Nurses being forced to go back to school

Tacokrunch · Sep 9, 2014

You should not have to but i think it is because hospitals want magnet status.

la_chica_suerte85, BSN, RN · Sep 9, 2014

Let me clarify......What I was trying to say is that I would love to hear what class it was that was taken that made you a better beside nurse. There is so much talk about increasing our knowledge base and how this is preferable to the nurse that has years of experience. With all due respect, after 18 years of nursing experience, much of which was cardiac critical care and cath lab, it would still take years of bedside experience before these "better educated nurses" could even touch our knowledge base. If you prefer the nurse that is more knowledgable......tell me about it when your in that bed crashing. If someone on this site can share with me the way one of these classes helped save a life, I would love to hear about it. The classes we are forced to take have nothing to do with clinical nursing. This is not to suggest that I will waste valuable time and energy being angry about the above. I won't! I just feel we are being brainwashed. This is not the first time this has happened. Forcing nurses to go back to school is partly a cyclic thing. I just feel when a nurse gets to a certain age that if the hospital isn't willing to pay for it they shouldn't be insisting on it.

I think I can take a stab at this. The only thing that separates my BSN program from an ASN is that we get a ton of research instruction (i.e. statistical analysis, lit review, how to devise studies, etc). Those of us with the BSNs/MSNs/PhDs/etc./etc. are the ones that are supposed to be expanding the knowledge base. We do the studies that find the evidence to support the practices that are touted as the "evidence-based practice." Nurses employed at these hospitals do research and gain the hospitals notoriety that help them increase their status (and, inevitably, profits; i.e. MAGNET status). THAT SAID.....

Having an army of BSNs or post-graduate RNs in a hospital is supposed to net benefits for that hospital. That's the reason for the preference. Since the idea is to increase status/profits, then it should behoove them to take the financial responsibility of educating (investing in) their ADNs and not leave it to them. Otherwise, what's the point of requesting such an undertaking of RNs and LVNs who do have a fantastic knowledge base rounded off by an incredible treasury of personal experience?

I get it if the facility you're employed at is willing to do some tuition reimbursement. I don't get it if they don't, especially for the employees who have heavily invested their careers there. What, are they afraid you're going to leave all of a sudden if you get your BSN? You should if they didn't pay for it and you can get better pay/benefits elsewhere, right? At least they can use the leverage of reimbursement to keep people around (i.e. give us 5 years on contract after completing your BSN).

APRN., DNP, RN, APRN, NP · Sep 9, 2014

Let me clarify......What I was trying to say is that I would love to hear what class it was that was taken that made you a better beside nurse. There is so much talk about increasing our knowledge base and how this is preferable to the nurse that has years of experience. With all due respect, after 18 years of nursing experience, much of which was cardiac critical care and cath lab, it would still take years of bedside experience before these "better educated nurses" could even touch our knowledge base. If you prefer the nurse that is more knowledgable......tell me about it when your in that bed crashing. If someone on this site can share with me the way one of these classes helped save a life, I would love to hear about it. The classes we are forced to take have nothing to do with clinical nursing. This is not to suggest that I will waste valuable time and energy being angry about the above. I won't! I just feel we are being brainwashed. This is not the first time this has happened. Forcing nurses to go back to school is partly a cyclic thing. I just feel when a nurse gets to a certain age that if the hospital isn't willing to pay for it they shouldn't be insisting on it.

I write the following with love and respect in my heart for my brethren ADN RN's in my heart, because I asked the same questions.

I can answer that question regarding what class was it that was taken that made you a better bedside nurse;

Evidence Based Practice.

Why do we do oral care q 2 hours on vented patients instead of willy nilly? Answer: Evidence Based Practice.

Why do we do skin to skin with babies after birth? Answer: Evidence Based Practice.

How did our Sepsis Bundles get started? Answer: Evidence Based Practice.

Who interprets the statistical outcomes from EBP studies? Answer: Students who have taken Statistical Analysis classes and application of statistical analysis outcomes in EBP classes.

Who takes the statistics classes, as well as the EBP classes that teach analysis of statistical outcomes from various research studies? Answer: BSN and MSN and DNP/DNs/PhD/etc, etc, etc.

