Is it true that a BSN will be mandatory soon?

[szccdw]

An instructor of mine (I'm in another state) stated that she recently went to a national educators conference and that they were saying that within the next several years in NY it would be mandatory to have your BSN. Does anyone know anything about this? Thanks

[lindarn]

LVN's/LPN's are being phased out at some hospitals in NJ as we speak. They are now jobless. It's a darn shame b/c I know some who have been a LVN/LPN for 15 plus years and they know a heck of a lot more than some RN's.

Now, I have seen many BSN nurses in action and let me tell you, they are not very intelligent. Experienced RN's have also commented on that. These people have a four year degree??? Could have fooled me. Just b/c you have a BSN does not make you smarter or a better nurse. Think about it, the four year degree only requires that you take more "unneccessary" classses in school that have nothing to do with nursing. It's all about money, NOT education!!

Just because a BSN grad is not able to "hit the ground running" the day after graduation, does not make them stupid. It means that we should emulate other health care professionals and require a 6 month to one year paid internship before we let them loose on patients by themselves. It would drastically reduce the "sticker shock" effect that hits nurses when they realize that they are not capable of being out there by themselves. PTs, OTs Pharmacists, etc are in the same boat.

In my BSN program, we were required to take Pathophysiology, Pathobiology, Statistics, Life Cycle I, II, III, and IV. We were exposed to non traditional areas of nursing, and the concept of nurses running their own businesses. Nurses as out side contractors, etc. To my knowledge, these classes are not routinely included in Diploma or ADN programs. These classes open your eyes to other things that nurses are capable of doing, with the many marketable skills that a nursing degree affords you.

There would be time to have, what I call, "quality of life" classes. Classes in Employment Law, Administrative Law, Independant Contracting, Running a Business, etc. PTs, OTs all take classes on how to po open their own businesses after they graduate. And they do. And bill for their services. And make more money than nurses do. Are these classes necessary to take care of patients? No. But they are necessary for us to take care of ourselves. Most nurses know squat about Employment Law, and management runs races over them as they are taken advantage of big time. How different the Employment landscape would be if nurses knew what was legal and not legal in a working environment, and were able to call the administration on it by quoting case law, and Federal and State Statutes that back up what the nurses are saying. That is the difference in what a four year degree can do. These can be taken as electives an added to the four year porgram. The would go along way to make life more bearable and we would have more control if we knew the rules and the law.

PT and OT was only a Bachelor Degree requirement until about 20 years ago. When DRGs hit the health care industry, they increased their educational requirements to put themselves in a position of importance and differentiate themselves from lesser educated individuals. How many PTs and OTs leave the profession in disgust within 2- 4 years after graduation? None. How many nurses leave in that time. The statistics say something like 75% are gone from bedside nursing in that time frame, if not more.

How much difference does the public see with an LPN who has a one year post High School education, or an RN with a two year Associates degree, and a med tech with 6 months of OJT? Not much. I wish that I had a nickel for every time that I heard someone say, "what do you 'girls' expect? You only went to school for two years"? And you know, they are right. The public does not see the professional requirements of our jobs and we are hamstrung by not being unionized with work place protection and little, if any, whistleblower protection. We are not free to inform the pubic how bad is it, and how the horrible working conditions affect their health care. So the public is "educated" on the RN scope of practice by the hospital. You know what comes out of their mouths- "there is a nursing shortage and we need to graduate more nurses". Right.

Nurses want professional recognition and compensation with a two year technical degree. I don't care if it takes almost four years to earn a ADN. It is still a two year degree. And that is what the public and the hospital sees, as well. If we want things to change we need to change the equation. What we are doing now is not working. If we don't act soon, we will not have a profession to call our own. It is being sold off to the highest bidder with the blessings of the ANA and our state Boards of Nursing. JMHO and my NY $0.02.

Lindarn, RN, BSN,CCRN

Spokane, Washington

[PMFB-RN, RN]

The argument that 'nurses with relatively less education have done just fine' is valid but doesn't address the fact that NOT requiring/earning a bachelors for RN school DOES give the impression - rightly or wrongly - that it must not be THAT difficult.

