Is it true that a BSN will be mandatory soon?

traumahawk99 · Aug 24, 2008

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Certainly all programs everywhere can be nitpicked. You find students graduating that never started a foley, don't know the basics of fluid resuscitation (isotonic vs. hypertonic, etc.), don't know what a normal sodium level is, etc. regardless of whether it's a BSN or ADN program. There's just too much to know and learn.

exactly. nothing except learning on the job really rounds a nurse to be a competent practitioner. and no one can possibly tell who has an adn or bsn unless they ask. at the entry level of floor nursing, there is simply no credible evidence to support requiring a bsn to start a nursing career.

hell, much of it comes down to who isn't too lazy to make their rounds. a few weeks ago i found a patient a few minutes from death. if i were more concerned about smoke breaks than making rounds, this patient would surely be in the grave. this, of course, has only to do with work ethic, not having an adn or bsn.

give me a good nursing tech who has genuine concern for patients any day over a lazy msn nurse. the biggest difference isn't made by evaluating the efficacy of homan's sign by a more educated nurse. it's about making rounds and keeping a keen eye on your patients.

which does nothing except point about how incredibly irrelevant to the job those extra

bsn classes such as community and family are for floor nursing. in all honesty, i've never seen a degree more loaded with utterly useless tripe.

i have a bsn in accounting, and a fifth year at a master's level, which is required to sit for the cpa exam. the extra education regarding accounting/law definitely makes a difference for a more qualified practitioner. in nursing, however, i simply don't see where this makes one iota of difference, given the nature of the job. it's monitoring patients, assessing and giving meds, for god's sake... not applying some idiotic nursing diagnosis dreamed up by an educator spinning mountains of nic, noc and nanda fluff.

i'm asking for a practical example where having a bsn makes a difference to the extent it should be required. let's stick with facts from the point of view of caring for patients, not how respected nurses need to be (which is a shamelessly selfish viewpoint). really, if someone is sitting on this credible evidence, why don't they present it to the state boards or even congress so they can save the public from unqualified adn nurses?

Susan9608 · Aug 25, 2008

I don't think anyone - or hardly anyone, because perhaps there have been a few - is arguing that ADN nurses are not qualified bedside nurses.

I think the idea of having a BSN as the entry point into nursing is to standardize the entry point into nursing and to raise the standing of nursing from vocation to profession.

if someone is sitting on this credible evidence, why don't they present it to the state boards or even congress

I'm sure that, some where, there are people working on doing just this ... not so much to protect patient from "unqualified ADN nurses" as you said, but for the reasons I stated.

You may not agree that nursing needs a standardized entry point, but you can't contend that with one, we wouldn't be arguing this point, at least, and could at least be at each other about something else.

neurorn6 · Aug 26, 2008

This has been floating around for quite sometime. The nursing shortage in this country is one of the reasons that it has not occurred, at least that is my thoughts. I lived and worked in Southern NJ for over 10 years and one of our community hospitals tried to go all RN and in even all BSN. They couldn't handle the patient to nurse ratio with just BSN nurses. They eventually went back to both LPN and RN nurses and most of their nurses did not have BSN after their name. It really doesn't make any sense when we all take the same boards. It comes down to training, critical thinking, determination and back breaking work. Too often this discussion causes nurses to start bickering between themselves. We need to stand united with each other no matter what level of education we have. We are EDUCATED MEDICAL PROFESSIONAL! :nurse:

traumahawk99 · Aug 28, 2008

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You may not agree that nursing needs a standardized entry point, but you can't contend that with one, we wouldn't be arguing this point, at least, and could at least be at each other about something else.

nursing does have a standardized entry point. it's the nclex exam. similarly, one can become a professional engineer with either a master's degree or a doctorate, provided he/she can pass the state certification exam.

let's face the facts. nursing isn't like other technical professions. the level of technical knowledge required is much, much less than engineering or pharmacy. that is why these extra courses above the adn level aren't technically difficult classes. they are classes in areas like community and family. this is why one can become a nurse (and a very good one) with very little math. chemistry or other "hard science " courses.

