I am having trouble understanding why an ADN RN needs to go back to college for a BSN? I've heard because there is a lower mortality rate with BSN nurses because they have higher critical thinking skills...Really? Basic RN's, wether ADN or BSN, were trained the necessary skills to perform at the bedside and to pass the NCLEX required to become and RN. So why all the critical thinking skills that are required all of a sudden? The duty of the bedside registered nurse is to assess and prove assessment feedback to the physician. He or she said physician is to analyze the data provided by the RN and give further direction from that point. There is no further obligation in the nursing process that states we must recommend to the physician what medication the patient needs to be prescribed as we have absolutely NO prescriptive authority OR obligation. We nurses are furthermore not obligated to formulate a diagnosis for the physician which would be beyond the scope of practice also. The scope of nursing actually ends with assessment and reporting to the ultimate responsible authority. The nurse then is to carry out the specific orders provided by the physician. I can already hear you diva's saying, "but your the pt advocate", and yes we are but we have limitations. Once we hit our limitations it is the responsibility of the physician to do his or her job and stop trying to force everything on the nurses. Nurses are not here to take up the slack of the physician. The physicians need to become the professionals they claim to be and stop forgetting orders and hospitals stop forcing the nurses to catch the mistakes of a physician because the hospital can't get the physician to comply.
All in all, there seems to be a stretch of nursing to become the physicians...well where is the pay and title change? Every order that a nurse corrects should be noted and send to the medical board. If a nurse was to make mistakes it can be reported to the board...Physicians should be held accountable at the same level.
So my take on the BSN requirement is BS.
Anyone else know why we must have a BSN? Why is it that a ADN can no longer fit the position?
However, BSN prepared nurses have had an additional two years of training in fully understanding why these skills and competencies are necessary. They have had the opportunity to further develop their own critical thinking and problem solving; rather than simply knowing that if assessment reveals A, then respond with intervention B. BSN prepared nurses are forcibly familiarized with evidence-based practice, both in conducting research and in constantly reading ever-changing EBP.
A) It's not "an additional two years" of education. Most ADN programs are more like 3 - 3-1/2 years when you factor in the prerequisites people have to take in order to get into the two-year ADN program. And most of the additional time represents additional general education requirements.
B) It's really insulting to suggest that ADN-prepared nurses are educated at the level of "if assessment reveals A, then respond with intervention B," although I'm sure that's what you were told in your BSN program. News flash -- it's not true. Associate's degree programs in nursing stress "critical thinking and problem solving" as much as BSN programs do. I've taught in both, and I have regular contact, in my current position, with students from multiple schools, from both types of programs, and I feel I am in a position to have a valid opinion about this.
C) BSN students are in no way "familiarized" with "conducting research" on any meaningful level -- and do you not think that ADN students are also educated to be lifelong learners and to continue to expand their knowledge and expertise through reading and utilizing EBP? They are.
D) If BSN education in nursing is so great, and BSN students are so much better prepared and skilled at critical thinking, how come most of the BSN students I have encountered over the years can't "critically think" their way out of a paper bag? Again, I've taught in both kinds of programs and have had ongoing exposure in the clinical setting to students from both kinds of programs, and, as big a fan of higher education as I am and as much I would like to see a significant difference between the two groups, I just don't see it.
Where I got my MN there were plenty of MNs working bedside-- I was one, and taught students as faculty at the same time. The city had many fine BSN programs, and most bedside nurses were either graduates of one or in one. And I have to say, I have never seen so much sustained excellence in bedside care all over town and in the 'burbs as I did then. It was fricking awesome. Knowledge and learning for its own sake tends to leak out and affect everything you do.
As to the rest of the OP's assumptions, you can go over to the student side and search out posts that say things like "We all do the same thing and pass the same NCLEX." True, but recognize that this is a very immature attitude from people who aren't very far along in their profession, and it's true only as far as it goes.
First, nursing is far, far more than the tasks we "do" or "can do." Students get a temporary pass on this early on, as they are in a lab-check-off mode from day one, and they have a long way to go before they understand the difference between what nurses "do" and what nursing is.
