NY State may require nurses to obtain 4-year degrees

[Brian]

But some worry that an already severe shortage will become worse.

New York is mulling over a requirement that would force all RNs to earn a bachelor's degree in order to keep their RN certification-a step that critics worry could serve as a body blow to a profession already facing a severe shortage.

Under the state Board of Nursing proposal, RNs with associate's degrees would have to earn bachelor's degrees within 10 years, or their RN certifications would be downgraded to that of licensed practical nurse. That would make nursing somewhat like teaching in New York state; certified K-12 teachers need master's degrees or must obtain one within three years of starting a job. It would also add years and thousands of dollars to the difficulty of becoming an RN...

Full Article: http://www.rochesterdandc.com/news/0413BA3TIOG_news.shtml

[markdanurse]

All right my fellow professionals. Are we getting caught up in the whole "more education means more respect and more professionalism" thing all over again? I have worked side by side with physicians for years...11 to be exact. And I have yet to have a physician, or even a patient ask me, "Are you a diploma, ADN, or BSN nurse?" Why? Because it does not matter. We all pass the same licensing exams, we all pretty much learn the same material minus some community health and management courses, and we ALL have the same scope of practice as an RN. So NO, more education does not equal more respect and professionalism. Please stop with this argument...it is nothing more than a logical fallacy.

In fact, education has become a joke. A doctorate degree is needed to become a physical tharapist or a pharmacist? Please. These two professions have such a narrow and limited scope of practice that it is almost ridiculous. When I worked as a pharmacy technician, I did the pharmacist's work for him. (i.e. filled the scripts, called physicians for prescription refills, mixed IV medications in piggybacks and 1 liter bags of IV solutions, alerted him to level 3 or higher drug interactions, and much more. He would come by, double check my work, and sign off on the labels.) The only things I could not do was counsel a patient on how to take medications, and I could not accept a new order from a physician. I made $24,000 a year, he made $90,000+ a year. Some of the smartest pharmacists I have met are those with the old B.Pharm (bachelor of science in pharmacy) degrees. Oh, but all pharmacists do the exact same job regardless of their degree. Yet, no one is forcing those with the bachelor's in pharmacy degree to go back to school for the Pharm.D. degree. See my point here? On orthopedic rehab units, I worked with physical therapists all day long. I also worked with associate degree trained physical therapy assistants. Yet, you couldn't tell the two apart when they were working with their patients. Having friends who are PTA's, they explained they can do everything a PT can do except initiate a plan of care, do the initial assessment, and cannot do wound debridement. Interesting that you would need a doctorate degree to do those three extra skills. Yet I have worked with bachelor degreed physical therapists and no one forced them to go back to school for their DPT degree. Why? Well, it's a neat concept called grandfathering. Those that have been practicing for years do not need the same level of knowledge as the new grad just entering the profession. I do not wish to be forced into a degree when I do not wish to go into more debt for school. Pay me an extra $4.00 an hour for my BSN, and I'll go back to school. Otherwise, the continuing education I constantly go through in my nursing position, as well as my specialty nursing certification, and the CE's I get through nursing journals more than prepare me to give safe care to my patients at the bedside.

Then we have my favorite issue... the 4 year, post BSN, doctorate of nursing practice (DNP or DrNP) requirement for all entry level advanced practice nurses (i.e. CNM, NP, CRNA, CNS). Yes folks, in the AACN position statement, by the year 2015, all programs will offer the DNP instead of the MSN degree for entry into practice. And why is that? Well, research has shown that NP's at the current MSN level are more than competent and capable of achieving outcomes the same as, and even better than their physician counterparts (i.e. as written in JAMA). It's because the profession thinks it will achieve more respect and professional recognition because it will offer a doctorate degree to its clinicians. Yet, having spoken to many physicians about this, most of them laugh and ask, "Why do you need that? Most NP's do just fine at the current master degree level? Why go through just as much didactic as a physician only to make less money and have a scope of practice that still does not parallel a physician. (i.e. NP's still do not do surgeries, and still cannot do 100% of what a family physician can do) Why not just go to medical school?" Yet, NP's will be grandfathered in regardless of their previous educational level (yes, we have diploma,ADN, and BSN advanced practice nurses still practicing out there from before the time of the MSN hooplah...none of them were forced to get their MSN degrees.)