The hospitals want nurses who can walk over to the computer and dial up a peer reviewed study that will help direct their patient care. They want nurses who know how to tell the difference between a peer reviewed study and something that is not. When patients request information, they don't want the nurses to go to Google as their first resource for information to give to patients.

Hospitals want nurses to use research in their practice.

A large survey was conducted of RN's from across the US. Of the clinical nurses who responded to the survey, more than 54% were not familiar with the term EBP. the typical source of information for 67% of these nurses was a colleague. 58% of the respondents had never used research articles to support clinical practice. Only 18% had ever used a hospital library. Additionally, 77% had never received instruction in the use of electronic resources. (Pravikoff, Tanner & Pierce, 2005).

Stalirris · Sep 9, 2014

I personally feel it is morally reprehensible these institutions are strong arming nurses, who have worked for them for 10 to 20 years and are just years away from retiring, to take on more debt. I work at a Magnet hospital, in a Gold Beacon ICU, and I see my co-workers being coerced into obtaining their BSNs. These are ladies in their 50's and 60's. It literally makes me sick to my stomach to talk to them and see the amount of stress they feel at the thinly veiled threats that they will be losing their jobs because they haven't matriculated into a BSN program.

It's all about the numbers for my manager. How many certified nurses does she have on staff. How many BSNs does she have on staff. Administration does not care about their long term employees who have a vast wealth of experience. I know 3 RNs who have combined century of experience between them and our manager would love to get rid of them. She could get fresh BSNs for cheap and guess who would have to orient the fresh ones?

I'm shocked no one has piped in about Aiken's studies yet. They're great and all... but the ANA needs to DO something about it rather then have institutions run the plan. Talk about the tail wagging the dog.

As for me, I've been a LPN, Associate Degree RN and in my last 2 classes for BSN. I've been an ICU RN, CCRN'd for 10, for 18 years. I've always kept up to date on current trends in my specialty. I have always kept up with the literature and attended conferences. I can honestly tell you that none of my BSN classes have helped me at the bedside. I don't care if you think that makes me a bad nurse, as some have commented on before, because I don't think those people really know what I do when I go in for my 12 hour shift at the Trauma ICU. The ONLY reason I'm getting my BSN is because I want to become a CRNA. I've had enough wiping poop up but love the clinical skills.

I personally think the OP should slow boat any further education, if she chooses to go that route. Whatever the reimbursement allows for is all she should do. It will keep her manager off her back. She might like some of the classes, too. My favorite was Ancient Western Science and learned a ton about Plato, Ptolemy, etc.

APRN., DNP, RN, APRN, NP · Sep 10, 2014

I personally feel it is morally reprehensible these institutions are strong arming nurses, who have worked for them for 10 to 20 years and are just years away from retiring, to take on more debt. I work at a Magnet hospital, in a Gold Beacon ICU, and I see my co-workers being coerced into obtaining their BSNs. These are ladies in their 50's and 60's. It literally makes me sick to my stomach to talk to them and see the amount of stress they feel at the thinly veiled threats that they will be losing their jobs because they haven't matriculated into a BSN program.
It's all about the numbers for my manager. How many certified nurses does she have on staff. How many BSNs does she have on staff. Administration does not care about their long term employees who have a vast wealth of experience. I know 3 RNs who have combined century of experience between them and our manager would love to get rid of them. She could get fresh BSNs for cheap and guess who would have to orient the fresh ones?
I'm shocked no one has piped in about Aiken's studies yet. They're great and all... but the ANA needs to DO something about it rather then have institutions run the plan. Talk about the tail wagging the dog.
As for me, I've been a LPN, Associate Degree RN and in my last 2 classes for BSN. I've been an ICU RN, CCRN'd for 10, for 18 years. I've always kept up to date on current trends in my specialty. I have always kept up with the literature and attended conferences. I can honestly tell you that none of my BSN classes have helped me at the bedside. I don't care if you think that makes me a bad nurse, as some have commented on before, because I don't think those people really know what I do when I go in for my 12 hour shift at the Trauma ICU. The ONLY reason I'm getting my BSN is because I want to become a CRNA. I've had enough wiping poop up but love the clinical skills.
I personally think the OP should slow boat any further education, if she chooses to go that route. Whatever the reimbursement allows for is all she should do. It will keep her manager off her back. She might like some of the classes, too. My favorite was Ancient Western Science and learned a ton about Plato, Ptolemy, etc.

