Change in BSN requirements

BSNtobe2009 · Oct 27, 2006

It can work someday, but not by strong arm tactics.
And not by quotes such as ADNs 'dumb down' nursing. An astounding lack of nursing history goes into that statement.
Indeed, ADN programs provided the link that BSN programs could not meet in the '50's and 60's to move nursing to college level prep. The goal of nursing to remove nursing education from doctors and hospitals and to put it into the hands of nursing with science based backgrounds was finally met: by the ADN program.
ADN programs represented the CREATION of college level prep for bedside nurses. Until that point, the fledgling BSN programs were so small that they were only creating educators and not bedside nurses. The ADN programs were so successful, that diploma programs either folded, or adapted as a result.
The result: today's bedside nurse is a science based, college prepped expert. Far from 'dumbing down' nursing, ADN programs advanced nursing to meet the new advanced times.
And so long as the debate about minimum entry revolves around comments like 'dumbing down', there will never be a consensus to move it forward. BSN entry can work. But, this is why it won't: comments like this just keep the debate fundamentally polarized.
~faith,
Timothy.

During the 50's and 60's, BSN's were extremely rare and taught at precious few colleges.

ASN's were not created because the BSN program "didn't take off". I would encourage you to check your history on that one. ASN's were created when hospitals slowly stopped offering diploma nursing programs that were offered directly through the hospital.

Since you copied my post, please interpret it accurately. I never said anything about "dumbing down" NURSING, as you conveniently and inaccurately added in.

Your ARGUMENT was that there was NEVER (ever!) going to be a requirement of a BSN because of the SHEER NUMBERS of nurses needed for the HEALTHCARE profession.

I said, "Sheer numbers of A PROFESSION (not specificaly nursing, ANY PROFESSION IN WHERE LARGE NUMBER OF EMPLOYEES ARE NEEDED) is never a reason to "dumb down" the requirements in order to INCREASE NUMBERS".

Then I WENT ON to LIST SEVERAL PROFESSIONS, where large numbers of employees are needed, BUT THE EDUCATIONAL REQUIREMENTS HAVE BEEN STEADILY INCREASED OVER THE YEARS, despite marked shortages.

RN34TX · Oct 28, 2006

It can work someday, but not by strong arm tactics.

I agree, so let me clarify my comment:

If it worked by way of the methods used by ND and some of those currently being proposed, they'd still be doing it.

I agree that it can work but one of the first things we need to, IMHO, is to stop making very poor comparisions of nursing to other professions such as teachers or pharmacists.

What one profession is doing does not justify what we should be doing.

We should be looking within, not "following the leader" and copycat what another profession is doing that has nothing to do with nursing.

np_wannabe · Oct 28, 2006

Up until last year ND only offered BSN programs and you had to have a BSN or prove that you were working towards a BSN if you were an ADN that moved here. Our great NDNA and legislature thought that they would "help" solve the nursing shortage if they allowed ADN programs. I personally think it was a step backwards for our state that was the only one to require a BSN. Nursing is a profession-not a technical career. While other health care professions such as PT and OT are moving towards a mandatory masters degree nursing takes a step back.

It looks like I am among the few that have to agree with Ali G. The reason is this: although ADN and BSN training are very comparable, I think there is something to be said for demanding more--raising the bar--of the profession as a whole. I think of it this way: I can be a "C" student and still receive a High School Diploma, or I can demand more of myself. Why not???

txspadequeenRN, BSN, RN · Oct 28, 2006

This is so very true. We go back and forth here in my area.. I never know when I can work again at certain hospitals...

LPN's being employed/utilized in hospital settings has always been a cyclic thing. Once you have been in nursing long enough, then you will have seen the trend for yourself come and go. It's not a new concept that has never been tried before.
The shift toward more education/experience is dictated by the job market and applicant pool, not solely because of increased technology. My first LPN job originally intended to hire only BSN grads, but there simply weren't enough RN's period, so LPN's were employed.
If a hospital believes that they are in a position to be choosey enough to only hire RN or BSN grads, then they may attempt to do so. But when the RN applicant pool runs dry or they start getting too expensive, the LPN's come back into acute care once again. It's a cycle.

ZASHAGALKA, RN · Oct 28, 2006

During the 50's and 60's, BSN's were extremely rare and taught at precious few colleges.
ASN's were not created because the BSN program "didn't take off". I would encourage you to check your history on that one. ASN's were created when hospitals slowly stopped offering diploma nursing programs that were offered directly through the hospital.
Since you copied my post, please interpret it accurately. I never said anything about "dumbing down" NURSING, as you conveniently and inaccurately added in.
Your ARGUMENT was that there was NEVER (ever!) going to be a requirement of a BSN because of the SHEER NUMBERS of nurses needed for the HEALTHCARE profession.
I said, "Sheer numbers of A PROFESSION (not specificaly nursing, ANY PROFESSION IN WHERE LARGE NUMBER OF EMPLOYEES ARE NEEDED) is never a reason to "dumb down" the requirements in order to INCREASE NUMBERS".
Then I WENT ON to LIST SEVERAL PROFESSIONS, where large numbers of employees are needed, BUT THE EDUCATIONAL REQUIREMENTS HAVE BEEN STEADILY INCREASED OVER THE YEARS, despite marked shortages.

For at least 20 yrs before the advent of ADN programs, leaders such as Dr. Brown advocated a jump to college level prep. The BSN programs didn't 'take off' on this model because it was very difficult to encourage workers to get a bach degree for what at the time amounted to a minimum wage job. It's not that there was anything 'wrong' with being a BSN, but that there wasn't enough interest in the programs because it was widely considered overkill. The result is that these programs only appealed to educators, and not bedside nurses.

There needed to be an intermediate to move to college level prep.

You are wrong to say that ADN programs took off because the hospitals stopped offering diploma programs. Hospitals began to have huge problems recruiting for their programs. Post WWII women either turned to nuclear families, or had learned because of the war that their options weren't limited. And diploma programs were basically 'chaperone' programs for adult women until marriage. Why commit to 3 yrs of not seeking a husband for a job that I really don't need when I can work anywhere? It's not that the hospitals stopped offering diploma programs (they worked GREAT for hospitals and hospitals resented the move away from their cheap labor pool). No, it's that those programs weren't able to sufficiently recruit in changing times.

And so the ADN program 'took off' because it was a great compromise between two extremes. It rode the post WWII GI bill wave of community colleges and it seated nursing education in a more favorable environment, where science became more important than anecdotal legacies.

Hospitals saw the advantages, in both superior education (not knocking today's diploma programs, they have adapted to the same superior level), and in the ability to recruit nurses. THAT is why diploma programs failed - because the ADN was a better alternative.

And the reason WHY BSN programs 'took off' in the wake of ADN programs is because the college model was validated. At the same time that ADN programs grew from 0 to 60% of programs, BSN programs grew from 5% to 35% of programs. The ADN program might have been a model that supplanted diploma programs, but it was also a model that validated BSN programs.

It's just not true to say that ADN programs 'dumb down' or 'hold back' nursing. ADN programs were the critical link to move nursing education to the college arena. BSN programs could not have done that alone because the jump from untrained apprenticeship to bacclaureate degree was too large for the stakes being offered. ADN programs provided the bridge between the two. They 'took off' because they work, and they work well. As a direct result, the stakes have equalized to the prep required and there is a real incentive for a student to go to a BSN program to be a bedside nurse.

I think we should examine how to move forward. But the key to doing that is two-fold: 1. We don't ignore the legacies that brought us to this point, and 2. we involve all stake-holders. There is a rational argument for BSN entry moving EVERYBODY along. Putting down the ADN programs that got us this far isn't it.

And, I never said that because there is a greater relative need for nurses, that 'dumbing down' the requirements was justified. I said that that drives the debate much more than a concept of 'shortage'. I disagreed that a 'shortage' holds back this issue; rather, for our employers, the relative greater need for nurses generally holds back this concept, shortage or not. And THAT is why our employers will never agree to BSN and will always outlobby for those requirements to be tabled or modified.

If your goal is to strong-arm BSN entry requirements by making them law, you are outgunned and not by ADN students but by employers with better lobbyists that don't want to give away the very pay and respect you think such a requirement would bring.

You are mistaken if you think that 'magnet' programs will offer this bridge to BSN-entry. Their goal is not improving nursing as a model, but improving the retaining of nurses. They may advocate for BSN entry, but they do all still hire ADNs with experience and most important, they still do not provide a real differential in salary that would move the standard to BSN. The goal isn't to create a new an improved BSN nurse: the goal is to offer non-monetary incentives for nurses to move to BSN at ADN prices. Think hard about that before you invest your hope in these programs for BSN. They might want BSN, but they want it WITHOUT the pay and respect that would come along with it. For employers, this is the magic pill: how to get a better trained nurse without having to pay for it in precisely the terms that you adocate such a move should create. For nursing's entire history, being 'called' was used as a rationale to pay nursing less. For magnet programs, they have simply substituted a measure of repect for BSN and some minor improvements that should have been standard fare in any case as a rationale to pay you less.

I think we CAN move to a BSN entry model. But it will take a consensus of all of us. And THAT is why I think that denigrating ADNs hold back this debate. So long as it is fundamentally polarized, it goes nowhere. 40 yrs of history should adequately prove that.

Where we go from here is either to continue to go nowhere, or to respect each other in whatever transition we all decide is best.

~faith,

Timothy.

Pompom · Oct 28, 2006

I have had my ADN for 11 years and in 5 months I will have my BSN. The "BS" part of the degree is obvious, having my BSN does not make my nursing practice any better, in fact there was almost no clinical, (12 shadow hours). My BSN program is all about writing papers in APA format, doing research for more papers, and power point presentations. Without ADN nurses I would fear for the patients.

RN34TX · Oct 29, 2006

I have had my ADN for 11 years and in 5 months I will have my BSN. The "BS" part of the degree is obvious, having my BSN does not make my nursing practice any better, in fact there was almost no clinical, (12 shadow hours). My BSN program is all about writing papers in APA format, doing research for more papers, and power point presentations. Without ADN nurses I would fear for the patients.