Well, because we like to follow logical fallacies such as "more is better" and "if we have a doctorate degree, physicians and patients will respect us more", and "physicians will have to take us seriously then", etc.

Welcome to the big expensive joke...more education = more respect/professionalism.

[dansdoll]

The option to pursue the BSN is available to any nurse who chooses to follow this path (see the advertisers on this page for distance, part time and scholarship program information). Any self-respecting nurse will use the educational credits to fulfill CE requirements to maintain licensure and not complain so about upgrading their education to a minimal professional standard. I have worked my way up from CNA to LPN to AS to BSN to NP. I know how hard, and expensive, it can be, especially as the sole income provider for my family, but I also know how rewarding it is to be the best. Without additional education a provider not only has a lack of knowledge and an ignorance of that lack of knowledge, but enough experience to feel they don't need the extra knowledge provided by formal education. If experience is all that is needed to be a nurse, why not promote the CNA who has 20 years of service to the RN position? Higher educational standards will promote the professional s a whole and bring nurses out of the service image held by most laypeople and into the new century as professionals instead of laborers.

[dansdoll]

The fact that many nurses who hold higher degrees are the ones who promote higher education, may be the point in fact. The more education a nurse has the more that nurse realizes how much was missing in their practice at the lower level........ just food for thought

[kstec, LPN]

Reading this forum made me very irritated. For you that have your BSN, or Masters, good for you. One you either were fortunate enough to go after high school, or you sacrificed alot of family time to do so. I on the other hand was not able to go to college after high school, and I was only willing to sacrifice my family for 1 year to the the LPN. I would definitely hope that none of the ADN get demoted down to the lowest form of a nurse, a LPN, that would just be awful. I'm very proud of my accomplishment of being a LPN. I don't think I'm better than anyone, and none of you are better than me. I get really tired of the hierarchy of nursing. Of course your going to have more book knowledge the longer you go to school but that does not dismiss that the nurses with less education are any less important in what they do. I went into nursing to take care of people not impress others or put a bunch of letters after my name. Eventually if they decide for all nurses to get the BSN, that would be fine, but in the interim lets not get on our high horses and belittle others who do not. Oh and by the way if I wanted my BSN or Masters it would be mine, but at this point in my life I work part time as a LPN and my family if my #1 priority not the letters after my name.

[ZASHAGALKA, RN]

New York does not have reciprocity with any other state. Where one went to school has nothing to do with reciprocity. I live fifteen minutes to another state (abutting New York) and it took five months to get a license from that state.The ncsbn has a list of states with reciprocity agreements.

Ok, maybe we have a minor disagreement over terminology. So, let me clarify:

If by reciprocity you mean that one license can work in another state, that is a reference to the multi-state compact, of which NY is not apart. Agreed.

However, the OP on this particular topic made mention of NY being picky about the education available in other states and I interpreted that comment to be mean that NY doesn't honor RN licenses from some states due to education. The correct term there is endorsement. NY doesn't refuse endorsements from other states, even if they take forever to process them.

The OP on this topic was using the term 'reciprocity' in reference to NY not recognizing the educational programs of other states. I also incorrectly used the term, in her same context, and refuted it with a statement from the Commissioner's office that said the NY recognizes the RN educational pathway of any other State so long as THAT State's BON recognizes the education.

Now, NY DOES require a few targeted CEUs to obtain license by endorsement, but that is not the same as rejecting the education offered in other states.