My opinion of your nursing practice doesn't really matter. I don't know you, but I will assume that you are a fantastic nurse. I don't even think that it matters that your BSN classes haven't changed your opinion of practice at the bedside. However, I'm fairly certain that within the last year, something in your clinical practice environment changed because of EBP. That is the point that I want to make. I don't want my point to be that the hospital is right to tell experienced nurses that they should go back to school to get higher degrees, because I don't think that is fair at all.

I DO want nurses to look at EBP and be able to understand EBP, use EBP in their practice, and disseminate EBP to others. All of the experience in the world isn't going to matter to your patient if it leaves the hospital with you at the end of your shift. If your experience has shown you, without a doubt, that post-procedure cardiac cath patients have waaaay better outcomes from lying flat for six hours versus four, then isn't it better to share that information with other nurses? Why keep that information to yourself, your immediate co-workers, or your individual hospital?

That's what nursing research is all about; EBP. We desperately need the clinical expertise of dedicated, experienced nurses just like you to inform future clinical practice changes. You've got the knowledge - don't let it leave at the end of your shift.

MunoRN, RN · Sep 10, 2014

My opinion of your nursing practice doesn't really matter. I don't know you, but I will assume that you are a fantastic nurse. I don't even think that it matters that your BSN classes haven't changed your opinion of practice at the bedside. However, I'm fairly certain that within the last year, something in your clinical practice environment changed because of EBP. That is the point that I want to make. I don't want my point to be that the hospital is right to tell experienced nurses that they should go back to school to get higher degrees, because I don't think that is fair at all.
I DO want nurses to look at EBP and be able to understand EBP, use EBP in their practice, and disseminate EBP to others. All of the experience in the world isn't going to matter to your patient if it leaves the hospital with you at the end of your shift. If your experience has shown you, without a doubt, that post-procedure cardiac cath patients have waaaay better outcomes from lying flat for six hours versus four, then isn't it better to share that information with other nurses? Why keep that information to yourself, your immediate co-workers, or your individual hospital?
That's what nursing research is all about; EBP. We desperately need the clinical expertise of dedicated, experienced nurses just like you to inform future clinical practice changes. You've got the knowledge - don't let it leave at the end of your shift.

That study shows current ADN grads are significantly less likely to understand or use EBP?

macawake, MSN · Sep 10, 2014

100 likes to your entire post.

Hospitals want nurses to use research in their practice.
A large survey was conducted of RN's from across the US. Of the clinical nurses who responded to the survey, more than 54% were not familiar with the term EBP. the typical source of information for 67% of these nurses was a colleague. 58% of the respondents had never used research articles to support clinical practice. Only 18% had ever used a hospital library. Additionally, 77% had never received instruction in the use of electronic resources. (Pravikoff, Tanner & Pierce, 2005).

This saddens me but unfortunately doesn't surprise me. I've repeatedly seen proof on AN that many members aren't exactly research literate. You don't have to venture far into for example the Pandemic Flu forum to realize that. That sub-section of the forum frequently scares me.

OP, you asked if someone could answer what if any classes, actually helped a nurse save a life. Well, for me I think it's actually all of them. Of particular value were the ten weeks when I spent between 60 and 70 hours per week, completing my "APA paper" for my most recent degree. It was a blood, sweat and tears ordeal and I am extremely proud over the result. I have learned a lot from it.

I also learned how to intubate and a patent airway certainly has its' uses too Seriously though, our profession is supposed to be evidence-based. Understanding research, being able to interpret a study correctly and to be able to identify flaws or limitations in things like design, method, discussion and conclusions is in my opinion a crucial skill in order to practice safely and optimally.

I understand the reluctance a person who has just a few years left until retirement might have to make the financial investment necessary to obtain a degree. I understand and I sympathize.

However, I do believe that the way forward for the nursing profession is EBP.

This reminds me of OP:s assertion that she believes that patients prefer a nurse who really cares over an educated one. Would patients say the same about their physician? I don't believe so, and for good reason.

