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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.
Interesting article on the history of the ADN program:
Originally posted by AuroraRN..............................................................Advanced degrees focus more on theories, research, and management issues. Although these are helpful topics, I believe the basic training. that I received with my ADN degree program prepared me for what most nurses do, which is TAKE CARE OF PATIENTS. The
on-the-job experience that I have obtained has taught me
more than any class could ever teach me. I will say that higher degrees do allow for more job opportunities and advancements. There is room in this profession for all education levels. I have worked with many LPNs who are much more knowledgeable about patient care than I am because they have been on the job for many, many years(and you can be sure that I let them know how much I appreciate their help). You cannot discount the value of experience.
Well said! My thoughts exactly AuroraRN!
same old biased arguments still prevalent on this topic:)
I for one have seen no advantage of having a BSn in the work place. while i may agree with the study quoted here and believe BSN should be the entry level of nursing for many reasons. I see no need for it in the current enviroment.
working the floor a lot of people are biased against BSN's because of the MYTH that they get less clinical time.
and as far as the pay goes one should be paid more for higher degrees even if it is the same job discription. not to do so offers no encouragement for a nurse to seek advanved degrees which would help us become more noticed and respected as a profession.
so why don't we stop bickering about this and start supporting each other and encouraging our coworkers to seek out advanced degrees.
this is all i will say on this hot subject:)
I really don't know that changing the basic requirement of becoming an RN would change anything..maybe amongst nurses but the general public? I just don't know.. Do you think administration would give everyone a 20K raise if all of us were BSNs or MDs would look at nurses any differently..Like I said, I just don't know.
As for the poster that said something to the effect that you can train a monkey to put in a foley and give injections..I would like to see that! I admire nurses in general and I have worked with good ones and bad ones.. some were ADNs and some were BSNs and yes, I have supervised BSNs in 3 different settings and I am an ADN...much of how far you go is who you are.
I appreciate the fact that you are proud of your degree but I am also proud of mine and worked my a** off to get it. I am also proud of my 13 yrs of exp and my other certifications/ education I have sweated for..do not discount my education and please please do not refer to me as a monkey!! Erin
Originally posted by KMSRNMy care and performance has improved at each level.
(And whoever said that going to school for LPN is harder than RN is highly misinformed.) Flame away if you like but I just don't get the "I don't need no educashun!" attitude of nurses.
My response to this statement is two fold. First, I have been through LPN school and I know from first hand experience that my LPN program was ALOT harder and more clinically indepth than the RN program I attended. I am thankful everyday that I received a top notch education during LPN school because had I graduated from a traditional ADN or BSN program without any experience or background in nursing, I would be out there struggling just like all the new grads today! To say that any level of nursing preparation is not difficult and trying for people is a drastic mis-statement on your part. Shame on you. All levels of preparation to become nurses are difficult in there own right and no one has the right to belittle the accomplishment of another in this diversified profession.
Second, in response to your last statement "I don't need no educashun!" .... I think each individual needs to look at their own professional career and make a decision whether additional formal education will make a difference in their clinical ladder. For some, such as myself, I desire to complete my MSN. For others, there is no reason at this time to go back and get a BSN .... is there going to be a big difference in respect from the physicians? ... NO .... is there going to be a difference in pay? .... NO .... so, for some, it is not necessary. I agree with many people that BSN needs to be the entry level into nursing ..... not because the ADN level provides sub-standard care, but because if we ever hope to have a collaborative relationship with the other members of the health care profession, nursing must be as highly educated as therapists, dietitions, etc .... and if nursing is ever to have a strong collabortive relationship with medicine, then education must be the corner stone of this relationship.
Originally posted by KMSRNIf nurses are ever to be respected as a profession then education is necessary. I believe that BSN's give better care overall. It has been my experience and observation. I have been an LPN, associate's RN, BSN, and am currently working on my MSN. My care and performance has improved at each level. (And whoever said that going to school for LPN is harder than RN is highly misinformed.) Flame away if you like but I just don't get the "I don't need no educashun!" attitude of nurses.
It never ceases to amaze me how many people just don't get it. Ainz - please don't give up, even though most of what you say seems to fly high over the head of most here. You state the case very well.
Delusions of superiority like this are sure to precipitate a fall from grace.
Originally posted by KMSRNIf nurses are ever to be respected as a profession then education is necessary. I believe that BSN's give better care overall. It has been my experience and observation. I have been an LPN, associate's RN, BSN, and am currently working on my MSN. My care and performance has improved at each level. (And whoever said that going to school for LPN is harder than RN is highly misinformed.) Flame away if you like but I just don't get the "I don't need no educashun!" attitude of nurses.
It never ceases to amaze me how many people just don't get it. Ainz - please don't give up, even though most of what you say seems to fly high over the head of most here. You state the case very well.
Thanks, you just gave me another reminder of what i will NOT be once i get my master's.
Originally posted by Erin RNI really don't know that changing the basic requirement of becoming an RN would change anything..maybe amongst nurses but the general public? I just don't know.. Do you think administration would give everyone a 20K raise if all of us were BSNs or MDs would look at nurses any differently..Like I said, I just don't know.
As for the poster that said something to the effect that you can train a monkey to put in a foley and give injections..I would like to see that! I admire nurses in general and I have worked with good ones and bad ones.. some were ADNs and some were BSNs and yes, I have supervised BSNs in 3 different settings and I am an ADN...much of how far you go is who you are.
I appreciate the fact that you are proud of your degree but I am also proud of mine and worked my a** off to get it. I am also proud of my 13 yrs of exp and my other certifications/ education I have sweated for..do not discount my education and please please do not refer to me as a monkey!!
Erin
wel erin let me say: You as well as everyone SHOULD BE PROUD OF THEIR EDUCATION WHAT EVER LEVEL IT IS. I just believe we should encourage each other to further our education and not belittle people for it. which I see all to often.
I wish i could find that study of the effect of making the BSN the entry level. it was very enlightening and interesting:)
as far as being able to train a monkey to do foleys and basic nursing care. I agree that if that wass possible the hospitals would have already done it. I find such insulting and inflamatory:)
Originally posted by KMSRN :
My care and performance has improved at each level.
(And whoever said that going to school for LPN is harder than RN is highly misinformed.) Flame away if you like but I just don't get the "I don't need no educashun!" attitude of nurses. [end quote]
Maybe their experience was different from yours. They were sharing their own experience. I was not flaming those with higher degrees. Nor did I say that we don't need education.
I was merely sharing the experience of some who were LPNs and went on the ADN, and found the second year of the ADN program easier than their LPN school (that is not the same as saying that they didn't learn anything more). How can you be more informed than they about their own experience?
I'm glad for you that you continued your education, and I hope to have the chance to do the same.
:)
Tweety, BSN, RN
36,337 Posts
The work and the duties required are the same for the ADN and BSN. If BSN's expect more money, then the job descriptions need to be changed somehow. Both come out of school performing the same jobs, so it's natural they should be paid the same in my opinion.
I would think of the BSN as more of a degree that has more future-oriented rewards. Fresh out of school it's hard to see that, because most RNs head for the bedside for the experience first.
I definately agree though that seeing that the pay is the same, I can understand why one would say "why bother". As an ADN making $30.00 an hour, at the age of 45, I'm kind of the same way. "Why bother". But unfortunately at the age of 70 I'll still be doing the same thing. If got off my butt and got my BSN, I'd have more options for the future. I woundn't necessarily be safer at the bedside though.