Snoopd

Thanks for "knowing some of us" who "are just nurses". I predict in another 5-10 years we will not be required through state statutes to legally collaborate with you on anything, so your "cautiously discussed concerns" will be so much wasted energy as the "golden age" of physician controlled monetary medicine disappears, and cost effective collaborative care given by practitioners with their own expertise replaces most of what you do and what you try to bill for. Your 2 minute assessments of patients and six figure death rate of patients do little to help you "cautiously discussed concerns" with legislators, or the public. Many studies have already proven the safety record of NP's and CRNA's - some of these studies state their safety records exceed those of the MD's and DO's. I guess that upper level chemistry class didn't do much to prevent that patient's unfortunate death. So I guess the MD's and DO's should stop belly aching about their high insurance premiums - they are there for a reason. You are in the twilight of a profession that will greatly change as society, legislators, insurance companies, and individuals realize that you offer only one facet to their health care solution. Perhaps you will play more of a role in research in the future and have even less patient contact. Ah, sort of glad to know you, see yah around, maybe? Snoopd

I understand the importance of education as it relates to competency of practice and personal fulfillment, but how much more could someone expect to earn with a doctorate in nursing? We work in an industry that rewards a BSN with an extra dollar over an ADN, and a Masters can expect to get a dollar more that a BSN. Pocket change, it's insulting. Can our profession make a doctorate financially rewarding? I don't think so. The universities offering these programs will enrich themselves. It also means job security and possibly job creation for instructors, but how financially rewarding will it be for the degree seeker? Are you going to earn $200,000 or $300,000 as a "doctor of nursing"? Of course not. You'll have your fancy little title and degree and will be working in an industry that can't possibly provide you with the compensation that should accompany that many extra years in school. On the CBS news they had an employment story about what the in demand jobs are. The biggest group of these jobs were technical ADN type trades such as electricians, construction, and of course ADN nurses. These positions paid more than most 4 year degree "white collar" jobs. What's the point? One needs to be in demand to receive a higher level of compensation. It's not the degree, it's the public's demand, and the public's perception of the service that they are receiving, that create financial value and compensation for the practitioner of that trade or expertise. As the news story said - "for 50 years people have been told to go to college and get a 4 year degree" but now we have millions of people with 4 year degrees (they are a dime a dozen, what high school grads were 30-40 years ago) who have crummy "cubicle" jobs and mountains of student loans. I don't think that there is a financial "floor" that can support or justify a nation-wide requirement to get a doctorate to be a NP or CRNA. Snoopd.

I think this BSN ADN debate is all about image. Apparently our politicians and the public believe they will receive better care from a BSN nurse than from a ADN nurse or a diploma educated nurse. This is laughable. First of all one must compare the courses that comprise most BSN and ADN programs. The nursing courses, "the meat and potatos" of the nursing education, are identical. For the BSN most programs generally require a statistics, a nutrition, maybe a slightly higher chemistry course, and perhaps some sociology. Then they throw in some liberal arts, and a "leadership" type course or two. That comprises most BSN programs. The "embelishments" don't provide a whole lot, if any, skill that can be used to improve patient care - that comes from work experience - period. If having a BSN degree is such a great qualification (earning 120-128 credits for that degree) what about nurses who have BA's or BS's and then go back and earn nursing degrees and end up with 150 -240 university credits? Wouldn't they be even more qualified to provide better, and "more rounded" nursing care to their patients? Maybe, maybe not. On the job, on the floor, experience will always be king. It doesn't matter if it's in nursing or any other profession. Perhaps a better way to assess the qualification of a nurse is to count how many hours or years they have been "on the job" - like pilots are assessed for how many hours they log in the air. The more fly time they log, the bigger planes (and more human cargo) they are responsible for. The "degree thing" in nursing, and in most professions, is a smoke and mirror act to calm the fears of customers/patients, yes they are our customers, who want the "degree holder" to provide a competent service for them. The degree is window dressing that provides hope that can't always be substantiated through actual performance. I've gone through the university route, and despite that, if I could mandate how nursing students are educated - or any health care professional, I would insist on a 3-4 year apprenticeship program- half a day in school, half a day at a hospital getting down and dirty in the trenches and earning a partial paycheck. That would be a good way to educate a new nurse, and expose him/her to the realities of their future profession. One would also end up with a new employee who would be more experienced and competent than the new graduates, both "2" and "4" year, that are being churned out today (with their 100-200 hours of "clinical experience":imbar ) This whole degree issue isn't grounded in reality. Reality in nursing, and any other profession, is based on experience and competency, not a piece of paper and an unproven expectation and an uncertain promise of future performance. Snoopd.

