First, I do not want to challenge nurses with several years of clinical experience that are ADN or diploma trained nurses or those nurses that graduated recently with a ADN, and I do not want to challenge anyone by saying that there is a difference between the ADN versus the BSN prepared nurse.
There is a push for all nurses to be BSN prepared or for ADNs to achieve their BSN; however, there is no increase in wages for the majority of those with their BSN or those going from an ADN to a BSN. I find that as a workforce, we do not understand our worth. Why do we need the BSN as it costs more and it has no pay benefits. Students that have an ADN from a community college have less student loans, and they make the same a student that has a BSN; however, the BSN student has increased student debt with no increased monetary income to show for their degree.
I challenge the nursing workforce to acknowledge our value as a profession, and demand an increase in pay if we are to have a BSN. The current yearly income of a nurse is based on the costs of an ADN level of education; however, it does not match the cost of a BSN cost of education. If I am required or it is preferred that I have my BSN, I need to be paid accordingly. I do not practice nursing strictly for the income, but I do appreciate putting a dollar value on the work I do.
Well that just illustrates the lack of consistency across nursing -- your instructor was touting the "appliance nurse" option to you as a reason why nursing was a good occupational choice for young women at exactly the same time as my instructors were pointing to "appliance nurses" as one of the significant reasons why nursing was not advancing as a profession, and as examples of nurses not taking themselves and nursing seriously.[/quote']
!!!!
And this is what I stated before...there needs to be a bridging of the minds in relation to this...that will advance the profession FAR more FIRST; the issue is, how many are WILLING to change their attitudes of nursing in order to provide strength to the new generation of nurses present generations down the line????
Nursing is here to stay, and even in the midst of the challenges, there has always been a push, even with the HACPS (if done correctly) nursing outcomes model and the nursing model will eventually be more prevalent and side by side with the medical model...I think it will take more if a push with the percentage who don't see this as a profession that will make it far more difficult than the current forces.
And I have been taken care of by "tasks" nurses and the "holistic" nurses range; I find more satisfaction and better outcome of MY HEALTH from those who leaned more towards the "holistic" nurse-the ones with nursing knowledge FIRST, then the tasks, REGARDLESS of education.
I agree. The current BSN is useless unless you were an RN first, who then went and finished the degree. If you just started nursing school and got a four year BSN, they teach you virtually no practical skills. What good is an RN who can't start an IV, drop and NG or put in a foley? I just taught an IV class to a group of LTC nurses and one RN told me that she has NEVER put in an IV and NEVER was allowed to do any skills in nursing school, and she went to school in a large school in Minneapolis! I may be biased because I was a paramedic first, and for paramedic training, you had X number of skills you had to do in addition to the 800 hours of clinical time, and if those skills weren't done, it didn't matter if you had 1000 hours of time in, you continued to do clinical time until your skills were complete. We intubated pts in the OR, changed dressings in the burn unit, did hands-on in L&D, did hundreds of hours in the ER, and all before we were allowed to ride on the ambulance. My nursing school clinicals were beyond a waste of time. Nursing school didactic is fine for teaching NCLEX exam skills, but clinical time would be better served doing actual skills, not observations. One bed bath, one turning a pt. Check, on to the next thing, not wasting weeks on end handing out pills. You should follow the wound nurse, or the ostomy nurse, and do rotations where actual skills are performed, like IVs, IMs, drug pushes, CPR, NGs, foleys and the like. Otherwise, you set up the new grads to fail. One of my nursing instructors said this, "I don't know WHY nursing students think they should be able to start IVs and put in foleys when they graduate nursing school!" Um, because that's EXACTLY what they should be expected to know when they graduate! You expect your mechanic to be able to fix your car when HE graduates from school, right? Why is this different?
Your experience of your BSN program without previous ADN/Diploma RN training are similar to comments I heard from generic BSN students in 1996/1997 when I bridged to BSN from my ADN program. In the final semesters I heard students say they had received hardly any clinical training and didn't feel prepared to be nurses.
I feel fortunate that my ADN program provided plenty of very good clinical training and prepared me to give direct patient care at the bedside. I had clinicals two days a week and in summer school at four different hospitals plus a long term care facility. I rotated through med/surg (oncology unit and neuro/ortho unit), ICU step-down, labor and delivery, two more med/surg units at different hospitals, rehab, psych on a locked unit and psych ER, pediatrics, and geriatric rotation in LTC. I did student work experience on an oncology unit, where I then did my preceptorship. Most of our instructors worked as nurses in the various hospitals we did our clinicals in.
When I read posts like yours I feel that students are being robbed both of their money and of the experience they are supposedly paying for, and ultimately patients are losing out.
This is just what I have found initially, but it sparked my interest and I will likely dig a little deeper.