Second, and more important to my mind, the thoughtful professional nurse takes a good look around and realizes that a really large part of what an RN does and thinks about all day has little to do with the implementation of parts of the medical plan of care, although we do that too. I'm not talking about just manipulative skills like making beds or passing meds, either.
Third, everybody gets to practice at their own level. If you don't want to engage physicians and other clinicians in a spirited and well-informed discussion of relevant patient care issues (not just the ones involved in your bit of delivering/delegating some of the medical plan of care), don't care to question why we do things like this, don't want to think about deeper reasons for things, don't want to think about a wider and deeper duty to care, then you don't have to. We have lots and lots of nurses like that. If that's what you're comfortable with and you don't have higher aspirations for yourself or your profession, that's your choice.
Where I got my MN there were plenty of MNs working bedside-- I was one, and taught students as faculty at the same time. The city had many fine BSN programs, and most bedside nurses were either graduates of one or in one. And I have to say, I have never seen so much sustained excellence in bedside care all over town and in the 'burbs as I did then. It was fricking awesome. Knowledge and learning for its own sake tends to leak out and affect everything you do.
As to the rest of the OP's assumptions, you can go over to the student side and search out posts that say things like "We all do the same thing and pass the same NCLEX." True, but recognize that this is a very immature attitude from people who aren't very far along in their profession, and it's true only as far as it goes.
First, nursing is far, far more than the tasks we "do" or "can do." Students get a temporary pass on this early on, as they are in a lab-check-off mode from day one, and they have a long way to go before they understand the difference between what nurses "do" and what nursing is.
Second, and more important to my mind, the thoughtful professional nurse takes a good look around and realizes that a really large part of what an RN does and thinks about all day has little to do with the implementation of parts of the medical plan of care, although we do that too. I'm not talking about just manipulative skills like making beds or passing meds, either.
Third, everybody gets to practice at their own level. If you don't want to engage physicians and other clinicians in a spirited and well-informed discussion of relevant patient care issues (not just the ones involved in your bit of delivering/delegating some of the medical plan of care), don't care to question why we do things like this, don't want to think about deeper reasons for things, don't want to think about a wider and deeper duty to care, then you don't have to. We have lots and lots of nurses like that. If that's what you're comfortable with and you don't have higher aspirations for yourself or your profession, that's your choice.
But some of us want to go beyond that. And see our profession go beyond it, too.
Interesting conversation and I thought I would add my 2 cents to the discussion. I am a 3 yr diploma grad. and will very soon finish up a RN-BSN program at a highly-rated university. I also have a high GPA, belong to a nursing honor society, and have heard all the arguments and research supporting the proposed BSN entry level requirement. Sorry though, I'm not buying it-just a lot of gobbledygook in my opinion! My BSN program has not provided me one iota of information or additional skills that I can utilize in better caring for a critically-ill patient. I continually ask myself-since the majority of nurses are employed in acute and chronic care settings, shouldn't the BSN curriculum ​really add to our nursing armamenterium? Advanced pharmacology/pharmacokinetics, gerotology, physiology....those areas, definitely! Yes, I've learned about multivariate analysis, Pearson's r, meta-analyses, illness vs. wellness, and primary health care, but these don't translate into my (and most) nurses' clinical practices. Does anyone really believe that a busy nurse with a team of sick patients has time to do a deep dive into a literature review or EBP recommendations? I did the BSN completion because it was a mandated requirement. Now, it seems that I can go back to doing the same thing I've done for 25 years, the same way, but with about $25,000 less in the bank.
Most of the nurses in my BSN program have no desire to work bedside after they get their BSN. I have an associates and I work away from the bedside already ,so I have no desire to go to the bedside. I wonder who will desire to work at the bedside not many nurse with a LPN,ASN,or BSN...so after this BSN push I do think this ideology will taper off because a majority of nurses do not want to work the bedside no matter the educational level
Do you have support for this statement aside from your own very small sample?
D) If BSN education in nursing is so great, and BSN students are so much better prepared and skilled at critical thinking, how come most of the BSN students I have encountered over the years can't "critically think" their way out of a paper bag?
