Does anyone see a huge difference between an ADN and a BSN prepared nurse, nursing skills wise? Very little of my BSN coursework have been utilized on the floor and to be honest, experienced Diploma nurses frequently possessed better skills. Sure, there was management and leadership skills, but unless that is your intent, I cannot see the point.
Personally, the nurse with desire and curiousity for her craft have always appeared to me better, at not only practical skills but also interpersonal. I acquired more debt but little else.
Is there collusion between the AACN and learning institutions pushing this agenda? Why is it so few nursing international bodies have adopted very little of this trend?
Government money always comes with strings attached.
And I agree bureaucrats, middle management, administration and such need to shrink drastically in size. They use so many resources with so little return value (which makes them inefficient) and many times they are useless. They sit there playing with their thumbs trying to create work because they have nothing to do (because they're not necessary). These make-work practices have not served economies well.
I believe it stems from a fear of unemployment. People think a more efficient way of doing things destroys jobs (because an employer needs less people) and that a less efficient way of doing things creates jobs. But this just raises production costs and means less profits for the workers all around. And if there's a glut of employees then wages won't be competitive because there will be a worker who will accept that job for less than they should.
Those bureaucrats could find jobs doing something worthwhile. There's always work to be done as long as any human need remains unfulfilled.
About the little return value part, Medicare has recovered 10 billion since 2008 from fraud and abuse investigations and much of the heavy handed regulations are in response to fraud and abuse as well as attempt to avoid more with value based purchasing. I just took a legal course (complex and I didn't absorb all of it) and the return is something like $7 for every $1 spent. A 7 to 1 return on investment is incredibly significant. Add that to all of the money spent on healthcare that makes no improvement or prevention of further expenditures against a shrinking inadequate beneficiary budget, and you've got your reasons for much of the regulation. Not that I have an opinion either way but studies that show BSNs impact better outcomes are going to have influence.
That doesn't mean I like the regulations nor that I think they are the most efficient and logical, but there's no argument against a 7-1 ROI.
Wait a second. I am so ignorant of the current educational system but the clouds might be clearing..
I thought all programs, both ADN and BSN, dedicated a full semester to pharmacology, peds, OB, psych, community based/public health, 2 or 3 med surg with critical care in the more advanced and a senior focus/practicum/preceptorship and then research and leadership in the last year of a BSN?? (They teach how to make an awesome run on sentence in the BSN programs, and comma abuse, apparently).
Programs are quite variable. Not everyone gets an entire semester of peds. It is sometimes combined with a women's health clinical. Not everyone takes a semester of pharm; some programs simply integrate pharmacology in the other classes. Not every program dedicates an entire semester to psych nursing or community health. Many ADN programs simply don't have time in the 4 semester program to offer a class on research methods and statistics. Etc.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
If bedside skills were the only thing required of nurses, than sure a diploma or AS would be great. There is more to nursing than bedside skills. A lot of the nurses who have been nurses for 20, 30, 40 years are great at the bedside. But they are not always great with computer competency, EMR competency, drafting policies, understanding legislation, understanding best management practices for the different demographics and generations they surely lead on the floor, making a dashboard in Excel, understanding how diversity affects the workplace, using a database to acquire scholarly research for bedside practice, or writing a proper professional email not in all caps. All things they would be fully competent in if they got a BS.
Then why do we see so many BSNs who aren't competent in drafting policies, understanding legistlation or best management practices, etc.? All of those things can be learned by ADNs and diploma nurses and by BSNs who didn't learn them in their programs through inservices, continuing education and and specialty organizations.
I resent the ageist assumption that because I've been at the bedside for forty years, I don't understand EMRs, cannot use the computer without outside help and use all caps to write a professional email. My BSN didn't teach me those things . . . I learned them on the job because they were important. I learned them well enough to be able to teach them.
Specializes in Float Pool - A Little Bit of Everything.
