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

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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...

The baby boomers at my work are not retiring any time soon at my snf. No one cares that I have my bsn. Haha.

fellow California RN

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Specializes in Adult Internal Medicine.

Most orchestrated by Master's prepared directors who have little to no bedside experience.

Now, it is a push to get em up and get em out. A BSN prepared nurse can pull a rabbit out of a hat--they had to--multiple papers on theory and other subjects have most researching the most obscure to make sense. It is an alternate education based on thinking outside of the box, which equates proper documentation to ensure facilities get paid.

Most facilities don't want one to be experienced enough to really KNOW that a patient is not actually at their best to be discharged. They don't necessarily care that one is clinically skilled. They seemingly care about how it is documented accordingly so that their reimbusement rate is at an all time high. They want spin doctors, not classic bedside nurses.

Is there a recent study or data that supports this? It's not my area of expertise, but it flies in the face of everything that I recall from education and practice. In fact, I try my hardest to keep my patients out of the hospital, and when they are admitted, I do my best to get them out of the hospital as quickly as safely possible.

I do agree the increasing the education level of the nursing workforce plays an important role in this paradigm shift in in-patient length of stay.

I have always considered this study one of the landmark studies on the topic:

Kaboli, P. J., Go, J. T., Hockenberry, J., Glasgow, J. M., Johnson, S. R., Rosenthal, G. E., ... & Vaughan-Sarrazin, M. (2012). Associations between reduced hospital length of stay and 30-day readmission rate and mortality: 14-year experience in 129 Veterans Affairs hospitals. Annals of internal medicine,157(12), 837-845.

"For all medical diagnoses combined, risk-adjusted mean hospital LOS decreased by 1.46 days from 5.44 to 3.98 days, or 2% annually (P

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Specializes in Oncology; medical specialty website.
Although I agree with lots you are saying I saddens me as a oldie (44) newly (not snotty) BSN graduate nurse (hca for number of years) I also know a jillion of non BSN nurses that's aren't better and to be honest would be scared if they were looking after my family member and boy they don't like change and have become dare I say complacent. However I am sure that is the same with either degree or non degree there is always good and bad but I Just wanted to say not all of us are snotty and not all non degree nurses are better. :) xxx

Why should they be scared to take care of your family member?

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I don't doubt how glad you were to have taken physics, 2 semesters of chem, organic chem, and the other classes. However a BSN behind a nurse's name is no more or less an indication they took those classes or not. They are by no means universally required.

Considering that ALL of my ADN students have come to the ADN program with previous bachelor's degrees, usually in science, I think neither the ADN or BSN is any indication a nurse has the kind of background you have.

Did you take all of those classes as part of a BSN program?

The physics was AP physics in high school. All the rest were in my BS program, four years in college (nursing major). The first two semesters (not quarters) of chemistry were a lab course, meaning 2-3 hours of lecture and a 2-hour lab each week; organic was just lecture. Also two semesters of English, one semester each of anatomy (lab course), bio (also lab), microbio (lab), physiology (lab), anthro, sociology, psychology, and economics. And clinical 8h/3x/wk for the 2,3,4 year, plus 3-6 hours/week of nursing lecture.

((Oh, and I had a mandatory gym class 2x/wk freshman year. Which I skipped almost all year until May, and then made it up going to various classes (swimming, dance, tennis, and I can't think what all else) in every spare moment to make it up. Sheesh.))

To the person who asked if an RN-to-BSN without this much education is inferior to a nursing bachelor's degree with it, well, what do you think? I think you can guess my answer.

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Specializes in Critical Care.
Provided they meet the appropriate criteria in association with a college or university. Any less and the students of these programs pay for and do the work without the recognition.

You so long as they include all of the aspects that produce optimal nurses and optimal outcomes?

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Specializes in Critical Care.

The physics was AP physics in high school. All the rest were in my BS program, four years in college (nursing major). The first two semesters (not quarters) of chemistry were a lab course, meaning 2-3 hours of lecture and a 2-hour lab each week; organic was just lecture. Also two semesters of English, one semester each of anatomy (lab course), bio (also lab), microbio (lab), physiology (lab), anthro, sociology, psychology, and economics. And clinical 8h/3x/wk for the 2,3,4 year, plus 3-6 hours/week of nursing lecture.

((Oh, and I had a mandatory gym class 2x/wk freshman year. Which I skipped almost all year until May, and then made it up going to various classes (swimming, dance, tennis, and I can't think what all else) in every spare moment to make it up. Sheesh.))

To the person who asked if an RN-to-BSN without this much education is inferior to a nursing bachelor's degree with it, well, what do you think? I think you can guess my answer.

You forgot "and I walked 20 miles to school, in the snow, uphill, both ways".

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Specializes in Critical Care.
You make some very good points but I do disagree about one thing. I think that for many supporters of BSN as entry to practice it matters VERY much what the education is called. I think very many of them pretty much only care about the letter and the name, and only give lip service to the actual education.

I'm finding that is true. I do think most of the BSN-only proponents would agree that it the components of the education that have the potential to produce better outcomes, you can't give someone a substandard education, call them a BSN and expect good nursing and good outcomes.

