I am a proud New York City EMS Paramedic preparing to enter the Excelsior nursing program.
As a professional in an urban EMS system, I've worked side by side with registered nurses under austere conditions for many years. I consider nurses to be my peers, and I have enjoyed a good rapport and a sense of mutual respect in the context of our professional relationship. The vast majority of nurses I have worked with recognize that health professionals -- paramedics and others -- can and do maintain valuable clinical experience and skills.
However, there is always a small minority of divisive individuals in healthcare and academia who are blind elitists. These are the ones who summarily conclude that if you were not a codified student of a particular discipline, you know nothing. Frankly, I think there needs to be a more nuanced and respectful analysis on the part of those few who think that the clinical experience of other health care providers outside of their own scope of practice amounts to nothing.
Excelsior College attempts to address this problem by recognizing that paramedics like myself, as well as LPNs, PAs, MDs and others, tend to acquire clinical skills that are reasonably compatible with nursing. Excelsior provides a bridge for those providers to fill in any gaps and cross over into nursing in the same way that nurses have demanded a bridge to cross into the paramedic's domain (as PHRN) without having to go through the extensive paramedic training programs and EMS internship.
The two states that summarily reject Excelsior grads do so because they believe the program provides insufficient clinical training compared to traditional programs. This ignores the fact that all students are required to be licensed healthcare providers with clinical experience from the outset. The typical paramedic working in the field has patient care experience that, frankly, meets or exceeds that of most nursing students, and it is probably fair to say the same is true of many other experienced clinicians.
I would argue that the minority powers-that-be who do not see this logic have probably failed miserably in their responsibility to be discerning in their judgment. The fact that there are Excelsior nurses practicing in all fifty states in supervisory positions is proof that the paradigm works. The bureaucrats from the two states who have placed restrictions on latter-day graduates and marked them with an unfair stigma will hopefully retire soon and make way for leaders who can think outside of the box.
Paramedics, LPNs, PAs, and MDs who wish to bridge into nursing require respect. Excelsior grads are experienced clinicians that have consistently excelled in national-level clinical and didactic nursing examinations, and they deserve to be universally and unequivocally recognized as registered nurses!
Please understand that my comments here are aimed at the person who evaluated (and failed you) in your first exam attempt. You have raised an important issue, which I believe to be the rampant ignorance of many in the nursing profession regarding educational preparation of our peers.
It infuriates me that this person failed you for performing as a well-prepared and critically-thinking professional nurse. It infuriates me equally that she would assume that a newly graduated RN candidate would not take the initiative to clean a soiled patient, or have the where-withal to take an apical pulse if she deemed the patient's radial pulse to be questionable.
I attended a BSN program where we had limited clinical time. Because our formal clinical experience was so limited, our instructors demanded excellent performance at all times. If we were not sufficiently prepared at the conclusion of our clinical laboratory course, we had to repeat it before ever laying eyes on a real patient. If we arrived at a clinical site without an individualized comprehensive care plan (in advance), we were sent home and faced with failing the semester. We were supervised at all times by our instructor or precepting staff RN. I can assure you that no one from my college of nursing ever left a patient soiled, or failed to verify a questionable radial pulse and lived to graduate. Those are not cognitive skills of an entry-level RN, they are the skillset of a CNA. I find your examiner's comments to be indicative of an elitist bias against graduates of traditional nursing programs, essentially the same issue Todd raises in his initial post.
I have no experience with nurses educated via distance learning programs, and no opinion as to whether they gain the same knowledge base and skill set as graduates of traditional programs. What I do have a strong opinion on is the bias of nurses of all varieties degrading the educational preparation of their colleagues who have passed the very same licensing exam and hold the very same practice privileges. (Entry-level MSN vs BSN vs diploma vs ASN vs distance learning)
I hear and understand Todd's frustration. I have no answer other than the very realistic one that in order to practice in a particular state, one must meet the requirements of that state. Anyone enrolled in EC must familiarize himself with those restrictions, and either accept them, or find an effective way to challenge them. I wonder whether EC supports its graduates by lobbying for change in acceptance of its graduates in the states that don't currently recognize them? If not, why not? Has EC conducted any objective research that demonstrates equal performance of its graduates to graduates of traditional programs? I would certainly think that by accepting tuition money from its students, EC has the professional obligation to advocate for its graduates and facilitate their acceptance by all boards of nursing.
I also understand the previous poster's frustration and agree that it is absurd that the compact licensing agreement that allows one to practice as a "traveler or visitor" in a state where they do not qualify for direct licensure due to lack of CEUs, continuing practice, or EC status. I am currently experiencing that myself, as I live in a compact state which requires continuing practice for licensure. I lack that due to having taken time off to raise my daughters. In order to receive a license here, I am currently enrolled in a nurse refresher course. If I held a license in another compact state, I could practice here (as a traveler or visitor) regardless of my lack current experience. I agree it's nuts! BTW, Todd, my refresher course is a distance-learning program, and it is the most challenging course I have ever taken.
But a state again can make the determination as to what they will accept and what they will not. And none of us have any control over that.
I would only contend that we can have a certain degree of control over what the states ultimately determine if we refuse to accept unfairness (without breaking any laws, obviously), and opt to stand up and speak out for what we believe in a logical manner.
i would only contend that we can have a certain degree of control over what the states ultimately determine if we refuse to accept unfairness (without breaking any laws, obviously), and opt to stand up and speak out for what we believe in a logical manner.
Good luck with your career. I agree. I have worked with a nurse form a program of this type. She is very good in the ED setting. I'm sure if she went to another feild it may be new to her but , she would do well. I have found after almost 30 years of nursing that the nursing education seems to be going down hill, new nurses graduate without basic knowledge of care. They are able to talk endlessly about reasearch and what nursing "needs to be", but unable to do the work that is required.It seems they graduate and then find out they have to really work at the job. Go figure. When I was in school, we worked weekends, holidays and took whole teams and critical pt's by ourselves. I'm all for higher education but, there are times I'm embarrassed at what comes out of their mouths in front of the doc's. I had an MA recognize a basic st elevation and the RN, that has been in orientation for over 90 days had no idea what she was looking at. I work with an RN that's going for her NP, she was never the sharpest tool in the box, but I about fell over one day when she said with a straight face, "you know, NP is difficult, did you realize that pt's have many different problems that when added up make them very sick!". I just wanted to tell her, "shut up dork....no sh shirlock".
Please understand that my comments here are aimed at the person who evaluated (and failed you) in your first exam attempt. You have raised an important issue, which I believe to be the rampant ignorance of many in the nursing profession regarding educational preparation of our peers.
It infuriates me that this person failed you for performing as a well-prepared and critically-thinking professional nurse. It infuriates me equally that she would assume that a newly graduated RN candidate would not take the initiative to clean a soiled patient, or have the where-withal to take an apical pulse if she deemed the patient's radial pulse to be questionable.
I attended a BSN program where we had limited clinical time. Because our formal clinical experience was so limited, our instructors demanded excellent performance at all times. If we were not sufficiently prepared at the conclusion of our clinical laboratory course, we had to repeat it before ever laying eyes on a real patient. If we arrived at a clinical site without an individualized comprehensive care plan (in advance), we were sent home and faced with failing the semester. We were supervised at all times by our instructor or precepting staff RN. I can assure you that no one from my college of nursing ever left a patient soiled, or failed to verify a questionable radial pulse and lived to graduate. Those are not cognitive skills of an entry-level RN, they are the skillset of a CNA. I find your examiner's comments to be indicative of an elitist bias against graduates of traditional nursing programs, essentially the same issue Todd raises in his initial post.
If I could "thank you" for this post a thousand times, I would. That REALLY burned me up. I graduated from an ACCELERATED program, and if I DARED to leave a patient lying in dried feces, or not be intelligent enough to realize I can get an apical pulse - I think I would have been put on an action plan.
If I deliberately left a patient that dirty on my unit now, I know I'd be pulled aside for a little "come to Jesus meeting".
Seriously - who's the so-and-so MSN scoring these people? How stupid does she think new grads are?
Sorry, but I'm really annoyed by that.
Give me a break. And thanks again for this post.
(BTW, I see both sides of the coin on the Excelsior issue. My first BS - not my BSN - came from Excelsior - and I'll challenge anyone to say my degree was handed to me. The credits I took at Excelsior were harder than any college class I've sat in to date - and I'll go so far as to include the master's level patho course I took in nursing school. The DANTES exam I took in Russian history is probably the hardest exam I've ever taken!)
First of all let me say that I am an Excelsior graduate and passed the NCLEX first time around. Working on my BSN now and hope to move to MSN after that.
Let me say this and I'll be real blunt here, when are these Boards of Nursing going to wake up and realize that we have a severe shortage of nurses right now and not enough programs to crank out the nurses that we need.
Traditional programs are great and good for people that can take 2-3 years off and go to school full time. Look at how many colleges and universities are creating Accelerated BSN programs and entry level MSN programs for people with degrees from other disciplines. Many are providing non-traditional means to complete degree requirements like night, weekend, and online classes to accommodate working professionals. They recognize that many people just can't take the time off.
