New Slant on ADN vs BSN: are ADN programs anti-intellectual?

[NurseFirst]

I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?"

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Another pharmacology teacher put down several foreign students who said that activated charcoal was used in their country as an anti-emetic, for indigestion--she told them that if someone took activated charcoal it would cause them to vomit (not true). How activated charcoal works was eventually brought up by another instructor who assured us that activated charcoal was not an emetic.

While we are told our ADN program has an excellent reputation, these kinds of responses bother me. I always learn better when I know MORE, because I understand how everything works.

I feel like my school and I have different educational philosophies.

Are all nursing schools like this? Is it more prevalent among ADN programs? I am a bit disappointed, to say the least.

Thanks,

NurseFirst

[Tweety, BSN, RN]

Yeeess? :)

steph

Sorry Steph. I cut and pasted and decided not to do that and just retype.

[Spidey's mom, ADN, BSN, RN]

Sorry Steph. I cut and pasted and decided not to do that and just retype.

I know how you feel about edu-speak.

Ok - It is almost 9 a.m. in Florida, I'll bet it is warm and sunny, and you are about to have a nice day. Meanwhile I sit here at work, it is dark outside, it is cold, I have two patients - baby with hyperbilirunemia and 50-ish man post-op gallbladder removal.

So, go have a nice breakfast and think of me slaving away in Northern California.

steph

[Tweety, BSN, RN]

So, go have a nice breakfast and think of me slaving away in Northern California.

steph

Breakfast was Nature's Path whole grain cereal with soymilk and almonds while surfing the net. I'm shaving now with my electric shaver and surfing the net. I multitask don't you know. How else would I get 14,000 posts!

Have a great day at work!

[plsunnybee]

I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?"

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Another pharmacology teacher put down several foreign students who said that activated charcoal was used in their country as an anti-emetic, for indigestion--she told them that if someone took activated charcoal it would cause them to vomit (not true). How activated charcoal works was eventually brought up by another instructor who assured us that activated charcoal was not an emetic.

While we are told our ADN program has an excellent reputation, these kinds of responses bother me. I always learn better when I know MORE, because I understand how everything works.

I feel like my school and I have different educational philosophies.

Are all nursing schools like this? Is it more prevalent among ADN programs? I am a bit disappointed, to say the least.

Thanks,

NurseFirst

Dear NurseFirst,

Please allow me first to congratulate you on your desire for more knowledge and understanding; I would not hesitate to be your patient, in the future! Re: your question: having just graduated from an MSN program, with the desire to teach nursing students, I can tell you that the general perspective is that ADN programs are more technically and skills-oriented, whereas BSN programs are oriented more toward planning and management of nursing care, which gets more into the "whys" of nursing action.

I personally disagree with this approach; as you do, I believe that all nurses need to understand the physiologic bases and pathologies that direct the need for specific nursing responses-the more we understand, the better nurses we all will be!

As a nursing instructor, I plan to give my students these tools of knowledge, and I encourage you, as a student, to continue to seek answers on your own, if your instructors cannot or will not provide them. As a new grad, I deliberately sought out experienced nurses as mentors, and pumped them for all the information I could get, and I never stop learning. Read, and ask questions, dear student; you are on the right path, and I wish you the best in your nursing career!

Peg

[Lilith]

Regardless of whether you go to an ADN program or BSN program you will get different standards of education depending on how good that individual program is. There are good and bad programs out there, just like anything. Even the best programs have some bad instructors. Education is what you make of it....as someone else said, look into things that interest you yourself via references, ask physicians to educate you (you will be surprised how willing most are), keep seeking learning and you will be an excellent nurse.

Personally, my education is all backwards. I attended Mount Holyoke College when I was just out of high school, majored in music and biopsych. Received my nursing degree at age 40 from an ADN program. Now in graduate school for FNP. I was actually pleasantly surprised how well my ADN program prepared me for graduate study.

[lifejourney]

This is an interesting discussion, and I have to reply...

Nursefirst,

I don't know the specifics of your educational background, but you mentioned one is present. Perhaps some of the differences in educational philosophy you are experiencing is simply that nursing may be very different than what you have schooled for in the past.

