Professionalism and Credentials

mattcastens · Nov 11, 2001

As the initiator of this thread, I'd like to make a few more comments.

First, I am an ADN -- remember that -- admittedly, one who is working toward his BSN.

Next, I did not start this discussion, it is one that has been going on for decades.

Third, I didn't start this discussion as a debate on who made better nurses. In fact, that issue is irrelevent! My point is that a higher level of education is smiled upon by our society, and if we are to advance the image of nursing, we should get that through our heads!! Look at a business model: do all managers have their MBA? No. Are there great entreprenurs that don't have that high level of education? Of course. And yet, thousands of MBA students graduate every year. Why? Because it opens doors and garners respect. Are some LPNs better nurses than RNs? Yes. Are some ADNs better nurses than BSNs? Of course. However, as I pointed out before, nurses will suffer (and have suffered) if society sees us as only needing a two-year education -- the same as an auto mechanic or dental hygenist, instead of higher education. We hold lives in our hands! That reason alone should demand higher education as our baseline.

Also realize that no matter what we do (save an outstanding increase in pay), the nursing shortage we have now will not be solved in a short period of time. Why? People aren't interested in nursing. To foster that interest, it would be to our benefit to play up the high level of education that should be needed.

Lastly, the issue of second-career nurses is a valid one. These people can be accomodated by having an extension-type program that includes only science and nursing classes. It would be for people who already have baccelaureate degrees and would be a two-year extension onto their existing degree.

nurs4kids · Nov 11, 2001

I've seen it twice here, now I have to correct the misconception. Dental Hygenist are EXACTLY like nursing with regards to education. There are different ways to obtain a hygenist license. Many hygenist DO have Diploma and MANY have a Degree. Several also sought the precept route that is available in some states. As the daughter and sister of hygenist, I'd like to add that to downplay one profession while trying to raise ours does NOT help our cause. I watched my sister go through hygenist school. Her studies were very closely related to mine, only difference is that at a point her focus was turned toward one part of the body rather than generalization. I remember my mother coming home from work after seeing 12 patients/day, barely able to walk. I watched both of them travel across states in order to obtain the necessary CEU's for their license. My point is, that just because we haven't traveled the road, don't downplay their profession.

This is an example of the same thing that happens with nursing. The public DOES see nursing as it sees hygenist, because it is closely related. Both are female dominated, therefore have been suppressed. HOWEVER auto mechanic only requires a few tools and a good shade tree. Do I have to point out why the pay between the three is close to the same?? Maybe I'm just blind, but I just don't see the respect as the same. I like to think I'm much more valued by my patients than their mechanic. I guess it just depends on a person's values.

KC CHICK · Nov 11, 2001

matt, I'm confused.....how exactly did you not expect the responses to be this way??? There have been many other threads on the SAME subject w/the SAME types of responses. You opened the can of worms again, knowingly or unknowingly.....sorry, but it's true. Not only that, another thread was created out of windfall from this one.....over the EXACT SAME SUBJECT!!

I think this dead horse has been kicked a few times too many. Please let him be.

Mijourney · Nov 12, 2001

Hi. Chas, you know how to make a difficult position more pallitable. Your response is refreshing to me. Matt, interesting suggestions. Nurs4kids, it's good that you're willing to see the education and credentialing situation from all angles, and you were very articulate in doing so. I know you were writing about BSNers being more articulate in a general way, but I find quite a few of us with diplomas and ADNs that are not close to half bad. Keep in mind that a growing number of diploma nurses and ADNers have other degrees. Fergus, you seem to be one of the rare ones that indicated that you would go back to school if your expenses where paid for. Does that mean that for some of us, no matter what type of incentive or support, we would not make any efforts to further our education for the gain of nursing as a whole?

Even though it may not be discussed on the job, there is an underlying competitiveness among the various workers who comprise nursing. The problem is how do we get our discussions and debates beyond the concerns of superiority into concerns of surviving and thriving on this bb? I don't believe that simply ignoring this issue will help, because I feel the nursing profession is sinking deeper into quicksand. With all the intelligence and talent in our profession, we deserve better then that.

Correct me if I'm wrong, but aren't most MSN programs applied programs meaning that the nurse learns a combination of skills, theories and beyond? Isn't it the MSN nurse along with all the other types of nurses that do the work that the PhD nurse uses for research and development? Are more NPs in administration or actually working in health clinics or doctor's offices? Aren't most MSNers at the frontline in a different setting or way? In my neck of the woods, I've observed that many of the people in nursing administration have diplomas or ADNs. If MSNers worked at the bedside in a hospital, for instance, wouldn't it be better that they do it as individually credentialed practitioners like the doctors instead of employees of the hospital?