Then why do we see so many BSNs who aren't competent in drafting policies, understanding legistlation or best management practices, etc.? All of those things can be learned by ADNs and diploma nurses and by BSNs who didn't learn them in their programs through inservices, continuing education and and specialty organizations.
I resent the ageist assumption that because I've been at the bedside for forty years, I don't understand EMRs, cannot use the computer without outside help and use all caps to write a professional email. My BSN didn't teach me those things . . . I learned them on the job because they were important. I learned them well enough to be able to teach them.
I don't care if you resent it, I am not here to fluff your ego.
About the little return value part, Medicare has recovered 10 billion since 2008 from fraud and abuse investigations and much of the heavy handed regulations are in response to fraud and abuse as well as attempt to avoid more with value based purchasing. I just took a legal course (complex and I didn't absorb all of it) and the return is something like $7 for every $1 spent. A 7 to 1 return on investment is incredibly significant. Add that to all of the money spent on healthcare that makes no improvement or prevention of further expenditures against a shrinking inadequate beneficiary budget, and you've got your reasons for much of the regulation. Not that I have an opinion either way but studies that show BSNs impact better outcomes are going to have influence.
That doesn't mean I like the regulations nor that I think they are the most efficient and logical, but there's no argument against a 7-1 ROI.
There'd be less fraud and abuse if there were less bureaucrats, which means more transparency in where the money moves. That means less resource consuming regulations. The taxpayers' money is what's being abused and it's the taxpayers' money that's enforcing regulations against abuse, paying the bureaucrats, paying the prosecutors of bureaucrats, and so on.
There wouldn't be a "$1 spent" if the government would stop intervening with the free market.
..."Add that to all of the money spent on healthcare that makes no improvement..." Is paying for regulations and not patient care going to make an improvement?
There'd be less fraud and abuse if there were less bureaucrats, which means more transparency in where the money moves. That means less resource consuming regulations. The taxpayers' money is what's being abused and it's the taxpayers' money that's enforcing regulations against abuse, paying the bureaucrats, paying the prosecutors of bureaucrats, and so on.
There wouldn't be a "$1 spent" if the government would stop intervening with the free market.
..."Add that to all of the money spent on healthcare that makes no improvement..." Is paying for regulations and not patient care going to make an improvement?
I'm not the one to convince, I'm in the trenches with you.
Are you familiar with home health? I'm not sure that reducing the bureaucrats will decrease the egregious amount of fraud and abuse in home health but maybe you're right about less regulation being the best direction.
I'm not the one to convince, I'm in the trenches with you.
Are you familiar with home health? I'm not sure that reducing the bureaucrats will decrease the egregious amount of fraud and abuse in home health but maybe you're right about less regulation being the best direction.
Actually I'm not familiar with home health. My experience comes from working a major, urban, teaching hospital.
I can't comment on adn vs bsn because in my country the only way to be a nurse is with a bsn.
But avid reader I'm really confused with you comment about nurses who just want to say on the floor and don't require as much education as that's all they want to do. doesn't sound like a nurse to me. Sounds like someone that is stagnant and shouldn't be in health care. Someone that's done the bare minimum just to get a job because it sounds like it has all these benefits, then come in sites like this and complain about how awful nursing is.
Nurses in my country not only have to have bsn they also start post grad study when they start there first nursing job. And must continue to learn and do so many hours of professional development each year just to say registered.
life long learning is a requirement of being a nurse. You will never know it all. There's not one nurse out there that has completed all of their education. Health care changes so quickly, you have to say on top of it and continue to learn to be competent.
Remaining on the floor and being stagnant. Not wanting to learn and further themselves and their career is a joke of a nurse. I don't care if you have a bsn or adn. People that work hard, actually like there job and are interested in it, continue to learn and progress are what the profession needs. Not people doing it for the money or only having to work 3 days, which I hear so much with American nurses and it really pisses me off.