I have a BSN and a BS in another science area. One might think that the educational approach might be similar. However, the two BS programs I completed couldn't be different!

And, within the BSN program I completed there were instructors of all kinds. One of my instructors did not allow time during lectures for questions or discussions at all. After a few weeks of class, it became almost comical it was so ridiculous. But, not one question would she answer! People tried - she would silence them. If students had questions, they could email the instructor or visit her during her "office hours."

On the other hand, there were instructors who would answer all sorts of seemingly "random" (maybe they made sense to someone but not to me!) questions and discussion points that put us way off topic and to the point of boredom for everyone but the instructor and inquisitive student.

My advice: if you have an instructor who doesn't like the questions, don't continue to ask that person question after question. Instead, write it down. You may find the answer yourself in your reading or you may have an instructor, preceptor, etc. who will shed some light someday. The ability to think of questions and analyze things will help you as a nurse. Don't be discouraged.

[SmilingBluEyes]

Dear NurseFirst,

Please allow me first to congratulate you on your desire for more knowledge and understanding; I would not hesitate to be your patient, in the future! Re: your question: having just graduated from an MSN program, with the desire to teach nursing students, I can tell you that the general perspective is that ADN programs are more technically and skills-oriented, whereas BSN programs are oriented more toward planning and management of nursing care, which gets more into the "whys" of nursing action.

I personally disagree with this approach; as you do, I believe that all nurses need to understand the physiologic bases and pathologies that direct the need for specific nursing responses-the more we understand, the better nurses we all will be!

As a nursing instructor, I plan to give my students these tools of knowledge, and I encourage you, as a student, to continue to seek answers on your own, if your instructors cannot or will not provide them. As a new grad, I deliberately sought out experienced nurses as mentors, and pumped them for all the information I could get, and I never stop learning. Read, and ask questions, dear student; you are on the right path, and I wish you the best in your nursing career!

Peg

Well, my ADN Program did get into the "whys" and "hows" of nursing. We were not trained to be drone-like thoughtless skill-monkeys, but to function as RN's, even charge nurses and managers, in my program. We had a units and classes on management and health care business, even. Can you believe that? And EVERY skill, every task, every function was explained as to the "why" of it....every med we gave, we had BETTER be able to explain the pathophysiology and reason for it's use in a particular patient/case and we were constantly challenged to "think ahead" in most cases, and work out "in-case scenarios" to the point of exhaustion. Critical thinking was a very tired and exhausted "hallmark" of my program, words I got reallllly tired of hearing after 2 years. It was like a kitchy catch phrase you see in advertising.

Unless you have been through and seen *all* The AD programs, it's best not to judge or say in general what " ADN programs" are like, until you know. I am really tired of the generalizing we see here. You won't hear me say, "BSN nurses are less clinically capable", like some do. I know that is not true. "all" BSN programs don't "always" do this or that. I have seen EXCELLENT nurses from all 3 programs of study, all capable and performing critical thinking and managing well.

Please don't simply generalize and say "ADN programs are technical and not focused on critical thinking" or other such thing. That is NOT true. Why is it people look to make others defend their educational choices so MUCH on these boards? It does frustrate me, I am sorry.

To the OP, I am not picking on you----and I don't want to upset anyone here, but I again say, if this bothers you so much, tackle it at the source. It sounds to me you have a legitimate complaint. Your challenge is to DO something about it. Consider it an excellent lesson for later when you are a nurse. You are bound to see and be subjected to very aggravating and unfair situations, and your challenge then, will be what to do about it. Good luck.

[rach_nc_03]

I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?"

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Another pharmacology teacher put down several foreign students who said that activated charcoal was used in their country as an anti-emetic, for indigestion--she told them that if someone took activated charcoal it would cause them to vomit (not true). How activated charcoal works was eventually brought up by another instructor who assured us that activated charcoal was not an emetic.

While we are told our ADN program has an excellent reputation, these kinds of responses bother me. I always learn better when I know MORE, because I understand how everything works.

I feel like my school and I have different educational philosophies.

Are all nursing schools like this? Is it more prevalent among ADN programs? I am a bit disappointed, to say the least.