I understand the concern for immediately increasing the number of nurses and CNAs in our profession. I agree we want our public to feel confident that there is enough of us there in their time of need. But, I'm more concerned that as we progress in the information age where knowledge is increasingly becoming a commodity that we don't find ourselves totally marginalized in the health and medical care system.

nurs4kids · Nov 12, 2001

Mjourney,

Of course I never intended to imply that all ADN's and diploma's are verbally inferior to BSN's. That would be a slight in my own direction . I do feel, however, that the more education a person has, they increase their chance of retaining information. You make a very valid point that I have pondered throughout this discussion. The fact that many ADN's and diploma's hold other degrees in higher education. If we grasp this whole idealogy that one should be paid by the TIME spent being educated, then does this mean that someone with a BS in physical education should be paid more than myself? I have two years of classes that did not go toward my ASN, does that mean that I, too, should be compensated for that education? I don't really see where a year's worth of electronic classes have enhanced my nursing ability. What has helped me is experience. I spent a few years working in and supervising Central Supply. Learned the ins and outs of sterilization, of supplies, etc. This doesn't necessarily make me a better nurse, so to speak, but a much more efficient nurse. I spent several years in purchasing. Again, made me more

efficient. A year or so as a Unit Secretary. Definitely made me a better nurse, for obvious reasons. My point in all this..how do we truly define education? Do we define education by years of college attended, by degree obtained or by knowledge retained?? I figure the answer depends on who you are and your level of "education". Heck, while we're at it, why don't we just throw out all the ADN and diploma nurses. After all, we're the ones dragging the profession down. I'm sure that if tomorrow we started the profession anew with nothing but BSN's and above, we'd see an immediate change in the way the public views nursing >

mattcastens · Nov 12, 2001

Originally posted by KC CHICK
matt, I'm confused.....how exactly did you not expect the responses to be this way??? There have been many other threads on the SAME subject w/the SAME types of responses. You opened the can of worms again, knowingly or unknowingly.....sorry, but it's true. Not only that, another thread was created out of windfall from this one.....over the EXACT SAME SUBJECT!!

I think this dead horse has been kicked a few times too many. Please let him be.

a) I guess I thought that most nurses could distinguish between a discussion that hinged on education and public perceptions and one that focused on skills and abilities. My mistake.

b) This is not a dead horse. Seeing as how this discussion as been going on for longer than I've been alive, the issue obviously hasn't been resolved.

d) Why are you so hostile KC? Do you feel threatened by these issues? Here's a radical idea: if you don't like the discussion, don't participate. That's why we have subject lines -- so you can avoid reading things that you can't handle.

Now then ...

About the dental hygenists. I did not realize that there were degrees in that field. However, the fact I assumed that it was only a two-year degree underscores my point. There are dental hygenists that have baccelaureate degrees but I assume that they don't. How many physicians and normal folks are assuming that nurses have less education than they do simply because there are so many associate degrees in nursing available?

Also, why I certainly don't want to belittle anyone's chosen profession, we have to agree that nurses have a huge responsibility -- health and lives are at stake. I continue to maintain that this responsibility in and of itself is the very reason to demand higher education as being the baseline for nurses.

**canoehead, BSN, RN** · Nov 12, 2001

Sometimes in these discussions we assume that the implication is that non degree nurses are not as good as degreed. I think the truth may be that nurses that are self starters and committed to lifetime learning are more likely to show up at a degree school eventually. This does not mean that non degreed nurses cannot have those same positive qualities, they may express them differently.

I think that Chas has hit on a truth when he spoke of the supply/demand issue. If nurses' skills are a challenge to obtain, and we are less available, not just anyone can be a nurse as we all know, then we will be a more valuable commodity. I think the nursing shortage is an opportunity. We can congregate to hospitals and situations where the nursing environment is professional, and constantly advancing, rather than places where nurses are another piece of equipment and a necessary expense.

Those of us in practice now can help by presenting ourselves as patient advocates and professionals in our own right, not just a set of skillful hands that carry out orders. Get involved in the organization of some part of your hospital's nursing, and in something related to nursing outside the hospital. I know if every nurse became accountable for their own practice, and for hospital decisions about nursing that are made in their names, our professional reputation would improve a thousandfold.

KC CHICK · Nov 12, 2001

Matt, I do not believe I am being 'hostile'. I just don't see it.

I don't feel threatened at all by these issues.

Here's a radical idea for yourself......if you can't handle the answers you get, don't start a thread over a controversial subject.

