lowering standards R/T shortage

Nurses General Nursing

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I have been hearing many stories lately about how nursing instructors/nursing programs are being asked to lower the "scales" to pass more students directly due to the nursing shortage.

Has anyone else heard of this? If so, what is your take on this subject?

I agree with FLO126 that it seems they are lowering their admissions standards and not the actual curriculum. But what does this tell you? To me it shows, as I have stated in other post, that the schools are not attracting the best and brightest college students. And how can they compete with other traditional college educated professions when the job conditions are so crappy and the job disription includes doing plenty of nurses aid work which requires no education. If nursing wants to compete with other professions in this day and age it will have to get a huge make over. Better pay, work conditions and respect, until then you will continue see a decrease in quality BSN applicants. Nursing has to decide does it really want to be a college educated professsion or more of a trade that requires a two year degree from a community college? I think the current trend seems to be showing that the community colleges have plenty of people trying to get into their programs where the BSN programs are stagnant. Why? Because at the community college level, which I started at and have plenty of respect for, nursing is seen as a high paying trade that in ables you to work inside and offers benefits. Compared with the university level where all the professions are offered and nursing is considered to be not that attractive for the reasons I mentioned earlier in the post. So, therefore, most people are choosing other more attractive careers. In addition, I feel the multiple entry points with nursing have as much to do with the dichotomy we find nursing in. If there was just one entry point we would at least know where we stand and would not try to be competing at two different levels.

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Anthony, what is this "competing at two different levels you speak of". I agree with you that if requiring a BSN to enter nursing would help us to become a true profession, then so be it. But I can't see how that alone would do it. AT THE BEDSIDE, what does a BSN do differently than an ADN. And please don't say critically think - because I can do that with the best of them.

I do believe that a BSN should be necessary for research and certain management positions. However, when hospitals and their administrators start hiring more aides to do the aide work - then maybe RN's won't have to do it. Nursing is becoming task oriented in certain markets - but I don't think acquiring a BSN would totally solve the problem. It may be a beginning step - but in the middle of this nursing shortage? Also, when all of the BSN's out there started their programs there were still ADN and Diploma programs being taught. Maybe at that point they should have realized that nursing was just a "trade" and not a profession. (I for one do not subscribe to this theory). Or maybe teaching - which does require a Bachelor's degree - could have been a choice. Because we all know how much teachers are paid and respected.

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Specializes in Nursing Professional Development.

Pretzlgl: Please forgive me for taking so long to respond to your previous post. I use my computer at work to participate in these discussions and therefore, don't participate on the weekends.

I agree that, at the bedside, there is very little difference between most ADN's and most BSN's. If you re-read my earlier post, you will see that I believe that an ADN is sufficient for bedside staff nursing. Also, I said that individual ADN nursing may outperform individual BSN nurses. I think we agree on a lot of key issues.

I think the differences start to show (for most, but not all nurses) after a little time in practice and in the practice of more complex and/or leadership skills -- and sometimes, that even means in staff nurse roles such as Charge Nurse, Preceptor, Committee Member. In general (but not always), I have found that the BSN nurses are more able to handle delegation to support staff, organize the work of others, evaluate the performance of others, develop a teaching plan, prepare a committee report, participate in policy and procedure development by analyzing literature, etc. These are all things that "advanced-level staff nurses" do in many hospitals.

Yes, some ADN nurses do quite well in these tasks and some BSN nurses do terrible. But, when considering thousands/millions of nurses, I think the BSN population is better prepared for these more advanced tasks.

llg

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Specializes in Nursing Professional Development.

To MICU RN: Another great post. I enjoy reading your thoughts.

As for me, if the option of starting with a 4-year college degree from a major university had NOT been available, I never would have become a nurse. As a high school valedictorian (spelling?), I wanted to "go to college" and have that 4-year university experience. And I wanted to enter a PROFESSION in which I could progress to higher levels with graduate education. Had nursing school been equivalent to a vocational trade school, I never would have gone. I would have chosen another (health) career.

If the generic BSN option were to disappear, nursing would lose a lot of its recruits -- the "college bound" high school kids would choose something else.

