New grads being rushed into "nursing maturity"

FMF Corpsman, MSN, RN · Jul 24, 2013

I couldn't agree more and I can't help thinking if it were a male dominated profession, how different it would be. I just don't understand why it is that a group of educated women can't set down together and eventually form a consensus. But you're right, I've been around the block a time or two myself and heavily involved in several organizations attempting to get people to get more involved and take control of their own future and it was like asking them to stick their hand in a garbage disposal or something. They just didn't seem to grasp the importance of it all. I don't know. It was all very frustrating. Hoping maybe that the passage of time has brought with it a new awareness and a willingness to actually take the reins so to speak, and instead of just going where the horse takes you, go where you want to go.

Jlm1206 · Jul 27, 2013

I chose my nursing school for the quality of its simulations lab and the clinical sites we will attend. Two of our sites are at the best hospitals in Memphis, one that is known for its ER dept and critical care and one that is the one of the best children's hospitals in Memphis. We will also be having clinicals at a large hospital in a well known college town. The mental facility isn't the greatest, but for the area, I will see a wide variety of different addictions and behavioral disorders. Two other clinical sites will be in rural areas, so I will have the opportunity to see a broad difference in the healthcare between urban and rural nursing. If you are going to spend so much on nursing schools, isn't it logical to "shop around" for the best program you can find? Yes odds are I won't have the opportunity to have hands on experience BUT I will see a wide variety of the different scopes of life my patients come from. You have to crawl before you can walk. And if we nursing students are stuck in this situation then we must make the best of the situation God has presented us with. We know we are walking down a hard road, so as students we should search out ways to overcome these obstacles. During the summer my school doesn't have nursing classes, so I plan to spend a few weeks or months overseas volunteering to gain the experience I may not be provided here. We have to make do with what we have and do the best with what we have to offer.

FMF Corpsman, MSN, RN · Jul 28, 2013

Jlm1206, It sounds to me as if you have put together an excellent plan for your nursing education as well as for the months in between classes. I'm willing to bet you will be a superior Nurse once you have completed your studies. Good luck in all of your future endeavors.

SRNA4U, BSN, DNP, RN, CRNA · Jul 29, 2013

As far as personalities in the ICU, I'll grant you most of them are type A, but that's exactly the type of person that is needed to do the job. Anyone who has been there for a while is definitely a type A; otherwise, they wouldn't have been able to handle the stress. Other personality types simply cannot deal with the types of trauma they are continually bombarded with day after day and expected to treat them and move on, regardless of their own feelings. People whose brains are pouring out of the side of their crushed skulls from a MC vs. Tree, crash without a helmet, in the next bed may be a former coworker who has suffered a stroke. The Unit is filled with cases such as these day after day, week after week and the staff must grin and bear it. Is there any wonder they might not always have such rosy personalities all of the time or deal with people they aren't familiar with in more than a cursory shrug? Critical Care and Trauma Nurses tend to be guarded and aloof, they aren't always accustomed to having to deal with people who are perpendicular. Give them a coma patient or someone in need of a great deal of care and then you will see the love and compassion.

On the point about Type A personalities being the type that is needed to do the job I must disagree with you. I am no where near Type A personality and I have done very well. There is a difference between confident and being arrogant/cocky. We get so many new military nurses from the wards that cross over to the ICU and you just can't tell them anything. You would be surprised how many times I have seen nurses disappear on certain nurses when their patient is coding. I in noway agree with this but it happens from time to time by our GS nurses towards some of the staff that are considered arrogant and cocky.

I have worked in various ICUs and I am the most laid back person you could meet in the ICU. When situations turn for the worse, I am the one remaining calm while quickly intervening and teaching at the same time. There are some ICU nurses that when they come into your room to help you out, they bring so much chaos and confusion that I would rather not have them in my room. I think it helps people to remain calm and to think clearer when the environment is controlled versus having a nurse coming in and making everybody else tense. that's just my opinion.