HazelLPN, LPN · Sep 10, 2014

I personally feel it is morally reprehensible these institutions are strong arming nurses, who have worked for them for 10 to 20 years and are just years away from retiring, to take on more debt. I work at a Magnet hospital, in a Gold Beacon ICU, and I see my co-workers being coerced into obtaining their BSNs. These are ladies in their 50's and 60's. It literally makes me sick to my stomach to talk to them and see the amount of stress they feel at the thinly veiled threats that they will be losing their jobs because they haven't matriculated into a BSN program.
It's all about the numbers for my manager. How many certified nurses does she have on staff. How many BSNs does she have on staff. Administration does not care about their long term employees who have a vast wealth of experience. I know 3 RNs who have combined century of experience between them and our manager would love to get rid of them. She could get fresh BSNs for cheap and guess who would have to orient the fresh ones?
I'm shocked no one has piped in about Aiken's studies yet. They're great and all... but the ANA needs to DO something about it rather then have institutions run the plan. Talk about the tail wagging the dog.
As for me, I've been a LPN, Associate Degree RN and in my last 2 classes for BSN. I've been an ICU RN, CCRN'd for 10, for 18 years. I've always kept up to date on current trends in my specialty. I have always kept up with the literature and attended conferences. I can honestly tell you that none of my BSN classes have helped me at the bedside. I don't care if you think that makes me a bad nurse, as some have commented on before, because I don't think those people really know what I do when I go in for my 12 hour shift at the Trauma ICU. The ONLY reason I'm getting my BSN is because I want to become a CRNA. I've had enough wiping poop up but love the clinical skills.
I personally think the OP should slow boat any further education, if she chooses to go that route. Whatever the reimbursement allows for is all she should do. It will keep her manager off her back. She might like some of the classes, too. My favorite was Ancient Western Science and learned a ton about Plato, Ptolemy, etc.

That's what I did 25 years ago when I was told that I needed my RN or would be put out to pasture and have to leave the MICU where I had been working since the early 1960s. I ended up taking the slow road too, taking classes that interested me...such as additional math and science classes that were beyond the nursing level and were required for students who followed a premedical course of study. I was in my late 50s at the time. I nearly finished my BSN, but life got in the way...my husband got sick and I dropped out very shortly into my final semester which was to be my professional rotation as a student nurse. Thankfully, LPNs were allowed to stay in the unit after all was said and done. Instead of finishing my BSN, I retired from full time nursing after my husband passed away. I simply had no interest anymore and didn't need the money. I spent the next 17 years in semi retirement and now am only marginally involved in nursing as a substitute assistant school nurse.

I would be lying if I said I didn't learn anything new in my BSN coursework. I learned a lot about research, especially how bias and poor research design are huge problems. I learned a lot about areas of nursing that I didn't practice. I learned more about science and math which I always loved in high school ( I was the only girl in my hs class who took calculus and physics, young women were not encouraged to do that in my day). However, what I know about critical care nursing was learned on the job and my BSN didn't change a thing about the way I did it. I learned a great deal about how the university system is different than hospital based schools. There was a great divide between academic nursing and nursing reality.

I'm glad that I'm retired now and was allowed to finish my career as an LPN working in critical care. It was what I knew best. I wouldn't have been able to work on the floor anymore...mainly because I had no passion for it and knew myself well enough that I would have been simply going through the motions if I had to leave the job I loved.

I've never seen a peer reviewed study that was written indicating that veteran LPNs or diploma RNs are anything but outdated relics from another generation who can't do (insert current buzz word...critical thinking, evidenced based practice....things we've been doing since Florence Nightingale but never put a name to). Experience matters, and I don't care what any scholarly journal has to say about that. You want to assign the sickest patient on the unit to a BSN because that's what the literature indicates? Never mind she's not that good of a nurse. Never mind that the patients diagnosis isn't her strength. Never mind that there is a 40 year veteran LPN coming in who's an ideal fit for this patient. However, this not so good BSN knows how to site properly in APA format (although puts commas in the wrong place sometimes). However, its not going to help her care for this particular patient this night.