Not that I think that's what you were suggesting ...

llg

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Thank you llg, I do appreciate your input. Continuing education is absolutely necessary in any profession. And I do agree that BSN nurses are better prepared for some situations. I think that my main point about the whole BSN/ADN/Diploma issue is that making the BSN the entry point for nursing in and of itself will not completely solve the many problems that nursing faces. Physician disrespect being one issue. Short staffing, high nurse/patient ratios, and on and on. As I stated in my previous post to Anthony, another example of a profession with similar problems is teaching. And this career requires a Bachelor's from the start. I think a big issue with nursing and teaching is that they are largely female professions. Recruiting more male nurses may be an answer. And becoming and being looked upon as a profession as separate from MD's and not exclusively as their hand maidens, if you will, would be another important step. How do we get there? Maybe making the BSN the entry level requirement would be a solution. But for now, if as a profession we focused on our current issues as well as looking to change the future of nursing, our world would be a better place. Since I have been an RN, I have sadly experienced the truth of how nurses eat their young and truly do not stand up for each other. MD's have a much more unified profession. Is it because of their advanced degree? Maybe. Could it be because their's is a male dominated profession? Possibly. I just can't help but think that until we have the support from the public, the hospital administrator's, and each other, working conditions in nursing are not going to improve no matter what degree one possesses.

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Specializes in Nursing Professional Development.

To Pretzlgl:

I agree with much of what you said in your last post.

I don't know what to do with the educational system we now have. While I agree that the ADN is sufficient for bedside practice, I feel that the 3 different levels of entry into professional nursing hinder our development and our ability to work together. Medicine and teaching both have an advantage over nursing in that their practitioners have a common basis of understanding. Because all the physicians went to medical schools and all the teachers went to 4-year colleges, they share a certain bond with their colleagues -- a common academic foundation and feeling of commeraderie (spelling?) that nursing does not share.

In nursing, the different levels of education cause problems because it sets up conflict. For example: an ADN nurse returns to school and gets a BSN ... she feels she deserves a raise because she has learned things in her BSN program that she feels will help her be better at her job. Is she wrong to feel that way? (Certainly, someone CAN and SHOULD benefit from taking classes if he/she makes an effort.) And yet, she has trouble discussing it with her friends who have not gone back to school because they take offense at her suggestion that she is somehow a "better" nurse than they are.

And then there are staff nurses who also have Master's Degrees. What about them?

The current system is messy ... very messy. I doubt we are going to get rid of the different entry levels for a long time, but I think we really need to clarify the roles of the different levels so that we can clean up some of the mess that the confusion has caused.

llg

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The different entry levels seem to engage nurses and prospective nurses in a neverending pissing contest . I guess in order to truly understand the value of a diploma or ADN vs. a BSN you would have to attend both programs. I am all for higher education and will pursue my BSN immediately after graduating from my 3 year diploma program in June.I have heard nurses say that they furthered their schooling and didn't become better nurses. In that case, maybe they weren't that great of a nurse to begin with. I think some nurses get too caught up in the tasks and technology and don't open themselves up to all they are capable of. If you apply what you learn, however, I can't see how additional education couldn't make you a better nurse all around. I chose a diploma program because I couldn't afford a BSN program. At the risk of sounding biased though, I truly believe I chose an excellent school and I have no regrets. I do believe however that someday a BSN entry level or even a 5 year masters program would result in nurses being viewed as educated professionals rather than subservient hand-maidens.My grandfather thinks that all nurses just give injections, spongebaths and empty bedpans. And I won't even go into the sex-role stereotype that depicts nurses as empty-headed ditzes in tight little mini-dresses who spend their shifts getting it on with the doctors. With the nursing shortage, a BSN entry level requirement is unlikely to happen anytime soon, not to mention the fact that a lot of potentially excellent nurses cannot afford the expense of an undergraduate degree. So since we are not going to resolve this issue in the next decade or so, can't we all just get along and work as a team, regardless of whether or not we have R.N or the entire alphabet behind our names?

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Exactly. Thanks Flo for your input. I too graduated from a wonderful diploma program and will also attain my BSN. Just wish we could work together towards a common solution instead of picking each other apart.

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I just wanted to add to this discussion:

I am currently in an ADN program and I do not feel that the standards have been lowered at my school at all.

Most of us in the program have spent a year or more before entering the program taking all of the corequisites (co, not pre) such as Anatomy and physiology, psychcology, etc before our first semester of nursing.

Entrace into our program was based on our GPA from our school and previous schools, the number of Ds or withdraws from other classes in the past 2 years and a placement test. For those who did not score at the top of the placement test were required to go to a seminar over the summer before this fall semester.