We all have different ways of handling stress but some ICU nurses are not that good at managing their stress level.

nurseprnRN, BSN, RN · Jul 29, 2013

From reading these boards it appears that many current ASN/ADN students are older students with work/life experience and often have previous degrees, and that many ASN/ADN prepared nurses were older students with work/life experience when they received their training. This was also the case in the ADN program I graduated from 18 years ago. I don't see a persuasive argument for a BSN being required for entry in to practice.

I don't see past the non sequitur in your paragraph. BSN includes more education regardless of the brain it's put into. That's nursing education. It's not just that it gives you more grey hairs that you could have gotten elsewhere, like in your math or marketing degree. :)

This is one of the most contentious issues in nursing: the level of education needed for a profession. As many of the NN'rs know, I come down squarely on the side of a BS in Nursing or BSN (not a BA or "BAS," whatever that is) as entry-level educational preparation. When I had smaller kids and they asked me a question, I always asked them, "Do you want the short answer or the long one?" Since I can count on the fingers of one hand the number of times they ever said, "Short" and still have enough left over for the Boy Scout salute, here it is again.

(Disclaimer: Have worked as a staff nurse, inservice/staff development, instructor, NCLEX prep course instructor, case manager in multiple settings, and other stuff too numerous to mention. In short, been around, seen that, done that.)

What's a profession? Is nursing a profession? What's the basic educational prep for people you think of as professionals? Would you want your chemistry research done by someone with an associate degree? Your child taught high school math or English? Your income tax advising? Sure, there are good people with lower level education who succeed in life, but don't let that "we all have the same license and sit for the same exam" fool you. Better education makes you better at what you do. There are any number of people who can give you examples of BSNs or MNs who don't know how to take a rectal temp (why does everyone focus on that and bedpans when they think of nursing, anyway?) and marvelous crusty old LPNs who saved the resident's butt one dark and stormy night, but for every single one of those I will see your anecdote and raise you half a dozen godawful errors made by nurses who didn't take the coursework and didn't get exposed to the idea of autonomy in school.

Time: The bachelor's degree takes four years. The associate's degree (AS or ASN) takes ... three and a half, once you count all the prerequisites you're going to have to take before they admit you into the nursing program. And those who say you can work on your BSN while you are working as an RN with an AS don't tell you (and maybe don't know, to be charitable) that many of your course hours from the AS program are not transferrable, so it won't just be a matter of a semester or two or three. AND working as a nurse is HARD, almost as hard as nursing school ... think you'll have the mental, physical, social, and financial energy for more education at the same time? Oh, and in most jurisdictions you can't sit for the LPN exam and work as one while partway thru a AS or BSN program anymore, either.

Job opportunities: Although the old a-nurse-is-a-nurse-is-a-nurse attitude is fortunately fading away, at entry level for new grads, about the same, and I realize that people who are just starting out have a very incomplete idea of what it means to be a nurse. However, look around the place and see who's working. Are you planning to be older some day? Do you see older nurses working in those entry-level staff or charge positions? If not, where did they all go? Why do you care? Well, suppose you work on a general medical floor and get entranced by cardiac rehabilitation after following a patient who did it. A job comes up in the department, hooray! Oops, BSN only. Or you find your heart drawn to helping underserved women in a public health clinic for high-risk pregnancy. Sorry, BSN only in public health. After five or six years as a staff nurse you have become a resource to new hires and your peers and you realize you have a gift for teaching. You see that a position in staff development has come open, and you are first in line at HR to apply. You got it.... BSN is the minimum. School nursing? BSN. Hurt your back and want to go for a job in case management? BSN. You discover you have a gift for asking, "Why do we do it this way?" and are amazed to find you want to look into jobs in management or nursing research.....BSN minimum. And if you look at the regular old want ads for nurses in the paper, you will see more and more and more of them say "BSN preferred/ required." And if BSN is becoming "preferred/required," then exactly how is getting the BSN later going to help you now? You are starting to get the picture now. Also, many, many practice settings give you a differential for BSN. No, I know, not all, but hey. One more factor.

Growth: The questions in the licensure exams (NCLEX) are developed from errors made in the first year of practice by new grads, and regardless of pass rates from different level programs, anyone in practice can confirm the research: In the first year of work all new grads perform at about the same level as they get their feet under them and get used to the idea of working as an RN. But after that year, the BSNs pull ahead in ways that are related to their higher level of education. Why? Because what we call in the ed biz "psychomotor skills," the things you do with your hands, can be done by anyone with enough practice. Hell, we teach lay people how to do peritoneal dialysis at home or suction tracheostomies. But the understanding of WHY some things are as they are is something you get in better education: more science, more sociology, more psychology, more history, a basic statistics class, exposure to more clinical settings (I doubt if you'll get a full semester in peds, psych, OB, or any public health at all in many AS programs) give you the insight to ask better questions and make better decisions.

PMFB-RN, RN · Jul 30, 2013

I don't see past the non sequitur in your paragraph. BSN includes more education regardless of the brain it's put into. That's nursing education. It's not just that it gives you more grey hairs that you could have gotten elsewhere, like in your math or marketing degree. :)

*** My BSN program did not include any nursing eduction not already taught in the ADN program with the exceptiopn of one research course.

What's a profession? Is nursing a profession?

*** I never worry about such questions. As long as nurses are punching time clocks like regular factory workers it makes it hard for me to think of if as a true profession. On the other hand I am not bothered in the least by the idea that I may be a skilled tradesmen.

What's the basic educational prep for people you think of as professionals? Would you want your chemistry research done by someone with an associate degree? Your child taught high school math or English? Your income tax advising?

*** Those fields, unlike nursing, lend themselves to classroom education. Much about nursing must be learned hands on in the field and can not be learned in the classroom.

There are any number of people who can give you examples of BSNs or MNs who don't know how to take a rectal temp

*** In my job as rapid response nurse I regularly see nurses who can't think criticaly or consider their patient wholisticaly, including those with BSNs and MSNs. To be fair I can't say that I have noticed any difference between the critical thinking of nurses regardless of their degree. Most get it, some do not reguardless of their academic preperation.

Time: The bachelor's degree takes four years. The associate's degree (AS or ASN) takes ... three and a half, once you count all the prerequisites you're going to have to take before they admit you into the nursing program.

*** Or two years and no pre-reqs like the public ADN program in my state.

And those who say you can work on your BSN while you are working as an RN with an AS don't tell you (and maybe don't know, to be charitable) that many of your course hours from the AS program are not transferrable,

*** What!? You are mistaken. Of coruse credits from accredited community colleges are transferable. I have never heard of any nurse not being able to transfer their credit to a university, unless they went to nursing school at an unaccredited program.

so it won't just be a matter of a semester or two or three. AND working as a nurse is HARD, almost as hard as nursing school ... think you'll have the mental, physical, social, and financial energy for more education at the same time?

*** The many, many graduated of RN to BSN programs demonstrate that it is possible for a large number of people. I completed my BSN in well under a year, as do most all my co-workers.

Oh, and in most jurisdictions you can't sit for the LPN exam and work as one while partway thru a AS or BSN program anymore, either.

*** In my state all ADN students can sit for the LPN NCLEX after the first year of the progrm. A lot of them work part time as LPNs during the summer and during the second year of the program, thus giving them a large leg up in clinical experience over the BSN students.

Job opportunities: Although the old a-nurse-is-a-nurse-is-a-nurse attitude is fortunately fading away, at entry level for new grads, about the same, and I realize that people who are just starting out have a very incomplete idea of what it means to be a nurse. However, look around the place and see who's working. Are you planning to be older some day? Do you see older nurses working in those entry-level staff or charge positions? If not, where did they all go? Why do you care? Well, suppose you work on a general medical floor and get entranced by cardiac rehabilitation after following a patient who did it. A job comes up in the department, hooray! Oops, BSN only. Or you find your heart drawn to helping underserved women in a public health clinic for high-risk pregnancy. Sorry, BSN only in public health. After five or six years as a staff nurse you have become a resource to new hires and your peers and you realize you have a gift for teaching. You see that a position in staff development has come open, and you are first in line at HR to apply. You got it.... BSN is the minimum. School nursing? BSN. Hurt your back and want to go for a job in case management? BSN. You discover you have a gift for asking, "Why do we do it this way?" and are amazed to find you want to look into jobs in management or nursing research.....BSN minimum.