I believe that I've been giving strong answers (reflects my personality) that have been addressed to you.... I have not personally attacked you, as you have resorted to doing to me. (That's too bad too, it just belittles yourself)

Let me ask you this question, seeing as how you are presently an ADN that is bridging for your BSN: Would you have gone into nursing if you had not been able to complete an ADN program to do so? Would you have been able to do it if a BSN were your only option??

Seeing as how us ADNs are (and were) non-traditional students, what steered you into an ADN program and not a BSN program initially?? Just curious.

Anne

PS

I'm not driven from a thread that easily....as you can tell. :cool:

mattcastens · Nov 12, 2001

Originally posted by KC CHICK
Let me ask you this question, seeing as how you are presently an ADN that is bridging for your BSN: Would you have gone into nursing if you had not been able to complete an ADN program to do so? Would you have been able to do it if a BSN were your only option??

Yes, I would have. It would have taken a little longer, but I still would have gone into nursing. The fact is that I am a second-career nurse without a previous bachelor's degree.

While I obviously made my own decision to pursue the ADN route, I feel that I had some poor career counseling from older nurses I was working with as a nursing assistant. I was told that BSNs were "useless". I now feel that this is incorrect.

KC CHICK · Nov 12, 2001

Interesting.

Seems as though we are very much alike. This, too, is a second career for me.

I am also a licensed cosmetologist, believe it or not. I chose the ADN route because I was paying my own way in college and living on my own. I am going to BSN bridge starting next summer or fall. (Due to wedding plans for May.) I've already been accepted to UMKC...would have started this fall, but the training for OR is 9 months long and both at once is way too much to handle.

I didn't want to be dirt poor while going through four years of school. It just worked out better for me this way. I didn't do it because I don't value higher education.

Anne :)

PS:

Also see that you are engaged to be married next Oct.....Congratulations Matt!!

Stargazer · Nov 12, 2001

I think this dead horse has been kicked a few times too many. Please let him be.

You know, Anne, my first impulse on seeing this thread title was exactly that. Imagine my surprise and delight to see that this is, on the contrary, one of the most civilized, calm, and intelligent incarnations of this topic that I have seen yet on this board. Could it be that people are finally learning to DEBATE?? :eek:

Even some new and innovative thinking, as evidenced by the suggestions on the 2-tiered NCLEX (not that I agree with that, and I'll tell you why in a minute---but innovative nonetheless).

Many great posts here that summarize my thinking. Although I think an MSN entry-level requirement is a pretty big leap to take (and I think Mijourney was using it to exaggerate for effect), she's got a good point that there is a huge untapped resource of nurses who have left the bedside because of poor pay, scary staffing, and lack of respect--and I include myself in this group. While I don't think a BSN entry would completely solve that problem, I do think it would give us a little surer ground in marketing ourselves as professionals, as Chas suggests.

As far as the 2-tiered NCLEX is concerned--I'm sorry, it's been 14 yrs since I took it, and maybe it's changed for the better--but my NCLEX test was NOT a measure of my nursing knowledge. It was heavily weighted towards OB, peds, and psych, and many of the questions were, not to put too fine a point on it, BIZARRE. I laughed out loud several times during the exam because the questions were so absurd. The NCLEX was basically a measure of how well I took tests, not how much nursing I knew. In contrast, my CCRN exam taken years later was a much more thorough, fair and accurate assessment of my critical-care knowledge. As I said, if the NCLEX has changed dramatically in the intervening years, please feel free to clue me in.

And as far as dental hygienists are concerned--they are now a significant leg up on us, so to speak, as they have just been granted the ability to practice independently of dentists. Maybe we should find out their secret?

morghan · Nov 13, 2001

I just wanted to add a comment here. I was a Diploma Grad(so many years ago, I hate to say, ha ha!) let's just say I'm a child of the 60's, OK?! Any way, I kept saying I didn't need that extra degree, but did finally go back and complete my BSN, in an

accelerated RN to BSN program. Best thing I ever did. You have

to remember, too, when I went to school, and many currently practicing RN's went, there weren't many BSN programs available, unless you had access to a large metro university, with a teaching environment. I believe, however, that those "extra courses" in the humanities, assist people to be more well-rounded from an education perspective. I also believe that the

more knowlege you acquire, the better off you are. I can recall when mandatory CEU's first came along, everybody griped about that too, like it was too much trouble to get a little extra info.

I agree with the Moderator, most environments are seeking BSN

prepared, and that's in the heart of the Midwest! I recommend

education for the advantages it offers, in many arenas. Since I am now working on my Master's, I have moved from a Clinical

Supervision position to Psychiatric Case Manager at my hospital.

Hope everyone has a great Thanksgiving, too.

PsychRN

:) :)