Future of Nursing

nilepoc · Oct 12, 2001

Wow, you really want to open a can of worms don't you? :)

I will skirt around a direct answer to say that some form of minimum standard of training is one of the only things that is going to get nursing the respect it deserves. Currently the view by management IMHO is a nurse is a nurse, is a nurse. One of the reasons I feel they think this way is that there is no consistent minimum level of training to practice as an RN.

If you look at other specialties in healthcare, they are all headed toward minimum levels of training. Currently the entry level for PT is a Masters, soon it will be a PhD. For a pharmacist, as recently as five years ago, minimum training rose to a pharm D, (PhD equivalent). I hear that RT is heading towards a bachelors degree as minimum. Also, for the specialties in nursing a Masters is the minimum to practice. So I would have to say that nursing is going to have to address a minimum level of educational training in the near future to be taken seriously.

Now I will don my flame retardant pants, because I have a feeling this discussion could get ugly.

ERNurse752, RN · Oct 12, 2001

I think people are afraid of getting torn to pieces if they reply to this one...

My opinion on this is that if nurses want to keep up with other healthcare professions...and if nurses want to be treated with respect as a professionals...then I think it would be good for all RNs to be bachelor's prepared.

However, I realize that this is difficult for many people who are in nursing school. Many individuals with kids etc are attracted to the 2 year programs b/c they can get in and get out, and get on with their lives without spending what seems like an eternity, and a fortune, going to school.

I know that the ANA has been talking about this for awhile, but nothing has ever really come of it, to my knowledge.

This does not mean that I think a four-year nurse is a better nurse than a two-year or diploma nurse...not at all. Both my parents are nurses...my dad has a BSN, and my mom has an ASN, and they're both equally darn good nurses, if I might say so!

I guess bottom line, I think if nursing wants to be respected as the profession it really is, I think the higher the education, the better.

OK...now I'm going to start running!!!!!!!!!!!

frustratedRN · Oct 12, 2001

my questions would be

whats the difference in education (course wise)between the BSN and the ADN?

what is the student really learning in those two extra years?

what do you learn in clinical for the BSN that is different from the ADN or diploma for that matter?

i cant compare the two when i dont know what the differences really are

KellyandtheBoys · Oct 12, 2001

Some of the best nurses I know are A.D.N. trained . And even the old Diploma nurses that are still floating around have taught me a lot.

I started out with an A.D.N. and went back for a bachelor's. I think it was pretty much a waste of time and money as I didn't learn any more about patient care.

I think that there is already too great a demand for nurses. Adding more requirements to becoming a nurse will do nothing for the nursing shortage.

Instead of requiring a B.S.N. it seems it would do morre good to require C.E.U.s for all nurses in a setting.

WashYaHands · Oct 12, 2001

To answer the question about course requirements for each program I went to the web sites of the local university and the local community college to find the differences in course content between the two. Here is what I found, but keep in mind, the offerings might be different in other areas:

ADN

Foundations of Microbiology

Human Anatomy & Physiology I

Human A&P II

English Composition I

General Psychology I

Human Development

Fundamental Concepts of Nursing Practice

Basic Concepts of Medical Nursing

Family Centered Nursing I

Medical Surgical Nursing I

Medical Surgical Nursing II

Mental Health Nursing

BSN

A & P I

A & P II

Theoretical Foundations of Nursing Practice

English Composition I

English Composition II

Nutrition

General Education Elective

Cultural Anthropology

Chemistry I

Chemistry II

Health Assessment

Fundamentals of Nursing

Pharmacology

Pathophysiology

Pharmacologic Math

Developmental Psychology

Microbiology

Intro to Sociology

General Psychology

Adult Health I (these are med/surg courses)

Adult Health II

Mental Health

Childbearing Family(mother baby)

Statistics

Nursing Research

Humanities Elective

Nursing Elective

Advanced Nursing

Pediatrics

Nursing management

community health nursing

General education elective

Humanities elective

Capstone (no idea what this is)

dodging the flames,

Linda

schmrock · Oct 12, 2001

I agree with you Nilepoc I probably have opened a can of worms but I believe it is something we as nurses need to look at. If we want to be recognized as a "profession" and not just a "job", we need to follow the ways of other health care professionals and require a minimum standard.

I'm sorry that KellyandtheBoys thought earning a BSN was a waste of time and money. Earning your BSN is not really about patient care it's about advanced/critical thinking, management, and theory. You learned everything you needed to know about patient care in the ADN/Diploma programs. The BSN program is designed to further your education and get you to think. I also agree with you that there are many ADN/Diploma nurses who are excellent.