I'm not bashing the university system, but we are losing some of the clinical excellence and the respect given to experienced nurses that the old diploma schools taught. I wish there was a way to bring some of it back and incorporate it into the university system. In this day and age of corporate nursing in sheep's clothing, I don't think we shall see that happen for a long time.

Glad I'm retired and I do not for one minute take for granted that I no longer have to worry about job security based on the kind of formal nursing education that I had.

APRN., DNP, RN, APRN, NP · Sep 10, 2014

That study shows current ADN grads are significantly less likely to understand or use EBP?

No - That study was done on ALL nurses. Which is the point I want to make; go out and learn about EBP. Incorporate EBP into your practice. Disseminate your EBP to others to learn from.

Where do you learn EBP? If your hospital teaches EBP classes - take the EBP classes.

Unfortunately, most hospitals don't teach EBP; the classes are taken in pretty much all BSN and graduate courses with current curriculum.

Laurie52 · Sep 10, 2014

So let me ask a question.....Should I be forced to go back and get my BSN? I have served the same hospital for eighteen years. Now, I'm no longer fit to do my job? At a time when retirement is just around the corner; I'm being forced to go into debt to get by BSN? I think that anyone who was involved in this decision should be paying for my education. Lets see how quickly they change their position! I can honestly say that I have never met an individual that was somehow made a better nurse because of this. So many nurses go into this field for the wrong reasons. I made a good decision and I'm an exceptional nurse. I don't need a BSN or MSN to prove that. I'm sure if you asked our patients what was more important to them......the more educated nurse or the nurse who truly cares about them, the decision would be simple. Shame on all of you who are forcing veteran nurses to do this. Any nurse over the age of 50 should not have this forced upon them.

How about a well educated nurse who cares about their patient? Well educated and caring are not mutually exclusive!

MunoRN, RN · Sep 10, 2014

No - That study was done on ALL nurses. Which is the point I want to make; go out and learn about EBP. Incorporate EBP into your practice. Disseminate your EBP to others to learn from.
Where do you learn EBP? If your hospital teaches EBP classes - take the EBP classes.
Unfortunately, most hospitals don’t teach EBP; the classes are taken in pretty much all BSN and graduate courses with current curriculum.

You seemed to suggest a correlation:

Who takes the statistics classes, as well as the EBP classes that teach analysis of statistical outcomes from various research studies? Answer: BSN and MSN and DNP/DNs/PhD/etc, etc, etc.

APRN., DNP, RN, APRN, NP · Sep 10, 2014

100 likes to your entire post.
This saddens me but unfortunately doesn't surprise me. I've repeatedly seen proof on AN that many members aren't exactly research literate. You don't have to venture far into for example the Pandemic Flu forum to realize that. That sub-section of the forum frequently scares me.
OP, you asked if someone could answer what if any classes, actually helped a nurse save a life. Well, for me I think it's actually all of them. Of particular value were the ten weeks when I spent between 60 and 70 hours per week, completing my "APA paper" for my most recent degree. It was a blood, sweat and tears ordeal and I am extremely proud over the result. I have learned a lot from it.
I also learned how to intubate and a patent airway certainly has its' uses too Seriously though, our profession is supposed to be evidence-based. Understanding research, being able to interpret a study correctly and to be able to identify flaws or limitations in things like design, method, discussion and conclusions is in my opinion a crucial skill in order to practice safely and optimally.
I understand the reluctance a person who has just a few years left until retirement might have to make the financial investment necessary to obtain a degree. I understand and I sympathize.
However, I do believe that the way forward for the nursing profession is EBP.
This reminds me of OP:s assertion that she believes that patients prefer a nurse who really cares over an educated one. Would patients say the same about their physician? I don't believe so, and for good reason.

It's way easier for hospitals to say "Hey, go back to school and get your BSN's and graduate degrees", than to say "We want our nurses to utilize EBP, so we're going to invest in our staff nurses and provide education to teach them about EBP". Nursing research is enormously important BECAUSE OF experienced nurses.

I think it would be a far kinder and expeditious process towards better patient outcomes to invest in the current nursing staff and educate them in truly utilizing EBP, than to kick them to the curb because they haven't gone back to school to earn a BSN or graduate degree in nursing.