An excellent point about who "brings in the money". Doctors do bring patients into hospitals thus allowing hospitals to bill for services. It's no different than a stockbroker or real estate person "getting the hot lead", forming a business relationship, and either selling the person something or providing a service that can be billed for. In all these cases a "billable event" has been created, and who ever "brought in the client" and caused a money making opportunity to transpire, is entitled to "a slice of the pie"- they get compensated for generating revenue. I've seen profit sharing plans offered to recruit new physicians (this seems to be a fairly common perk, get that monster bonus at the end of the year) but have never seen this for RNs. Opening nurse run clinics may be an option. We could bill physicians and insurance companies to "safely house" their patients and create our own billable event. This could probably be done more cheaply than what the hospitals charge, and this would be attractive to insurance companies- we could undercut the competition. Another option would be to become shareholders in our own hospital chains or individual facilities. If we have personal financial stake in how things are done (and thus the right to implement policies) and how people are compensated, we could improve not only our working conditions, but our financial bottom line as well. Also, passing laws that are favorable to nurses and what procedures they are allowed to perform, can only improve our compensation. Recent examples of this are the emergence of NPs and CRNAs. They have more autonomy, in most cases earn more, and are gradually improving their professions, both in the awareness and recognition they receive in the "health care community" and in their ability to bill for more types of services, and in their ability to attract patients to their practices.

This is a relevent topic for nurses at all educational levels. I think the degree "requirements" being proposed by some legislators have more to do with image (and who is backing them? Hospitals of course) than the skill level of the trade. ADN programs and BSN programs are virtually identical in their core nursing education. The BSN programs vary a little, but most have an additional course in statistics, maybe a nutrition course, a harder chemistry, and maybe two additional "nursing theory" courses. A couple of extra "embelishments" but the "meat and potatos" of how to become a rookie nurse are identical. The MSN programs add more theory courses and a little bit of "management". What's the reward for that extra BSN? Maybe a buck more an hour, for the MSN maybe another buck an hour. That's how much hospitals think of the extra education. The proof is in the pay, and the hospital chains don't care enough to pay. Of course they can use your education to promote themselves - use it as a marketing tool, but in their eyes, and most MD's eyes, and the public's eye, a nurse is a nurse is a nurse - nobody cares (except the nurses who have worked so hard) what kind of "alphabet" you have behind your name - BSN, MSN, CCRN, blah, blah, blah. They want you to be educated, of course, so they can use that to their advantage, but are not willing to reward you in a significant way. The issue of education is becoming worse in my opinion. There are to many nursing programs, and with the advent of online degrees, the educational problem is becoming even worse . What is happening is that the "market" is being flooded with thousands of new, "more highly educated" (who have no work experience) nurses, and this will lead to lower pay and lower respect for new RN's regardless of degree. There are 125 medical schools in the US and they consistantly average about 16,500 graduates a year. When was the last time you heard of an MD shortage in the US? Never. They are selective, choose the best candidates, keep the quality high, and "turn out" a limited number of graduates a year. You don't see online MD programs springing up like weeds. Thus, they can command high salaries and professional respect and have the power to control their compensation. The AMA isn't crying about an MD shortage, why should they? All that would do is flood the market with new MDs and they would earn less. The "nursing shortage" is a ploy to attract new people to the profession and lower pay scales. Hospitals don't care about your level of education (except to use it as a marketing tool), they want a cheaper employee. If nurses want their future BSN or MSN to have any status, they need to have more political clout and get laws passed that are favorable to nurses - and not just staffing ratios- but greater autonomy in patient care and in what "skills" and procedures they are allowed to perform, as well as how future nurses will be educated and how many will be graduated each year. We need to focus more on the politics of our profession if we want it to be respected and financially rewarding. Having a "caring nirturing attitude" and being "a well rounded people person" are not enough, neither is having a bunch of abbreviations behind your name that only you and your colleagues value.

