Do you think ADN programs will really be phased out?

laKrugRN · Aug 24, 2014

Some hospitals will phase them out but ADN's will never be phased out of the nursing world.

lindarn · Aug 25, 2014

I will again state that nursing does not need three levels of entry. What are ADN programs attempting to accomplish by adopting a BSN curriculum? If they are adopting a BSN curriculum, so that they can transition to BSN programs.

The only way to achieve an all BSN workforce, is to close ADN and Diploma programs. Not dance around it, like the ANA has done for 50 years.

I have no idea why the one state at did go to an all BSN etp, changed it a year late. Was it because they weren't churning our new grad every six months, all so they get disgusted and leave nursing after a year? No more churn em out, then throw em out?

It is not important that we would lose, "second degree grads", in the process. What other profession bends over backward for individuals who have a Bachelors degree in another field? They can incorporate their college credits into another bachelors degree program, and pick up what they do not have. Just like anyone else would do.

Or, just have all nurses do their first two years at a community college and transfer to a BSN program for the last two years. That is what Downstate College in Brooklyn NY did.

Either way, I do not understand the reluctance of nurses to upgrade the standards of the profession, like other health care profession have done. Degree inflation is not a bad thing. It was not that long ago, that physicians practiced with no college degree. Was it a bad thing that the education was increased?

How are we doing things better? We have a splintered profession from the get go, by three entry levels. We have no respect, (spare me the, 'the public votes us the most trusted profession', blah blah, blah). They might trust us, but they certainly do not respect us . The public equates worth with education. When nurses enter the profession with technical degrees and diplomas, it makes us look like blue collar, trailor trash, not respected professionals.

We will never be a unified profession without a single entry into practice. That is what the PTB want. We are not, "jumping head long over a cliff", by unifying our education levels, we are following the lead of other health care professions who have seamlessly transitioned to higher levels of education. They command far more respect than the nursing profession does, and out earn us by a significant amount of money.

It is not better to have different levels, and serves no purpose. What level of accomplishment are we achieving when we do not have the same education levels? Why do we believe that we need to make it easy to be a nurse? Do other professions make it easy to enter their professions? Most other professions limit the number of individuals to can be accepted to the schools, with the explicit reason, to keep their numbers low, and keep themselves in demand. That is what most professions do. It boggles the mind that nursing shoots itself in the foot, by allowing anyone and their brother to become a nurse, thereby allowing us to be treated like dirt, because there is always a new grad waiting to take our spot if we are not happy, and leave. That sort of defeats our best interests.

Other professions have a unified education level, are not concerned with diversity of grads, and manage to attend Masters level education, if not doctoral levels, and no one is whining, complaining, stomping their feet, but nursing. The ADN/BSN combination pathway is a rarity, for a reason- because it serve no positive purpose. Other professions have a national organization, and state Boards, who have their members best interests in mind, unlike nursing.

Other heath care professions do not have mediocre education. What examples can your provide, that other health care professions have mediocre educations? NURSING is the one with mediocre characteristics to its educational pathways.

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the PACNW

applewhitern, BSN, RN · Aug 25, 2014

Lindarn, thank goodness you don't speak for all nurses everywhere. I obtained my ADN at a private 4 year university, and this was after I obtained a degree in Business and Accounting. I did obtain a BSN later on. I really don't know why you are saying "technical degrees and diplomas." My ADN was not a technical degree, and most of the diploma nurses I work with run circles around the new BSN nurses. Nice to know that you think ADN prepared nurses make you look like "trailer trash." The ADN degree was designed to put registered nurses into the workforce quicker, during a vast shortage of nurses. This degree has always been almost identical to the BSN; this is why they take the same NCLEX. The ADN is a second degree for tons of people, so I don't see why you think anyone with an ADN is uneducated, or under-educated. I found your post to be extremely hostile.

smartnurse1982 · Aug 25, 2014

I would love to see a paper published by the ANA of pt outcomes with Bsn Degrees vs Msn Degrees.

I have a feeling that the outcome would be that Msn prepared nurses will have better pt outcomes than Bsn.

Then they would push for Msn prepared nurses.

Then Doctorate prepared nurses.

Hopefully,it will not happen as i have 30 plus years left before retirement.

smartnurse1982 · Aug 25, 2014

We have a splintered profession from the get go, by three entry levels.

I would just like to point out that there are 4 entry levels into nursing,not 3.

Lpn..Certificate Program

I just do not know why people forget "Lpn" when they mention nurses.

Rn..Bsn, Adn, Diploma

I also see nurses who have an entry level MSN.

trudeyRN · Aug 25, 2014

While nurses may not be the most educated professionals in the hospital setting, they are the most populous (anyone who wants to argue against that can pop over to Bureau of Labor Statistics- or just look around a hospital floor).

Supply and demand may also play into what happens, especially as baby boomers begin to retire, en masse.

lindarn · Aug 25, 2014

Did Physical Therapy, Occupational Therapy, and Pharmacists, have published papers, on the improved outcomes of PTs with Doctorates, OTs, with papers on improved outcomes with a Masters Degree, or Pharmacists with published papers with improved outcomes for customers of Pharmacists? All before they increased their entry into practice?

