Professionalism and Credentials

[mattcastens]

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...

[Teshiee]

What is the problem? I agree with both sides getting a higher education is great. But I like to know who are the ones who cares what credential a nurse has? Everytime I go on the floor to my patients they never ask me what degree I held. It does not make you a better nurse. Experience does! Having a higher degree makes you well rounded but I am failing to see what does that have to with being professional. There are some lousy ADN and BSN nurses I dont think their degree had a thing to do with it.

If they decided to make all nurses BSN we would have no nurses unless they revamp the system to allow them in the workforce faster. Then you have to consider the average RN she is not a teenager. For some women it is a second career. Nursing should be looked upon as a profession not just having some initials behind your name but the beauty of choosing a higher education or remain learning new ideas you are still a nurse no matter what. Nurses need to come as one stop this seperatist attitude that is the problem right there. I respect all nurses regardless of what their initials I feel we are all sisters wanting the same thing. Let it be optional. PHd nurse are not better than an ADN nurse each on has something unique and special to add to their expertise so please STOP THE DRAMA!!!

:D

[KC CHICK]

Julie, RN....seeing as how I'm now labeled as being in a certain "sub-group", let me tell you that I carry myself w/dignity and professionalism that demands respect. I went into the ADN program because it was the best option for me....not because I'm low rent or low class as you are definately implying in your post. You should be more sensitive to others in your responses in the future.....BSN or not, attitudes like this are not becoming to a lady. :)

I also dress in professional attire for meetings (no jeans) and feel that my ADN program demanded a lot from me. They held high standards that not everyone could meet. They definately didn't pass everyone that walked through the door. For example, my clinical group during my freshman semester started with 7 students......2 of us passed.

BTW, I'm not someone's assistant......I'm a REGISTERED NURSE. I am perfectly capable of making decisions regarding patient care on my own, thank you very much.

[nurs4kids]

KC,

Girl, don't waste your breath..or fingers. You know, I know, as do most BSN/MSN's that the degree/diploma does not make the nurse. Let it go. They can blame the ADN's all day long for the nursing problems, but it just ain't so (yes, I learnT that grammar in my adn program). I guess the "no blue jean 301" class was another of those enhancements that we missed. Funny thing though, I see MSN's/BSN's wearing jeans to meetings just as often as I see ADN's. They had MORE English courses than was required by lowly ADN's, but ON THIS BB, I see just as many grammar/spelling errors by BSN/MSN as I do ADN/LPN. They were SUPPOSED to have had more classes in teaching how to deal with different cultures/socioeconomical groups, yet I believe it was one of THEM who made the comment above about our "sub-group" . Perhaps the thought is that it's the HOURS of education that matters, not the capability to APPLY education (Julie's post case in point). Julie is obviously beyond reality with her "sub-group" analogy, seeing that the government will pay for the "sub-groupies" to go to school AND pay room and board, so it would be in their best interest to go to school LONGER. For the "upper sub-groupies" like myself and you, well we just have to struggle to put food on the table, clothes on our backs, roof over our heads; all while working our "sub-group" job at the local fast food resturaunt , so we settle for what we can get. This analogy was ridiculous! #1 WHO in the public SEES nurses in a meeting??? #2 Just because someone dresses professional, doesn't automatically give them the air of professionalism . The diploma, the clothes, NOR the ARROGANCE will move nursing into the professional realm. Nurses becoming united and taking a stand is the ONLY thing that will benefit nursing. Not likely to happen based on the separation drawn from the "upper group" on this thread.

I'm willing to bet my entire profession on one thing, it'll never happen. Just as soon as diploma and ADN nurses are called "nursing assistants", you will have a mass exodus from nursing. If you think the nurse patient ratios are bad now, ROFLMAO..just wait and see.

Some people have NO clue. You can send a dog to 100 English classes...but ya just can't make him talk. I'm willing to bet Ms Judgemental came from a "sub-culture" otherwise, she'd have never made that comment. An obvious need to raise herself above SOMEONE. lol..not this girl.

[KC CHICK]

nurse4kids, "I love you, man"!!!!!

You totally rule.

Anne (member of ADN 'sub-group')

[donmurray]

"Low rent, low class slobs" Unite! Let's form a union! :D

[askater]

I love getting more rounded...both by reading and experience.

In time we'll need more year's education. As fast as technologies advancing .

I've had patient's ask about my education background. But than again I work on a stepdown unit. I sit there for 1/2 hour after pulling a patients femoral sheath....I guess we have to talk about something.