I do not know how many people total were admitted (there are some people that I saw at orientation that I did not see in September) but the Freshman class was 100 strong and we have only had 2 drop outs so far (one of whom was 1 of only 2 students admitted out of high school).

I get frustrated to hear some of my classmates complain of having to write papers. I would consider this more of a technical degree if we did not that requirement.

Many of us plan to continue to get our Master's I have not heard of anyone who does not plan to get their Bachelor's. For many of us the plan is to be back in school Fall 2004 but to also be employed by an iinstitution at that time and to have the institution pay for the rest of our education.

I was very disappointed to see it stated in an earlier post that many ADN students are just looking for a job with a high hourly rate and benefits. Many people in our program have one of not 2 previous Associate's degrees as well as some with Bachelor's.

I personally have made more money and had many more benefits than I will receive in my first few years as an RN.

Nurses should be and with organization and pulling will be fairly compensated for the job that we do, however I believe that a lot people go into nursing somewhat out of vocation thatn the idea that they will make a lot of money from it.

Also I would like to comment that I strongly agree with the writer who mentioned that it is a dumbing down of America in general. A lot of college graduates cannot write a decent paper, and how many people with Master's Degrees do you know who think it is proper to ask "where someone is AT?"

Problably many as do I.

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm an ADN grad (who was an LPN before that) who is enrolled in an on-line ADN to MSN course. I don't feel that I was dumb in taking the long way around to the MSN at all. I now have ten years of nursing experience and know this is what I want to do for 20 more years. However, (and I know this will open the floodgates) - I feel that since ADN, BSN and diploma grads all take the same NCLEX - there should be no pay difference.

Congrats on getting started. I too have done other things in my life and didn't get into nursing until I was in my 30's.

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This has turned into a VERY interesting discussion.

What I've noticed isn't so much the lowering of standards in nursing school so much as on the floor itself.

I was told by someone who had been helping a family member in hospital that even during the most incapacitated the family member was, she didn't get a bed bath from a nurse or tech. "We don't do that anymore." I think they change linens every 3 days to a week.

Okay, that's just surface stuff. But if you've worked on a floor, how many times have you asked for help/staffing/whatever and been told "we can't... we don't have.... DO THE BEST YOU CAN DO."

You know that all your patients are receiving lower standards of nursing care on days like that.

So it seems like some people say that their program has been relaxed a bit, but most do not. Some even say that standards are higher.

I think that it's reasonable for nursing school standards to be higher today, because the graduate nurse is facing a MORE challenging atmosphere, and needs to be BETTER prepared.

IMO

Love

Dennie

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So much for me to say, I don't know where to start! First of all, I entered nursing with a BSN on the urging of my mother, who has her AD after being an LPN. She assured me all along the way that my education was more thorough than hers. But is has no bearing on the actual bedside portion of nursing. I think one of the problems, and this has been addressed clearly in earlier posts, is that a new nurse fresh out of school who had no previous experience as a tech is going to be appalled at the fact that she got a college education and is wiping butts. BUT, if the hospital is paying for an RN, then that is money that isn't being spent on probably two aides for the same amount of money. I talked to a new RN just this afternoon and he was concerned about the tech portion of his job at this facility. I think that is a big factor in what nurses think of this profession.

Someone asked earlier about the military/VA method of treating the different education levels of nursing. I work for VA and did some looking into the military after I got out of school. In the military, that BSN degree means being commissioned as an officer and being in the medical branch. An ADN can become an officer but must first enlist, if I understood correctly. In the VA system, there are 4 levels of RN and then there are steps within the levels that determine pay grade. Because of my BSN, I was hired as an RN2 step 2....the step based on my years as an RN.

Directly answering the original question in this thread, nursing schools can only go so far in "dumbing down" the curriculum because a certain percentage of total grads have to pass NCLEX every year for the school to maintain accrediitation. My school spent a great deal of time on critical thinking skills and had a very tight entry level requirement. What I noted in my particular graduating class was that the students with the high GPA and low entry test scores were able to graduate with honors but didn't pass NCLEX the first time. A full third of our graduating class failed the first time they took the test!

Our school also had a different track for ADNs getting their BSN. They only took classes that are not offered by ADN programs, but they also had to take an additional pharm course and were required to do some extra stuff with the rest of us students in an almost teaching capacity, such as assist in our clinical labs. It was interesting.

Better stop typing now.....getting long winded.

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