Education of Nurses in the United States

Nurses Activism

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  1. Which of the following nursing education programs do you think would be better?

    • 11
      4 year nursing course with CNA, LPN and ADN integrated within the program ending with a BSN
    • 10
      4 year BSN course with less general education courses and more specialized courses related to Nursing
    • 6
      Keep it as it is. And let each State decide
    • 13
      Abolish LPN and ADN and make BSN the minimum entry level
    • 0
      Make the minimum nursing degree MSN and keep LPN as a separate entity

40 members have participated

The educational structure of Nurses in the United States have always been marked by different pathways due to the historical deviations of scarcity and changing needs. Although having different roads to be a nurse is more of a benefit than a disadvantage, it has created an unintended effect of appearing fragmented, if not actually fragmented.

Among the different licenses and registrations within professional health care workers, nursing has the most options. With all these options, roles and functions come in with confused definitions and fragmented expectations. Unfortunately, it will not be fair nor just to dismantle the existence of any nursing designation (e.g. LPN, ADN, Hospital Nursing, et al) in favor of a centralized path (e.g. BSN as minimum) because that would force excellent nurses in their current condition to do unnecessary and costly acts of compliance which may or may not improve the delivery of health care. There is no guarantee that a health care environment will work better when there are no LPN's, ADN's or Hospital Nurses around in the same way that there is no truth in a belief that a hospital staffed only with BSN delivers a better health care system than those with a diversity of nurses.

Nonetheless, this current condition has created an unhealthy competition in certain environments rather than foster a spirit of collaboration. If nursing programs around the United States agreed to have a standardized process starting from the education of a CNA all the way to level of an ANP, then perhaps some day, there would be more cohesion rather than confusion, identity and function would be better established, and team work could truly be fostered. I believe that there is something like this being done in California. Those from other States, are you aware of any?

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This is an interesting concept.

It would certainly give clinical skills an importance in nursing as much as the theory based components.

There are many who would go back to school for more education if it were more available, cheaper, or convenient to those who need to work full time.

Much like a hospital diploma program, it would be great if faciities who require a BSN entry and who have a nursing education department partner with local colleges to make that happen for their health care workers.

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I would go back to school right now if there were reasonable LPN to RN programs around here. The hours and cost are just unrealistic.

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Specializes in Critical Care, Education.

Quote " there is no truth in a belief that a hospital staffed only with BSN delivers a better health care system than those with a diversity of nurses. "

Sorry - but you are mistaken. There is incontrovertible evidence that patient outcomes are significantly improved in hospitals with increased BSN staff. Here is a link to the IOM report which summarizes this information:

The Future of Nursing - Institute of Medicine

I support everyone's right to express their own opinions, but please check your facts.

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I apologize for posting without an evidence. The proof of my statement will follow next. Thank you for your response.

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" there is no truth in a belief that a hospital staffed only with BSN delivers a better health care system than those with a diversity of nurses. "

http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Education%202010%20Brief.pdf

This article does not argue that Hospital Staff should be a 100% BSN. That is precisely what my statement is saying. What I said, although an opinion, is still TRUE and is not in contradiction to the article you posted.

Please apply critical thinking before responding. Thank you so much!

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Please read your post thoroughly before posting. It does not contradict what I say.

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Specializes in Nursing Professional Development.

I ended up picking one of the options for the purposes of joining the thread ... but my personal preference was not listed as a choice. It is to:

Combine LPN, Diploma, and ADN into one program and designate it as one level of nurse. Graduates of such a program would be licenced to practice at a certain level of functioning and take an NCLEX exam designed for that level -- a "blend" of the current LPN level and basic RN staff nurse level. BSN grads would take a different NCLEX exam and be licensed to function at a higher level that was consistent with their higher level of education.

I am in favor of maintaining 2 levels of basic nurses -- one that could be educated in 2 full time years of school, but have a limited scope of practice -- and a higher level for those with 4 years or university education. The levels would be differentiated by education, NCLEX, license, and scope of practice.

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Your preference is a good idea, but with the following road blocks:

1. The LPN program is a non-academic program. Although it requires a license, it normally does not have an academic credit that can be converted into an academic degree. After fulfilling an LPN program, the student earns a diploma which is merely a proof that the student finished a program

2. An ADN is an associate degree that is above and beyond a diploma since it carries with it Academic Credits convertible to a Bacelor's degree within the bracket of Higher Education.

3. In order for your suggestion to be possible, something will have to be done to elevate the LPN training and convert their courses to academic credits.

4. It is because of this that "bridge programs" from LPN to ADN are not easy to formulate. In one school that I know, the bridge program is also a 2-year course, exactly the same as and ADN. If that were the case, then an LPN would be better off starting ADN from scratch and be ahead of the game because of experience rather than being in a "Bridge Program" with advanced expectations and get the same degree.

5. If someone could find a way to fuse the LPN within the ADN program, that would be an excellent choice

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Yap, ever since Nurses fought for their rights to be included within an Academic Profession, the academic community swallowed them up as another source of business revenue. Really? Nursing is a ministerial profession and a vocation for the many. And so is medicine. Unless the cost of education for these studies are adjusted, the cost of health care will always have an excuse to go up. Health care is a public service and not a capitalistic tool.

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Specializes in Nursing Professional Development.
Your preference is a good idea, but with the following road blocks:

1. The LPN program is a non-academic program. Although it requires a license, it normally does not have an academic credit that can be converted into an academic degree. After fulfilling an LPN program, the student earns a diploma which is merely a proof that the student finished a program

That's a solvable problem since the current LPN, Diploma, and ADN programs would all cease to exist. The new "blended" programs would be all that would remain at that level. Current programs would merge with each other, etc. to form the new ones. Diploma programs convert to either ADN or BSN programs all the time. LPN could similarly be converted.

No "solution" is without problems -- and there are PLENTY of problems with the current system. We need to "let it go" and get rid of our attachment to the old programs. Start with a clean slate and develop a system that works long term -- one not based on the old. Two levels (with differentiated education, license, and scopes of practice) make sense. If an LPN school doesn't want to upgrade its education and affiliate with a degree-granting institution, then it can become a school for CNA's or Medical Assistants.

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Do you distinguish between blended and integrated. I agree with a 4 year BSN program. However, if a student does not finish, what does he/she get? Nothing, right? I go more for the integrated. 4-year BSN as a goal, integrating LPN and ADN within it, to the point that if some event happens, a student ends up with something as opposed to nothing at all. To be more concrete, a first year BSN could be integrated as an LPN program. A second year BSN could be integrated as an ADN program. If at the second year, the student stops, that person could be an RN and then continue later within the same program. In this way, from a student's perspective, nothing is abolished. If you abolish LPN, ADN, not all facilities are able or are willing to hire a 100% BSN nurses. For this reason, the total abolition of LPN and ADN from all health care facilities will only result in higher health care costs without a total guarantee that service would be better.

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