Most are surprised there's 2 year R.N. program's. I remember when I spoke with a community college counselor...I didn't realize I had the option of a ADN or BSN. And I definitately didn't realize I'd get paid equivalant for a 2 as a 4 year degree.

Now working with fellow nurses....I honestly couldn't tell you who is a ADN or a BSN nurse. From the time I'm at work we're RUNNING and I don't have time to converse with nurses....now patients with sheath removal that's another story

[Mijourney]

Hi. The dialogue. It's wonderful. Unfortunately, I continue to see where some of us have mastered weighing down the issue of moving nursing forward with the superiority and shortage issue. That is a perfect diversion, because it cleverly takes us away from where I feel we really need to focus.

The degree itself is really not the issue. It's what a certain type of degree may do for nursing and the public as a whole. That's called looking at the big picture. Nurses, in case any of us haven't been paying attention, we're already in a shortage. The healthcare system is already in crisis. The shortage will be worsening despite the fact we have different nursing programs available and we haven't gotten our demands met for improved pay and working conditions. We have well over 2 million nurses in the US and many more worldwide. Many of us don't work in nursing anymore. I don't see how revamping our nursing education in some form will hamper or compromise our situation any more than it already is. We already have posters under other topics discussing the recruitment of nurses from other countries. That's happening in spite of the fact we have all these nursing programs available in the states. I've seen very few posters make the valid point that the combination of professionalism, experience, and credentials can turn a good nurse into a great nurse or give a great nurse a major edge and place him or her at a more competitive advantage with insurance companies, the government, doctors, administrators, etc. Like education, experience all by itself does not make a person.

Someone asked who cares if nurses get more education and credentialing? The AHA and the AMA, that's who. They don't want to see sacrifices of any of their pet projects (it's called pork in the political arena) going to the likes of nurses even though many individual doctors and health care executives support nurses. It's to their advantage to see that nursing stays in a certain position. Yes, the colleges and universities have a vested interest like the hospitals and public do, but I believe it's really out of their hands at this point. Changes are happening so quickly. Many of us nurses have been misled in my opinion into thinking that since we're in the mist of a crises or that a nurse is a nurse is a nurse that it's almost sacriledge to consider what nursing's next move should be educational wise.

I'm afraid that ten or 15 years down the road, when I'm retired, I'll be in the position of saying I told you so.

Finally, I want to write that I'm proud of every single nurse and CNA on this bb who is doing his or her level best on the job. The practice, science, and art of nursing is challenging to say the least. I still feel that nursing needs to start going for it soon so that we will be prepared for the future as the population ages, technology advances, the economy and changes, and the worldwide health care manpower shortage intensifies.

[KC CHICK]

donmurray, you're always a hoot. Thanks for not letting us take ourselves too seriously.

Anne

[KatWright]

Nurs4kids and K C ....YOU ARE THE ONES THAT I WOULD WANT TO WORK WITH !!! :D

I know that you would be right there with me in any emergency !!

I know that you would watch my back.

Julie baby, I'm afraid that you would find yourself alone, trying to put out all of the forest fires by your self, because if this is what you truly think of the ADNs, its pitiful. And if the ADNs that you work with knew what you thought of them, you would really have your hands full. Because they may be lacking a few credits but they are certainly lacking knowledge.

You can't know what you know nothing about and your ignorance is certainly showing.

A nurses assistant ??? How rediculous. I know MANY ADNs that can run circles around many of the BSNs.

Good luck to you, you need it

[nurs4kids]

Umm, I have a few questions about these poll results. My questions are in bold.

1) An overwhelming majority of the public (92 percent) said they trust information about health care provided by registered nurses, ranking nurses even with physicians.

DID THIS INCLUDE ADN & DIPLOMA NURSES, WHICH COMPRISE THE MAJORITY OF BEDSIDE NURSES????

2) 85 percent of the Americans said they would be pleased if their son or daughter became a registered nurse.

DID THIS INCLUDE ADN & DIPLOMA NURSES????

3) 76 percent of the public thinks nurses should have four years of education or more past high school to perform the duties of their job.

Were they aware the majority of nurses currently caring for them/their family ONLY have an ASN or diploma???

1) Public's trust of nurses

An overwhelming majority of the public (92 percent) said they trust information about health care provided by registered nurses, ranking nurses even with physicians. Nurses ranked higher than teachers (62 percent) or journalists (51percent). Only two percent of respondents said they didn't trust health care information "at all" provided by doctors or registered nurses.

DID THIS INCLUDE ADN & DIPLOMA NURSES????