To sum, up, using correct terminology: NY DOES allow licensure by endorsement, thereby validating the educational processes of other States. There is nothing about NY's education of nurses that leads it to insist that others states provide inferior education.

~faith,

Timothy.

[cookie102]

this is something that has been going around for many, many years. when i graduated from "diploma" school back in the 70's, the "rumor" was that you were going to have to go to a 4 yr college to become a nurse....yes education empowers us, but education can be obtained in many ways, as i stated once before, it doesn't matter if you go to a diploma school, 2 yr, or 4 yr....unless you pass the boards and have RN after your name, none of the other letters mean anything!! let's support the different roads people choose to take.

[ZASHAGALKA, RN]

let's support the different roads people choose to take.

At a minimum, we need to acknowledge that the different pathways we have taken to RN is our united history; it's how we got to this point.

Where we go from here MUST, if it is to be successful, give homage to the past that brought us this far. Future pathways must respect the contributions of our trailblazers, past and current.

Unless ALL stakeholders are involved, our future vision will remain clouded. At its very core, this debate, and it's failure to move forward, is a direct result of a certain lack of respect to our past and present.

No group of peoples that ignore or repudiate its past can easily embrace its future.

Can we move forward while still respecting each and every one of our united contributions? That question should be turned on its head: how can we move forward without doing so?

~faith,

Timothy.

[dansdoll]

Reading this forum made me very irritated. For you that have your BSN, or Masters, good for you. One you either were fortunate enough to go after high school, or you sacrificed alot of family time to do so. I on the other hand was not able to go to college after high school, and I was only willing to sacrifice my family for 1 year to the the LPN. I would definitely hope that none of the ADN get demoted down to the lowest form of a nurse, a LPN, that would just be awful. I'm very proud of my accomplishment of being a LPN. I don't think I'm better than anyone, and none of you are better than me. I get really tired of the hierarchy of nursing. Of course your going to have more book knowledge the longer you go to school but that does not dismiss that the nurses with less education are any less important in what they do. I went into nursing to take care of people not impress others or put a bunch of letters after my name. Eventually if they decide for all nurses to get the BSN, that would be fine, but in the interim lets not get on our high horses and belittle others who do not. Oh and by the way if I wanted my BSN or Masters it would be mine, but at this point in my life I work part time as a LPN and my family if my #1 priority not the letters after my name.

Dear kstec,

Just a note, I was not "fortunate" as you put it, to go to nursing school right out of high school, in fact I did not get my CNA until my late 30's and I did not obtain my ADN until my early 40's, my BSN in my late 40's and my FNP at well over 50. The process is one that takes time. I also have a family that is placed at the highest priority; I home school my children and set the school example by attending school myself. Everything I have done has been through alternative, distance, and part-time schedules to accommodate my otherwise busy life. I do not work part time, I work full time, yet I still have time to recognize the importance of example and pursuit of the goal to be the best by upgrading my education. I worked the first 30 years of my life as a waitress (great preparation for nursing by the way), and I wanted a better example for my children. I started nursing school when my children were 2 and 4, my children never knew what it was like for me not to be in school, but like I said, it served as an excellent example and is completely manageable without disrupting the home life or sacrificing time if one pursues a higher degree on an alternative schedule. You do not have to "sacrifice" your family for nursing school and I find it disheartening that you chose to do so the first time. As you are proud of the letters behind your name, LPN, I am proud of the letters behind mine and feel I should be recognized for the extra effort I put into getting those letters and the extra knowledge and work required should be compensated for with both respect and money. I have never said or implied that I am "better" than you or anyone else, I have only asked for the respect I deserve. Nurses who are not willing to invest time in continuing education are sacrificing the satisfaction they could hold with these accomplishments and the higher quality of care they can provide their pts with the increased knowledge. I didn't go back to school for letters behind my name, I went out of a desire to provide better care for my pts, something all nurses of high caliber should desire. As I said before, many nurses with higher degrees support higher levels of education because we recognize what was missing from our practice at the lower levels, nurse still practicing at the lower levels do not recognize what is missing because they do not internalize the entire process by going through it to advance themselves. The high percentage of low-level practitioners is what brings the entire profession to that level in the eyes of the layperson, hurts nursing as a profession, and hinders the recruitment process for new nurses. The poor image is why most nurses are as myself, "second career" nurses and young people do not choose nursing as a first choice career.

