New Slant on ADN vs BSN: are ADN programs anti-intellectual?

Nurses General Nursing

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I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?" :eek:

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Another pharmacology teacher put down several foreign students who said that activated charcoal was used in their country as an anti-emetic, for indigestion--she told them that if someone took activated charcoal it would cause them to vomit (not true). How activated charcoal works was eventually brought up by another instructor who assured us that activated charcoal was not an emetic.

While we are told our ADN program has an excellent reputation, these kinds of responses bother me. I always learn better when I know MORE, because I understand how everything works.

I feel like my school and I have different educational philosophies.

Are all nursing schools like this? Is it more prevalent among ADN programs? I am a bit disappointed, to say the least.

Thanks,

NurseFirst

Dear NurseFirst,

Please allow me first to congratulate you on your desire for more knowledge and understanding; I would not hesitate to be your patient, in the future! Re: your question: having just graduated from an MSN program, with the desire to teach nursing students, I can tell you that the general perspective is that ADN programs are more technically and skills-oriented, whereas BSN programs are oriented more toward planning and management of nursing care, which gets more into the "whys" of nursing action.

Please please please PLEASE don't encourage or cultivate this attitude with your students!

Can I ask why this is accepted as the "general perspective?"

Do you think we just call the ABG's to the doc without looking at them/interpreting them for ourselves first? Do you think that when my pt's potassium is out of whack and the doctor orders an amp of D50 then ten units of insulin that I don't know why? Do you think I don't make a connection between my pt's decreased UOP and his fever? Or that when I start a Cardizem gtt I don't know why the rate and rhythm need to be converted? Do you think that I don't realize why a COPDer's H&H is almost always elevated or why you shouldn't give beta blockers to a cocaine overdose?

Honestly, I'm not being sarcastic, I really would like to know if this is actually what you think about ASNs. I commend you for going into teaching (because God knows we need you! :nurse: ) but I sincerely hope you don't think that way. Whether you meant to/realize it or not, you have just insulted many of your peers.

To the OP, I don't think there is a single piece of knowledge that wouldn't aide you in your nursing practice. And no, not all ADN programs are like that. (At lease mine wasn't.) I am very sorry that your instructors chose to make light of your comment, but please don't let a couple of bad eggs spoil the whole bunch. Good luck to you, keep thinking along those lines!

hi,

i have a question. what year/quarter/semester are you in? because i can see the possibility that the pharmacokinetics of aspirin excretion as it relates to the ph of urine, etc. might be a teensy bit complicated for the very beginning of a nursing program. any nursing program.

i am starting my 2nd year. but we did cover abgs and fluids & electrolytes in our 2nd term. (although perhaps not as much as i would have liked--but that's okay for where we were.)

however, the other posters were excellent in pointing out that it's all useful information, especially if you work peds or er, and see aspirin poisoning. you need to know why their acid-base balance is wonky, which way it's screwed up, where is it going next, how do you need for it to be, and specifically what things you can do to accomplish this. if indeed you are in a fundamentals class, or the first year of nursing school, i'd suggest easing off on the teachers a bit. then go and get two books: pharmacology for nursing care by lehne, and find a good pathophysiology book. even "pathophysiology made incredibly easy" will do; some of my classmates really like it. don't confuse that with a med-surge book.

you can then proceed to cross-reference the two whenever you are curious, and maybe enlighten your friends/classmates outside of class time on the interesting stuff you find out. it may be that you're simply jumping ahead of the structure of the program, and that it'll catch up to ya; or maybe you'll have different instructors in later classes who will more fully cover the metabolic/pathophysiology stuff.

actually, our cohort was the last class to use lehne. pity. and i have the pathophysio book, too. lots of people in my class didn't like lehne, but i did. but i think it's because the chapter they really needed to read was listed as a "review" chapter, and so folks didn't read it (it probably also didn't help that the first pharm instructor said she tested from her lectures)--the one where lehne basically says that you need to have a good understanding of neurotransmitters to understand pharmacology. that, by the way, is an excellent example of how knowing more helps you to have to learn less--because once you have neurotransmitters down, you only have to know which neurotransmitters a drug affects to have a pretty good idea of how the drug functions (and all its pharmokinetics). it's a matter of whether you are teaching from the bottom up or the top down. i learn better, and i think there is research to demonstrate that most people learn better, by a top down method. but then, maybe that's my software background talking--when "top-down" programming was all the rage. :)

sorry if i'm rambling,

indy

ps -- sorry, guys, if i seemed like i was "nit-picking" -- i found the initial responses of the two posters i mentioned to be a bit off-putting.

nursefirst

or, as one aphorism wisely states: "take responsibility for your own experience."

Specializes in ICU, telemetry, LTAC.

Oh, the chapter on neurotransmitters still gives me a headache, but I keep going back to it. I'm also really fond of the "I Can" publication company's little drug review book. Ms. Manning's mnemonic for anticholinergics: "can't see, can't pee, can't sit, can't ****" will be forever stuck in my head.

By the way, that tree analogy is wonderful.

nursefirst,

i think it totally sucks that your instructor(s) responded as if you were an alien from outer space. op stated might be r/t egos, i.e., not knowing the answer??

i happened to graduate from a superior adn program where critical thinking was key to us learning. we HAD to understand the whats, whys, hows and their correlations/implications to the patient's current and pmh.

i personally am extremely motivated and if there was something i didn't learn in school, i learned at home by doing my own research. and in spite of a couple of 'doozy' instructors, again, my education was superior.

good luck to you.

leslie

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
PS -- sorry, guys, if I seemed like I was "nit-picking" -- I found the initial responses of the two posters I mentioned to be a bit off-putting.

NurseFirst

or, as one aphorism wisely states: "Take responsibility for your own experience."

NurseFirst: I am sorry I was off-putting, as you put it. Your thread title was and is very off-putting to me, too. It is indeed incendiary to me as an ADN graduate. Nevertheless, the challenge for you, as I said before, is what to do about your situation. (As you said, taking responsibility for one's own situation). I did acknowledge and recognize your problem. I made a reasonable suggestion to discuss it with your instructors and director as I used to do...... Is that off-putting to you, as well? If so, I humbly apologize. I honestly mean you no offense.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
nursefirst,

i think it totally sucks that your instructor(s) responded as if you were an alien from outer space. op stated might be r/t egos, i.e., not knowing the answer??

i happened to graduate from a superior adn program where critical thinking was key to us learning. we HAD to understand the whats, whys, hows and their correlations/implications to the patient's current and pmh.

i personally am extremely motivated and if there was something i didn't learn in school, i learned at home by doing my own research. and in spite of a couple of 'doozy' instructors, again, my education was superior.

good luck to you.

leslie

from what I am reading here, mine was superior, as well. I have a feeling MOST ADN programs are, no matter WHAT the BSN proponents and universities try to have people believe.
Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
from what I am reading here, mine was superior, as well. I have a feeling MOST ADN programs are, no matter WHAT the BSN proponents and universities try to have people believe.

I agree, as a RN to BSN student, I do see the focus in the baccalaureate courses different, but no more intellectual than my ADN experience, which so far has been the greatest intellectual challenge of my life.

Specializes in Med-Surg.

The fact that your instructors have gone out of their way to inform you that you ask tangential questions makes me believe that it might not mean that they're anti-intellectual, it might simply mean that you're being a pain in the A$$.

For example, if I go to clinical on my first day and ask 300 well thought out intellectual questions of my clinical instructor or patient's nurse within the first hour they're going to hate the sight of me. Especially if they're also working on an agenda other than fulfilling my requests for further knowledge.. say they've got other students to tend to, or other patients to take care of. Now, if I'm asking questions that don't even seem to be pertinent for the moment... say they're helping me insert a foley and I want to stop and have an intellectual discussion on nosocomial infections in the 21st century... then I can see how they're going to be throwing words like "tangential" and "selfish" around.

We have a tangential question asker in our ADN program too. Lecture always stops while she asks about things she doesn't understand that seem to be peripherally related to the topic at hand. I swear as soon as we hear the words "I have a question..." a collective groan goes up through the class. Personally I think it's her way of drawing attention to herself... but I'm sure that's not what you're up to.

Ego all the way.... sometimes it's hard to say I don't know....

Specializes in NICU.

We have a tangential question asker in our ADN program too. Lecture always stops while she asks about things she doesn't understand that seem to be peripherally related to the topic at hand. I swear as soon as we hear the words "I have a question..." a collective groan goes up through the class. Personally I think it's her way of drawing attention to herself... but I'm sure that's not what you're up to.

I'm sure the op isn't this person either, but doesn't every class seem to have one? :chuckle I had a teacher who handled this very well, though. When asked something she didn't know the answer to or that didn't really apply to the lecture, she would tell the questioner to research it out and report next time. Those who were asking just to use up class time soon stopped and those genuinely interested in the subject would do the research and give a brief report (the teacher would help with resources). It was usually very interesting and useful.

Specializes in Med/Surg, Ortho.

Hmm, edu-speak. ok,, well fact is i wont go into bashing instructors. I gave only an opinion not so different than a lot of others here. What i do know is BSN, ADN whatever the case everyone sitting in those chairs have the same goal in mind. Again,, i say, if you have an area you are particulary intrested in, finish what you are doing whether it be ADN or BSN,, and then move ahead to further concentrate on what YOU find interesting.

the fact that your instructors have gone out of their way to inform you that you ask tangential questions makes me believe that it might not mean that they're anti-intellectual, it might simply mean that you're being a pain in the a$$.

great observation. i think i can identify between task-oriented situations and "theory". this all pertains to neither: the statements about asa and urine ph were made outside of class, when no one else was around except the two instructors and me.

for example, if i go to clinical on my first day and ask 300 well thought out intellectual questions of my clinical instructor or patient's nurse within the first hour they're going to hate the sight of me. especially if they're also working on an agenda other than fulfilling my requests for further knowledge.. say they've got other students to tend to, or other patients to take care of. now, if i'm asking questions that don't even seem to be pertinent for the moment... say they're helping me insert a foley and i want to stop and have an intellectual discussion on nosocomial infections in the 21st century... then i can see how they're going to be throwing words like "tangential" and "selfish" around.

we have a tangential question asker in our adn program too. lecture always stops while she asks about things she doesn't understand that seem to be peripherally related to the topic at hand. i swear as soon as we hear the words "i have a question..." a collective groan goes up through the class. personally i think it's her way of drawing attention to herself... but i'm sure that's not what you're up to.

no, unfortunately; i'm just tormented by insatiable curiosity (that's how i got so many college credits. btw, they certainly discuss and encourage critical thinking skills in our curriculum--however, i do believe that at least some of the questions i've asked would stimulate such thinking.

but, i also recognize that i am unusual among many learners. i come from a background which emphasizes "stretching"--getting out of one's comfort zone. i also have a friend--very, very smart and talented, but without a college degree. he used to apply for contract jobs where he had no particular experience, raid the bookstores, read the books and interview--and get jobs.

nursefirst

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