BSN's deliver safer care than ADN's??

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Now, I am all for further education, but I think this study is skewed. I truly don't see how they have come to the conclusion that taking more courses in the humanities and other such non-nursing related courses is going to produce a more competent bedside nurse. The core nursing cirriculum for most ADN and BSN programs is quite similar in my experience. I can see where the BSN nurse may have it over the ADN in managerial type roles, but as a bedside nurse? I think lots more studies need to be done before this quick conclusion is drawn. One factor that may affect nursing in this negative way is the poor economy. Maybe it is that some people are going into nursing just because it will almost guarantee them employment and don't really want to be in nursing and therefore are not as dedicated as nurses? These people may not want to go for the BSN. I don't know...that is just something I am throwing out there because this makes no sense to me. I don't want to start the old BSN vs. ADN war, but this is news and I was wondering, what do you all think?

http://www.upi.com/view.cfm?StoryID=20030923-050052-9024r

WASHINGTON, Sept. 23 (UPI) -- The ongoing nursing shortage in the United States has forced some hospitals to rely on nurses with less than a college education as they scramble to fill vacancies but new research suggests the practice can yield deadly consequences for patients.

The study, the first of its kind, reveals patients undergoing surgeries at hospitals where a greater proportion of nurses have obtained a bachelor's or higher degree experienced a lower rate of death than patients at hospitals where most nurses had only associate degrees.

Such findings have implications not only for patients but also for how nursing schools, hospitals and even the U.S. Congress should address the nursing shortage, Linda Aiken, a nurse and lead investigator of the study, told United Press International.

These institutions have made efforts to address the nursing shortage by facilitating the rapid training of nurses via associate degree programs, but the study indicates in the long-run the strategy might be worse for both patients and hospitals, said Aiken, who is director of the center for health outcomes and policy research at the University of Pennsylvania's School of Nursing in Philadelphia.

It underscores the need to find ways to increase the numbers of nurses graduating from bachelor degree programs, she said, noting some hospitals studied did not employ a single nurse with a bachelor's or higher degree.

In the study, which is published in the Sept. 24 issue of the Journal of the American Medical Association, Aiken's team examined patient data from 168 Pennsylvania hospitals over a 19-month period beginning in 1998. They found, all other factors being equal, hospitals where 60 percent of the nurses held a bachelor's degree or higher had a 19-percent lower rate of surgical patients dying within 30 days of admission or dying from complications than hospitals where only 20 percent of nurses had higher degrees.

The authors estimate if all the hospitals in the study could meet the 60-percent, bachelor's-degree-or-higher threshold, 725 patient deaths could have been prevented over the study period.

The differences in patient mortality rates "are stunning and should make people very concerned," Geraldine Bednash, a registered nurse and executive director of the American Association of Colleges of Nursing, told UPI. "One of the first questions (patients) ought to ask people in a hospital is what is the proportion of their nurses with bachelor's degrees, and if it's not 60 percent or higher, I'd be very concerned about going into that hospital," Bednash said.

The higher rate of patient deaths associated with lower education level is compounded by the fact that "all of the federal government's projections about the nursing shortage over the past decade have not only projected a shortage of nurses but a severe shortage of baccalaureate degreed nurses," Aiken said. At present, less than half of all hospital staff nurses across the nation hold bachelor's degrees or higher.

"Policymakers seem to think we just need to get nurses out fast," but that is not good for hospitals or patients, Bednash said, suggesting legislators should focus on developing ways to produce more nurses with bachelor degrees because "it makes a difference in people's care and whether or not they live or die."

President George W. Bush signed the Nurse Reinvestment Act into law in 2002 in an effort to remedy the nursing shortage and Congress will likely authorize no more than $163 million for fiscal year 2004. But this falls far short of the $250 million the American Association of Colleges of Nursing estimated would be needed to address the problem.

"To date, we've had mostly a symbolic response from Congress," Aiken said, noting the money the legislative body has appropriated is "not a sufficient amount to close the nursing shortage."