Generalizations on this subject are usually bogus, and yours above illustrates it. There is nothing unique about a BSN program that causes its students to be "unable to think their way out of a paper bag," and nothing magical about getting an ASN that makes them critical thinking geniuses. Ditto for the myths that BSNs are super smart nurses with no skills or ASNs are just amazing at skills right out of the gate but don't have "book knowledge." All these stereotypes are crap imo. I've seen incredible nurses who stopped at the associates level and have no desire or need to go on. Likewise, some of the nurses I most admire are BSN prepared and perfectly capable of kicking ass as it relates to skills as well as being top notch "critical thinkers."
Again, I've taught in both kinds of programs and have had ongoing exposure in the clinical setting to students from both kinds of programs, and, as big a fan of higher education as I am and as much I would like to see a significant difference between the two groups, I just don't see it.
You contradict yourself here. If BSN prepared nurses can't think their way out of a paper bag, then there is a huge difference, unless you are saying that ASN nurses are similarly cognitively impaired.
I really despise the BSN/ASN wars.
The main difference in the education between ASN and BSN nurses has little to do with actual nursing. A Bachelor's degree simply gives additional generalized education, in the form of English and literature, foreign language, social studies and government , and general studies (electives, which may be in any subject) . A Bachelor's prepared nurse has received more formal education, but not necessarily in nursing. It seems that brick and mortar universities provide their graduates with more opportunities to round out their education, compared with online BSN programs, which many have claimed to provide more "fluff" than substance. That may have to do with the vast variety of classes available at brick and mortar universities, taught by experts in the field.Just more inventory to choose from, if you will.
I did not intend for my comments to come off as insulting or for you to interpret that I meant ADNs are not lifelong learners. I simply meant exposure while receiving education. Our programs differ; our experiences differ. Certainly most new grads from any type of program have difficulty or lack confidence to fully critically think their way "out of a paper bag". Perhaps that's where our educational standards fall short. However, thank you for your input and service to educating future nurses.
Generalizations on this subject are usually bogus, and yours above illustrates it. There is nothing unique about a BSN program that causes its students to be "unable to think their way out of a paper bag," and nothing magical about getting an ASN that makes them critical thinking geniuses. Ditto for the myths that BSNs are super smart nurses with no skills or ASNs are just amazing at skills right out of the gate but don't have "book knowledge." All these stereotypes are crap imo. I've seen incredible nurses who stopped at the associates level and have no desire or need to go on. Likewise, some of the nurses I most admire are BSN prepared and perfectly capable of kicking ass as it relates to skills as well as being top notch "critical thinkers."
You contradict yourself here. If BSN prepared nurses can't think their way out of a paper bag, then there is a huge difference, unless you are saying that ASN nurses are similarly cognitively impaired.
I really despise the BSN/ASN wars.
The main difference in the education between ASN and BSN nurses has little to do with actual nursing. A Bachelor's degree simply gives additional generalized education, in the form of English and literature, foreign language, social studies and government , and general studies (electives, which may be in any subject) . A Bachelor's prepared nurse has received more formal education, but not necessarily in nursing. It seems that brick and mortar universities provide their graduates with more opportunities to round out their education, compared with online BSN programs, which many have claimed to provide more "fluff" than substance. That may have to do with the vast variety of classes available at brick and mortar universities, taught by experts in the field.Just more inventory to choose from, if you will.
I fail to see how commenting on the capabilities I have observed in the nursing students with which I have worked directly over time is a "bogus" "generalization." If I had said "most BSN students can't ...," that would be a generalization which I would agree was "bogus." I am commenting specifically on my direct experience and observations.
I'm not contradicting myself, and I did not say, or even suggest, anything about ADN students being "critical thinking geniuses." I meant what I said -- that I have not seen a significant difference, overall, between the two groups in this regard.
I agree with you about despising the ADN vs. BSN war.