[Tweety, BSN, RN]

dansdoll, I took the long slow road too and wasn't "fortunate" enough to go right out of high school. It took me over five years to get my ADN. After 2.5 years I'll hopefully have the BSN this summer. And then going half-time an MSN.

We all have our priorities and goals and they differ from one another. I hope someone next year doesn't look at my BSN and presume anything.

[GrnHonu99, RN]

Dear kstec,

Just a note, I was not "fortunate" as you put it, to go to nursing school right out of high school, in fact I did not get my CNA until my late 30's and I did not obtain my ADN until my early 40's, my BSN in my late 40's and my FNP at well over 50. The process is one that takes time. I also have a family that is placed at the highest priority; I home school my children and set the school example by attending school myself. Everything I have done has been through alternative, distance, and part-time schedules to accommodate my otherwise busy life. I do not work part time, I work full time, yet I still have time to recognize the importance of example and pursuit of the goal to be the best by upgrading my education. I worked the first 30 years of my life as a waitress (great preparation for nursing by the way), and I wanted a better example for my children. I started nursing school when my children were 2 and 4, my children never knew what it was like for me not to be in school, but like I said, it served as an excellent example and is completely manageable without disrupting the home life or sacrificing time if one pursues a higher degree on an alternative schedule. You do not have to "sacrifice" your family for nursing school and I find it disheartening that you chose to do so the first time. As you are proud of the letters behind your name, LPN, I am proud of the letters behind mine and feel I should be recognized for the extra effort I put into getting those letters and the extra knowledge and work required should be compensated for with both respect and money. I have never said or implied that I am "better" than you or anyone else, I have only asked for the respect I deserve. Nurses who are not willing to invest time in continuing education are sacrificing the satisfaction they could hold with these accomplishments and the higher quality of care they can provide their pts with the increased knowledge. I didn't go back to school for letters behind my name, I went out of a desire to provide better care for my pts, something all nurses of high caliber should desire. As I said before, many nurses with higher degrees support higher levels of education because we recognize what was missing from our practice at the lower levels, nurse still practicing at the lower levels do not recognize what is missing because they do not internalize the entire process by going through it to advance themselves. The high percentage of low-level practitioners is what brings the entire profession to that level in the eyes of the layperson, hurts nursing as a profession, and hinders the recruitment process for new nurses. The poor image is why most nurses are as myself, "second career" nurses and young people do not choose nursing as a first choice career.

Wow, very well put. I can see both sides of the fence and while I am ALWAYS an advocate for more education (education is NEVER wasted, no matter what people say) I don't think we will ever see a uniform degree. The shortage is just too large. It would be nice for us to unite as a profession and choose one path, but I feel like it could also hurt us in the long run. Reallly it comes down to, we just need nurses.

[lindarn]

Wow, very well put. I can see both sides of the fence and while I am ALWAYS an advocate for more education (education is NEVER wasted, no matter what people say) I don't think we will ever see a uniform degree. The shortage is just too large. It would be nice for us to unite as a profession and choose one path, but I feel like it could also hurt us in the long run. Reallly it comes down to, we just need nurses.

We have nurses. To be exact, 500,000 nurses are not practicing at the bedside, me being one of them. Nursing has become a revolving door job, where the practitioners work 2-3 years, and leave for greener pastures. Nursing does not have enough power, and control, to improve, and fix, what makes bedside nursing and un-attractive career choice.

Why is this? Because we have multiple entries into practice, and most of us choose the easier path with a plethora of excuses as to why they cannot go the longer/harder route.