Hospitals also have a role to play in addressing the problem, however, Aiken continued. They should "subsidize continued education to the nurses because there is a return to the hospital in terms of greater productivity and better patient outcomes," she said. But many hospitals do not seem to recognize the value of more education in their nurse because many have discontinued tuition reimbursement programs to help their nurses obtain bachelor's or advanced degrees, she said.

Aiken also noted the study found nursing experience was not associated with lower mortality rates of patients. "It's the educational level that's important and experience alone cannot achieve the same level of benefit for the patient as education plus experience," she said.

Joan Hrubetz, dean of the school of nursing at Saint Louis University, said as medical treatments become even more sophisticated, hospitals "will need nurses with advanced education to be able to deal with the kinds of treatments and diagnostics" that likely would be developed in the era of genetics and molecular-based medicine. "I don't think there's any question we need better trained nurses," Hrubetz told UPI.

Nevertheless, hospitals appear to be reluctant to make any changes based on this single study.

"Hospitals are very interested in studies such as this ... but it really needs to have further studies done because this really only represents one state," Rita Turley, president of the American Organization of Nurse Executives -- a subsidiary of the American Hospital Association -- told UPI.

The good news is although enrollment rates in baccalaureate nursing programs had been down over the past decade, they now appear to be on the rise. In addition, many schools are offering rapid training programs, in which holders of bachelor degrees in other fields can obtain a bachelor's degree in nursing in approximately one year, which may help increase the number of people joining the nursing profession.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by njstudentnurse

That is why I said If and when.....no one knows when the shortage will end. I'm also sure that it won't be a all-BSN entry in the NEAR future, but like I said before, I wouldn't get TOO comfortable believing it is going to be like this forever. Only time will tell, I'm sure we'll find out before I retire in 35 years.

The only way i see the shortage ending is by flooding the market with immigrant nurses. and that is very likely, sadly.

Like I said before, all you holier-than-thou BSN students...who do you think is going to precept you when you graduate?

Surely you won't lower your standards by being precepted by lowly diploma and ADN nurses, will you?

:(

Originally posted by SmilingBluEyes

The only way i see the shortage ending is by flooding the market with immigrant nurses. and that is very likely, sadly.

If they would concentrate on opening more nursing programs and pay the teachers a competitive wage, they wouldn't have to worry about recruiting internationally. Makes no sense to me........

Specializes in Nursing Education.
Originally posted by fab4fan

Like I said before, all you holier-than-thou BSN students...who do you think is going to precept you when you graduate?(

Wow, what happen to our civil conversation? People, we are all nurses here. Please, everyone is entitled to their own opinion, we certainly do not need to degrade each other's educational status. Let's all try to be nice.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by njstudentnurse

If they would concentrate on opening more nursing programs and pay the teachers a competitive wage, they wouldn't have to worry about recruiting internationally. Makes no sense to me........

ah but therein lies the rub. it's cheaper and easier NOT to bother. dont' you KNOW this already??????

this practice is alive and well in most of our USA industries today...from Walmart to nursing. This is not going away, either. Why bother to treat US workers fairly, pay them fairly when you can just suck in cheap labor from overseas??????????

:(

it's infuriating. especially when you are ARE a nurse, working in current conditions the way some of US ALREADY ARE. wait and see......

Originally posted by RNPATL

Wow, what happen to our civil conversation? People, we are all nurses here. Please, everyone is entitled to their own opinion, we certainly do not need to degrade each other's educational status. Let's all try to be nice.

Sorry, but I am sick and tired of being told how my educational choice has dragged down the profession. I've been putting up with this crap for 20y, and I am just fed up.

Funny, no one gets admonished when the BSN's start their usual rant against diploma/ADN grads. Why is that OK?

There are good BSN grads, there are bad BSN grads. There are good diploma/ADN grads, there are bad diploma/ADN grads. To paint one group with a brush of inferiority just makes no sense.

And really, until someone has graduated and is working as a nurse, that person really can't speak with such authority as to "how things should be." Most of this is just parroting what is being said at university.

(And I still think my point is valid...if we are so inferior, then BSN grads should be refusing to be precepted by us. Double standard?)

