Hi. I just graduate with my ADN as a second career. Before that, I was full time mom and before that I was an attorney (yeah, weird, I know). So, I'm hearing here and there that if I want even a chance at a hospital residency position (I want to be in the ICU one day), I need a BSN. But I keep thinking, "really? I already have a B.A. and a J.D.!" My original plan was to work, gain experience, and then go for a masters in a clinical specialty. But now, I'm now sure. I just can't believe that all my other experience and education doesn't count, especially when the BSN program really doesn't have any clinical component -- it's just more research and writing. I'm working in a really well run SNF, so I'm not really unhappy, but my dream has been to be in the ICU. I'll do what it takes but I'd like to know what other people have heard before I jump back into school. Thanks!
It's not the same comparison. Now, if nursing did use a similiar system for residency--like medicine, for say NP's, in terms of clinical hours, etc, that would be a start.
I think we are arguing the same point from different sides. You say clinical experience makes whole the didactic and I say the didactic makes whole the clinic experience. It takes two pieces.
If I had your critical care experience I would no doubt be a better NP. I would think similarly if you had (I am assuming education here so please forgive me if I am off-base) my additional pathophys, management, and pharm knowledge you would be a better CC nurse. I am unsure how many RNs would admit that.
That being said I have always been a proponent for NP residency programs and even more importantly I owe much of my success to the fact I not only listen to but seek advice from the RNs.
*** For who? To potential patients? For luring RNs to work there? My observation is that patientsd have no idea what Magnet is and don't care. As for nurses, many many I know see Magnet as a con when considering working at a particular hospital. I am happy I managed to obtain a position as a good non-Magnet hospital and am even happier to no longer be subjected to the Magnet recert process. Being told EXACTLY how to respond to surveyors questions with vauge threats if we fail to tow the party line during the re-cert process gets old. Waching the hospital jump to implament such things as an RN practice counsil or "shared governance" only to see them done away with immediatly after obtaining Magnet is demoralizing.
Once again, I do not disagree with you. But they believe it to be so, and it's been the craze for the last 7 years or so. I too have my issues with it.
And yes,
Waching the hospital jump to implament such things as an RN practice counsil or "shared governance" only to see them done away with immediatly after obtaining Magnet is demoralizing.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
This is a great example of the need for quality nursing educators.
*** When I graduated from nursing school I entered a 9 month nurse residency program for new grads going directly in the SICU. It was tough! I stayed awake nights studying, nurses failed and were dropped, the stress was significant. We had bi-weekly exams that were very challenging, not to mention hands on skills tests usually every day. Our instructors were actual working bedside ICU or ER RNs, PAs and attending physicians. Our A&P exams and pathophysiology exams where way harder than those in nursing school. We each rotated through each position of the code and trauma response teams. By the time we graduated each of us had preformed each roll in a code, including code leader, several times in real codes or trauma responses. We had mock cardiac tamponade, respiratory distress, unplanned extubation, elivated ICP and all kinds of other drills daily. All this was mixed in with clinical experience were we were assinged the most challenging patients along with our preceptors. I was throughly challenged and learned a TON but graduated feeling very confident and well supported by my clinical mentor. I am now an instructor and preceptor in that same program.
Somehow when I entered the RN to BSN program I expected to find the same level of competence and dedication in the instructors I had experienced in the residency. Maybe my expectations were too high.
*** When I graduated from nursing school I entered a 9 month nurse residency program for new grads going directly in the SICU. It was tough! I stayed awake nights studying, nurses failed and were dropped, the stress was significant. We had bi-weekly exams that were very challenging, not to mention hands on skills tests usually every day. Our instructors were actual working bedside ICU or ER RNs, PAs and attending physicians. Our A&P exams and pathophysiology exams where way harder than those in nursing school. We each rotated through each position of the code and trauma response teams. By the time we graduated each of us had preformed each roll in a code, including code leader, several times in real codes or trauma responses. We had mock cardiac tamponade, respiratory distress, unplanned extubation, elivated ICP and all kinds of other drills daily. All this was mixed in with clinical experience were we were assinged the most challenging patients along with our preceptors. I was throughly challenged and learned a TON but graduated feeling very confident and well supported by my clinical mentor. I am now an instructor and preceptor in that same program.
Somehow when I entered the RN to BSN program I expected to find the same level of competence and dedication in the instructors I had experienced in the residency. Maybe my expectations were too high.
Sadly, on a national perspective, I suspect they were. Doesn't it show you how much you could teach these new students? It sound like you do via precepting but maybe a transition to professor would have a big impact on the future of the profession?
I feel fortunate that attended a program that integrated us with medical students from grad year one, provided ATLS training, and a painstaking amount of simulation time. I am
sad to say that I hear this year the simulation budget was cut.
I think we are arguing the same point from different sides. You say clinical experience makes whole the didactic and I say the didactic makes whole the clinic experience. It takes two pieces.
If I had your critical care experience I would no doubt be a better NP. I would think similarly if you had (I am assuming education here so please forgive me if I am off-base) my additional pathophys, management, and pharm knowledge you would be a better CC nurse. I am unsure how many RNs would admit that.