Probably not. And why not? Because members of those professions believe that increasing the educational levels of the profession makes for a better profession, in terms of pay, benefits, respect, and benefit for the patient. They also bill for their services.

No one threw a hissy fit, tantrums, and spent more time trying to find fault with published studies than trying to validate and improve the image of the profession, which would improve compensation and benefits.

We need to fight to have our nursing professional practice billed separately on patients bills, instead of having our professional practice rolled into the room rate, housekeeping, and the complementary roll of toilet paper. Our professional practice always show up on the negative side of the balance sheet. When we have nothing to show for our work, we will have nothing to show at the bargaining table. When we can show that our improved education levels improves patient outcomes, and we can), we have better bargaining power at the bargaining table. When we can show staffing ratios improve patient outcomes, (and these studies have been out now for a number of years), we can demand better staffing. We also need to educate our patients, their families, and the public, how they are being shortchanged when in the hospital.

They all also do not have an abundance of members, who wish to keep things the way they are, regardless of the fact that it is not working out for anyone but the PTB, that wish nursing to remain splintered, powerless, "barefoot and pregnant", ie, helpless. Insanity is doing the same thing over and over, and expecting different outcomes.

You can complain and disagree all you want, but nursing is in the state it is in now, because the ANA, did not have the strength to not cave into the AMA, AHA, insurance companies, etc, when they wanted to make the BSN the level for entry practice. They caved in and threw nurses under the bus. Same with the state BONs.

We have no control of our profession, working conditions, staffing, etc, because we have let the PTB decide what they want for nursing, which is NOT what is in the best interest in nursing.

The PTB want to remain in control of nursing. THAT is the battle that is being fought. Is not staffing, ratios, degrees, pay, or benefits, THEY want to remain in control. If nurses increased their educational levels, we would and should demand higher pay, and far better benefits than we now receive now.

There us also other reasons the increase the length of the educational program. A longer program allows time for what I call, "quality of life", classes.

Classes on Employment Law, learning how to use unions for the benefit of nursing. Starting a business. How much of our practice can be turned into a successful business. Like Wound and Ostomy care, Catheter Care, Diabetes Education, teaching families how to care for family members at home, the list goes on.

Some of the increased educational classes in PT, OT, etc, consisted on classes on how to open up and run a successful business. These professions used their increased educational time to learn how to think out side the box, and flourish.

I am tentatively talking with a friend, who is an RN, but who also is a licensed attorney. He continued to work as an RN until last month, and is now pursuing avenues to combine his BSN and Law degree. I have believed for a long time, and nursing needs to learn how to practice, what I call, "defensive nursing". Practicing while knowing the pitfalls that employers use to trip up nurses so they can blame nursing for problems caused by the organizational practices, like deliberate under staffing in hospitals, and especially in nursing homes.

Learning how to respond to challenges from managers, and administrators, to force them to follow their own policies so the nursing staff protect themselves from management abuses, etc.

Some of this may not be immediately apparent as useful at the bedside, but yes it can be. Knowing the law, can protect you from management abuses.

In my case, I was an AF Reservist, who got called up for Desert Storm in 1991. I was sent to Germany, and was gone for six months. According to FEDERAL LAW, which by the way, supercedes State Law, and any and ALL Hospital Policies.

I was to have the time I was gone counted into my total number of hours. We were a unionized facility, and our seniority was determined by the number of hours that we worked. My time away should have been added into my total seniority hours

A couple of years later, the country started to do into what was called, "care redesign". Which meant we are trying to run a hospital with as few nurses as possible, and the hospital I worked in,was laying off nurses.

My name came up because my hours were lower than other nurses. When i questioned the administration, I was told that the time that I was gone was not counted. That is in blatant violation of the Federal Law.

I called them on it, and I was told, "that it was my 'voluntary decision to be in the reserves", and in a nutshell, I would have to live with the consequences of that decision".

Again, another blatant violation of Federal Law. I called a local attorney, who himself, had been in the military, and used the GI Bill to go to Law School.

I had my 2000 + hours back on the books by the next day. I was never bothered by them again about my reserve obligation. You should have seen the look on my nurse manager's face, when I told her, that if she tried to lay me off, I would do to court and get a restraining order to prevent her from doing so. And by the way, they cannot make you make up the weekends that you did not work because you were on Reserve Time, they cannot make you take your vacation time or PTO to perform reserve time, and it matters not, if you volunteered to be activated, or were under an involuntary recall. Period. They cannot take any negative employment action against you for being a reservist.

These are the kind of things that I would like to educate nurses about, and teach them ways to respond that puts them in control.

Sorry for the long rant.

JMHO and my NY $0.02

Lindarn RN, BSN, CCRN (ret)

Somewhere in the PACNW

DoGoodThenGo · Aug 28, 2014

Do not think ADN programs will be phased out by any sort of top down edict. Rather as with diploma schools in most areas of the USA employment market conditions and their subsequent effects on upon enrollments will make the decision.