2) Nursing as a career

Americans on average would be considerably more pleased if their son or daughter said they wanted to become a registered nurse than a journalist or a lawyer, and much more pleased if they wanted to become a registered nurse than a police officer. Nursing ranked roughly the same as teaching. On a scale of one (very displeased) to 10 (very pleased), respondents were asked to rate how they would feel about their son or daughter choosing a certain profession.

DID THIS INCLUDE ADN & DIPLOMA NURSES????

3) Education levels for nursing

When asked about the education of nurses, nearly one-half of the public said nurses should have four years of education beyond high school. Three out of ten Americans think nurses should have five to 10 years of education beyond high school.

Were they aware there are currently diploma, LPN and ADN nurses who have LESS than four years education, or did they think four years IS the current minumum?? Were they aware that 10 years of education would give a nurse more education than many physicians in charge of their care? Is the public willing to pay the increased healthcare costs necessary to pay for a 10 year-educated nurse???

By the year 2000, the U.S. Department of Health and Human Services projects there will be 596,000 registered nurses with a BSN, with a need for 854,000 baccalaureate nurses. Nurses with five or more years of education (Master's or Doctorate degree) are projected at 175,000, with a need for 377,000 in the health care system. Projections for 2010 and 2020 continue to drop off significantly in each degree area.

4) Nursing's role in health care

When asked about specific duties of registered nurses, the public recognized that nurses monitor care and provide counseling to patients, but were less aware that nurses diagnose, treat and prescribe medicines, which are duties of advanced practice nurses.

If they weren't aware of THESE facts, isn't it logical to assume that they aren't aware of the current education requirements for nurses???

Now, will someone PLEASE tell me where these results show ANY public concern over nurses lack of education?????????!!!

I keep hearing how more education would give us more professional standing. However, I've not read here, or seen in the media where the general public feels NURSING care has been substandard. Just WHO are we wanting to impress? Do you think a CEO will say, "Why heck, they've got more education now, let's pay them more!"?? According to the title of this thread, they don't recognize education NOW. Why do you think they will recognize it more if BSN is required of everyone?? I can hear it now: "You have to pay nurses more because they all have BSN's now." CEO/Manager, "Why should I pay more NOW?? I'm not getting any more out of them than I did when they had LPN/diploma/ADN's!!!".

Come on guys, I'm all for education, but this is NOT our problem!

[CareerRN]

Every time I hear this debate about how more education is going to lead to increased respect and professionalism, there are two relevant topics that come to mind.

One is the african-american physician who was a pioneer in the field of hematology and blood transfusions. He literally bled to death at a hospital because they would not give much needed blood. He did have the educational credentials that should have brought about respect. Yet when push came to shove, he died because he was not respected. I wish I could remember his name.

The other is the Tuskeegee Airmen. This was a group of highly educated men who could not get jobs with airlines when they returned home from the war.

In both instances, education was not an issue. Knowledge and skills were proven to the point that there were no doubts of abilities in either one of these circumstances. Yet respect was not automatically granted because of education alone.

In fact, respect for the group as whole came only after a long hard battle. It literally took millions of people to win it by saying "we are not going to take it anymore and this is the way it is going to be". Many of the participants had never been to college. Many had not even graduated from high school. In fact many were fighting for the chance to attend school or for their children to attend school. These people fault for the equality and self respect and respect as a group. The fight they won then open many doors that had been previously been locked shut. It took a long time to unit these people and I bet many of the same issues were common with the nurses of today. In other words, the same excuses and apathy that is prevalent.

Nursing is a female dominated profession. It does follow the movement of women in general with an unfortunate difference. It in many ways lags behind in many respects. I am sure we can all come up with reasons or excuses for this. There is one thing that is clear and has been proven time after time. If a group of people will not stand up and fight for themselves then they will continue to be dictated too. Education alone is not the key to respect, nor is it the only key to self governing.

This debate boils down to the ability to self govern our profession. We have some nurses who say that we need to prove our abilities by increasing entry level requirements. We have other nurses who are saying that we do not need to prove anything and that we are more than capable already. My question is to whom do we have to prove ourselves to in order to self govern ourselves and our profession as a whole? Is it the public in general, the federal government, the American Medical Association, the American Hospital Association, JACHO, to each other, or maybe it is to God himself? Who do we have to prove to that we are smart enough and capable enough to set our own rules which dictate our own practice in our own profession?

Some times if you want something, you have to demand it and not take no for an answer. As they say, if you want an omelet you have to break a few eggs.

[nurs4kids]

Career RN,

VERY WELL SAID!!! Very good parallels.

tracy