Is the RN--->BSN push a clever way to get older nurses out of the way

martymoose, BSN, RN · Apr 15, 2014

Many reasons have been given as to why hospitals are moving towards BSN's in nursing. From what I read many years ago it stated that there was a higher incidence of mistakes with ASN's compared to BSN's and that is why hospitals are moving towards higher education

Funny, some of the mistakes I've seen lately are from the 22 year olds with their BSN degrees and no experience. But I suppose there's no study to prove that. Anecdotal I guess doesn't count

cinlou, BSN, MSN, RN · Apr 15, 2014

I have to say in A&E we get continual rotation of new docs (F1's and 2's) they go see a patient or a child then come up to me and say "what do you think I should give them" I am like "I don't know your the doctor" I am sure they must be scared just like we are straight out of university or as soon as we have done our IV training and let loose. However if they think about it they know the answer or they ask advice like we do :)

I agree all new grads are scared and nervous, I have worked with many med students and residents and fellows over the years. When you have an opportunity to work in a University setting where nurses and doctors are on first name bases and see each others as peers, it is a wonderful place to work.

I have worked in this type of place and I have worked in other hospitals where Docs thought they were God, and nurses abused each other.

I started out when you had to leave your chair for the Doc, when you walked behind them carrying all the charts on rounds, and presenting the chart so the Doc saw the chart but never laid eyes on you. Anyone who started out in the old days know how far we have come, and yet we as nurses continue to bash each other instead of support each other.

I think there is a place for every level of nurse, and just as many have said financially and for our future we must support the certificate program on up to the terminal degree programs. Each level has a role to play and if those who are pushing for the upper level entry would stop and think about what it would do to this country maybe they would get a clue.

If facilities would stop and realize how cost effective this would be by growing their own nurses the way they want them, ultimately saving money, and improving their communities, all while giving excellent patient care, maybe they too would see the benefit.

If the employee is happy the patient will be as well.

allnurses Guide · Apr 15, 2014

No kidding.

Yes, yes, we have all seen the Aiken study over an over for years now. I was under the impression you were refering to a different, more recent study done by UPenn,

There is a new Aiken study just published.

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., ... & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet.

Chicago

martymoose, BSN, RN · Apr 15, 2014

Ok. too many variables . Staffing. that goes without being said. Of course inadequate staffing, which is the norm now , will affect pt care . We don't need a study to prove this. The " corporations " want to make the most profit. They don't really care about outcomes then do they, if they don't staff appropriately.

European countries- Why didn't they do the study in the ole US of A? with the main fact that most european countries have socialized medicine. I think that gives a slightly different demographic than here - especially since here we are throwing in medicare and medicaid- and Find me a medicaid pt who doesn't have some chronic or dire condition that is not going to have a bad outcome no matter how many staff are on?

allnurses Guide · Apr 15, 2014

Ok. too many variables . Staffing. that goes without being said. Of course inadequate staffing, which is the norm now , will affect pt care . We don't need a study to prove this. The " corporations " want to make the most profit. They don't really care about outcomes then do they, if they don't staff appropriately.
European countries- Why didn't they do the study in the ole US of A? with the main fact that most european countries have socialized medicine. I think that gives a slightly different demographic than here - especially since here we are throwing in medicare and medicaid- and Find me a medicaid pt who doesn't have some chronic or dire condition that is not going to have a bad outcome no matter how many staff are on?

We don't need a study to prove that staffing levels influence patient outcomes, but we need a myriad of flawless studies to prove education level of nurses influences outcomes?

cinlou, BSN, MSN, RN · Apr 15, 2014

So UPenn does a study that finds that the product they sell, the BSN, results in better outcomes, or something like that. Even if the study is indeed a paragon of scientific rigor it is easy to understand people's skepticism.
I haven't seen that particular study. Do you have a link handy?

Educational Levels of Hospital Nurses and Surgical Patient Mortality

BSN Prepared Nurses Connected to Fewer Patient Deaths

Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes

The last research study points out that there are more issues involved in giving quality safe care other than degree.

martymoose, BSN, RN · Apr 15, 2014

We don't need a study to prove that staffing levels influence patient outcomes, but we need a myriad of flawless studies to prove education level of nurses influences outcomes?

