Professionalism and Credentials

Nurses General Nursing

Published

OK, just some thoughts here so early in the morning (after work...)

I've been thinking on how we can improve the image of nursing and a couple of thoughts come to mind.

First, what do people think about having a baccelaureate be the entry-level for nursing? (I ask this as an associate degree nurse, who's going to be going for my BSN, so bear with me.) I realize that this has been an ongoing debate for decades, but hear me out. Nurses are constantly looking to get paid more (as we should be), and demanding more respect (as we should be). However, I good-naturedly ask, why should we be expecting those things if the entry-level education requirement is the same as an auto mechanic or a dental hygenist? Granted, we hold people's health (and many times lives) in our hands -- but shouldn't that be even more reason to demand a higher base education? True, with the nursing shortage the way it is, it's not necessarily a practical idea; but perhaps there's a way to grandfather in the existing ADN and diploma nurses and make a transition to the BSN requirement over a few years?

Second, it seems to me that many nurses (at least one's that I work with) are reluctant to get specialty certified in their fields (CCRN, CEN, etc.). Why? Sure, time is frequently a factor (especially if you have kids), but the reason I hear most is that there's no financial incentive from hospitals. So? What better way to reinforce that "a nurse is not a nurse" philosophy that to get specialty certified. Also what better way to impress upon patients, physicians, and the public that we're well educated and masters of our art than to get certification? Doctors love to get certified and credentialed because it increases patient confidence and garners collegue respect. Would it not do the same for nurses? The financial incentive (if you really need one), is that if the public see us as specialists, there will be more public support for paying us as specialists and professionals.

Just my $00.02 worth. Now I'm going to bed... :mad:

Hi KC. My suggestion is not just based on quantity. My understanding is that we have the numbers in the nursing profession right now. But many of us are not willing to work under the conditions or with the pay we're expected to accept, work full time, work in certain settings, or work in certain areas, like the needy rural areas.

If legislators put bite behind their bark, we could see legislation that gives nearly full support to nursing students, new and returning, that would eventually dramatically increase the number of practicing nurses annually. The fact of the matter is that the crises in nursing is not merely about numbers.

CareerRN, the problem, I feel, with using the same advanced NCLEX test on diploma and baccalaureate nurses is that in most cases, the general ed cirriculum of the programs are not the same. I know that many of the diploma programs have added cirriculum since my diploma nursing school days, but so have many of the university based programs.

I think that a case can be made for those who have a two, four or more year degree in something else and a ADN or diploma in nursing to take the advanced NCLEX exam, however. The LPNs and those with only a two year nursing degree or diploma can take the standard NCLEX. After that it can be determined how much more work experience and/or education they need for the advanced NCLEX.

Finally, I wonder about the percentage of success of baccalaureate graduates on an advanced NCLEX. My observation is that these programs vary widely in their curriculum from school to school. I don't believe that baccalaureate graduates dramatically outperform, if at all, diploma and ADN graduates on the boards that are administered today. Correct me if I'm wrong.

Not only do master's prepared RNs have to pass boards but they have to pass a certification tests. More often than not, master's prepared nurses show more earning capacity then other RNs. Sorry this was long.

"INCOURAGE education"......sorry Brandy, don't you mean 'encourage'? (has since been corrected)

A question for you all....How is more SEPARATISM in testing and licensing going to bring nurses more together? I don't get it. And, as far as the hard feelings and bitter attitudes that Brandy mentioned......I feel just fine about being an ADN RN that is making the same amount of $$$$ as a BSN RN that has the same experience level as myself.

I just happened to get more out of my $6-8,000.00 investment than a 4-year grad who might have invested $15-20,000.00, or more, for the same nursing knowledge base and license qualification. I'm not hurt, or bitter, about that whatsoever. In fact, I feel savvy.......... and a bit thrifty.;)

PS:

Show of hands please....am I the only one posting to this thread w/an ADN right now??.....everyone else BSN? By the responses, I'm sure getting that vibe. Is it me???:confused:

Yes, ENCOURAGE is what i meant. Thank you for correcting my misspelling, I just hope that the correction was not made out of spite, as it is not typical of you to post spitefully.

Matt is also an ADN I believe. Look at the first post in the thread.

Don't you think that we will have separatism as long as there are multiple ways to get to the same place? There are ALWAYS going to be arguements about which prepares one better. By giving different classifications we would eliminate this.

BrandyBSN

Specializes in jack of all trades, master of none.

Hmmm. I don't even know where to begin. So many good points here.

I think I will start with the LPN thing. Started as CNA, then LPN, went back to school for ADN, next step will be BSN. Gotta take those "baby steps. I have been hearing the LPN phase out thing for years, & I believe that one has been recycled for decades.

I don't think that different NCLEX tests would really work, and possibly cause more rifts in an already troubled area of health care.