*** I don't know that impression is out there. My anecdotal experience doesn't lead me to think it's a widely held belief. If you are right I could care less. Let's face it, nursing isn't THAT difficult.

The people arguing for BSN to entry aren't necessarily arguing that non-BSN nurses aren't "good enough."

*** I think that's foolish argument to make, some do make it though.

They are arguing that MANY other fields that aren't nearly as demanding nor have at much at stake DO require a bachelor's degree

and that that makes nursing *look* like it must not take much in the way of smarts to become a nurse.

*** I am not concerned with how it looks. Let's face it, it doesn't take much in the way of smarts to be a nurse. Anyone who is capable of being physicians, pharmacists, engineers, police officers or a whole host of other occupations is likely smart enough to be a nurse.

Can't nurses handle another couple of years of college?

*** Of course we can.

What about a few extra years of college courses is so distasteful to nurses?

*** You and like minded people are not advocating for a few extra years of college. You are calling for a bachelors of science in nursing to be the sole entry point for RN practice. Two very, very different things. Perhaps is the requirement was for a more useful degree you might not find such opposition. Many of the ADN prepared nurses I work with already have degrees in other areas. Among those I work with include business administration, biology, chemistry, mortuary science, dairy science, elementary education, history and others.

If a person really wants to be a nurse, they won't let that dissuade them.

*** WHat might dissuade them would be the lack of access to nursing school. I don't know what percentage of nursing schools are associates programs but I would guess about half.

And given the current strong interest in nursing school across the nation, there would still be more than enough applicants.

*** I don't disagree. Though I think that on average they would be different kinds of people than community colleges now attract.

As it is, ADN programs take at least 3 years to complete,

*** Maybe in some areas but here is Wisconsin the ADN is designed to be completed in two years.

so why not just make it an even 4 years and toss in a bach degree to boot?

*** Like I said there are many people who find attending a community college that is likely near their home and likely inexpensive and probably uses an adult learning model to be much more doable than to go to a university.

Teachers and accountants need bachelors degree plus certifications so it's 4-5 years of formal education (not including any remedial coursework for pre-reqs) for most who pursue those. Why should it take any shorter to become a professional nurse?

*** Why shouldn't it? Maybe those professions are just inflated degrees designed more to keep people out of the profession than to ensure quality performance. I think you would be hard pressed to convince the vast majority of practicing pharmacists out there that they are not as good of pharmacist as more recent grads with their pharm docs. I bet the same thing is true for PTs. I bet those with bachelors degrees are not inferior in practice to the PTs with doctorates.

And also keep in mind that supporting the idea of BSN to entry doesn't mean that one supports the *current* BSN curriculum either.

*** Let's see the proposed changes first then see if you get more support.

Then there's the argument that BSNs are more likely to leave the bedside.

*** As a RN who works in a hospital where BSN nurses for outnumber ADN nurses at the bedside I don't buy that argument.

But do you really want to argue to keep non-Bach nurses because they are limited in their professional options and thus more likely to put up with poor working conditions?

*** Any RN can choose to further their non-nursing credentials (like by getting a BSN for example) and open up their opportunities if they wish to.

[PMFB-RN, RN]

Just because a BSN grad is not able to "hit the ground running" the day after graduation, does not make them stupid.

*** Of course not.

It means that we should emulate other health care professionals and require a 6 month to one year paid internship before we let them loose on patients by themselves.

*** I agree. When I graduated from nursing school I took a job at a hospital that offered a 9 month training program for new grads. There where ADN and BSN nurses in the group and there was no difference between them after the program.

In my BSN program, we were required to take Pathophysiology, Pathobiology, Statistics, Life Cycle I, II, III, and IV. We were exposed to non traditional areas of nursing, and the concept of nurses running their own businesses. Nurses as out side contractors, etc. To my knowledge, these classes are not routinely included in Diploma or ADN programs. These classes open your eyes to other things that nurses are capable of doing, with the many marketable skills that a nursing degree affords you.

