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

LadyFree28, BSN, LPN, RN · May 10, 2014

Several generic BSN students in the state university program I bridged into actually told me in their final semesters that they had received hardly any clinical training and didn't feel prepared to be nurses. Their lack of training was evident during our community health practicum.
In my ADN program we were in clinicals two days a week from the second week of classes, including summer school. I did clinicals at four different hospitals, in med-surg oncology and ortho/neuro, step-down ICU, labor and delivery, pediatrics, psychiatric rotation on a locked unit, psych ER, and rehabilitation. My geriatrics rotation was at a long term care facility. We did total care until our final semester, when we transitioned to team leading with a minimum of four patients. Unlike the generic BSN students who spoke to me, I felt prepared and was prepared to function as an entry level nurse in an acute care setting.

But again, that could be instructor specific; in my BSN program and my clinical placements and instructors, I had the same experiences as you have; meaning, we keep having this discussion about "clinical placement" and hours when lack of preparation can occur REGARDLESS of program; just because there were students who were "ill prepared"-as a preceptor I've seen "ill prepared" nurses from LPN, ADN, Diploma and BSN programs flourish into competent, confident nurses-has NO bearing on their ability to become a competent, confident nurse.

I have went through an ADN program for a semester, a Diploma program as a PN student, and completed a BSN program; what I've learned was to be active in my clinicals and have had myself challenged by each of my instructors for clinical exposure that did help; but the work began ONCE I became a licensed nurse; and it started again as a new grad RN.

PMFB-RN, RN · May 11, 2014

Several generic BSN students in the state university program I bridged into actually told me in their final semesters that they had received hardly any clinical training and didn't feel prepared to be nurses. Their lack of training was evident during our community health practicum.
In my ADN program we were in clinicals two days a week from the second week of classes, including summer school. I did clinicals at four different hospitals, in med-surg oncology and ortho/neuro, step-down ICU, labor and delivery, pediatrics, psychiatric rotation on a locked unit, psych ER, and rehabilitation. My geriatrics rotation was at a long term care facility. We did total care until our final semester, when we transitioned to team leading with a minimum of four patients. I did student work experience on an oncology unit, where I also did my preceptorship. Unlike the generic BSN students who spoke to me, I felt prepared and was prepared to function as an entry level nurse in an acute care setting.

In my state the ADN programs are 1 + 1 programs. That means after the first year of the nursing program everybody is eligible to sit for the LPN NCLEX. After the second year they are qualified to sit for the RN NCLEX. Every one of the students I was in school with, that I knew well enough to be in the know about their life, was working part time as an LPN during the second year of the RN program. Every single one either did a clinical preceptorship in a hospital (36 eight hour shifts) working one on one with an RN on an acute care floor, many in ICU, ER, L&D, med-surg, etc, OR were working full time as LPNs during the three month summer break between the first and second year. During the second year most everyone was working part time as an LPN.

I think we graduated ready to work as RNs on a med-surg floor with a minimum of orientation.

While not counted as clinical hours, the LPN experience certainly counted for something.

BrandonLPN, LPN · May 11, 2014

Are there any BSN that allow their students to sit for the PN NCLEX after the first year of the nursing program? It would make the BSN program much more affordable if the students could work as a LPN through the last couple years.

applewhitern, BSN, RN · May 17, 2014

In a BSN program, the nursing classes are usually taken during the last two years; the first two years is just general classes and pre-reqs. In an ADN program, you already have the pre-reqs, so you go straight into nursing classes, mostly the same as the last two years of a BSN program. I doubt there are very many BSN programs that prepare you to take the PN-NCLEX after the 2nd year. Maybe the 3rd year.

PMFB-RN, RN · May 18, 2014

In an ADN program, you already have the pre-reqs, so you go straight into nursing classes,

Maybe, depends on the program. Many ADN programs do not have pre-reqs. Mine didn't and still doesn't to this day. At least not college class pre-reqs. They do require CNA, back ground check, BLS, immunizations and high school chemistry with a B or better.

avengingspirit1 · May 16, 2015

What a bunch of mindless robots some nurses are. All those driving the BSN push are in some way affiliated with academia. These people figured out that in most healthcare facilities, nurses make up the bulk of patient care staff. And once they have many nurses running back for the BSN, they will begin to push the Master's by hiring another nursing professor (or maybe the same one) to publish another flawed study saying that hospitals with more nurses educated at the Master's level provide better patient care. Of course the study will be backed by organizations such as the ANA, IOM, AACN as well as state nurses associations and all others committed to the BSN entry and stand to gain from it.