I know we are in the midst of a nursing shortage but do we want to sacrifice education for bodies?

nursehathaway · Oct 12, 2001

I believe that an entry level into practice is necessary in order for nursing to be recognized as the profession it is. There are many barriers as mentioned by others responses. Financial barriers are frequent now is the time to develop programs to assist ADN nurses in obtaining their BSN. We are in demand! I believe we have the ability to be heard now more than ever. Programs like loan pay back and scholarships are acheivable, they need us!

nilepoc · Oct 12, 2001

Also, is our shortage a result of poor image as hypothesized in another thread started by somenone this afternoon.

We need to sit down and critically think about why people are not joining the ranks of nurses. I have to say, that I have not found my career as a nurse, to be a profession, as much as I have seen it as a job. What I mean, is that nurses have no collective voice, that management is willing to listen to. Take a look around your workplace, you will see many individuals with concerns and issues regarding the practice of nursing. How many of those people are willing to stand up and work towards changing the environment they work in?

I see two possible solutions, one is to unionize across the country, and the other is to raise the bar and require more leadership out of practicing nurses. i.e. raise the minimum level required to practice as an RN. By doing this, credibility is added to the nurse role. With this credibility comes power. You want more pay and better public appreciation for what you do, then you have to show them you are worth it, by holding yourself to higher standards. How does the public treat a doctor?, with respect, as they know that that person has gone through rigorous training to gain their education. Where as in nursing, you can get a one year degree off of the internet and do clinicals for a year or less and become an RN. Does this sound like professionalism to you?

I also don't see why nurses in general are upset with the thought of having to add another certification or degree after their name. Hell nurses I know love to add more alphabet soup after their name. Nancy Nurse, RN, CCRN, CERN, TNCC, CNS,........ I mean how often do you see that. I see it frequently. This is a product of trying to show that they are educated and knowledgeable in their field. Unfortunately I think this has become necessary because of the lack of a minimum standard to practice in nursing. So how do we change it? We grandfather everyone in and up the standard. Then we empower nurses to do more, and educate the public as to what a nurse does. I can't tell you the number of times I have been laughed at, because I am a nurse. There is very little appreciation of the nurse role in the general populaces mind. But say you are a physical therapist, and the doors open. You are thought of as a professional. I am not saying this is right, but something has to be done to respond to this perception.

Ok there is my newest word salad response to this thread, I am now donning my flame retardant shirt.

NurzofFaith · Oct 12, 2001

Ouch tough topic is right!!

I am a student and I chose an ADN program/community college for these reasons:

Cost, closeness of college to my home, programs NCLEX pass rate,

and time! My spouse is in the Air Force and my time is limited, I need to

go to college and earn a degree using my time wisely! This is the second college I have attended thanks to Uncle Sam..so I want to get it done!

I do plan to get my BSN..I agree it is important to have. But several classmates

of mine dont see it as a must have. They think if one has a BSN they will be teaching or sitting behind a desk..big misconceptions!! I plan to work as a RN and pursue the BSN..but it will happen at our next base...there is that time thing again. I have to say also...I hear colleges offering the 2 yr ADN..I think if this happens its rare! The college I attend requires a ton of prereqs...for me it took 2 years to complete and then I applied and was accepted into the nursing program itself..so I am doing 4 years.

Linda posted above a list of classes to compare the ADN vs. BSN, I dont know what community college the class list came from but I know she mentioned that colleges would vary..I agree! My college offers classes comparable to the BSN she listed.

I think one must do what is best for themselves..whether ADN or BSN..but I strongly agree..Nurses deserve respect and with higher education achieved we should demand it!!!

Just my thoughts...Channa

debbyed · Oct 13, 2001

What would you do with the 46 year old nurse with>22 years experience (20 in Emergency Medicine) who worked her way up the clinical ladder to the top with responsibilities in administration, education and clinical practice.

One who is a CEN with ACLS, PALS, TNCC, ENPC who also teaches PALS and ENPC. A nurse who serves on professional boards and ethics boards. A nurse who precepts new nurses.

A nurse who has an ADN with absolutely NO plans to go back to school.

Who would you replace her with when none of the hospitals can even staff their units with agency nurses.

Any good answers?

nilepoc · Oct 13, 2001

Yes, do what every other profession does when they upgrade the requirements to practice. As I said before, grandfather them in. Obviously anyone currently practicing can continue. You just slowly up the entrance requirements. Thsi is what pharmicists and PT did.