In the NYC market for instance there are now only about a handful of healthcare networks that own/run nearly all the facilities especially in Manhattan. Thus when NS-LIJ, NYP or Mount Sinai stop hiring new grads without the BSN and stick to it you are making hundreds of entry/new grad positions off limits. Sooner or later the message *will* filter down to potential students that it is better to get a four year degree out of the box and that will influence ADN programs decisions to remain open.

The other fly in the ointment will be if the federal government continues to place heat on higher education programs that have poor to low job placement rates where students have taken out debt.

llg, PhD, RN · Aug 28, 2014

We're also left with the problem that in general ADN programs are transitioning to BSN curriculum, to create more separation between the two, we'd either have to add time to the BSN degree or reduce the schooling of an ADN degree, and it's hard to see how that would add anything to either degree.

There is another (better) option that you are ignoring. Those ADN programs that keep expanding their curricula should just own up to the fact that they are teaching BSN level material and convert their programs to BSN programs. They should meet the remaining standards for BSN programs and award BSN degrees -- rather than expand their ADN course content, charge additional money for those expanded programs, but then award the lower-ranked academic degree.

That's one of the things that really bothers me about this mess. An Associate's Degree is "supposed" to take 4 semesters of full time study -- which is the national standard for all disciplines. But some ADN programs are adding so much to their requirements that students end up taking far longer from start to finish. Those are the people who should be most angry about this -- the ADN grads who went to those expanded programs that require them to do BSN level work, but don't get the BSN level course credits! They are being ripped off by their schools in multiple ways -- first by not getting the full academic credit they deserve for their educations -- then for paying extra money for the extra coursework that is not required for ADN level degrees -- and finally by graduating with a degree (credential) that is at the bottom of the academic hierarchy and that will limit their career options.

If those ADN grads are truly getting an education equal to a BSN -- they should be furious at their schools for ripping them off by not awarding them the degree they have earned. Put the blame where it really belongs, not on the people wanting well-educated nurses -- but on the schools who sell lesser degrees while stating that their graduates are "just as well-educated."

MunoRN, RN · Aug 28, 2014

Did Physical Therapy, Occupational Therapy, and Pharmacists, have published papers, on the improved outcomes of PTs with Doctorates, OTs, with papers on improved outcomes with a Masters Degree, or Pharmacists with published papers with improved outcomes for customers of Pharmacists? All before they increased their entry into practice? ...

There are many studies that suggest, if not prove, that the ADN/diploma curricula of the 60's, 70's, 80's wasn't up to par, which is why programs responded to these studies by taking on the curriculum that as far as we can tell is what produced these better outcomes. You seem to be focusing on what we call the student who's been taught under this curriculum as being the source of better outcomes. I think it's pretty unlikely that if you take an ADN student who went to a bad program, and just rename them "BSN" that their patients outcomes will change.

Esme12, ASN, BSN, RN · Aug 28, 2014

There are many studies that suggest, if not prove, that the ADN/diploma curricula of the 60's, 70's, 80's wasn't up to par,

Could you point me to a few of those studies.

MunoRN, RN · Aug 28, 2014

There is another (better) option that you are ignoring. Those ADN programs that keep expanding their curricula should just own up to the fact that they are teaching BSN level material and convert their programs to BSN programs. They should meet the remaining standards for BSN programs and award BSN degrees -- rather than expand their ADN course content, charge additional money for those expanded programs, but then award the lower-ranked academic degree.
That's one of the things that really bothers me about this mess. An Associate's Degree is "supposed" to take 4 semesters of full time study -- which is the national standard for all disciplines. But some ADN programs are adding so much to their requirements that students end up taking far longer from start to finish. Those are the people who should be most angry about this -- the ADN grads who went to those expanded programs that require them to do BSN level work, but don't get the BSN level course credits! They are being ripped off by their schools in multiple ways -- first by not getting the full academic credit they deserve for their educations -- then for paying extra money for the extra coursework that is not required for ADN level degrees -- and finally by graduating with a degree (credential) that is at the bottom of the academic hierarchy and that will limit their career options.
If those ADN grads are truly getting an education equal to a BSN -- they should be furious at their schools for ripping them off by not awarding them the degree they have earned. Put the blame where it really belongs, not on the people wanting well-educated nurses -- but on the schools who sell lesser degrees while stating that their graduates are "just as well-educated."

I was part of a workgroup in my state that initially had the intention of moving at least to BSN-in-10 and even BSN as entry to practice. We gathered a significant amount of information on ADN student's views on their education and their educational level and we didn't find what you're claiming. Many ADN grads already had a previous bachelor's degree and even more had no problem with being "only" an ADN. There was overwhelming support for the idea of continuing to allow ADN as an option while keeping the RN to BSN pathway for those who truly want a BSN. What they wanted was a quality nursing program education, and not necessarily the name that goes with it particularly since that adds, on average in my state, about $35,000.