BlackbirdRN

What I don't see is is do what every you can do to avoid calling a Dr. at 3 am by anticipating problems based on your first assessment at the beginning of your shift. Much easier to call someone at 12 mn rather than at 3 am. For example: if you think your patient will not be able to void 8 hrs post-op and it has already been 6 hrs since the patient returned from surgery, get the straight cath & leave the catheter in if more than 300 cc at 12mn, not 3 am. Get additional pain meds, sleepers, tylenol for temps, nausea prns etc. If you are lucky, the on call intern is smart enough to call you at 12mn as ask you about the patients you have of his/her and then they will ask you who else has their patients so they can talk to them and get all those preventive orders out of the way. If not call them and help them learn this is a good way to not be woken up. Then the only calls you are making are the ones that could not be anticipated.

You may be right that programs have changed. I graduated in 1981. Unfortunately, my son was recently ill and in the hospital for one week and I figured by this time the ADN nurses might be closer to the BSN ones. Instead I had to instruct a young ADN nurse how to call the doctor and ask whether she should be giving NSAIDS to my son who was going for a procedure due to possible risk of bleeding. She responded, "It isn't my job to decide what meds to give, the doctor would have changed the order if he was concerned." With my anger restrained, I told her it was exactly her job to question whether a med was safe for a patient that the doctor may have not thought about holding it. As a young nurse, I might have been nervous to call the doctor but I would NEVER have said, "It wasn't my job ..." So I hope you are right. That ADN nurses have enough pathophys to question doctors orders because nurses are infact the last check to make sure patient are kept safe.

I clearly differ from you. I applied to both ADN and BSN programs. I reviewed the curriculum for both. I have tutored ADN nurses. You my friend need to get over yourself. You are clueless when it comes to what a BSN program teaches.

I graduated with my BSN in 1981 and was also told that ADN programs would be phased out. The bottom line is there is a difference between ADN nurse and BSN ones and it is not about research and it is not about management. It is about thinking bigger & broader with theory based decision making. The ADN new nurse will always out perform in clinical skills the BSN nurse in the first 6-9 months but after that, EVERYONE has figured out how to start IVs, put in foleys and NGs, do dressing changes, change beds with patients still in them. It is after that when your patient is febrile but their white count is stable, they are SOB but their lungs are clear and their urine specific gravity is unchanging though they are putting out tons of urine. That is where theory based learning of pathophysiology comes in to help you decide not only to call the doctor but what to tell him. What else did you think to check on the patient before calling? BSN nurses may or may not make better managers because they don't really teach that in a BSN program but what they do teach is communication analysis, psychology and sociology prerequisites help you figure out why people verbally respond differently. What motivates people. So stop with the comparisons. They are different. ADN nurses make excellent direct care providers while BSN nurses have a year of extra theory and many prerequisite classes to further their ability to problem solve and analyze situations to develop a path to solve problems.