Specializes in Nursing Education.

Fab4Fan .... I hear you and have to say that as an ADN myself, I received great training. I bet you are a great nurse! Most of the nurses on this board are probably some of the best out there. Hell, any nurse that stays in the field and survives each day gets my vote of confidence I can tell you that. I work my butt off daily and some days I wonder if it is all worth it. ASN, BSN or whatever other degree, the reality of it is, we are in the trenches and we are doing the best we can for our patients. I can not believe that any study would hold a real valitidy when patient ratios are so high. Most days, I just try to make it through my shift and try to do the best I can for my patients. Somedays I do great, other days I don't.

Hello everyone,

Coming from an LVN (LPN) to BSN background, let me give you my perspective. I've precepted for ADN's and BSN when I worked as an LVN. When any new nurse come's on the floor they will need guidance no matter what your degree is. If you have more experience on the floor than someone with a higher degree does then it makes sense that you are going to know how to do more, as far as clinical application. I was shocked when I had to show ALL these RN's how to put foley's in and start IV's. It's not always about not knowing how to do something. It's about being out of school, starting a new career and finding out how things are done in that hospital. I decided to go the BSN route (after 12 years as an LVN) because I wanted more opportunity to go into management. As I went through the BSN program they stressed critical thinking. I kept thinking to myself, you know, I haven't learned a thing more (medically) than I learned in LVN school (this is an exaggeration). I did, however, learn how to think more critically for my patient's and in different situations. I learned to look at the whole picture. In my experience, LVN's have more clinical experience than ADN's, ADN's have more experience clinically than BSN's, and BSN's have the least clinical experience but more knowlegde based education than the others. My point is...within 6 months, the BSN nurse will catch up, clinically, with the LVN and the RN but she still has the advantage of the critical thinking skills taught in the BSN program. This is not to belittle anyone and of course this doesn't apply to everyone. I know several very sharp ADN's. I also know some very sharp LVN's. I know some BSN's that I can't believe graduated. We are all in this together and there are plenty of jobs for everyone. I would hope that everyone would want to better themselves educationally. Not everyone has the time, money or will to go the BSN route. I think it is all up to the person and what they want in life. There are advantages to going the LVN route as well as the ADN and BSN. We should all support each other and not knock each other down.

Originally posted by fab4fan

Like I said before, all you holier-than-thou BSN students...who do you think is going to precept you when you graduate?

Surely you won't lower your standards by being precepted by lowly diploma and ADN students, will you?

:(

Not sure if you were directing this to me or not, but it came right after my post. I'm actually a ADN student, but plan to go for my BSN once I'm working (so hospital can foot the bill). I really don't care if a ADN or BSN precepts me when I graduate as long as they know what they are doing. I have a number of friends who are RNs and when they are on the floor, degrees are not even discussed. No one even asks if someone has a ADN or BSN, it doesn't matter as long as they can do the job. The only point I'm making it that the push to have the BSN as the entry to nursing has been going on for years, it hasn't happened because of the shortage. Although everyone agrees the shortage is here for a long time, we really don't know how long and if and when it does end the possibility that BSN as an entry to nursing requirement may become a reality. I don't have to be a nurse to know this, most of it is common sense.

BSNurse: Just because you were not taught critical thinking in your LPN program does not mean that diploma/ADN's were not.

I get so sick and tired of the "critical thinking" comment. Unless you graduated from my program (or someone else's program), you cannot assume that critical thinking was not part of my education. And while critical thinking is certainly essential, if you can't apply it into practice, then it doesn't do you or the pt a whole lot of good.

it's infuriating. especially when you are ARE a nurse, working in current conditions the way some of US ALREADY ARE. wait and see......

Big time, Deb, big time.

Originally posted by fab4fan

Like I said before, all you holier-than-thou BSN students...who do you think is going to precept you when you graduate?

Surely you won't lower your standards by being precepted by lowly diploma and ADN nurses, will you?

:(

When did a holier than thou BSN student say that ADN and diploma nurses are lowly? I have never heard such a thing.

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