I am a nurse and chose to go to nursing school for my career. I have no desire to be a physician otherwise I would have gone to med school. I agree that going above and beyond is nice and feels great to be able to provide quality nursing care. But what about those nurses who stress that their license is gonna be taken away and or be disciplined at work over issues that the physician is dropping the ball on? Its not fair as this can cause increased nursing anxiety which can lower the nurses threshold to stress and decrease the ability to provide quality nursing care and may even be a big cause of nursing burnout. Why is no one supporting boundaries between the professions?
I'm confused. Do you think that having a BSN blurs lines between physicians and nurses?
Another thing to consider isn't something I see brought up often in these recurring thrashes, and that's the future. Look around your workplace at the staff nurses. Do you see a lot of them over age 50 or so? No? Why do you think that is? Sure, there are some who love being staff or can't retire or go part-time for some reason. But is that what you want to be locked into forever? Do you want to be working like that day in and day out for the thirty or forty years you have before you? Yeah, sure, you think you'll just love it forever. I'm here to tell you that the mature and prepared mind admits to the possibility that things could change it.
If you don't have a BSN, you won't have a lot of opportunities open for you. Those doors will be shut tight; don't even bother knocking. Things like (but not limited to):
public health
cardiac rehab
certified diabetic educator
gerontology specialist
nurse informatics
clinical specialist
case management (in many cases)
charge or management roles
risk management
pharmacy and medical device sales
clinical research
certification in a specialty you don't even know how much you're going to adore because you don't know about it yet
school nursing and camp nursing (!)
military careers
teaching (including clinical, staff development, and in some places, precepting)
and of course all the stuff we know about like APRN, NP, and CRNA.
You don't think there will ever be a time when something like that will look interesting to you? OK, then. But don't say we didn't warn you.
Another thing to consider isn't something I see brought up often in these recurring thrashes, and that's the future. Look around your workplace at the staff nurses. Do you see a lot of them over age 50 or so? No? Why do you think that is? Sure, there are some who love being staff or can't retire or go part-time for some reason. But is that what you want to be locked into forever? Do you want to be working like that day in and day out for the thirty or forty years you have before you? Yeah, sure, you think you'll just love it forever. I'm here to tell you that the mature and prepared mind admits to the possibility that things could change it.
If you don't have a BSN, you won't have a lot of opportunities open for you. Those doors will be shut tight; don't even bother knocking. Things like (but not limited to):
public health
cardiac rehab
certified diabetic educator
gerontology specialist
nurse informatics
clinical specialist
case management (in many cases)
charge or management roles
risk management
pharmacy and medical device sales
clinical research
certification in a specialty you don't even know how much you're going to adore because you don't know about it yet
school nursing and camp nursing (!)
military careers
teaching (including clinical, staff development, and in some places, precepting)
and of course all the stuff we know about like APRN, NP, and CRNA.
You don't think there will ever be a time when something like that will look interesting to you? OK, then. But don't say we didn't warn you.
A lot of those positions you listed now require an Msn.
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elkpark
14,633 Posts
A) It's not "an additional two years" of education. Most ADN programs are more like 3 - 3-1/2 years when you factor in the prerequisites people have to take in order to get into the two-year ADN program. And most of the additional time represents additional general education requirements.
B) It's really insulting to suggest that ADN-prepared nurses are educated at the level of "if assessment reveals A, then respond with intervention B," although I'm sure that's what you were told in your BSN program. News flash -- it's not true. Associate's degree programs in nursing stress "critical thinking and problem solving" as much as BSN programs do. I've taught in both, and I have regular contact, in my current position, with students from multiple schools, from both types of programs, and I feel I am in a position to have a valid opinion about this.
C) BSN students are in no way "familiarized" with "conducting research" on any meaningful level -- and do you not think that ADN students are also educated to be lifelong learners and to continue to expand their knowledge and expertise through reading and utilizing EBP? They are.
D) If BSN education in nursing is so great, and BSN students are so much better prepared and skilled at critical thinking, how come most of the BSN students I have encountered over the years can't "critically think" their way out of a paper bag? Again, I've taught in both kinds of programs and have had ongoing exposure in the clinical setting to students from both kinds of programs, and, as big a fan of higher education as I am and as much I would like to see a significant difference between the two groups, I just don't see it.