*** And my BSN program does not include any of those classes except statistics. My ADN program did include pathophysiology and through guest speakers in our Professional Development class we learned about the many options available for RNs.

There would be time to have, what I call, "quality of life" classes. Classes in Employment Law, Administrative Law, Independant Contracting, Running a Business, etc.

*** There might be time for such classes but I have looked at many BSN curriculum and nothing like what you propose are included, certainly not in my program. Are you suggesting that BSN be required for RN practice but a different BSN than is now available?

PTs, OTs all take classes on how to po open their own businesses after they graduate. And they do. And bill for their services.

*** Bill for their services. That is I think THE key.

And make more money than nurses do. Are these classes necessary to take care of patients? No. But they are necessary for us to take care of ourselves.

*** But those classes are not part of most, if any BSN programs.

Most nurses know squat about Employment Law, and management runs races over them as they are taken advantage of big time. How different the Employment landscape would be if nurses knew what was legal and not legal in a working environment, and were able to call the administration on it by quoting case law, and Federal and State Statutes that back up what the nurses are saying. That is the difference in what a four year degree can do. These can be taken as electives an added to the four year porgram. The would go along way to make life more bearable and we would have more control if we knew the rules and the law.

*** Nice idea but my hospital is crawling with BSN nurses who can't (or don't) call administration on the BS they try to pull. You know who I see doing so? Nurses who have experience in other areas and professions and know how the real world works and who developed confidence and assertiveness before they became nurses. People likely to have gone to a community college to become RNs as a second or third career.

PT and OT was only a Bachelor Degree requirement until about 20 years ago. When DRGs hit the health care industry, they increased their educational requirements to put themselves in a position of importance and differentiate themselves from lesser educated individuals. How many PTs and OTs leave the profession in disgust within 2- 4 years after graduation? None. How many nurses leave in that time. The statistics say something like 75% are gone from bedside nursing in that time frame, if not more.

*** You make a good point but I don't see the reason PTs not leaving their profession in as large number simply a result of their longer stint in school.

I think comparing RNs, who can not bill for their services to PTs and OTs who can bill for their services as an unhelpful comparison. Apples to oranges.

How much difference does the public see with an LPN who has a one year post High School education, or an RN with a two year Associates degree, and a med tech with 6 months of OJT? Not much. I wish that I had a nickel for every time that I heard someone say, "what do you 'girls' expect? You only went to school for two years"?

*** I have never heard anything like that, course half the 54 RNs in my unit are men and not likely to put up with such stupid statements.

And you know, they are right. The public does not see the professional requirements of our jobs and we are hamstrung by not being unionized with work place protection and little,

*** There you go. If the goal is more money for nurses then unionization is a much more proven way of getting it.

if any, whistleblower protection. We are not free to inform the pubic how bad is it, and how the horrible working conditions affect their health care.

*** I don't work under horrible conditions, but I know many of my fellow nurses do. BSNs included. A strong union is far more likely to adress that rather than just makeing all nurses have BSNs.

So the public is "educated" on the RN scope of practice by the hospital. You know what comes out of their mouths- "there is a nursing shortage and we need to graduate more nurses". Right.

*** Ya, right. You and I both know why there is a shortage of bedside nurses, but not of nurses in total.

Nurses want professional recognition and compensation with a two year technical degree.

*** RN compensation is not and will not be tied to education level. More an example of the point you make above about nurses not understanding or standing up.

I don't care if it takes almost four years to earn a ADN. It is still a two year degree. And that is what the public and the hospital sees, as well. If we want things to change we need to change the equation. What we are doing now is not working.

*** True but no reason to head off in the wrong direction.

If we don't act soon, we will not have a profession to call our own. It is being sold off to the highest bidder with the blessings of the ANA and our state Boards of Nursing.

*** Yes, you are right.

[nurseby07]

I don't have a problem with the associate degree programs, but the graduates should not be recognized as nurses, but "nursing assistants," just like physical therapy assistants.