I think it would be helpful for ALL nurses to start as CNA's and progress through the ranks to LPN, RN, etc. Maybe have a minimum requirement for the time spent at each level, 6 mos CNA, then 1 yr as LPN, 2yrs as RN and so on. I know it's wishful thinking, but maybe something like this would help promote the spirit of nursing & help us all remember why we chose this profession in the first place.

There have been other threads of this nature....and different things have been said. For instance, I can recall one posting that stated a BSN instructor was advising her students that they were better prepared than students from an ADN or diploma program. I think this separatism is a reflection, sometimes, of what students may be told when it comes to a description of all the degree options......by their instructors. Other times, it could be something else...I don't know.

I had no idea how strongly some felt about BSN as opposed to ADN, or diploma, before I started coming to this board. I don't see, or feel, the same attitudes at my job....thank goodness. All are encouraging about moving forward w/my education if I choose to do so. They don't look at my education background as something that is holding back the profession from being taken seriously. They are glad that I am one of them....an RN that will do her job to the best of her ability and will help them out if they need it.:D As I've stated on previous postings, my hospital does not discriminate....there is no differential for BSN.

Brandy, I was not being spiteful....merely making a point, as others do on this board. If a post is to be made about higher education...cross those T's and dot those I's. Show us what mom and dad are paying for, little buddy!

Again ladies, research your statistics in regards to the future of the nursing shortage. The more options that are available to future nurses, the better.;)

LOL :) VERY true. Unfortunately spelling is not my forte, and I am EXTREMELY glad that my 3rd grade spelling test scores did not transfer to my college GPA, or I would not be here :)

if mom and dad were paying for college, I might not look at my education as such an investment :) Its all out of my pocket (actually, its out of my future pockets, since its all loans with sky high interests rates:eek: :eek: They DO pay my car insurance, and I am very thankful for that :)

Brandy,

You did not step on my toes nor were my comment meant to be a personal attack.

We do need to find a way to end the bickering about BSN vs ADN vs diploma RNs. It always seems to come down to 2 things. One is actual nursing knowledge and the other is clinical experience. A 2-tier system of N-CLEX testing would put a stop to one of these. If a diploma or ADN nurse feels they have as much knowledge as a BSN, then they would have a way to prove it. The same can be said about BSN who feel their nursing knowledge base is superior. It is a win-win situation and a way to determine who should be rewarded in the long run for higher education directly related to nursing knowledge.

I do not think you find too many nurses who are actually opposed to obtaining more knowledge in general. In fact, I think you will be hard pressed to find an experienced nurse who will not say they are still learning something new all the time. It is just a matter of what one person finds or chooses to be interested in. I have other interests outside of nursing. I call them hobbies. Many of them do come in handy as a topic of conversation when I am doing a physical assessment. I can not honestly say that any of them have actually made me a better nurse though or a better person.

I do not speak Spanish nor am I interested in studying Spanish. I can see how Spanish would come in handy at times, but the same can be said for French, German, and even sign language as well as a dozen other languages. So where do we stop. I agree more knowledge is a marvelous thing, but there are many subjects that would not in any way make me a better nurse. Sociology was a prerequisite for my nursing program and in some ways it was enlightening.

Yes there are major differences between one college or program to the next. One would think that all nurses would be trained in almost a cookie cutter fashion, but they are not. This is part of the argument that always comes up with this discussion. I used to resent having to take those idiotic tests given by most hospitals when you apply for a position. My contention was that I was a licensed RN and as such I had already proven my body of knowledge. Then one day I while talking to another RN I found out why the hospitals insisted on the testing. Her program was no where as intense as mine in both educational and clinical requirements. This should not at all be the case. When a licensed RN applies for a job, then the basics of nursing knowledge should be automatically accepted. Right now this is not possible.

As a point of discussion, higher education in and of it's self is not the only answer to the professions problems. If higher education were the sole problem then NPs would still not lag behind PAs in many of the areas including salary.

What is the difference in salary between a PA and an NP? We dont have any PAs here (no PA programs in this part of the state)?

I didnt take your comment as a personal attack :) I just wanted to stay on a friendly basis, while still debating a very important issue :)

Thanks

BrandyBSN

Specializes in Pediatric Rehabilitation.

I stayed away from this thread because of the topic. I figured the conversation would, as usual, turn into a LPN vs ADN vs RN battle. Yaaaaaaawn.

As an ADN, first let me say as I've said before, I have NO problem with a BSN making more than me IF they are doing the same job without having to LEAN on me. With that, I mean, I don't see a new grad BSN coming in making more than me when she/he is constantly dependant on my experience and knowledge (this is happening to me right now). If we're doing the same job and you have more education, then by all means, give you the extra quarter..it's no sweat off my back.

The second NCLEX is a ridiculous proposal. Hmmmmm, I know nothing but peds, your knowledge is in psychology. So, we both take the second NCLEX and I get one full of peds questions, you get one full of pharmacology. I pass, you fail. What was proven there? nada. Doesn't mean I'm a better nurse, just a bit luckier on the day of testing.