*** You make a good argument for requiring a BSN, one that I also agree with. However all of those jobs are available to the RN with a BSN, reguardless if that nurse started her practice as an ADN or BSN. Just about any ADN RN can be a BSN RN in 6-24 months after graduating. In my area many of the ADN programs have partnerships with universities where students are dual enrolled and graduate in 4 years with a BSN, however they also graduate in two years with an ADN and get two solid years of work experience under their belt.

And if you look at the regular old want ads for nurses in the paper, you will see more and more and more of them say "BSN preferred/ required." And if BSN is becoming "preferred/required," then exactly how is getting the BSN later going to help you now?

*** Now THIS is a great point and valid argument for BSN as entry to practice. It is exactly why, when I am asked for advice by those who are considering nursing, I usually advise them to attend a BSN program.

I say this without addressing any of the reason that more and more employers are requiring / prefering BSN grads. That is a seperate discussion.

You are starting to get the picture now. Also, many, many practice settings give you a differential for BSN. No, I know, not all, but hey. One more factor.

Growth: The questions in the licensure exams (NCLEX) are developed from errors made in the first year of practice by new grads, and regardless of pass rates from different level programs, anyone in practice can confirm the research: In the first year of work all new grads perform at about the same level as they get their feet under them and get used to the idea of working as an RN. But after that year, the BSNs pull ahead in ways that are related to their higher level of education. Why? Because what we call in the ed biz "psychomotor skills," the things you do with your hands, can be done by anyone with enough practice. Hell, we teach lay people how to do peritoneal dialysis at home or suction tracheostomies. But the understanding of WHY some things are as they are is something you get in better education: more science, more sociology, more psychology, more history, a basic statistics class, exposure to more clinical settings (I doubt if you'll get a full semester in peds, psych, OB, or any public health at all in many AS programs) give you the insight to ask better questions and make better decisions.

Susie2310 · Aug 1, 2013

I don't see past the non sequitur in your paragraph. BSN includes more education regardless of the brain it's put into. That's nursing education. It's not just that it gives you more grey hairs that you could have gotten elsewhere, like in your math or marketing degree. :)

May I politely (I address other posters politely, even if I disagree with their posts) point out that I was replying to Altra's post. If you re-read my reply to Altra and consider it in the context of Altra's post, you may find my reply more comprehensible. Other educated posters on this thread managed to comprehend my reply; some even liked it. Have a good day.

nurseprnRN, BSN, RN · Aug 2, 2013

May I politely (I address other posters politely, even if I disagree with their posts) point out that I was replying to Altra's post. If you re-read my reply to Altra and consider it in the context of Altra's post, you may find my reply more comprehensible. Other educated posters on this thread managed to comprehend my reply; some even liked it. Have a good day.

"From reading these boards it appears that many current ASN/ADN students are older students with work/life experience and often have previous degrees, and that many ASN/ADN prepared nurses were older students with work/life experience when they received their training. This was also the case in the ADN program I graduated from 18 years ago. I don't see a persuasive argument for a BSN being required for entry in to practice."

In the above quote, I understood you to be implying that older students with work-life experience and previous degrees don't need more nursing education than they're going to get in an ADN/ASN program because they are older, presumably with more life experience, and may have demonstrated previous academic achievement. Therefore you don't see the reason for BSN per se being an entry-to-practice requirement (for those people?). Am I mis-paraphrasing your words? If so, my apologies for missing something.

My point was, however imperfectly expressed, that expanded basic nursing education, i.e., BSN, for anyone, of any age, with any prior education or none, is a good thing. Although life experience and other degrees can enhance it (and that's why many BSN programs allow you to count past academic achievements for partial credit), nothing can replace it. Therefore I stand by my assertion that BSN education for entry is beneficial for the profession and the people we serve in all capacities.