That being said I have always been a proponent for NP residency programs and even more importantly I owe much of my success to the fact I not only listen to but seek advice from the RNs.
But here's a tangential point related to what I mentioned earlier. When I took pathophysiology, it was with a load of other classes, and I was working full-time with many off shifts. Sure, I got an A in the course. Still, I get the most from such courses by going back to re-learn and learn more AS I HAVE pts with particular pathophysiological disturbances. I have done that from the very beginning of nursing. That's what I meant by striving to be a truly educated person. Everyone knows there is a curve of forgetting; but that curve is less when the clinician puts together the actual person with the clinical disturbance with the didactic. That's truly when we solidify the didacts--otherwise, it stays hazy and more abstract. This is precisely how I know that a person with strong clinical experience, although they may have been away from a particular clinical area for a while, will be able to jump back on the bicycle. Now, compare that with new grads, who have not even started with training wheels yet.
And what do institutions do? They take inexperienced new BSN grads, who have to start with just about zero clinical insight and judgment over nurses that left for a time to care for families. I want to laugh when I hear some of these people. Yes, after all the hard work and experience a nurse has put into her role, why she/he must have developed dementia and the slate is wiped clean--why they just about forgot everything. Not true. You don't lose a lot if it was built on a strong foundation. I have worked with nurses that built their know-how, insight, and skills on a very strong foundation, only to see HR and/or NMs treat them as if their brain utterly deteriorated for taking time off to do other things. It's ridiculous. Many of these nurses have forgotten more than a lot of others will ever know. Yet they get zip upon application for nursing employment--even after taking refresher courses, volunteering, whatever.
When I see things like that, I know that money and politics are the underlying forces at play.
Yes, more education is a good thing, so long as it is coupled with solidifying experiences, and so long as the person takes on the mentality that true education is ongoing and evolving.
We can debate this issue forever. In the end, market forces and hiring practices will dictate requirements. In Canada, we've already been through this. All recent grads as of 2009, 2005 in my home Province, are required to have a BSN as entry to practise. We have no 2 year diploma RN programs anymore. Nurses who were educated with the 2 year program were grandfathered in. However, many of those nurses must return to school to obtain their BSN should they wish to advance to certain clinical positions. Is this fair? Maybe not, but it IS. End of discussion up here. And the US seems to be heading in the same direction. Am I a better nurse because I have a BSN? Definitely not. However, that is now the requirement.
We can debate this issue forever. In the end, market forces and hiring practices will dictate requirements. In Canada, we've already been through this. All recent grads as of 2009, 2005 in my home Province, are required to have a BSN as entry to practise. We have no 2 year diploma RN programs anymore. Nurses who were educated with the 2 year program were grandfathered in. However, many of those nurses must return to school to obtain their BSN should they wish to advance to certain clinical positions. Is this fair? Maybe not, but it IS. End of discussion up here. And the US seems to be heading in the same direction. Am I a better nurse because I have a BSN? Definitely not. However, that is now the requirement.
Yup. It is what it is.
Market forces and trends in hiring practices are what dictates...like it or not.
It's just amazing that in trying to unify, the current approach is only adding to disunity. It is the how that is disturbing.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
All recent grads as of 2009, 2005 in my home Province, are required to have a BSN as entry to practise. We have no 2 year diploma RN programs anymore. Nurses who were educated with the 2 year program were grandfathered in.
*** Just curious. How many credit hours must be taked to earn a BSN in Canada? Is the the same as here, 120 or more?
Our BSN is 4 years, 2 semesters each year. I'm not exactly certain how many credit hours, but I do know that all BSN students are required to complete 1500 clinical hours. No exceptions. If you miss clinical, you make up the hours or fail the year. We also have no online BSN programs in Canada. Students must attend class, which I think is a positive.
Well I know *I* would rather have a floor full of brand new grad 23 year old BSN nurses taking care of me over 15 year veteran ASN's and LPN's...how bout you?
Classic straw-man...
I would rather have -- on average -- 15-year veteran RNs who had baccalaureate and postbaccalaureate education.
The reality is that many employers, mine included, place value on higher levels of education. Either give them what they want or be excluded... no different than any other profession (the vast majority of which require, formally or informally, baccalaureate degrees).
It kind of cracks me up to hear people argue so strongly AGAINST education.
I had a nursing instructor point out to me that nursing is the only field in which higher levels of education are deemed inferior.
Agreed. Education for the sake of learning is always a positive. At the end of the day, it doesn't matter. The decisions are made whether we agree or not. Those people who choose not to get their BSN will have fewer options down the line. The writing is on the wall.
BostonFNP, APRN
2 Articles; 5,584 Posts
I think we are arguing the same point from different sides. You say clinical experience makes whole the didactic and I say the didactic makes whole the clinic experience. It takes two pieces.
If I had your critical care experience I would no doubt be a better NP. I would think similarly if you had (I am assuming education here so please forgive me if I am off-base) my additional pathophys, management, and pharm knowledge you would be a better CC nurse. I am unsure how many RNs would admit that.
That being said I have always been a proponent for NP residency programs and even more importantly I owe much of my success to the fact I not only listen to but seek advice from the RNs.