Healthcare facilities love it because now they have nurses who are in debt and less likely to speak up against unsafe patient loads as well as other less-than-ethical hospital practices. As one nurse said,"Nothing says keep your mouth shut like a $400-$500 a month student loan payment."

allnurses Guide · May 16, 2015

What irritates me is that they start to program nursing students who I would say are not mindless, but trusting. They talk about assignments like "explain why a BSN nurse is better than an ADN"? It embarrasses me on behalf of the faculty who would come up with such a petty topic, and often the student is broadsided with a bunch of hostile replies. I lay that right at the feet of those peddling the misinformation.

subee, MSN, CRNA · May 16, 2015

What a bunch of mindless robots some nurses are. All those driving the BSN push are in some way affiliated with academia. These people figured out that in most healthcare facilities, nurses make up the bulk of patient care staff. And once they have many nurses running back for the BSN, they will begin to push the Master's by hiring another nursing professor (or maybe the same one) to publish another flawed study saying that hospitals with more nurses educated at the Master's level provide better patient care. Of course the study will be backed by organizations such as the ANA, IOM, AACN as well as state nurses associations and all others committed to the BSN entry and stand to gain from it.
Healthcare facilities love it because now they have nurses who are in debt and less likely to speak up against unsafe patient loads as well as other less-than-ethical hospital practices. As one nurse said,"Nothing says keep your mouth shut like a $400-$500 a month student loan payment."

Bitter, bitter. Do you really believe that because someone has a college debt, they will provide less ethical care? Health care is simply a lot more complicated than it was when the ADN programs were invented to train a lot of nurses quickly for WW II. It used to be that a teacher didn't need a 4 year degree. If nurses become a more valuable commodity, working conditions will improve, but not until then. More is being asked of nurses and we have to rise to the challenges. Those who don't, will be left behind...period. The marketplace is a cruel master but that's just the way it IS, always has been and always will be.

avengingspirit1 · May 17, 2015

Bitter, bitter. Do you really believe that because someone has a college debt, they will provide less ethical care? Health care is simply a lot more complicated than it was when the ADN programs were invented to train a lot of nurses quickly for WW II. It used to be that a teacher didn't need a 4 year degree. If nurses become a more valuable commodity, working conditions will improve, but not until then. More is being asked of nurses and we have to rise to the challenges. Those who don't, will be left behind...period. The marketplace is a cruel master but that's just the way it IS, always has been and always will be.

And everything I said is true, true. The BSN push is purely money-driven with many entities that stand to benefit. Nursing programs of all levels have changed their programs over the years to keep up with the latest technologies and acuity levels. The latest patient satisfaction stats in my area showed that hospitals that have BSN only hiring policies did not provide better care. And that's the fact. And you're right, the marketplace is cruel. So let's see if these organizations can take it as well as they dish it out as myself and other nurses let the media know what this degree elevation is really about and how hospitals are losing the most experienced nurses because they won't go into debt at age 45+ for $15,000 - $20,000 to write APA format papers on topics such as "Sociology of Nursing" and "Theories of Nursing". In a certain hospital in Phila., a nurse told me the average amount of years of experience on the floor was three. The BSN push is about business and revenue period. And just to let nurses know, more cuts to medicare have been made which means less reimbursement to providers. What this means is less jobs and having fewer nurses take care of more patients. This is no shortage. That was simply another lie to drive nurses to four year programs with the promise of better paying nursing jobs. Not happening any time soon, period.

avengingspirit1 · May 28, 2015

Aside from the already made cuts to medicare; with more likely to come, there is another major factor that will shortly influence the hiring of nurses as well as all other healthcare practitioners.

The "risk corridor" and "reinsurance" programs which are keeping the Obamacare exchanges afloat programs are ending in 2017 when our current president will be leaving office (this was done by design in case any of you didn't know). The exchanges will then have to stand on their own; and they can barely do it now with all this infusion of billions of federal dollars propping up insurers. When this happens, insurers may be screaming that they can't pay out on medical claims. If providers fear loss of reimbursements, it is highly likely they will consider adding to their payrolls. In fact, one major Philadelphia hospital recently laid off a bunch of nurse practitioners. The ending of the two federal programs in 2017 may also affect the subsidies many Americans are getting for healthcare plans. Those subsidies are also in jeopardy as the Supreme Court is currently reviewing their legality.

These are the things nurses need to know before they go into debt for thousands of more dollars for BSN and higher nursing degrees. These are the facts those driving the BSN push will not tell you because as "Subee" above said; "the marketplace is a cruel master." The people driving the degree elevation do not care about patients, nurses or elevating the profession. They do not care if nurses in their 40s and 50s go into debt for $15,000-$25,000 for a BSN degree only to find a couple of years later that they no longer have a job as a result from the consolidation of healthcare facilities. They only care about the revenue gained from coercing nurses into running back to school. Organizations such as the schools themselves, hospitals that lease space to schools offering RN-BSN programs, the financial aid lending institutions, the companies that supply books, the state nurses associations that highly "encourage" schools to tell students to join the associations and the hospitals that pay the ANA thousands of dollars for Magnet Status and then receive large government stipends: They see all you nurses who are so "trusting" as Nursel56 said above simply as dollar signs, nothing more. And that is the true cruel reality of the marketplace.

avengingspirit1 · May 28, 2015

If providers fear loss of reimbursements, it is highly likely they will consider adding to their payrolls.

Sorry, the line should read; If providers fear loss of reimbursements, it is highly unlikely they will consider adding to their payrolls.

PMFB-RN, RN · May 29, 2015

Health care is simply a lot more complicated than it was when the ADN programs were invented to train a lot of nurses quickly for WW II.

Exactly why the ADN programs have continued to evolve just as other programs have. I think you won't find enough difference between most current ADN programs and current BSN programs. If we assume that true ( I know it to be true) then the only real difference is the letters after the name.