what makes nursing a difficult profession is the level of physical skill and stamina required to make an effective nurse. you don't nurse technical charts... you nurse patients. it is a combination of skills including butt wiping, starting iv's and scooping patients off the floor. it is being organized and able to prioritize care for 6 or 7 patients when you don't get a tech. it is about working for hours without even a chance to pee when you have to. it is backbreaking physical labor.

the realities of floor nursing aren't effectively addressed by bsn level courses. a good PE course, complete with weightlifting would be better preparation for floor nursing than family or community.

the attempt to require a bsn is motivated by political reasons, not reality. otherwise, it would have been a requirement long, long ago. the "research" being feverishly prepared by those phd nurses in the education system simply won't stand up to the common sense realities of the job. but that doesn't mean they are going to stop. their egos and psychological need to control the profession will never go away.

so of course this debate will continue in its present form, just as it has for the last 20 years.

let's say somehow they succeeded, and a bsn was required. does anyone think patients would give a rat's behind? does anyone think it would improve staffing ratios? does anyone really think we'd actually be more respected? the public doesn't care! they only want their sodas, drugs, and service when they call for it. if their butts need wiping, they still expect you to do it.

i have yet to have a patient ask me "have you had your community class or your family class". instead, i'm always asked things like "do you know how to access my port?" or "can you lift me up in bed?".

Nurserton · Aug 28, 2008

OK since everyone keeps ranting about who knows what an isotonic solution is and whether they learned rhythm strips, I am going to copy/paste my response from 2 pages ago since people don't read:

It's not about the pay if your aspiration is to be a hospital nurse, then you will be paid the going rate. However, many autonomous positions (such as an office nurse), managerial positions, etc., DO require more than an associate's, logically. Newsflash: Not all nurses work "on the floor" in hospitals!!!

The push for a B.S.N. requirement is not about clinical skills at all. It is to legitimize nurses as respectable professionals and not just skilled workers or a technical trade. There are not many positions in other fields in which you can be considered a "professional" unless you have a bachelor's degree. Why does nursing settle for less?

Also, the push for the B.S.N. aims to standardize nursing. This is another major step in changing the image of nursing to that of professionals. Nurses with A.A.'s, diplomas, B.S.N.'s....nursing education is a jumble that really does need to be sorted out. We wonder why often times we don't get the respect we deserve. I think the B.S.N. push is a positive step towards garnering that respect.

I'm not knocking those with A.A.'s or anything like that, but, you do get what you pay for. And I'm not just talking about your hourly rate.

PMFB-RN, RN · Aug 28, 2008

There are not many positions in other fields in which you can be considered a "professional" unless you have a bachelor's degree. Why does nursing settle for less?

*** How many of those other fields punch a time clock in and out of work factory-worker-style as nurses do?

nursing education is a jumble that really does need to be sorted out.

*** Why? I do not feel any of this need.

We wonder why often times we don't get the respect we deserve.

*** I don't wonder that. I have a pretty good idea why we don't and so far as I can see degree doesn't have anything to do with it.

I think the B.S.N. push is a positive step towards garnering that respect.

*** In the SICU where I work nurses with MSNs outnumber associated degree nurses. I have not observed them getting and more or less respect than anyone else.

I'm not knocking those with A.A.'s or anything like that, but, you do get what you pay for. And I'm not just talking about your hourly rate

*** Speaking of witch do you are anyone else expect that standardizing nursing education at the BSN level will result in nursing wages being raised to the professional level? If so how will this happen?

Fodonga · Aug 28, 2008

let's face the facts. nursing isn't like other technical professions. the level of technical knowledge required is much, much less than engineering or pharmacy. that is why these extra courses above the adn level aren't technically difficult classes. they are classes in areas like community and family. this is why one can become a nurse (and a very good one) with very little math. chemistry or other "hard science " courses.
what makes nursing a difficult profession is the level of physical skill and stamina required to make an effective nurse. you don't nurse technical charts... you nurse patients. it is a combination of skills including butt wiping, starting iv's and scooping patients off the floor. it is being organized and able to prioritize care for 6 or 7 patients when you don't get a tech. it is about working for hours without even a chance to pee when you have to. it is backbreaking physical labor
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I'm assuming you have never worked in critical care, which is but one area of nursing that can be very technically challenging. You're over-generalizing the profession the profession a bit. I also feel that if this is all you see in your daily work, then you might be missing something. If you work in trauma (judging from your user ID here), then this viewpoint really surprises me. I worked in trauma for nearly a decade, and had a totally different experience that that which you describe. Yes, those tasks existed, but there was so much more to it than that.

