Pros and Cons of Excelsior Program

ChesterRN · May 14, 2006

out of curiosity, you sure seem to have invested a lot of energy in learning about ec and the cpne. is there a particular reason, or is it just a hobby?

Now now traumahawk, be nice...I think Liz is just troubled and misguided and wants to get to the bottom of things. You see, for us, there was no teaching--you prove it or your fail. You can do it or you can't. You're safe or You're not. Very little touchy feely stuff, and certainly no second chances.

Its hard for those outside to understand. Most folks subscribe to the work hard and not smart approach and really don't understand the notion of where we come from; what its like to work in the field, to run an MCI, throw down a tube with no light, do an IO on a shattered pedi femur, work an algorithm until the box emptys, do a pleural decompression when theres barely a chest left or any of the critical thinking that goes along with that prior to us becoming nurses. Folks hear of the process, but don't really understand what's really behind the license. It's so easy to cast dispertions when there is so much ignorance related to the process.

You shouldn't come down so hard on Liz. It's not like she requested a sticky for this thread, or was the second poster following the moderator after the sticky was established, or created links to the BRN decision, or the BRN's delightful response to the courts decision or EC's response (which is now a broken link), or in any way wants to put EC in a bad light...oh, maybe she did.

I think that Liz is just concerned that EC gets a fair shake, just like the BRN gave EC a fair deal. I don't think Liz really has an agenda, right Liz?

Sheri257 · May 14, 2006

I think traditional U.S. education has a lot of flaws. I personally think the Filipinos have it right. From what I understand, their nursing schools are four years minimum. Three days are spent in class, two days are spent in clinical. Basically, they have quadruple the amount of clinical time that most U.S. programs have.

If we're talking safety, obviously that's the ideal scenario: giving students as much training as possible before they hit the floor. U.S. schools really should do the same but, for all practical purposes, that's probably not going to happen.

Since the U.S. clinical time is limited, and the hospitals do have to train new grads even further ... I don't think the solution is cut back clinicals to virtually nothing like EC does. If anything, we need more clinical time. The CPNE or any other clinical exam is useful, but it's obviously got limitations.

I think it's also important to remember that EC doesn't require actual work experience. They only require the license. There's no guarantee that their students even have experience. An EC LVN might have ten years experience or, they might be fresh out of school with no work experience and still get an RN license.

If EC had actually required work experience, and limited their program to LVN's then, I think the California situation would have turned out differently. If other states and authorities think that's fine well, that's their opinion. I think it's pretty obvious that the board doesn't care what other states do. I mean other states don't have ratio laws ... does that mean California shouldn't either because we're the only state that does? Obviously not.

Ironically, one of pro-EC arguments is that California needs more nurses. Well ... travel pay rates have been dropping here because so many travelers want to work in California, rather than other states, because of ratios.

:typing

ChesterRN · May 14, 2006

I think traditional U.S. education has a lot of flaws. I personally think the Filipinos have it right. From what I understand, their nursing schools are four years minimum. Three days are spent in class, two days are spent in clinical. Basically, they have quadruple the amount of clinical time that most U.S. programs have.
If we're talking safety, obviously that's the ideal scenario: giving students as much training as possible before they hit the floor. U.S. schools really should do the same but, for all practical purposes, that's probably not going to happen.

Filipino education certainly seams the way to go. Unfortunatley, when one of the hospitals I worked at about 6 years ago tried to recruit 89 nurses from the Philipines, wouldn't you know it, not one passed the NCLEX-RN. But, I'm sure the training is superior.

If EC had actually required work experience, and limited their program to LVN's then, I think the California situation would have turned out differently.

Thats an interesting concept. When I took the CNPE with 18 others during the weekend seminar, all you can eat CPNE party, only 3 of us passed. And wouldn't you know it every LVN failed, and the three paramedics passed.

Ironically, one of pro-EC arguments is that California needs more nurses. Well ... travel pay rates have been dropping here because so many travelers want to work in California, rather than other states, because of ratios. Call us crazy ... but we must be doing something right.