I found this thread and a few of the responses to be somewhat humorous and perplexing. Apparently the big issue revolves around who is "qualified" to to be in a "leadership" or "management" position in nursing? Is it a nursing ADN, BSN, MSN, or what? Let's look at the ADN vs BSN. If you exclude all the liberal arts from a BSN, the only difference (here in the "midwest" -ya betcha!:chuckle) is that they require a general chem. with a lab, a nutrition course, and a statistics course, and two nursing "theory" classes. As far as academically learned nursing skills or clinical time, or "learning how to be a nurse" the BSN doesn't add anything to the ADN. Where are the management courses? Where are the business administration courses? Where are the human resources courses? What about accounting or financing courses? Then why would anyone say a BSN or MSN nurse is qualified to be in a "management" position? It's like telling a Porsche mechanic to start working on Lear Jets. The job is incompatible with the skill level or education. If you want RN's for management positions hire RN's who have business degrees, finance degrees, MBA's, or human resources degrees. Keep the ADN's, BSN's, and MSN's, with their nursing education, at the "bed side" a.ka. "patient care," "hands on", where they can best utilize the education and skills they were taught. If they want to get into leadership or administrative positions then they should, at the very least, complete the necessary education that would allow them to attempt to qualify for "management" or "administrative" roles. It's simply a question of advancing the people who have the necessary skills and education that are compatible with the job description. It seems odd that anybody, with just a nursing background, would even be considered for a management or administrative position. Their education, and if they don't have a past history of management or administrative experience, doesn't qualify them for this. Snoopd QUOTE=Da Monk]In SC you need a BSN to teach clinicals at the ADN level, but an MN or MSN to teach at the ADN level in the classroom. I am flabbergasted than an ADN grad is hired to teach anywhere. At the university level here you may be hired with masters level prep, but you must attain doctoral level education within 5 years to keep the position. I think a good analogy for understanding nursing ed is this: a nursing student being taught by diploma or ADN nurses is akin to a mechanic learning how to work on cars from another mechanic; a nursing student being taught by a BSN is akin to a mechanic learning how to work on cars from the senior mechanic or service manager; as masters level degrees are specialized, a nursing student being taught by that level is akin to being taught to work on Porsches by a specially trained Porsche mechanic; and a nursing student being taught by a doctorally prepared nurse is akin to a mechanic being taught to work on cars by an automotive engineer/designer. As far as the NCLEX goes, do not sweat the pass rate. All schools have as their goals to have their students pass. That's what you should get in basic nursing programs. If the programs begin to have very poor pass rates, they get into trouble and heads roll. I base most of this on my clinical experiences of 29 years and having passed through a diploma, RN to BSN, and MSN programs. As the progression occurs one's focus on nursing changes. Diploma and ADN nurses should be relegated to staff level positions in most cases. I know this line of thought upsets a lot of people, but the notion of a nurse is a nurse is a nurse because we all pass the same boards is negative for nursing in an overall sense. That line of thinking has been used by hospital administrators for decades and none of those guys are nursings friend. By the way, all of my education cost not more than $5000.00 because of scholarships and employer reimbursement and upfront payment over the years.