Thanks,

NurseFirst

OK, let me start by saying that it has *nothing* to do with the type of program. I know diploma students who have fantastic intellectual (and tangential) discussions in class, and MSN students who get chastised for asking detailed questions like yours. It's absolutely NOT a characteristic of a certain type of program- maybe of the individual programs themselves.

That being said, I attend a program in a small, conservative town. If you read some of my other posts, my curiosity, assertiveness, and desire to help change things for the better have generated strong reactions- both good AND bad.

There are always students- and instructors- who only want to focus on the minimum ('is this going to be on the test?') amount of information. I have encountered this in my own program, but have found that (most of the time) presentation is everything. If you're genuine, professional, respectful, and pertinent (it *does* matter how meds are cleared with variations in body chemsitry), most of the time, you won't run into issues.

It's a quality that will serve you well, I think, in all areas of life- don't let a few narrow-minded people stifle your curiosity.

[Indy, LPN, LVN]

I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?"

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Thanks,

NurseFirst

Hi,

I have a question. What year/quarter/semester are you in? Because I can see the possibility that the pharmacokinetics of aspirin excretion as it relates to the pH of urine, etc. might be a teensy bit complicated for the very beginning of a nursing program. ANY nursing program.

However, the other posters were excellent in pointing out that it's ALL useful information, especially if you work peds or ER, and see aspirin poisoning. You need to know why their acid-base balance is wonky, which way it's screwed up, where is it going next, how do you need for it to be, and specifically what things you can do to accomplish this. IF indeed you are in a fundamentals class, or the first year of nursing school, I'd suggest easing off on the teachers a bit. Then go and get two books: Pharmacology for Nursing Care by Lehne, and find a good pathophysiology book. Even "Pathophysiology Made Incredibly Easy" will do; some of my classmates really like it. Don't confuse that with a med-surge book.

You can then proceed to cross-reference the two whenever you are curious, and maybe enlighten your friends/classmates outside of class time on the interesting stuff you find out. It may be that you're simply jumping ahead of the structure of the program, and that it'll catch up to ya; or maybe you'll have different instructors in later classes who will more fully cover the metabolic/pathophysiology stuff.

Sorry if I'm rambling,

Indy

[RN4NICU, LPN, LVN]

Great advice, Indy

Lehne's Pharmacology text is excellent. For a patho text, may I suggest Pathophysiology: The Biologic Basis for Disease in Adults & Children by McCance and Huether. It is very thorough and comprehensive.

[Sarasgrd94]

I was preparing some med sheets that a group of my classmates and I made up for the medications we were given as likely meds to be given.

While doing this, I learned an interesting fact: that if the urine is alkaline, up to 80% of ASA would be eliminated from the body, compared to 2-3% if it is acidotic (according to Davis' Drug Guide for Nurses).

When I shared this with the lab instructor, she swept her hand over the mannikins and said "Where would I need to know that?"

I then shared it with the 1st term instructor, who also teaches pharmacology, who also seemed to shine it on as like "why would you need to know that?"

After being lectured by the lab instructor some time after this event, she as much as said that I was confusing other students by asking "tangential" questions in class. (For me, the questions help me to form a bigger picture.)

She said, surely I must have been told this in other classes? I have a long history of education and many many units, and I said--"No, I've never been told that before I entered nursing school." (In fact, I've been told as much that I am "selfish" for asking questions.)

Another pharmacology teacher put down several foreign students who said that activated charcoal was used in their country as an anti-emetic, for indigestion--she told them that if someone took activated charcoal it would cause them to vomit (not true). How activated charcoal works was eventually brought up by another instructor who assured us that activated charcoal was not an emetic.

While we are told our ADN program has an excellent reputation, these kinds of responses bother me. I always learn better when I know MORE, because I understand how everything works.

I feel like my school and I have different educational philosophies.

Are all nursing schools like this? Is it more prevalent among ADN programs? I am a bit disappointed, to say the least.

Thanks,

NurseFirst

sounds like just a problem with the instructor. many instructors frown on students that seem to ask intelligent questions.

[lady_jezebel]

your school definitely seems anti-intellectual, and it would bother me, too ... by the way, these kind of questions are asked by very good clinical nurses, especially icu rn's & np's.