Here's a bit of a snippet about the value of BSNs compared to ADNs in terms of reducing patient mortality. A few studies note reduced mortality of patients when an increased presence of BSNs exist. Is it a direct correlation to the BSNs present or the type of facilities where BSNs are found in increased numbers? More research is needed, but if this holds true through numerous large studies, and can be proven to be a direct correlation, then a BSN should be paid more than an ADN.
"A growing body of research documents that hospitals with a larger proportion of bedside care nurses with BSNs or higher qualifications is associated with lower risk of patient mortality. Aiken and colleagues (2003) in a paper published in the Journal of the American Medical Association(JAMA) showed that in 1999, each 10 percent increase in the proportion of a hospital’s bedside nurse workforce with BSN qualification was associated with a 5 percent decline in mortality following common surgical procedures. A similar finding was published by Friese and associates for cancer surgical outcomes (Friese et al., 2008). Aiken’s team has replicated this finding in a larger study of hospitals in 2006. Similar results have been published for medical as well as surgical patients in at least three large studies in Canada and Belgium (Estabrooks et al., 2005; Tourangeau et al., 2007; Van den Heede et al., 2009)." and "In Aiken’s JAMA paper, evidence was presented to show that the mortality rates were the same for hospitals in which nurses cared for 8 patients each, on average, and 60 percent had a BSN and for hospitals in which nurses cared for only 4 patients each but only 20 percent had a BSN (Aiken, 2008; Aiken et al., 2003)."
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine. (2011). The future of nursing : Leading change, advancing health. Washington, D.C: National Academies Press.
All the studies here measure education level and nurse/patient ratios simultaneously. How can you measure two variables simultaneously without a corollary study? It's blatantly obvious that the data has been manipulated to fulfill an agenda. Where are the credible studies that measure ADN vs BSN with nurse/patient ratios as a constant? That is the one I'd be interested to see.
I would think that critical thinking skills, along with proper and timely interventions would improve patient outcome, regardless of the degree level of the nurse.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
All the studies here measure education level and nurse/patient ratios simultaneously. How can you measure two variables simultaneously without a corollary study? It's blatantly obvious that the data has been manipulated to fulfill an agenda. Where are the credible studies that measure ADN vs BSN with nurse/patient ratios as a constant? That is the one I'd be interested to see.
Good point! I would add that when they separate ADN and BSN nurses, all of the BSN nurses who started as ADN need to go into the ADN category. At least they di if an accurate study is to be done.
Good point! I would add that when they separate ADN and BSN nurses, all of the BSN nurses who started as ADN need to go into the ADN category. At least they di if an accurate study is to be done.
That makes no sense. If at the time of the study they've gotten a BSN, they now have a BSN and the benefits (however questionable you may think they are) that go along with that.
All the studies here measure education level and nurse/patient ratios simultaneously. How can you measure two variables simultaneously without a corollary study? It's blatantly obvious that the data has been manipulated to fulfill an agenda. Where are the credible studies that measure ADN vs BSN with nurse/patient ratios as a constant? That is the one I'd be interested to see.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
That makes no sense. If at the time of the study they've gotten a BSN, they now have a BSN and the benefits (however questionable you may think they are) that go along with that.
If a study is going to be used to justify BSN as the only point of entry then it need to compare nurses who entered with a BSN and nurses who entered with an ADN, regardless of subsequent educational attainment.
If it doesn't it won't be valid.
if, on the other hand the study is being used as evidence that nurses should obtain a BSN at some point in their careers and NOT that BSN should be the sole entry to practice then there would be no need to separate them out.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
If BSNs on the floor lead to better outcomes, then having them get that BSN earlier only makes sense.
*** Yes that is true. However that is a very, very big "if". Maybe what leads to better outcome is experienced nurses who have learned critical thinking and assessment skills through a combination of on the job experience and education.
Unless outcomes are measured between those who entered nursing with an ADN and those who entered with a BSN and controlled for experience or we won't know if there is any difference..
If BSN means better patient care, then why should patients have the lesser patient care until the nurses finally get around to getting that BSN?
*** We don't know if BSN means better patient care, or if some other factor combined or independent of the BSN makes a difference. Maybe a nurse with a BSN only provides better care after some experience and there is not benefit to requiring the BSN initially. Maybe there is no patient outcome benefit to a BSN prepared nurse at all and the better outcomes measured are a result of some other factor.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
That makes no sense. If at the time of the study they've gotten a BSN, they now have a BSN and the benefits (however questionable you may think they are) that go along with that.
That is a good point. Was it their ADN preparation or the addition of the BSN that kept their patients from dropping like flies? Maybe a truly accurate study would have to exclude BSNs that started out as ADNs.
LadyFree28, BSN, LPN, RN
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