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

[Nola009]

As in certain "Baby Boomers" who wont retire? Wont we NEED a faster RN producing mechanism (hello again, ADN programs!) in order to provide enough nurses to care for this huge group of people due to retire soon?? Just wondering...

[Nola009]

If there was a transition to BSN entry, how would nursing "lose a lot of new talent"?

I am not sure where the "thrown away" comes from, is someone actually advocating for delicensing current ADNs?

As I said, if ADN programs were no longer utilized, we would, as a profession lose out on some good people. If higher education becomes affordable again, then its feasible to say BSN could/sho u ld be the entryway to practice. When I said "thrown away" I was referring to the ADN nurses whose positions were cut and replaced with new, highly indebted RNs with zero bargaining power. By the way, do you really need a financed 'study' to tell you what is going on right in front of your nose?!

[BostonFNP, APRN]

Personally I don't believe there is much difference between ADN vs Diploma vs BSN. So the BSN took organic chemistry and possibly physics for nursing, while that would be interesting and challenging I don't think it applies to bedside nursing.

Many of the ADN nurses already have a Bachelors degree or at least many college courses.

...or for nursing and choose the cheapest and fastest way an ADN

Experience trumps credentials. For bedside nursing I think certifications trump a BSN.

Truthfully a BSN is a way out for nurses to get away from the bedside and get into case management and other office based nursing positions.

Curious, what do you make of the research data that opposes your option that there isn't much difference?

I agree with you about bachelor-prepared nurse should be equivalent to BSN. There is some data to support this.

Cheapest and fastest way. That makes me cringe a little as it sets a bad image for the profession.

I disagree with you about experience trumping credentials. Does a RN with 20 years experience trump a NP with 6 years of experience? Credentials also dictate scope. I agree that they are both important.

I don't think the data supports that most BSNs work away from the bedside.

[BostonFNP, APRN]

MunoRN just told you it's actually about the author's conclusions regarding their raw data, and he was the person who provided the main argument against you on that thread. What part of "regarding their raw data" is difficult for you to understand?

Have you ever taken a research class? You can appreciate the difference between critiquing the conclusions the authors draw from the data and questioning the validity of the data right?

[martymoose, BSN, RN]

Someone posted that it is mandatory that the hospital pay for required education as is the case with ACLS, BLS etc.

Actually, not anymore . We had to pay for our classes this year, when in the last 8 years they have been paid for ( renewals , etc). The certification is required by the job.

[nurseprnRN, BSN, RN]

What makes those places scary is the lack of resources. The lack of diagnostic testing technology. The lack of physician specialists. The lack of specialty units in general. Do you really think that the fact that their nurses attended a CC program plays anywhere near as big a role? A BSN grad working at Hicktown General will be in a better position to provide care than the ADN grad working next to her..... how? Please explain.

You bet I do. If the SMCC grad did her candy-striping at HGH, did all her clinicals there, and works with a staff the majority of whom did the same, the institutional memory of "We've always done it this way" and "Dr BigGuy is always right" is overpowering. I have seen this in many small hospitals with a majority of staff from a limited number (or single number) of ADN programs. When someone with experience in a wider scope of practice and who has been educated in expecting it and doing it comes into this setting, you ought to see the teeth come out. The docs are outraged that someone with a nursing cap has a brain under it and questions them, the nurses get snarky ("Who does she think she is?") or threatened ("I don't know how to do that...will she take my job?"), and the better-experienced/educated nurse gets bewildered and disheartened. It's not pretty.

[MunoRN, RN]

So we agree, it's about the authors conclusions not the actual data?

No it's about both, their formulated data and their conclusions regarding that data.

[MunoRN, RN]

So eliminating the ADN pathway to entry by requiring a BSN bridge would result in half as many nurses? Is there that kind of nursing shortage?

Requiring a BSN bridge wouldn't eliminate the ADN pathway. A BSN bridge typically refers to an ADN to BSN bridge in my experience. You can't bridge from ADN to BSN without ADN programs.

[brandy1017, ASN, RN]

Comparing an RN to an NP is not relevant. An RN can't be an NP without either an MSN or DNP. Also I do think an NP that was an experienced RN first is going to know more and have a smoother transition to advanced practice because of all the "medical" knowledge already learned. An ADN RN and BSN RN pass the same boards and do the same job. I was not comparing RN's to NP's as we do not do the same job nor could we. I don't think the push for DNP is about more than exclusivity, keeping competition down and increasing profit for the colleges. But that's another discussion.

[BostonFNP, APRN]

Comparing an RN to an NP is not relevant. An RN can't be an NP without either an MSN or DNP. Also I do think an NP that was an experienced RN first is going to know more and have a smoother transition to advanced practice because of all the "medical" knowledge already learned. An ADN RN and BSN RN pass the same boards and do the same job. I was not comparing RN's to NP's as we do not do the same job nor could we. I don't think the push for DNP is about more than exclusivity, keeping competition down and increasing profit for the colleges. But that's another discussion.

Isn't the difference credentials and education? Really I was trying to illustrate the point that credentials (RN vs NP) and education do make a difference.

As far as the rest of that, it's off topic enough that I won't comment. There are many threads on those topics though.

[nurseprnRN, BSN, RN]

Please point out any place where someone has argued that RN experience is not an important factor in patient outcomes.

This has been demonstrated in the literature countless times, as has staffing level, and nursing education level. They are not mutually exclusive, education and experience, in fact any rigorous study would control for both experience and staffing levels when examining nursing education.

And, of course, they do, explicitly, thus cutting the effectiveness of that whole rationalization.

[MunoRN, RN]

It seems as though there is a belief that by continuing to have an ADN pathway that we are ignoring the findings of those studies. Based on those studies, it would seem likely that there were aspects of BSN education and curriculum that had the potential to produce better outcomes.

So the argument is that those aspects should be part of every nurse's education, which I think most agree with. I think the disagreement lies in the idea that ADN programs that incorporate those aspects as a result of that research still aren't providing sufficient education, they need to have the letters "BSN" after their name, which would mean that it's not actually about the education or their related outcomes.

[TiffyRN, BSN, PhD]

This study controlled for hospital characteristics (such as safety-net hospitals) and staffing. Found lower rates of CHF mortality, decubs, failure to rescue, post-op DVT, post-op PE, and shorter LOS in hospitals with higher proportions of BSNs.

http://ovidsp.tx.ovid.com.ezproxy.lib.utexas.edu/sp-3.12.0b/ovidweb.cgi?QS2=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

Have fun, pick it apart, it does have limitations. We can't RCT this in our current system.

Interesting thing here is that it is a large university teaching hospital system. They point out that even in their lower BSN areas, the staffing levels are higher than average US hospitals; yet the improved outcomes for BSNs remains. One conclusion would be that even with improved staffing, outcomes can be better with higher levels of education.

I'm suspicious of my link so here's the name:

Baccalaureate Education in Nursing and Patient Outcomes by Blegen, Goode, Park, Vaughn and Spetz (2013).

Y'all aren't giving me college credit so I'm holding out on the formal APA.