One of the reasons I decided to become a NP was b/c of all this confusion. I was sick and tired of people assuming that I had gone through a "vocational" program. It seems that anyone can put on scrubs and be called a nurse. After working as a nurse for a few years, I became a pharmaceutical representative and I'll never forget a doctor asking me how I did that without a college degree! I kept trying to explain that the "Bachelor of Science in Nursing" was a REAL degree, but he just didn't get it.

Now, patients don't assume I'm a medical assistant, they assume I'm the doctor!

did you really say that?

[nurseby07]

After all of the slander I have to say, I did my pre-reqs, got my cna, worked in a hospital, fretted and waited just like everyone else, got into a "vocational" program, proudly got pinned, studied my orifice off for the n-clex, "thru some scubs on" and called myslef an RN. I still do.

Proudly a nurse, fighting for my patients daily, happily perusing over some of this nonsense on my off time.

[jjjoy, LPN]

Just because a BSN grad is not able to "hit the ground running" the day after graduation, does not make them stupid. It means that we should emulate other health care professionals and require a 6 month to one year paid internship before we let them loose on patients by themselves. It would drastically reduce the "sticker shock" effect that hits nurses when they realize that they are not capable of being out there by themselves.

I'd love to see something like this as an option for new nurses who could use more of a transition between student and full professional. Perhaps those desparate for money and willing to dive in head first could opt for a short orientation but for those who do better with a bit more of a transition period, I'd love to see paid internships available for new nurses. This would pay substantially less than a regular staff nurse position, but the newbie would be supernumary during this time and able to work up to full responsibilities over an extended period as opposed to having just 2-3 months (which usually comes out to under 30 12-hr shifts which isn't not much, really!) This could also be a great for those out of hospital nursing to get back into it.

Yes, there is the threat of being taken advantage of (eg hospitals trying to count the intern as full staff) but hospitals DO take advantage of newbies by asking them to put their licenses on the line and take responsibility for a full load of patients even if they don't feel ready - because there are NO OTHER OPTIONS for those nurses who may need more of a transition. Instead, newbies often job-hop the first year or two instead, which hospitals don't appreciate either. I'd love to see another choice out there like there. That might even keep more nurses at the bedside in the long run since there are many who flee the bedside after their first experiences of "being thrown to the wolves" with full responsibilities when they don't feel experienced enough to be truly competent full-fledged acute care nurses.

Kinda off topic....

Now back to that dead horse...

[StudentNurseJeff]

In my BSN program, we were required to take Pathophysiology, Pathobiology, Statistics, Life Cycle I, II, III, and IV. We were exposed to non traditional areas of nursing, and the concept of nurses running their own businesses. Nurses as out side contractors, etc. To my knowledge, these classes are not routinely included in Diploma or ADN programs.

Lindarn, RN, BSN,CCRN

Spokane, Washington

Michigan here, Required courses at my ADN program. (I got A's, woo!)

[pagandeva2000, LPN]

I know that many of you want the BSN to be the required degree to become a nurse, but I don't believe it will happen. Here are some questions that people should think about concerning this issue:

First, what about all of the LPNs/LVNs? I work in LTC as a nursing assistant, and they do a great job at the bedside and supervising, even without a degree. If a new law was passed requiring the BSN, what would happen to them? Nursing homes primarily use LPNs, so would these nurses be required to find a BSN school within a certain amount of time to get their degree or else lose their license?

2. If having the BSN is so important, why don't hospitals and other employers pay BSN graduates significantly more than ADN graduates? I know that some places offer a bit more, but it's usually only .25 to $1 more per hour.

3. Is there any real evidence that LPNs/LVNs and ADN nurses are harming patients/residents more than BSN nurses simply based on the level of their education?

4. ADN and BSN nurses take the same NCLEX. Why don't BSN nurses take a different version of the NCLEX? Also, is there a big difference in the pass rates of ADN and BSN nurses on the NCLEX?

5. If the BSN became the required degree, what would happen to the LPN/LVN and ADN schools? Where would the students in these programs go, since many colleges now are already turning away qualified nursing students because there aren't enough teachers.