I also feel you miss the point in comparing nurses to engineers. Engineers begin specializing while they're in school. Nurses specialize after they are out into the workforce. One of the reasons for this in engineering, is to standardize the different pathways within the profession. That's where they get so 'technical.' A chemical engineer's job is going to be totally different than a civil engineer's. It's pretty much the same thing for physicians/surgeons. So, perhaps the argument could be made that in order for nursing to become more standardized (and allow for that 'technicality'), we could include specialization in our curriculum as well.

And as the post after yours indicates, there are many nurses who do not work in the hospital, whose job responsibilities are totally different than what you described. I haven't done any of those things in nearly a year, but I still utilize the nursing process, affect change in patient health, etc.

If all you see being required of you as a nurse is starting IVs, pushing bedpans, etc. then I think you may be missing out on a lot of opportunities to do more than that, and your hospital's expectations of you must be very low.

I don't mean this in a mean way at all (and I hope it doesn't sound that way). I'm actually wondering of you're suffering from burn out? I have suffered from burn out before, and I felt the same as you during that time. That's why I ask.

RN516 · Aug 28, 2008

Thanks. You said it all. I have met nurses with bsn,msn,etc,etc,. that have no respect for themselves or others. Some of them act like MSN means that you can curse,be abusive and rude to other nurses. Letters don't make you respected ,how you carrry yourself and treat others gets you respect.

traumahawk99 · Aug 29, 2008

I'm assuming you have never worked in critical care, which is but one area of nursing that can be very technically challenging. You're over-generalizing the profession the profession a bit. I also feel that if this is all you see in your daily work, then you might be missing something. If you work in trauma (judging from your user ID here), then this viewpoint really surprises me. I worked in trauma for nearly a decade, and had a totally different experience that that which you describe. Yes, those tasks existed, but there was so much more to it than that.
I also feel you miss the point in comparing nurses to engineers. Engineers begin specializing while they're in school. Nurses specialize after they are out into the workforce. One of the reasons for this in engineering, is to standardize the different pathways within the profession. That's where they get so 'technical.' A chemical engineer's job is going to be totally different than a civil engineer's. It's pretty much the same thing for physicians/surgeons. So, perhaps the argument could be made that in order for nursing to become more standardized (and allow for that 'technicality'), we could include specialization in our curriculum as well.
And as the post after yours indicates, there are many nurses who do not work in the hospital, whose job responsibilities are totally different than what you described. I haven't done any of those things in nearly a year, but I still utilize the nursing process, affect change in patient health, etc.
If all you see being required of you as a nurse is starting IVs, pushing bedpans, etc. then I think you may be missing out on a lot of opportunities to do more than that, and your hospital's expectations of you must be very low.
I don't mean this in a mean way at all (and I hope it doesn't sound that way). I'm actually wondering of you're suffering from burn out? I have suffered from burn out before, and I felt the same as you during that time. That's why I ask.

REQUIRING a bsn would address the entry level nurse, and that's exactly what we're talking about in this thread. i am discussing the entry point of nursing, which is typically a med surge floor. specialization comes later, and is largely the result of on the job training.... not taking community or family classes.

are you suggesting that a bsn program would pop out fully qualified critical care nurses? if so, where is this program? i've oriented several nurses and i honestly haven't found that having a bsn or an adn makes a whit of any difference. i mean absolutely none. which is why the push to require this strikes me as utterly useless.

and no, even in critical care, this isn't nearly as rigorous a profession as say, pharmacology. the level of science required is NOWHERE close. we can't even seriously compare them. nursing is vastly easier from a technical standpoint, which is why the bsn level courses aren't technical. they're fluff.

i really can't fathom what burnout would have to do with this question or any of the responses i've seen here. perhaps you've had a bsn level course that allows you to assess burnout from reading posts online :). ??