And of course this hasn't caused any problems with holds and bed availability either. You're right, California is way ahead of its time, even at the expense of the patients and financial solvency of hospitals...or perhaps you work as a volunteer nurse.

traumahawk99 · May 14, 2006

i think the horse is dead in this one. i'm an ec grad, and proud of it. it's saturday nite, and i'm gonna snuggle with my girl, who thinks i'm crazy for following this thread so long.

it's a :deadhorse.

liz, it would seem that there's more to your feelings here rather than just a nursing student going through school. in all honesty, i don't fbelieve you've let us know the history of your obsession with this topic. it wouldn't make sense for a nursing student to put so much energy into this and make it a primary focus of her life. of course, i don't expect you to be forthcoming now.

not that i'm trying to degenerate this thread into a personal attack. it's just clear that you've got an agenda, for a reason you're not disclosing.

Jo Dirt · May 14, 2006

I've got to agree on one point with a certain anti-EC poster here (since we aren't allowed one-on-one comments) even if it is just partly so: MA's and CNA's never had any business going through Excelsior College. I have to believe someone in EC management probably realized this and allowed it anyway. This may have hurt EC's reputation. I know people who think an EC degree is like a cracker jack box diploma. They ask, "you actually get a job as an RN?" and even have made such comments as, "that doesn't sound legitimate." when you describe the program. This irks me to no end and it is such a crying shame. Of course, most people who make these comments and ask these questions do so out of ignorance, but this to me is all the more reason EC should have been walking a straighter line when it came to who they allowed in the program.

BTW, I think paramedics and RT's are right qualified to go through EC's program.

G-BOZ · May 14, 2006

I think traditional U.S. education has a lot of flaws. I personally think the Filipinos have it right. From what I understand, their nursing schools are four years minimum. Three days are spent in class, two days are spent in clinical. Basically, they have quadruple the amount of clinical time that most U.S. programs have.
If we're talking safety, obviously that's the ideal scenario: giving students as much training as possible before they hit the floor. U.S. schools really should do the same but, for all practical purposes, that's probably not going to happen.
Since the U.S. clinical time is limited, and the hospitals do have to train new grads even further ... I don't think the solution is cut back clinicals to virtually nothing like EC does. If anything, we need more clinical time. The CPNE or any other clinical exam is useful, but it's obviously got limitations.
I think it's also important to remember that EC doesn't require actual work experience. They only require the license. There's no guarantee that their students even have experience. An EC LVN might have ten years experience or, they might be fresh out of school with no work experience and still get an RN license.
If EC had actually required work experience, and limited their program to LVN's then, I think the California situation would have turned out differently. If other states and authorities think that's fine well, that's their opinion. I think it's pretty obvious that the board doesn't care what other states do. I mean other states don't have ratio laws ... does that mean California shouldn't either because we're the only state that does? Obviously not.
Ironically, one of pro-EC arguments is that California needs more nurses. Well ... travel pay rates have been dropping here because so many travelers want to work in California, rather than other states, because of ratios.
:typing

liz

I'm confused so you are saying that EC should limit their program just to LVN's, I totally disagree I 'm a military Corpsman some things we do are at a level of a RN and higher, a military corpsman is eligible for the EC nursing program, there is a reason why EC allows more than just LVN's into their program, have you even reseached that point? People that are accepted into the EC nursing program have tons of clinical experience, so why re-invent the wheel.

traumahawk99 · May 14, 2006

I've got to agree on one point with a certain anti-EC poster here (since we aren't allowed one-on-one comments) even if it is just partly so: MA's and CNA's never had any business going through Excelsior College. I have to believe someone in EC management probably realized this and allowed it anyway. This may have hurt EC's reputation. I know people who think an EC degree is like a cracker jack box diploma. They ask, "you actually get a job as an RN?" and even have made such comments as, "that doesn't sound legitimate." when you describe the program. This irks me to no end and it is such a crying shame. Of course, most people who make these comments and ask these questions do so out of ignorance, but this to me is all the more reason EC should have been walking a straighter line when it came to who they allowed in the program.
BTW, I think paramedics and RT's are right qualified to go through EC's program.

i'd have to agree that the current admission requirements are appropriate. one of the things we need to keep in mind is that this program was a pioneering effort. there were bound to be mistakes. but overall, society has benefitted phenomenally from this program. excelsior deserves more than just a stream of constant criticism and nitpicking.

the point is that we're where we are today, and need to go from here. i'd love to see some properly researched evidence about excelsior grads in practice, with the evidence presented in the light of day.

i've met several nurses who were excelsior grads. some of them phenomenal leaders in the workplace. and many of these wouldn't be nurses today if not for excelsior.