If this wasn't part of a written contract that was established when you were hired, I wouldn't sign it. It seems rather strange that you would receive this after being hired, rather than agreeing to it and signing it as a condition of accepting their employment offer. What makes me suspicious is the part about "being fired within 18 months". Any employer can figure out a way to fire someone at anytime. It's also almost easier to make them quit. Bad working conditions, harassment, pressure by "supervisors", can make even the "toughest" employee feel sick and defeated and decide to quit. If you haven't signed you are in a position of power. I would probe their HR Dept. and explore why they want you to sign this now, after they have already hired you. Perhaps it's a psychological ploy - they want to make you feel anxiety - that if you don't sign, your "brand new" job may be in jeopardy. Or they may want to make you feel like you have an "$11,000 bill hanging over your head that you must work off! If that is the case, I would look for a new employer - you don't want to work for that kind of outfit. They'll "screw you over" on other things as well. Another question I would ask is how did they arrive at the figure of $11,000? Sounds like a lot to "orient" someone. Are they giving you 2 hour lunches at nice restaurants every day? I suspect this figure was calculated based on what they believe the cost of turn over is for their facility. That raises the next point. Why would they have a high turn over rate? Additionally, does this mean that you might be helping your employer recoup their 'turnover" expenses by agreeing to this contract if you are "fired" or "quit" within 18 months and have to repay $11,000? This sounds really bad. Don't sign it.

:rotfl:

Thanks for the info. snoopd

I agree with your comments about retention rates. That ties in to why I am suspicious and a little cynical about this commercial. Retention rates will be less important to hospitals if they have a constant stream of "starry eyed" new "recruits" - new RNs, flowing in the door, and then out the door - attracted by this ad. They will have a generous supply they can cycle through for several years. I don't hate the add, on the surface it's positive and kind of "feel goodish", and optimistic. I just started to think about the motivation behind it and why a big corp. would sponsor it, and does it do anything that will advance nursing and improve the individual lives and careers of nurses? Also, there have been some comments about "what about the LPNs", "we are just as important". My post wasn't intended to start that debate, but I will say that the RN designation is now gaining prominence as many states have passed laws specifying who can legally use this title, and the RN designation is starting to be understood by the public and demanded by the public when patient ratios and treatment are considered. This gives the RN designation some power, "trademark" type power if you will, and this is something RNs can use to advance their profession and their individual lives. That's why I think an "I want an RN" commercial would be a good idea. It's not RN versus LPN issue. Here I will throw in my cheap shot: if anyone is unhappy because they are an LPN, or they feel that they contribute as much or more than an RN and are not getting recognition, or if they are just plain feeling jealous, then they should continue their education and get a higher designation. This goes for anyone. If your an RN and are envious, or feel left behind, because of M.D.'s, study your tail off and get into medical school. Our society and economy rewards education. They always have and always will, more so than hard work. That is why CNA's, who work their a**'s off physically every day and are critical to patient health and safety earn less than half of what most RNs earn. Everybody in a health care setting has an important function, from the janitors to the M.D.'s. If they weren't important, no one would hand them a check every two weeks. Snoopd

Hello nurses and students! Here's the question; you've all seen the commercial by Johnson & Johnson, those smiling, yet serious, faces proclaiming BE A NURSE! This is supposed to promote the career of nursing. They are even showing male nurses in an attempt to promote this career choice among our male populous (good for them!). Who is really benefitting from this add? It's obviously being aired because of the hype of a "nursing shortage" in our country, but what affect is this add having on the nursing profession? What is this commercials real purpose? I believe this commercial is helping create a glut of new nurses (as evidenced by the 2-3 year wait at most nursing programs, and the "cooling" of hiring new nurses in many locations). This will result in a cheaper labor force for hospitals to choose from in my opinion - "the dime a dozen theory". What do you think? Here is my suggestion or "strategy". Many hospitals are now hiring non RNs to do RN type tasks and skills. They give these people fancy little technical titles and pay them less. This results in fewer RNs being hired. Why not have a commercial where some sick or elderly person, or a concerned family member looks seriously into the camera and states: I WANT AN RN!! This would help reinforce the legitimacy, professionalism, and technical expertise that has been associated with the RN designation, and create a demand among our population that they expect to be treated by an RN, not some "Walmartish" "technical associate" who is willing to work for peanuts. Honestly, this commercial scares me a little because all it is designed to do is flood the market with new nurses, and this will lower pay scales and weaken the "bargaining power" (what little there is) that RNs have. What do you think? Snoopd P.S., this commercial is by Johnson & Johnson, who supply many hospitals with products (see any connection)? Why doesn't the ANA shell out some of its own money and run a commercial like "I WANT AN RN" that would actually strenghten the RN profession?

I wouldn't worry about this questionaire. To even get into nursing school you probably had to be a registered CNA first, which means you had to go to clinicals for that, which means your state required a background check so you could go on your CNA clinical. Do you remember ever being asked for your driver license number on any forms you filled out? If you were, this was the real background check that was done on you in your state. Questionaires that ask you to provide "criminal" or "arrest" or "conviction" info are basically people or organizations that are on a fishing expedition and want a confession out of you. For a real criminal background check you do not have to provide any info, not even a social security number - just your driver's license number, and/or fingerprints. "They" can trace all your driver licenses from other states with your current drivers license number and all felonies and gross misdimeanors convictions. Your driver license number is your legal I.D. Nothing, not even your social security number matters. All felony records and gross misdimeanors can be traced with a valid driver's license number. Even your fingerprints don't unearth everything in every state. Your program will "conduct" a "background" check every year as required by state law. Any questionable criminal history will be automatically sent to the BOD so that they can consider whether to allow that individual to enroll and later practice nursing. I bet you are already out of the woods - since you are starting a nursing program - unless you have a conviction dated after your CNA background check. You are 33, your "past" has probably been purged from any file already anyway, or is sitting lost in a file cabinet in a storage facility, slowly turning to mold - probably not on a computer anywhere. Despite the seriousness of these background "official proceedings" and the nervousness they cause in people, nobody, not the nursing school, not the BOD, not even the state, really wants to invest much time or money to look into your "sordid" past. That's why they often expect you to provide all the info with these "confession questionaires". Even Police Depts. and Sheriffs' Depts. do this with law enforcement recruits, because they know that they, despite their computer data bases, can't find out much about any body except for recent "crimes". Relax, and answer no on these forms. You will not have a problem. If you answer yes, you are then forcing them look deeper into your past - they are then required to investigate because of your "yes" answer, and you may cause yourself even more stress and maybe some embarassment. If there was any thing wrong with your very minor past history, you would never have even been offered admission to a CNA program, or clinical, let alone nursing school. You are in the clear. Enjoy your future education and profession! P.S., I doubt your Board has a background check dept! They probably get a stack of paperwork and contract it out to the county or an independent contractor who probably spend less that a minute per application. If they wanted to really look deeply into someone's past this would cost hundreds, if not thousands of dollars per application. Your Dept. head is lying to you. Shame on them. You're cool.

Sorry to hear about your misfortune. I agree, there are some mean sociopathic nursing instructors out there who don't care how long you've been in the program or how much money you have spent on tuition and books. They also seem to have a great deal of power (as you've unfortunately found out) and don't seem to be accountable to anyone. If you feel you have been mistreated, you should consult with an attorney and seek money damages. Nursing classes are practically untransferable, so you may have to repeat your first year and repay tuition. Also "they" are delaying your entry into the work world of nursing by probably at least a year (if you can even enter another program, most have 2-3 year waiting lists. That's $50,000 -$60,000 of potential future income lost in one year. Add that to your tuition (I don't know your tuition - maybe $5000 to $12,000 depending on school, and you are out a lot of money because of their "decision". Sue them and make them accountable if you truly feel you were wronged.

I'm glad to hear you are thinking about this academically challenging program. I graduated from nursing school and did not know what to expect either when I started, but I can tell you one thing, it's tough! Before entering the program I thought, how tough can a nursing degree be? I thought it must be comparable to any other college program. I've found out that it is tougher than any other college class work I've completed. This includes microbiology. chemistry, anatomy, physiology, general biology, calculus. In those classes you are dealing in absolutes - point A,B,C, lead to answere D. Its' fairly clear cut. Nursing classes present scenarious where all 4 or 5 answers are correct, but one answer is slightly more correct than the others! It can be maddening. Thus, nursing school takes an astounding amount of study if you want to remain in your program. Most programs are notorious for their fail/dropout rate - often 50%-70%. One big advantage that you have is your English degree. This will help tremendously when you are writing clinical case studies and research papers on various diseases. You will be able to fly through some of the written assignments and turn in impressive papers. There is also a great deal of subjectivity regarding clinical assignments (will you get an "easy" patient or someone who needs a great deal of care)? This is totally unpredictable. Your clinical instructor - and his/her personality will also be a "crap shoot". They vary from being decent knowledgable kind instructors, to being bipolar, borderline sociopaths who will not hesitate to fail you at the slightest perceived infraction or mistake. That may sound over dramatic, but it is true. Iv'e seen it in my program and I don't like it, but there are students who have been failed or decided to drop out of the program (after spending thousands of dollars on tuition) because of clinical instructors who couldn't care less if they were there or not, and who were unwilling to teach them anything at clinicals or provide any instructive support. Another potentially good future nurse lost. This is the "scary" part of nursing school. Because of this I approach every assignment, test, and quiz, with the mentality that I must under all circumstances achieve 100% in everything I do. That sounds extreme, and I usually don't get 100% in anything, but that mindset has allowed me to earn good grades thus far (good enough to consider an accelerated masters program in nursing or a Nurse Practitioner masters if I wish). Forget about C = RN. That is a loser mentality. Most of the people who have had that attitude are no longer in a nursing program or are hanging on by their fingernails - they can forget about Grad school to. Don't work a job unless you absolutely have to. Again, most of the people in my program who worked are now ex-nursing students or students who barely, barely, passed. After my first year our class shrunk from 137 to about 75-80. This all sounds horrible and stressful, and it is at times, but one of the wonderful things about anything that is hard is that if you are able succeed, you can look back at what you have accomplished, see "who is still there", and feel like you have conquered "something," and that you are "better" than you thought you were, and that you are a lot "better", tougher, and smarter than many of the people who are no longer there. This sounds arrogant and narcissistic, but it feels good - like you want to stand on top of the mountain, raise your arms, and scream a little. What do you get for all this stress and misery and never ending scrutiny? In most areas, especially the East Coast, West Coast, and Midwest, a decent paying job right out of school. Whether you have a "two" year ADN or a "four" year BSN - I use quotation marks because it takes most people more time than this to complete either degree, you can expect to earn about $50,000 right out of school with either an ADN or BSN. The BSN usually pays 50 cents to a buck more an hour, add on another buck if you have a masters in nursing. So you'll be making more money right out of school than most of your professors. No wonder they are mean and nasty! That's the base rate. You can add on another 2 or 3 dollars for working a second, night, or weekend shift. So one has the potential of raking in $50,000 to $60,000 as a rookie nurse in many geographic locations. One thing that I have been warned about is to be leary of huge "sign on bonuses". Apparently, these are not always such good deals - they can lead to positions where one is swamped with patients and employee moral is low. Finally, if it's something you feel seriously about, go for it. As I was told my first day of nursing school, "you will experience more stress in the next two years than you will experience in your entire nursing career," but if you survive school, you have a variety career options open to you - not just working in a hospital or clinic. You could be a mobile nurse, work as a consultant for biomedical companies, start your own nursing business, or go to grad school and specialize. Best of luck to you!

I think, and have been told by several college recruiters, that there is no such thing as a 2 year AD or ADN degree anymore. With all the pre-requisits most two year programs now take 3 years to complete. Ditto for the "four" year degree, it takes most people now five years to complete a BA, BS, or BSN. As far as one's pecking order "on the food chain" chain goes, this sounds like just more infighting and backstabbing and one upsmanship by nurses who should be working together and supporting each other's efforts, and their profession, instead of trying to tear each other down. It's pathetic what I sometimes hear in the work world, and often read, in these forums. To any outsider, someone not in the nursing profession, it must seem absolutely laughable and kindergardenish to witness. This is why nurses get exploited by hospital corporations - they waste all their energy trying to tear down their coworkers, and are totally distracted as to what is happening to their career, and the future of their profession. No wonder the nursing profession is an easy target for "employers" to exploit. Why not band together and focus on lowering patient/nurse ratios, raising wages, and taking on management instead of each other? P.S., no matter what type of degree you have, work expeience will always be KING. School education and work education are two different worlds and the one that counts is the hands on education you develop on the job.