I can't speak for other facilities, however mine pays BSNs a whopping $1000 more per year than ADNs. In fact, more money is paid for ADNs that have certifications in their specialty area.

I also suspect that there is no more harm done by LPNs and ADN nurses based on our level of education. It appears to me that safer nurse to patient ratios and placing more focus on patient care than document care would permit better outcomes. I was just speaking to a nurse that earned her Masters Degree a few weeks ago that told me privately that the assumption of BSNs achieving better outcomes was false in her personal opinion. Not sure if she would say this publically due to the outlash.

It is also a mystery to me how ADNs and BSNs take the same NCLEX.

Basically, you are saying that crosses my mind frequently...what about the rest of the licensed nurses out there? If we can't come together and contribute collectively within our scopes of practice to bring about positive patient outcomes, then, we will continue to destroy ourselves.

[suzy253, RN]

In my BSN program, we were required to take Pathophysiology, Pathobiology, Statistics, Life Cycle I, II, III, and IV. We were exposed to non traditional areas of nursing, and the concept of nurses running their own businesses. Nurses as out side contractors, etc. To my knowledge, these classes are not routinely included in Diploma or ADN programs. =

Maybe not 'routinely included'--but were included in my 3-yr Diploma program.

Cheers

[suzy253, RN]

4. ADN and BSN nurses take the same NCLEX. Why don't BSN nurses take a different version of the NCLEX? Also, is there a big difference in the pass rates of ADN and BSN nurses on the NCLEX?

Actually, the Diploma grads have the highest pass rate in the NCLEX, followed by BSN & ADN.

https://www.ncsbn.org/Table_of_Pass_Rates_2007.pdf

[Absolutely13]

Very interesting. Thanks.

[pagandeva2000, LPN]

Just because a BSN grad is not able to "hit the ground running" the day after graduation, does not make them stupid. It means that we should emulate other health care professionals and require a 6 month to one year paid internship before we let them loose on patients by themselves. It would drastically reduce the "sticker shock" effect that hits nurses when they realize that they are not capable of being out there by themselves. PTs, OTs Pharmacists, etc are in the same boat.

How much difference does the public see with an LPN who has a one year post High School education, or an RN with a two year Associates degree, and a med tech with 6 months of OJT? Not much. I wish that I had a nickel for every time that I heard someone say, "what do you 'girls' expect? You only went to school for two years"? And you know, they are right. The public does not see the professional requirements of our jobs and we are hamstrung by not being unionized with work place protection and little, if any, whistleblower protection. We are not free to inform the pubic how bad is it, and how the horrible working conditions affect their health care. So the public is "educated" on the RN scope of practice by the hospital. You know what comes out of their mouths- "there is a nursing shortage and we need to graduate more nurses". Right.

Nurses want professional recognition and compensation with a two year technical degree. I don't care if it takes almost four years to earn a ADN. It is still a two year degree. And that is what the public and the hospital sees, as well. If we want things to change we need to change the equation. What we are doing now is not working. If we don't act soon, we will not have a profession to call our own. It is being sold off to the highest bidder with the blessings of the ANA and our state Boards of Nursing. JMHO and my NY $0.02.

Lindarn, RN, BSN,CCRN

Spokane, Washington

I can agree with your statement that orientation should be extended for a nurse. I don't think that new grads on any level is stupid...they are being hit with the reality that there is no support for the shock that is experienced. My issue is that it seems to me that none of them, may it be LPN, ADN or BSN do not seem to prepare the person for the actual reason they became nurses to begin with-patient care with the skills they have learned. To take fluff classes in non-nursing related subjects doesn't knock it when a new nurse is thrown to the wolves to care for a critically ill patient that is crashing before their very eyes. Clinical hours are shortened in the nursing programs, people being prepared to take the exam, but walk away with no clinical skills or critical thinking leaves any nurse in a quandary. All of us are expected to hit the ground running. And, I can see why senior nurses would be disgusted-they are comparing the new grad to their personal nursing school experience, where it seemed to be more of a focus on clinical experience that directly related to the task of nursing a person.