stressed1 · May 14, 2006

I have quitely monitored these exchanges and I would like to state my position. I am a student in the RN program. Prior to this I attended a traditional ADN program for 50% of my training as Excelsior required. The purpose of the 50% requirement is that in a traditional ADN program each student must successfully pass clinical test-offs in all skills a RN is required to have to graduate nursing school and subsequently take the NCLEX. I have the clinical experience, and I personally used all these skills under supervision in actual clinical settings; most students who graduate an ADN or BSN program do not use these skills in a clinical setting prior to graduating. Our instructors constantly reminded us of this and encouraged us to seek out what we did not know during our hospital clinicals. I can tell you many don't because if a error is made that is classified as unsafe practive,they can be dismissed from clinicals. This is a catch 22 situation. I am from a family of nurses and clinicals are something you endure not enjoy. It is not real nursing by any means. As a matter of fact we have had the discussion many times that a nurse should never be in a clinical setting until they have the academics behind them. So you see, there are many views even within the nursing practice regarding nursing school. I am the only one ADN educated. I was told ADN's are taught to do and BNS's are taught why. I think too many fingers are being pointed and personally feel an overhaul of the entire education of student nurses is long overdue. Until the requirement is made that instructors must complete minimum educator cirriculum no one will ever receive the education they pay for and deserve. Personally I think this is where the State Boards of Nursing need to be focusing their attention. A good nurse does not equate to a good nursing instructor.

Sheri257 · May 14, 2006

most students who graduate an ADN or BSN program do not use these skills in a clinical setting prior to graduating. Our instructors constantly reminded us of this and encouraged us to seek out what we did not know during our hospital clinicals. I can tell you many don't because if a error is made that is classified as unsafe practive,they can be dismissed from clinicals. This is a catch 22 situation. I am from a family of nurses and clinicals are something you endure not enjoy. It is not real nursing by any means. As a matter of fact we have had the discussion many times that a nurse should never be in a clinical setting until they have the academics behind them.

I have to disagree with a lot of this ...

I don't know how your program was run, but that's not the case in my program. For one thing, we've got to get re-checked off on all skills in fourth semester in the hospital. If you don't do those skills (again), you don't go to preceptorship. I'm not sure why people would worry about errors since an RN is with you at all times. They're not going to let you screw up because it's on their license.

Clinicals are far from perfect. But I also work as an extern and I learn a lot from both. The more exposure, the better. Some clinicals are worthless but, it's usually because you have a low census one day or, you do occassionally get an RN or an instructor that's not particularly helpful. It's gonna happen.

But I wouldn't trade my ICU rotation for anything. You usually can't get externships at ICU so, for me, and it was a phenomenal experience. And I'm sorry but, I do think theory concurrent with clinical is really worthwhile. You read about dopamine drips and respirators in the book, but it's nothing like seeing how it works for real the next day. It does really help you tie it all together. I'd much rather be there while I'm studying it than try to remember all the details one or two years later. And you do really learn better when you actually see and do it the next day.

Even the psych rotation has been beneficial. I mean ... you can study all these drugs all you want. But it doesn't come close to going to the facility and consulting with the doctor about why he prescribed various meds, how he came up with a particular diagnosis. How do you rule out a medical condition or drug addiction versus psychosis. There's a lot of things you learn that aren't in the books ... like new drugs that make patients really aggressive that our textbooks fail to mention. And talking to the patients and seeing these conditions first hand, well ... I certainly haven't seen anything like it on med-surg floor. It's certainly broadened my perspective.

I mean ... to me, at least, these clinicals are priceless. Not to mention, you get to go into all these hospitals and ask the RN's how they like working there, etc. You find out how different each facility can be. It's great for making career decisions about where you want to work.

:typing

traumahawk99 · May 14, 2006

you know what's vastly better than clinicals? actually working for real!

ChesterRN · May 14, 2006

A good nurse does not equate to a good nursing instructor.

Very well said!

As an educator and one charged with the task of hiring educators, I must say you are well aware of one of the most fundamental flaws in the provision of postsecondary education.

ChesterRN · May 14, 2006

you know what's vastly better than clinicals? actually working for real!

What are you trying to say...that we learn more from our patients than from educators, powerpoint slides and books combined?!? Can it be true? :lol2: