Do you feel more people are entering nursing only to become APRN's?

llg, PhD, RN · Sep 15, 2017

BSN level knowledge needed to take care of complex patients at a tertiary care center?? May I ask what you perceive are the components in BSN nurses education that make nurses with a BSN better qualified to take care of complex patients than ADN/Diploma nurses? I ask genuinely, as a nurse with an ADN and a BSN. You do know that nurses with an ADN/Diploma take care of complex patients? Tertiary care isn't rocket science.

I'm not going to continue this aspect of the discussion beyond this post as I don't want to hijack this thread into yet another ADN/BSN debate. But when another poster suggested that hiring ADN's would solve the turnover problem because ADN's are less likely to want to leave the bedside (his/her idea, not mine) ... I brought up the fact that my hospital prefers BSN's at the bedside. We expect our staff to have the following knowledge and skills that are more common in BSN programs than in most ADN programs.

1. Understanding research, exploring the literature, evaluating research for practice readiness, etc.

2. Experience with evidence-based practice -- able to be a useful member of an EBP committee

3. Community health basics -- to include a consideration of community health when thinking about inpatient health for patient and familty

4. Intro to leadership, management, etc. -- prepared to step into front-line management roles after gaining some experience

5. Familiar with basic teaching/learning principles -- prepared to move into front line staff and patient education roles after getting a little experience

Of course, there are exceptions to the rule ... but most BSN programs include more depth on the above topics than do most ADN programs.

Switching to a predominantly ADN staff will not help us move forward in our nursing practice. We need to attract and retain the BSN's at the bedside.

Julius Seizure · Sep 15, 2017

That sounds very unfair. (and regarding calling parents... there I truly feel sorry for you.)
BTW, it is also not likely to lead to much results. I can only speak from the point of "too smart" person, but what would hold someone like me in place would be chances to develop as a clinician, not working schedule my way. Free subscription for AANC classes for the first year, for example. "Perks" like you describe have little to no attraction for really smart people who know for sure what high-rank nursing grad school entails.
Did anyone of your administration actually try to speak with or poll recent new grads or students in local schools to know what their expectations, beliefs and preferences and make correlations by their experiences and educational achievements? If no, that could be a nice capstone project for some in Ed/Leadership program and results can be used by your facility.

I know from my experience, one of the things that was very disappointing to me as a beginner nurse (say, 1-4 years of practice) was that I didn't see opportunities to make a difference at my workplace beyond my patient assignment for 12 hours. I wanted to get involved, join committees, help with quality improvement projects for the unit, etc. There was nothing like that available for me to sink my teeth into. Some might say it was because a beginner nurse shouldn't have those opportunities yet, I guess, but it was disappointing to me and was one of the things that led me to apply to a different hospital system eventually.

Julius Seizure · Sep 15, 2017

But "progressing nursing as a profession" has nothing to do with the quality of nursing care a nurse delivers, and "knowing how to play with others in the sandbox" - are you actually suggesting that BSN trained nurses have superior communication abilities to ADN/Diploma nurses?

I took this to mean that the "sandbox" of healthcare professions is quickly starting to be filled with careers that have a bachelors degree as the minimum standard of entry. Therefore, if nursing wants a seat at the table, we may need to play by those rules.

RNperdiem, RN · Sep 15, 2017

I believe nursing is a gentrifying profession. It is embracing advanced degrees and distancing itself from its female, working class origins. Barriers for entry get raised higher and higher.

It remains to be seen where this leads.

Dodongo, APRN, NP · Sep 15, 2017

I am not a nurse yet, but I'm an EMT, have worked in and around the hospital, and I am currently finishing my last two prerequisite courses before applying for ABSN programs. It seems like 90% of my current classmates in nursing prerequisite courses, along with other prospective nurses I've worked with, are entering the nursing profession with the goal of become a Nurse Practitioner or CRNA.
Do you, especially those already working as nurses, feel a lot of new graduate nurses are entering nursing for the sole purpose of becoming an APRN? I feel like since APRN's are gaining more popularity, people are entering the nursing field to become an APRN and not a "nurse", in lieu of becoming an MD/DO or PA. I'm not saying more education is bad, but it seems like people want to be an NP, not a nurse, if that makes sense. Which leads me to believe (and I know it's been discussed before) a huge over saturation of APRN's is in the near future.
Thoughts? Again, I'm not a nurse yet, so I could be completely off base.

Not everyone who enters nursing is able to matriculate into, and graduate from, an APRN program. These "barriers" serve as a rate limiting step in this process. Now, of course there is the problem with 100% online, no requirement NP programs letting anyone with the ability to take out a loan enter the profession. However, for the most part, the vast majority of those who enter nursing are *not* becoming advanced practice nurses, and are therefore, remaining bedside nurses - see the statistics provided in earlier posts. If the profession ever does reach this critical max, market forces will swing us in the opposite direction soon enough.

Plus, simply being on this forum reinforces an inherent idea called the availability cascade. You read constantly on this forum that there will be an over saturation, and over time, the more your read that, the more plausible it becomes, and the more people start to believe it. That does not mean it's true. NPs need to do a better job of policing who is able to become an NP by eliminating a handful of bottom tier programs, but overall, there are way more people applying than are granted entry, and there are more jobs than there are graduates.

operations · Sep 15, 2017

Believe me, it has nothing to do with treating new grads better. These folks are boasting that they're applying to an NP program or only looking for ICU experience to get into anesthesia school before they've spent even a single day on the unit.

Actually I just noticed this. I worked on CCU and everyone there had plans of going somewhere else. It is fine and all, but I remember one new grad that was terrible with foleys at first and always needed (me, the tech) to help or take over. Within months she is being accepted to CNA school. I had no clue they could get in that quickly... But she did, and suddenly she was the holy queen God, correcting everyone as if she was so exceptional and talented... You can manage to handle putting a tube in a bladder how you gonna manage putting one in lungs?

Rekt · Sep 16, 2017

Actually I just noticed this. I worked on CCU and everyone there had plans of going somewhere else. It is fine and all, but I remember one new grad that was terrible with foleys at first and always needed (me, the tech) to help or take over. Within months she is being accepted to CNA school. I had no clue they could get in that quickly... But she did, and suddenly she was the holy queen God, correcting everyone as if she was so exceptional and talented... You can manage to handle putting a tube in a bladder how you gonna manage putting one in lungs?

CNA school is actually really easy to get into. I am surprised she worked as a RN then CNA, very interesting career choice.

operations · Sep 16, 2017

BSN level knowledge needed to take care of complex patients at a tertiary care center?? May I ask what you perceive are the components in BSN nurses education that make nurses with a BSN better qualified to take care of complex patients than ADN/Diploma nurses? I ask genuinely, as a nurse with an ADN and a BSN. You do know that nurses with an ADN/Diploma take care of complex patients? Tertiary care isn't rocket science.

You learn ethics etc. Technically, your ticket into nursing is Nclex stamp of approval. I truly believe BSN does not make you that much better of a nurse, but it does make you more rounded professional/leader. Most hospitals don't care about BSN as much as you would think. They may request you earn the bachelors within a couple years

operations · Sep 16, 2017

CNA school is actually really easy to get into. I am surprised she worked as a RN then CNA, very interesting career choice.

Actually it should have been CRNA school. I could not edit the post in time. Sorry lol

BiscuitStripes, BSN, RN · Sep 16, 2017

CNA school is actually really easy to get into. I am surprised she worked as a RN then CNA, very interesting career choice.

Lol...

elkpark · Sep 16, 2017

Let's see...enter a BSN program...pay 25-35k for said program...work another 10 years after that. I'd rather not since it doesn't pencil out well.

Gee, I wouldn't do that, either. But there are many options for BSN completion that don't cost nearly that much. I don't recall how much I paid when I went through the BSN completion program at the nearest state university to me (many years ago), but I do recall that I was able to pay for it out of pocket easily, comfortably, as I went (while continuing to work full-time). I just Googled the school to see what the program costs these days, and the university nursing program website states that the average total cost for the BSN completion program (for in-state tuition), including textbooks, is $5,700. I'm sure there are additional costs that come up over the duration of the program, but not enough to get anywhere close to $25k. $6k "penciled out" over ten years doesn't look bad to me.

operations · Sep 16, 2017

Lol...

Really? That's actually pretty pathetic. If you read the post you wouldn't need to be told I was talking about CRNA. Like I literally described the role. How juvinille.