Credentialing has very little to do with professional appearance. Until we unite, quit the bickering over who has the bigger, better, longer letters behind the name, we'll just keep dragging ourselves down. The general public does not care about credentials. They want a nurse. They want someone to compentently care for them and their loved ones. With the shortage, we don't have to establish a minimum level of education. We have to establish unity, GUTS and COURAGE. We have to quit fighting like cats and start ACTING like professionals. We have to stand up for what we deserve, plain and simple. Then again, we could just keep blaming ADN's for dragging a profession down. :rolleyes:

I'm like KC, here there is no difference between BSN & ADN. As for pay, we all start out with equal pay and then have the opportunity to advance by experience and education. My employer doesn't even allow credentials on name badges. Perhaps this is why it's not an issue here, they just don't differentiate between the two. They do, however, recognize excellence..regardless of degree/diploma. My coworkers never even discuss this issue, the only way we know who holds what is because we discuss college and know which is 4yr vs 2 yr.

I think it's absolutely ridiculous DURING THE LARGEST NURSING SHORTAGE IN HISTORY to even talk of raising the educational level minimum to BSN. We can't recruit enough people as it is, then you want to isolate thousands more???? I guess in my pathetic, ASN education, I wasn't taught the logic that goes into that proposal.

As soon as the minimum level is raised to BSN, you BSN's better watch out...the MSN's will be raising the level over you :D

Every nurse should be required to be a CNA, LPN..etc for a year prior to advancing??? Hell, I started out in Central Supply, I kinda like your idea... EXCEPT I think we should all just start out in housekeeping...after all, then we'd appreciate everything ALL the ancillary people do . ***NO ONE CAME INTO THIS PROFESSION TO DEDICATE THEIR LIFE TO POVERTY AND OVERTIME*** so bleeding hearts, please quit reminding me why I chose this profession. I chose this career because I like helping people and I thought nursing was a profession. one out of two ain't bad :D Until we behave professionally, we will not be treated as professionals...even if we raise the educational minimum to the level of MD.

off my soapbox

Hey nurses!

Not trying to step on any toes......

I think the original poster asked about professionalism, education and credentials. Not who or what makes a better nurse. I would love to here some more thoughts as it relates to our profession. ;)

Canadian nurse: Where I work we are required to take classes in our specialty called "core curriclum" offered by the hospital itself (free). However, it only spends two days on one broad topic ( for oncology we have 5 broad topics total). I love the classes and feel they have increased my oncology nursing knowledge alot, thus improving my pt education abilities and prioritizing care. I have a more indepth understanding of the "how's and why's" of oncology care now. But, I would really love if the hopsital would pay for me to take college classes on these topics that goes much more in-depth and helps prepare me for my OCN exam.

Cheers,

Julie M.,RN

Knowledge is power!

I am doing a term paper on NP's and found Brandy's comments interesting. So I thought that I would make some comments (facts) about NP's and their education.

First, most NP's are CERTIFIED through a MSN program. They have a separate board to sit for that is designed by the American College of Nurse Practitioners. The first NP program was started in 1965 at the University of Colorado (against physician's wishes). This was after thousands of studies looking at quality of care, patient acceptance, patient satisfaction and cost-effectiveness of NP's were conducted. The education process for NP's has become more standardized over the years and the move to require a master's degree for entry level practice has taken a long time. The last to make this change was the Women's health NP and the last funding for women's health certificate prams under Title X ends in 2004. By 2007 all women's health NP's will need a master's degree to sit for the national women's health certification examination.

In 1992 (when the nation was discussing healthcare reform under the Clinton Administration) NP's moved to develop greater organizational cooperation because they thought that they would be totally left out of any new reform due to not being unified with a national presence in Washington, DC. There was a national summit of NPs and a National NP Coalition was created. This coalition was formalized into a permanent political arm for NP's which became the American College of Nurse Practitioners.

Now, so you don't get totally bored reading about NP's here's a little info about salaries. In 1997 the average salary was $52,532 and in 1999 it was $58,391. And (go figure) allot of the salaries are still gender specific. For instance in 1999 the female NP's salary averaged $58,120 and the male NP's salary averaged $62,680.

These are just some of the facts that I uncovered when I was doing research for this paper.

So YES, furthering your education is important and YES there should be a difference in salary.

Perhaps nurses that are NOT NP's should take a lesson and organize like the nurses with more education did!!!

IMHO!:D

Specializes in Critical Care,Recovery, ED.

A few random and scattered thoughts on this thread.

Education is only useful if it is applied. Not everyone with education applies that knowledge.Of course you have to obtain that education before you can apply it

.

The application and utilization of Knowledge/education has been equated with power. Change can not be obtained or effected without power. Does anyone believe that the Nursing Profession and our health care system doesn't need change?

Encourage education at all levels, ecourage continuing education, and encourage the raising of education standards for all.

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