Yes. Since I think ( of course no study done on what I think ,lol) staffing has a large influence on the outcomes.

Is there a study done of outcomes with same staffing levels ( which you won't find in the US anymore except in CA.) for a specific pt demographic with ADN vs BSN vs RN-BSN ?

Were some of these studies done using pts with diseases secondary to their lifestyle choices ( extreme obesity,drugs, ETOH) with the damage being already done? Does it matter for that demographic whether they have care provided by an adn or bsn?

eta- noted that one of the studies said surgical pts. Most of my hospital is medical pts. You know, the above listed who have no interest no matter if you are DNP or MD or anything , in what anyone has to say- hence the frequent flyer name. Elderly that are tube feeds ,decubs large enough to put a hand in,and so demented they don't even realize they are in a hospital, yet are full code. Prisoners. Etc. That's my demographic. Is BSN going to help them?Wonder if a study has been done on that

PPs. Sorry OP this is a bit of a derailing My apologies.

TiffyRN, BSN, PhD · Apr 15, 2014

because going part time here is about 4000 a semester. It is the only state school in the area. All the others are private- at a tune of 30,000 + per year. Why on earth would I do RN- to BSN and pay 60,000 dollars or more that I DON"T HAVE and would have to get loans.

I agree you certainly shouldn't be paying for $30-60,000. There are multiple more reasonable programs with easy admission.

Lots of programs out there can be completed for $9-11,000. If you have tuition reimbursement these are an extremely reasonable investment.

Check out WGU, UT Arlington.

I completed Excelsior's BSN for approximately $12,000. Got about $7,500 in reimbursement.

Please, let's stop patronizing those incredibly expensive RN to BSN programs! I can kind of understand the desperation of initial entry RNs trying to get licensed no matter how but few need to spend tens of thousands on BSN completion programs!

PMFB-RN, RN · Apr 15, 2014

There is a new Aiken study just published.
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., ... & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet.
Chicago

Yes thank you. I am familiar with that study.

I continue to await the study that compairs patient outcomes when masters prepared nurses are compaired to BSN prepared nurses.

morte, LPN, LVN · Apr 15, 2014

In the USA we have a standard, it is called NCLEX....

We went to mandatory BScN in Saskatchewan almost 20 years ago (and LPN has become the diploma designation). Diploma RNs who already had licenses were grandfathered in. If they want to do advanced practice or education they have to get their degree, but they continue to work in the fields that have always been open to them. They have never had threats of job loss. Of course we have a provincial nurses union to protect seniority rights, so there's that.
I think it's more about standardization than anything. There really shouldn't be multiple levels of education for the same designation and often the uneven education is used as a criticism of nursing in general and an argument to keep nurses from increasing scope. The most obvious answer to that criticism is to standardize.

morte, LPN, LVN · Apr 15, 2014

Es, not so much that they are, though there is some truth to it, but, that is how they are perceived by the hierarchy. I went to a diploma school, and many were working class/blue color kids, with the occasional "other", ie we had one with a BS in elementary Ed.

I am not even sure how to respond to the statements that ADN nurses are less professional and from a "lower" working class and in the obtaining a BSN somehow refines ones "class".
I am rendered speechless and that is hard to do.

I know they do....sigh....and it makes me sad. I'm an ADN grad and I can nurse circles around the best of them. I had college educated parents and at the time ADN was the way to go with the "phasing out" of diploma programs. BSN was NP level where I went to school. I just resent the implication that ADN grads after 35 years at the bedside are somehow inferior. :no:

morte, LPN, LVN · Apr 15, 2014

then make it like a "6th year" certificate in education...do they still have that? lol....anyway, my point is to require it in a set amount of time after initial graduation. that way you get the technically proficient ASNs, and with time the BSN.

Most other higher level professions require Baccalaureate degrees. Nursing has held out because of the "nursing shortage" and the need to create nurses in a shorter amount of time. BSN is the way nursing needs to go for the future nurses coming in to the field. I understand that there are EXCELLENT Diploma degree nurses and Associate degree nurses however, nursing needs to catch up in this regard.