Again I don't know the difference between adn and bsn but I do know a good nurse, of anyone's watch nursing channels on YouTube I'm sure you know nurse bass, he has a adn and is exactly what I mean. The right nurse attitude who I would be happy to work with. Or Ashley Adkins who has a bsn that has the same attitude. It's not about your title or letters. Nursing is a career, something to be proud of. Not something that you should complain about or the opportunity to further you self.
But I will say 2 years does seem awfully short to learn everything.
NzRn, you sound like a young, naive person, not deñigrating, actually I am. I'm jealous. Oh to be able to have suçh idealism. Wait a while and you'll find stagnant or stationary can be blissful state. Sweetheart, your choice might be otherwise but you shouldn't dictate others. I suggest you read all the posts for your answer and please don't lose the idealism just yet. Many people will be pleased with your naivete'. Not being facetious either.
NzRn, you sound like a young, naive person, not deñigrating, actually I am. I'm jealous. Oh to be able to have suçh idealism. Wait a while and you'll find stagnant or stationary can be blissful state. Sweetheart, your choice might be otherwise but you shouldn't dictate others. I suggest you read all the posts for your answer and please don't lose the idealism just yet. Many people will be pleased with your naivete'. Not being facetious either.
No nurse should ever be stagnant. Whether it's formal education or just CEUs, every nurse should make the effort to keep up with the latest developments in their particular field. Many states require the nurses to obtain continuing education as part of the license renewal process. I'm amazed that there are any states that do not.
I would never say that I regret having been afforded the opportunity to have a traditional 4.5 year college experience at a highly nationally ranked college which ultimately resulted in my having my BSN. However, while in nursing school, and while at my first hospital job, I frequently burst with frustration and resentment at the time fillers to which we were subjected, such as nursing theory, broad lecture courses for community health, women's health, policy, and a fetish for designing "nursing care plans". In my view, what has made my nursing career successful was hands on training on an inpatient hospital unit. I would have been much better prepared for my first job had I been afforded much more time in clinicals vs. lecture halls. I have never made more money for the fact that I had my BSN vs. my nursing colleagues without their BSN. However, having my BSN has afforded me opportunities to work outside of a clinic or hospital setting, as my last 2 positions have mandated BSN credentials. And, for what it's worth, I was a primary nurse for a surgeon for 3 years, and had this same discussion with him, as our office employed a BSN (me), 2 LPNs, and 2 ADNs. I was recalling the scrutiny and suspicion I faced at my first hospital job as the ONLY BSN prepared RN in the building (small hospital in Pacific NW--my director was a Diploma nurse). It was really a trial by fire, and I don't know that I could have identified any of them for not having had their BSN had I not known, as they seemed roundly capable and competent. He turned to me and said "You want to know who can tell whether or not a nurse has a BSN? WE can tell.", meaning, physicians. I have no desire to go on for an advanced degree, but having my BSN also would pave the way for that as well. I think if you're relatively certain that you don't want to go on to advanced studies, and are savvy about the industries and tracks out there for nursing which do not require a BSN and if you're ok with that, I'd have a very hard time justifying spending the kind of money you will spend for a BSN today. You can have a very financially rewarding career with an ADN. Like I said, when it comes to hands on nursing, I've never been paid more because of my degree.
Libby1987
3,726 Posts
About the little return value part, Medicare has recovered 10 billion since 2008 from fraud and abuse investigations and much of the heavy handed regulations are in response to fraud and abuse as well as attempt to avoid more with value based purchasing. I just took a legal course (complex and I didn't absorb all of it) and the return is something like $7 for every $1 spent. A 7 to 1 return on investment is incredibly significant. Add that to all of the money spent on healthcare that makes no improvement or prevention of further expenditures against a shrinking inadequate beneficiary budget, and you've got your reasons for much of the regulation. Not that I have an opinion either way but studies that show BSNs impact better outcomes are going to have influence.
That doesn't mean I like the regulations nor that I think they are the most efficient and logical, but there's no argument against a 7-1 ROI.