance etc. But it is an expensive model of care; it burns people out (ie their identity becomes "pooper scooper"); they spend the bulk of their time on tasks that anyone could do and a fraction of their visible time on tasks only they can do (assessment and integration of facts with the patient and families reality). When we have gone the other way and taken nurses away from the bedside, then they often lack the knowledge of the patient's particular circumstance to be good integrators of information. So what about your model will avoid some of these previously visited pitfalls?

Additionally, as a new grad, I worked with a nurse who probably graduated in the early 1940's. She said that hospitals hired very few RN's. The RN's were charge nurses. Most RN's were employed outside of the hospital in private duty nursing. The bulk of the hospital work force was--ta-da--the diploma nursing students. (And boy, did the hospitals believe in getting their money's worth!) As all of us will agree, a good NA is above rubies--the one who will tell you that your BP's are concerning, tell you when there's too much or too little drainage in your Foley's gomco's CT's etc or that the skin is reddened. This entity is so rare that many of us don't often meet one. This is alot of informational processing coming from someone who is minimally educated (in a formal way in nursing and often otherwise).

I understand they why and I even think I understand the how of your model, but my questions are who will do the care and why should the hospitals bite? How will we avoid the problems of reduced bedside care quality? By the way, I don't doubt your assertion that we have a great tradition of task teaching and can teach anyone anything. My CM clients were tech dependent peds clients and we had really pretty academically unspectacular parents doing bang up trache-vent care on their kids. Their motivator for sacrifice was that it was their kid. What will motivate the bedside care giver if they do not identify with a profession or a calling?

Keep going, I am intrigued.

ajohnson · Mar 21, 2001

Originally posted by Lburns:
It is my firm belief that the minimum requirement for nursing should be a BSN. We want to be accepted as a profession, yet we allow 2 year programs to dominate the field. Now I went to a 2 year program and will be finishing my BSN this semester. My school did a great job preparing me for "tasks" of nursing, but oh, it is so much more than that. Many other countries have moved or are moving towards 4yr degree minimums and the US needs to stay atop in this competative field. The nursing shortage will not always be here and it is to your advantage to get your degree now. The 2 yr programs will make a great footstep in the years to come, but the 4yr degree will become the RNs of the future. As nurses move into the 21st century we need to pull together to demonstrate our power as a profession, the only way to do this is to have strong, educated nurses in not just bedside tasks but critically thinking, politics, research and community health. Think about it, comments welcome.

"...critically thinking..."? what does that mean? With your BSN, you had to take some grammar and English and you know the phrase is "critical thinking." I had a pretty strong reaction to you attitude, but I see you were responded to with a great deal of enthusiasm by a great many nurses. I, too, am an ADN, and I'm good at what I do. I don't care if you're a LVN, CNA, ADN, BSN, or MSN, we're all in it together. Divisiveness is not the answer to any working problem. Why would you want to do that? School is school, academics are just that, and many many people have college degrees with little or no common sense to secure their intelligence to practicality. You must know that by being alive in the world. Personally, I'll take all the help I can get without assuming that a degree is a measure of the human involved. Your compassion seems to be aimed toward your ego and not toward the mammoth problems that are coming. Compassion is what's required for the patient and the nurse, even if she/he is a lousy ADN...

ajohnson · Mar 21, 2001

Originally posted by Lburns:
It is my firm belief that the minimum requirement for nursing should be a BSN. We want to be accepted as a profession, yet we allow 2 year programs to dominate the field. Now I went to a 2 year program and will be finishing my BSN this semester. My school did a great job preparing me for "tasks" of nursing, but oh, it is so much more than that. Many other countries have moved or are moving towards 4yr degree minimums and the US needs to stay atop in this competative field. The nursing shortage will not always be here and it is to your advantage to get your degree now. The 2 yr programs will make a great footstep in the years to come, but the 4yr degree will become the RNs of the future. As nurses move into the 21st century we need to pull together to demonstrate our power as a profession, the only way to do this is to have strong, educated nurses in not just bedside tasks but critically thinking, politics, research and community health. Think about it, comments welcome.