But keep in mind that a generic straight through BSN program is not all about writing papers, research, and APA format.

Believe me, I hear what you are saying, my program seems the same way.

But our programs are designed for RN's needing the additional coursework not covered in our ADN programs. The generic BSN students are going through those same clinicals and theory in ADN programs in addition to the coursework you mentioned.

If generic BSN and RN to BSN programs were identical, then I too, would fear for the patients. But they are very different because the two programs serve different needs.

suznan · Nov 8, 2006

Up until last year ND only offered BSN programs and you had to have a BSN or prove that you were working towards a BSN if you were an ADN that moved here. Our great NDNA and legislature thought that they would "help" solve the nursing shortage if they allowed ADN programs. I personally think it was a step backwards for our state that was the only one to require a BSN. Nursing is a profession-not a technical career. While other health care professions such as PT and OT are moving towards a mandatory masters degree nursing takes a step back.

I have to say that as a student of an ADN program here in North Dakota I am offended by this. I have worked very hard in this program and feel that I have had a great education. Not only that but the class that just graduated a year ahead of me has had a 100% pass rate on the boards. My LPN class has also had a 100% pass rate and we were a class of 1 year LPN's.

Susan

truckerlover · Nov 29, 2006

But keep in mind that a generic straight through BSN program is not all about writing papers, research, and APA format.
Believe me, I hear what you are saying, my program seems the same way.
But our programs are designed for RN's needing the additional coursework not covered in our ADN programs. The generic BSN students are going through those same clinicals and theory in ADN programs in addition to the coursework you mentioned.
If generic BSN and RN to BSN programs were identical, then I too, would fear for the patients. But they are very different because the two programs serve different needs.

We must also remember that although we, as ADN to BSN, do not have the same exact type of clinicals, the ADN's have had the on the job experiences that the BSN's can only dream about (or have nightmares lol). I, too, am working towards my BSN and am working on the paperwork portions. This is the part I hate most about this as well. But it is a necessary evil to obtain a dream.

Gromit · Dec 14, 2006

Well, as soon as I can get caught up on debts etc. (in other words be financially stable again, I fully intend to get my BSN. But it should also be known -and I make myself very clear when I say that I'm very proud to be an RN -ADN. In no way do I feel "inferior" or less prepared to care for my patients, when compared to any BSNs. My desire for BSN has NOTHING to do with my abilities to care for the patients on my critical care floor. But it has EVERYTHING to do with being able to be upwardly mobile in the future.

When someone insinuates that we need to be BSN to be viewed as 'professionals', I'm insulted by that. NO doctor is going to look up and suddenly notice that you are now a "professional" because you have a bachelors degree. In fact, by and large, they aren't really going to care. They WILL care that you can use your common sense and not wake them up or call them repeatedly for no reasons at all. I don't need extra letters behind my name to make me a 'professional'. I AM a professional. I'm an RN. I'm damn proud of it. I've held a lot of different titles over the years, and this one is the one that has meant the most to me. With it, I have touched far more lives than any other line of work I've been involved in.

Honestly, after reading some of these threads, I think some folks have forgotten just what it means to actually BE a part of this profession. The good and the bad. Its still a profession that no outsider could possibly comprehend or even begin to understand what we really DO and go through to get there.

Too many are so full of themselves bickering about titles and what they want the outside world to see, its no wonder why the common consensus is that nurses eat their own.

anonymurse · Jan 28, 2007

I think we CAN move to a BSN entry model.

I learned lots from your post, thanks! One Q, how are we going to move to a BSN entry model when the same state that runs the BoN runs the community college system that so economically makes RNs for that state, and more importantly, is so convenient for working moms, seeing the campuses are spread all over the state? Or more broadly, what do you see as a blueprint for getting there from here?

nd4sprn · Aug 29, 2010

Hi everyone,

In response to changing requirements for RN Licensure to include obtaining a BSN is sort of unrealistic at the moment. I also don't agree with the statement that someone made in regard to ADN nurses being like "Tech school grads." Because I don't really feel that the care delivered at the bedside is really that much different, and you probably could not "tell" who was an ADN, BSN, or MSN. I've been a nurse since 1995, graduated with an ADN. Now I am almost finished with a RN to BSN program, and one thing I can say is that I've noticed a difference in myself since this endevour. The major thing that I noticed, since my third class, is the way I think now. The one think that really isn't covered in an ADN program is theory and philosophy of nursing practice. I do feel more educated, more well rounded, and feel differently towards nursing than I did prior to taking classes. Am I a better nurse..I don't know. But my understanding in regard to nursing ethics and practice acts is expanded, which I believe makes the whole person. I do plan on going on to be Master's prepared so I can teach nursing one day. I wouldn't say you have to have a BSN to practice nursing, but I would recommend eventually doing the online program somewhere, I'm glad that I am. In one way I do agree with the educational level, as nurses we are dealing with mid-levels and docs that have 6 to 8 years of college, so that is also worth considering.