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.
ERKev
34 Posts
Sorry, I have to jump in here. Sorry if this has been touched upon already. This particular post REALLY raised the hair on the back of my neck...
I have an ADN. I have been nursing for 15 years. I am an Emergency Nurse (and a damn good one, I might add). I have worked with ADN nurses, BSN nurses, MSN nurses, MDs, DOs, NPs, PAs, etc... Some scare me to death! Regardless of their educational levels!
Bottom line is this: NURSE! Do you know what you're doing??? Are you in over your head? Deal with it responsibly! Get out if you can't handle it. Press forward if you can!
Nursing tends to make things seem more complicated than it has to be in order to justify their desire for professional recognition. Nursing Care Plans... WHAT A JOKE!!!! I haven't done one since school. My patients LIVE!!! I don't have (nor WANT) a BSN. I'll stand up against any other ADN, BSN, MSN in my dept!!!
This is all a bunch of bull, as far as I'm concerned. We don't need the devision within our ranks! This report is, after all, by JAMA!!! Do you see this??? JAMA... They have an inate hatred for RNs to begin with! They have, over the years, attempted to replace us with high school grads under the tutiledge of MDs over and over as their "fix" for our shortage. And Holier-than-thou persons within our ranks back them up with this bickering.
I (WE!!!) don't NEED to justify ourselves to the physician communty (the authors of this rediculous waste of paper). We do not need to convolute our own practice to look important!!! WE ARE IMPORTANT!!! We don't need to make extra work for ourselves to perform already difficult tasks!!!
If I'd had the money and time, I may well have gotten a BSN. I didn't! But, don't tell me that I (we) am not a good nurse! Don't tell me I (we) am less than a BSN (or MSN!). I've worked with both over the years and I'm here to tell you that those degrees mean NOTHING when it gets down to the bottom line: saving lives....
Maybe my 15 years means nothing to you, but my patients appreciate it. The physicians I work with appreciate it. The PAs I work with appreciate it. The only ones I have trouble with are Residents/Interns, NPs and other advanced practice nurses (who seem to look down thier noses at the lowly "little people").
Smoke THAT....
Sorry for the steam, but you folks REALLY ruffled my feathers tonight!!!
ERKev
ADN and PROUD OF IT!!!!
P.S. I would suggest you and others of your ilk read between the lines. Maybe you won't destroy your own profession!!! Oh! And READ my taglines....