"...critically thinking..."? what does that mean? With your BSN, you had to take some grammar and English and you know the phrase is "critical thinking." I had a pretty strong reaction to you attitude, but I see you were responded to with a great deal of enthusiasm by a great many nurses. I, too, am an ADN, and I'm good at what I do. I don't care if you're a LVN, CNA, ADN, BSN, or MSN, we're all in it together. Divisiveness is not the answer to any working problem. Why would you want to do that? School is school, academics are just that, and many many people have college degrees with little or no common sense to secure their intelligence to practicality. You must know that by being alive in the world. Personally, I'll take all the help I can get without assuming that a degree is a measure of the human involved. Your compassion seems to be aimed toward your ego and not toward the mammoth problems that are coming. Compassion is what's required for the patient and the nurse, even if she/he is a lousy ADN...

jenspec · Mar 21, 2001

For o many times i have read a discussion about this level of entry in nursing and which is the best one to go through to become a good nurse...ADN/BSN? well it all ends up to one thing and that is to become a NURSE! The problem with the system of nursing education is that they provides a lot of different choices/programs for anyone who is interested in nursing. And these programs offers a lot of different trainings and these produces a lot of different kinds of nurses and the product is the never ending discussion of who is the best among the different programs and which has produced a quality NURSE! OK but my point is would it be much better to provide a good training for the future nurses through comprehensive education? some might say it matters not for how long you have you education the important thing is your quality of providing care. But then a job to be considered a profession must have a basis of strong knowledge and this knowledge that im talking about can be acquired through proper education. And besides two years of staying in college is not a bachelor degree but rather a vocational degree.

jenspec · Mar 21, 2001

For o many times i have read a discussion about this level of entry in nursing and which is the best one to go through to become a good nurse...ADN/BSN? well it all ends up to one thing and that is to become a NURSE! The problem with the system of nursing education is that they provides a lot of different choices/programs for anyone who is interested in nursing. And these programs offers a lot of different trainings and these produces a lot of different kinds of nurses and the product is the never ending discussion of who is the best among the different programs and which has produced a quality NURSE! OK but my point is would it be much better to provide a good training for the future nurses through comprehensive education? some might say it matters not for how long you have you education the important thing is your quality of providing care. But then a job to be considered a profession must have a basis of strong knowledge and this knowledge that im talking about can be acquired through proper education. And besides two years of staying in college is not a bachelor degree but rather a vocational degree.

journeyy · Mar 21, 2001

I worked for four years as a CNA, then two years as a mental health tech, went to nursing school and graduated with my AD, just passed the NCLEX-RN, and, will soon begin my first job as a nurse.

I am going into this knowing that I am a member of a team for patient care. The doctors, nurses, unit secretaries, techs, dietary, even housekeeping will all play a role in the care of my patients. I want to learn all that I can, from everyone that I can, so that I can give the best care possible and do my job most effectively. I'm hoping that the people I work with will invest a bit of time in helping me to find my way so that I can be an effective team member. That small investment will pay off for them and I can then pass on my knowledge to the next new team member. Whether our title is CNA or PHd, I figure the best patient care will occur when we work together. There is strength in numbers and we're all supposed to be on the same side. (How much power and political strength would a FEDERAL union of nurses have?) Maybe someday I will have the opportunity to pursue a BSN. In the meantime, I just want to be the best AD, RN nurse/co-worker that I can be. You can support me and help me be a strong member of your team, or, you can chew me up and spit me out and go back to complaining about 'what's wrong with nursing'. YOU DECIDE. : )

journeyy · Mar 21, 2001

I worked for four years as a CNA, then two years as a mental health tech, went to nursing school and graduated with my AD, just passed the NCLEX-RN, and, will soon begin my first job as a nurse.

I am going into this knowing that I am a member of a team for patient care. The doctors, nurses, unit secretaries, techs, dietary, even housekeeping will all play a role in the care of my patients. I want to learn all that I can, from everyone that I can, so that I can give the best care possible and do my job most effectively. I'm hoping that the people I work with will invest a bit of time in helping me to find my way so that I can be an effective team member. That small investment will pay off for them and I can then pass on my knowledge to the next new team member. Whether our title is CNA or PHd, I figure the best patient care will occur when we work together. There is strength in numbers and we're all supposed to be on the same side. (How much power and political strength would a FEDERAL union of nurses have?) Maybe someday I will have the opportunity to pursue a BSN. In the meantime, I just want to be the best AD, RN nurse/co-worker that I can be. You can support me and help me be a strong member of your team, or, you can chew me up and spit me out and go back to complaining about 'what's wrong with nursing'. YOU DECIDE. : )