I would not be a RN today if it wasn't for Excelsior. The program allowed me to continue working while completing my degree. My license says RN on it and is no different than any other nurse.
So I say WAKE UP we are in the midst of a crisis and instead of limiting means and ways to fix this problem we should be looking at creating and innovating ways to introduce people to this wonderful profession.
I think the "good ole boys" still have there hand in making these crazy decision and it would not surprise me if a lot of the have MD following their name.. Just my opinion- Same with Alabama. I love the South but we usually progress slower than most!
i think the "good ole boys" still have there hand in making these crazy decision and it would not surprise me if a lot of the have md following their name.. just my opinion- same with alabama. i love the south but we usually progress slower than most!
i can't imagine why a physican would care where we get our licenses. i live in the south and where i work we've been first in alot of areas, first with cardiac cta's, first with bar code scanning of meds, among others. i'm proud to be among the grits (girls raised in the south)
I remember a time when I took a practice CPME at the GA BON headquarters. So the GA BON would accept my money but would not reconize my degree to sit for the Ga nclex. But if you obtained your RN from an other state Ga would accept you new License. That was just klazy man.
Hi everybody. I love the forum. I am a PA and i currently live and practice happily in GA. Initially in college I started in the pre-nursing program but early on i got accepted in a PA program and decided to follow through. I always felt a deep connection towards nursing and wanted to finish my nursing degree but my schedule is all over the place(days,nights,weekends) and changes every month. I also have 2 small children. So I think its next to impossible to attend a conventional nursing program. I was wondering if there are any nurses that got their degree from Excelsior and currently practice in GA and what were their experiences regarding the process to obtain their GA license . Thanks:D
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Jeez... never heard of failing an exam because you do something too well.
Jolie, BSN
6,375 Posts
Dutchgirl,
Please understand that my comments here are aimed at the person who evaluated (and failed you) in your first exam attempt. You have raised an important issue, which I believe to be the rampant ignorance of many in the nursing profession regarding educational preparation of our peers.
It infuriates me that this person failed you for performing as a well-prepared and critically-thinking professional nurse. It infuriates me equally that she would assume that a newly graduated RN candidate would not take the initiative to clean a soiled patient, or have the where-withal to take an apical pulse if she deemed the patient's radial pulse to be questionable.
I attended a BSN program where we had limited clinical time. Because our formal clinical experience was so limited, our instructors demanded excellent performance at all times. If we were not sufficiently prepared at the conclusion of our clinical laboratory course, we had to repeat it before ever laying eyes on a real patient. If we arrived at a clinical site without an individualized comprehensive care plan (in advance), we were sent home and faced with failing the semester. We were supervised at all times by our instructor or precepting staff RN. I can assure you that no one from my college of nursing ever left a patient soiled, or failed to verify a questionable radial pulse and lived to graduate. Those are not cognitive skills of an entry-level RN, they are the skillset of a CNA. I find your examiner's comments to be indicative of an elitist bias against graduates of traditional nursing programs, essentially the same issue Todd raises in his initial post.
I have no experience with nurses educated via distance learning programs, and no opinion as to whether they gain the same knowledge base and skill set as graduates of traditional programs. What I do have a strong opinion on is the bias of nurses of all varieties degrading the educational preparation of their colleagues who have passed the very same licensing exam and hold the very same practice privileges. (Entry-level MSN vs BSN vs diploma vs ASN vs distance learning)
I hear and understand Todd's frustration. I have no answer other than the very realistic one that in order to practice in a particular state, one must meet the requirements of that state. Anyone enrolled in EC must familiarize himself with those restrictions, and either accept them, or find an effective way to challenge them. I wonder whether EC supports its graduates by lobbying for change in acceptance of its graduates in the states that don't currently recognize them? If not, why not? Has EC conducted any objective research that demonstrates equal performance of its graduates to graduates of traditional programs? I would certainly think that by accepting tuition money from its students, EC has the professional obligation to advocate for its graduates and facilitate their acceptance by all boards of nursing.
I also understand the previous poster's frustration and agree that it is absurd that the compact licensing agreement that allows one to practice as a "traveler or visitor" in a state where they do not qualify for direct licensure due to lack of CEUs, continuing practice, or EC status. I am currently experiencing that myself, as I live in a compact state which requires continuing practice for licensure. I lack that due to having taken time off to raise my daughters. In order to receive a license here, I am currently enrolled in a nurse refresher course. If I held a license in another compact state, I could practice here (as a traveler or visitor) regardless of my lack current experience. I agree it's nuts! BTW, Todd, my refresher course is a distance-learning program, and it is the most challenging course I have ever taken.