Susan9608 · Aug 29, 2008

nursing does have a standardized entry point. it's the nclex exam.

That's the licensing portion - not the educational portion. And even that is not totally standardized, because there is the NCLEX-RN and the NCLEX-LVN. So, while you might not have patients asking you questions about your background, I have patients asking me quite often, "Are you an RN or an LVN?" "Did you go to El Centro (community college) or a university?" What's that old saying ... "All generalizations are false" ?

I find this sort of thing especially prevalent in hospitals with dress codes, where LVNs wear different colored scrubs from the RNs ... it seems to lead to questions from patients on the differences between LVNs and RNs and then the differences between RNs themselves, even more so in hospitals where BSN is placed on name badges.

I think it would be beneficial to have a standardized educational entry point into nursing ... for one thing, then course content could be structured by nurses and wouldn't be "fluff" as so many people keep saying.

I also think raising the minimum educational requirement to a bachelor's degree is important to distinguish nursing as a profession, rather than a vocation.

traumahawk99 · Aug 29, 2008

what is wrong with having lvns? i don't see what having a single point of entry would accomplish. you aren't going to transform the reality of the job, which is patient care, with a single level of education. patients aren't going to say, gee.. this person has a 4 year degree, so i'll act differently. when they're sick, they're going to act just like they do right now. the families aren't going to act any differently either. who are we kidding?

nursing is already a profession, not a vocation. this year i'll make 150k, or close to it. i'm well respected by patients and doctors, as far as i'm concerned. it's all in how you handle yourself and treat your patients.

no way, no how, impossible that i'd learn the things i know in a bsn setting. they are things you can only learn from experience. i've oriented too many clueless bsn's to know that this level of training doesn't produce a better qualifed entry level nurse.

so the point becomes why create a nonsensical barrier to entry in the profession (yes, it is a profession) by requiring family and theory and other such nonsensical classes? are you proposing that we really teach high level science to do the job of floor nursing? it isn't required! what are we going to replace the fluff with?? more fluff?

so honestly.. i suggest we take nurses out to an obstacle course.. .make them run and lift weights... as silly as that sounds, it would actually be immensely more of a benefit than having a bsn vs an adn.

traumahawk99 · Aug 29, 2008

OK since everyone keeps ranting about who knows what an isotonic solution is and whether they learned rhythm strips, I am going to copy/paste my response from 2 pages ago since people don't read:
It's not about the pay if your aspiration is to be a hospital nurse, then you will be paid the going rate. However, many autonomous positions (such as an office nurse), managerial positions, etc., DO require more than an associate's, logically. Newsflash: Not all nurses work "on the floor" in hospitals!!!

The push for a B.S.N. requirement is not about clinical skills at all. It is to legitimize nurses as respectable professionals and not just skilled workers or a technical trade. There are not many positions in other fields in which you can be considered a "professional" unless you have a bachelor's degree. Why does nursing settle for less?
Also, the push for the B.S.N. aims to standardize nursing. This is another major step in changing the image of nursing to that of professionals. Nurses with A.A.'s, diplomas, B.S.N.'s....nursing education is a jumble that really does need to be sorted out. We wonder why often times we don't get the respect we deserve. I think the B.S.N. push is a positive step towards garnering that respect.

so it's really not about the patients and filling society's need for nurses? it's about the collective glory of nurses? i find this to be an utterly self centered approach.. if i can be accused of burnout, it's this mentality that i'm burned out with.

and heck yes, the gold standard is in fact working on the floor! if you can train a nurse to do that, you've effectively filled society's needs. THIS IS WHERE THE SHORTAGE IS. a competent floor nurse is well qualified to do almost any other job off the floor. there is no substitute for floor nursing experience in a hospital setting. that is where you learn the wealth of skills and knowledge that will help you anywhere you work in the healthcare industry.

i don't have a problem with folks learning anything they want to learn. i'm all for it. but don't create a barrier to entry in this profession by requiring useless material that has no impact on the job in the name of creating a profession people respect.