But when it comes down to it, it would appear it's not the better outcomes they're really focused on, it is more about what you call it, it's degree snobbery at it's most basic.

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I agree, degree snobbery. I have been a nurse for 40 years(diploma) and the degree nurses are not any better now than they were in the late 70s. We had two days in the class room and three in clinical, what does a BSN get in clinicl now? I have a neice in southern Cal. in nursng school, a BSN progrm, and her clinicals are on Sunday evenings only, not enough room for all the schools in that area to have appropriate clinical time. Just because they have BSN behind their name doesn't make them any better than other nurses.

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Specializes in Adult Internal Medicine.
I'm finding that is true. I do think most of the BSN-only proponents would agree that it the components of the education that have the potential to produce better outcomes, you can't give someone a substandard education, call them a BSN and expect good nursing and good outcomes.

But when it comes down to it, it would appear it's not the better outcomes they're really focused on, it is more about what you call it, it's degree snobbery at it's most basic.

If there was good data on what particular components yielded the best results (and there are studies in progress right now on this on both the RN and NP level) then this could be used to develop better RN education. I believe this better/expanded education should be considered bachelor-level.

At least for me, it has absolutely nothing to do with "degree snobbery"; saying that most of the debate boils down to this is the same as saying it boils down to "degree envy".

Can you pint out particular posts that highlight the statement that "it's not better outcomes [they're] really focused on"?

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Specializes in Critical Care.
If there was good data on what particular components yielded the best results (and there are studies in progress right now on this on both the RN and NP level) then this could be used to develop better RN education. I believe this better/expanded education should be considered bachelor-level.

At least for me, it has absolutely nothing to do with "degree snobbery"; saying that most of the debate boils down to this is the same as saying it boils down to "degree envy".

Can you pint out particular posts that highlight the statement that "it's not better outcomes [they're] really focused on"?

We don't know what it is about BSN programs that had the potential to produce better outcomes, which is a point that often seems overlooked. I think we can safely rule out that it because of the name. If you take a nursing program and change nothing but the name, it's highly unlikely the quality of the nurses or the outcomes of their patients would be in any way effected.

You made the point earlier that our focus should be on our patients and how to provide the best care for them, in which case what we chose to call a program is irrelevant, it's about the requirements and characteristics of the program. Although now you seem to be suggesting it is actually about the name.

I was part of a work group charged with implementing a transition to BSN as entry to practice in my state. Most of the group, myself included, saw the transition as a foregone conclusion, it just came down to how it was going to happen. The problem is that in practice it's a pretty bad idea.

The first problem is effect on our nursing workforce, which we'd be effectively cutting in half. The BSN programs in my state were already under a moratorium for expanding their programs due to their over-saturated clinical opportunities, so expanding them to make up for the closed ADN programs was not an option, particularly not doubling their size.

There really wouldn't be any other option but to drastically change the role of RN's in patient care, all of the scenarios of how this would play out didn't end well.

We spent hours pouring over every ADN and BSN curriculum, pre-reqs etc, and found that the difference, while it's there, is surprisingly small.

It didn't seem that huge of a step to just make all of the current ADN programs satellite programs of BSN programs which would allow all graduates of ADN programs to now graduate as BSN grads, often without ever stepping foot on the campus of the BSN program. The BSN granting institutions didn't quite see it the same way and were happy to make such a deal, but were proposing a fee of around $25,000 to label the ADN grads as BSN grads.

Since our original intent was to make the 'proper' BSN education the education that all nurses receive, we set up a plan for making that transition. We saw no point in requiring ADN programs to now pay an extra $25k for something that doesn't add to their education. If ADN grads want to purchase the title they are free to do so.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

The physics was AP physics in high school. All the rest were in my BS program, four years in college (nursing major). The first two semesters (not quarters) of chemistry were a lab course, meaning 2-3 hours of lecture and a 2-hour lab each week; organic was just lecture. Also two semesters of English, one semester each of anatomy (lab course), bio (also lab), microbio (lab), physiology (lab), anthro, sociology, psychology, and economics. And clinical 8h/3x/wk for the 2,3,4 year, plus 3-6 hours/week of nursing lecture.

In our area all the ADN programs require one semester of chem, two semesters of combined A&P with lab, one semester of micro with lab, one semester each for English, sociology, and psychology.

So YOUR program required all those classes (you don't say they are required but I am assuming). Other program do not. A BSN behind a nurse's name doesn't give you much of an indication whether they took all those classes or not. I also haven't seen any data that shows patient outcomes are or would be better depending on whether those classes were taken or not.

Apparently, from the data I have seen, it is only the letters "BSN" that seem to matter.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
We don't know what it is about BSN programs that had the potential to produce better outcomes, which is a point that often seems overlooked. I think we can safely rule out that it because of the name. If you take a nursing program and change nothing but the name, it's highly unlikely the quality of the nurses or the outcomes of their patients would be in any way effected.

While it shouldn't effect patient outcomes, it likely effects the perception of those doing studies and data collection.

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