Potential PT, OT, and Pharmacists, I am sure, face the same obstacles to earning/achieving a college degree. I bet there are just as many single parents, individuals who have a myriad of problems, issues, obstacles, to attending college. Yet they all somehow find a way to attend college for not just 1-2 years, but earn, not just a Bachelors Degree, but a Masters, and Doctorate Degree program. And they are actually happy that the educational levels have been raised. They all say, it makes it harder to get accepted into the schools, makes their numbers smaller, and by the law of supply and demand, they are very much in demand, and in control of their profession. And in case you haven't noticed, they ALL MAKE ALOT MORE MONEY THAN NURSES.

Making a BSN the entry into practice would accomplish the same thing. When nurses are REALLY IN SHORT SUPPLY, and not in a revolving door situation, nursing will have the control to increase pay, improve benefits, demand respect, and have more satisfaction. Nurses will be taught what their skills, knowledge, and expertise are worth at the bedside, and start to bill for their services. When our services are listed on the patients bill, they will realize what their nursing care is worth. As it stands now, a nurses' professional services are rolled in with the room rate, housekeeping, and the complimentary roll of toilet paper and box of kleenex.

Less nurses will leave the profession ony 1-2 years after graduation, because they have more invested in their career, and will not be easily be forced to leave because of the conditions that are present now. We don't need more nurses. We need nurses to be happy and content with their profession, and be willing to hang in for the long haul, instead of jumping ship after less years than we went to school.

Lindarn, RN, BSN, CCRN

Spokane, Washington

[arita2]

We have nurses. Ot be exact, 500,000 nurses are not practicing at the bedside. Nursing has become a revolving door job, where the practitiners work 2-3 years, and leave fo greener pastures. Nursing does not have enough power, and control to improve, and fix, what makes bedside nursing and un-attractive career choice.

Why is this? Because we have multiple entries into practice, and most of us choose the easier path with a plethora of excuses as to why they cannot go the longer/harder route.

Potential PT, OT, and Pharmacists, I am sure, face the same obstacles to earning/achieving a college degree. I bet there are just as many single parents, individuals who have a myriad of problems, issues, obstacles, to attending college. Yet they all somehow find a way to attend college for not just 1-2 years, but earn, not just a Bachelors Degree, but a Masters, and Doctorate Degree program. And they are actually happy that the educational levels have been raised. They all say, it makes it harder to get accepted into the schools, makes their numbers smaller, and by the law of supply and demand, they are very much in demand, and in control of their profession. And in case you haven't noticed, they ALL MAKE ALOT MORE MONEY THAN NURSES.

Making a BSN the entry into practice would accomplish the same thing. When nurses are REALLY IN SHORT SUPPLY, and not in a revolving door situation, nursing will have the control to increase pay, improve benefits, demand respect, and have more satisfaction. Nurses will be taught what their skills, knowledge, and expertise are worth at the bedside, and start to bill for their services. When are services are listed on the patients bill, they will realize what their nursing care is worth. As it stands now, a nurses' professional services are rolled in with the room rate, housekeeping, and the complimentary roll of toilet paper and box of kleenex.

Less nurses will leave the profession ony 1-2 years after graduation, because they have more invested in their career, and will not be easily be forced to leave because of the conditions that are present now. We don;t need more nurses. We need nurses to be happy and content with their profession, and be willing to hang in for the long haul, instead of jumping ship after less years than we went to school.

Lindarn, RN, BSN, CCRN

Spokane, Washington

BRAVO!! Thank you for taking the time to put forth this very well stated argument in favor of the 4 year BSN. Until we step up to the plate and invest in our educations, how can we expect to be taken seriously as capable professionals worthy of the pay?

2 years does not equal 4 years, no matter how people try to spin it. Nurses at one time were little more than domestics. We have come a long way since then, but we have further to go.

:smilecoffeecup: