Reforming nursing education...

[SteffersRN87]

After reading several threads regarding the entry-level MSN programs and which level of nursing education should become the standard, I want to share a classroom discussion I had a while back...

What if a MSN became the solid standard for entry into nursing practice? What if we all practiced in the role of a nurse practitioner? Now, I know that this will surely NEVER happen! But, a six year program leading towards a MSN degree with the outcome of a nurse practitioner may not be such a bad idea. Think about it... We could manager our own patients' care instead of the way a physician thinks it should. We could prescribe pain medication when a patient needs it.

Anyways, as I said it will probably never happen, but it was a very interesting discussion.

SO WHAT DO YOU THINK ABOUT IT???

[Nissan350z]

+1..i agree

[classicdame, MSN, EdD]

I have had the privilege (and pleasure) of visiting hospitals and clinics in several different countries. When Nurse Practitioners are utilized there appears to be better service for patients who are not having life-threatening situations. That saves the MD for the "bigger" situations. Seems like a smart way to do business. In those instances the hospitals have more LVN/LPN type nurses to fill MD orders. The service seems to break down a little in hospitals, as there are fewer RN's to do procedures and make decisions and follow protocols without the MD being on board. However, the attending is usually a hospitalist, not family MD, so the MD is more available.

[interleukin]

Heck, I have a BSN and I'm still not really sure what that does for me. So I paid more to go to school than an ADN, yet we all get paid the same. And here's something schooling didn't really prepare me for: taking responsibility for everyone else's job. I mean really right now as it stands I'm the go between for EVERYONE.

You mean all those years in nursing school and not one teacher told you what you really are responsible for?

I'm shocked..........not!

It's amazing that so many kids graduate from nursing school and not a single teacher tells then what they really have to do.

Perhaps too many would drop out with the cold hard truth.

[FLmomof5]

I am just starting term 3 of NS. In our school, they don't pull the punches....nurses are responsible for everything and the first one's thrown under the bus. It definitely gives one pause about becoming a nurse. It definitely crossed my mind......"Gee. I am responsible for all this and all I will get paid is $15 - 17 less per hour than I earn now! Wow!":crying2:

[PMFB-RN, RN]

There's not enough money. RNs get paid OK for people with a community college degree that took a couple years. Nurses don't make anything like enough money to compensate one for a masters as entry level. Who would want to devote all that time and money just to make what we make?

[Music in My Heart]

What if a MSN became the solid standard for entry into nursing practice? What if we all practiced in the role of a nurse practitioner? Now, I know that this will surely NEVER happen! But, a six year program leading towards a MSN degree with the outcome of a nurse practitioner may not be such a bad idea.

Yes it is... it's far more costly than needed to create an excellent bedside nurse. It would endow most of its students with a skillset far beyond what they would use or need.

I'd far rather see the standard be a BSN program with less emphasis on nursing theory, care plans, and writing papers and more emphasis on clinical skills and experience.

[prinsessa]

There are programs that graduate people with a MSN to work as a RN. I know of one in Chicago (there may be more I don't know about). These people don't work as a NP, they work as an entry level RN when graduating. These programs are for second career students who don't want to get another bachelor's.....they would rather get a masters. I don't know how it works if they go back to school to become a NP.

[VICEDRN, BSN, RN]

I think its a good idea to "clean up" nursing education.

First: I think we need a humane way to transition to Bachelors level only for RNs. I say we grandfather folks in for a few years and then make the switch. Its fair. Enforcing a minimum standard of education has worked so well for the teachers. Its not that I am all high and mighty about my own training (relaax people!), its just that its a better professional image if nurses can say bachelors minimum.

Its not good news when the docs are publishing articles in their own journals studying what the best education level of nurses is. We need to police our own.

Second: I think the future will bring nurses more to a case manager where the nurse does patient teaching, coordinating and checking doctors care and nursing care (yeah, this means paperwork) and procedure specific activity, as in "insert foley," etc. I am guessing that the rest of the stuff will be done by people like medics and EMTs or something similar.

Third: I think and hope that NPs will begin to replace lots of MD centered care so that the overall picture of care changes. Its hard to describe but I think it makes sense on a bigger picture level.

[PMFB-RN, RN]

I think its a good idea to "clean up" nursing education.

First: I think we need a humane way to transition to Bachelors level only for RNs. I say we grandfather folks in for a few years and then make the switch. Its fair. Enforcing a minimum standard of education has worked so well for the teachers. Its not that I am all high and mighty about my own training (relaax people!), its just that its a better professional image if nurses can say bachelors minimum.

*** I would be far more likely to support BSN as entry if BSN was a useful degree where one could learn thing helpful and important to nursing. I am an ADN who went back and got my BSN from a state university. All fluff and mostly useless.

[VICEDRN, BSN, RN]

*** I would be far more likely to support BSN as entry if BSN was a useful degree where one could learn thing helpful and important to nursing. I am an ADN who went back and got my BSN from a state university. All fluff and mostly useless.

Very true! Very fluffy and mostly useless! The point is to enforce a uniform standard that people associate with having an education. Unfortunately, nurses are surrounded by other professionals who have a masters level degree as their minimum standard of education. It creates the right appearance more than anything else but that's just the way the world works unfortunately.

So frustrating to read people heckle nurses and watch people say salaries are inflated since "only need a high school diploma to be a nurse."

[laynaER]

I agree with lovebug. We need to as nurses start demanding more respect and establishing nursing as a unique disciplinary with our own research and evidence based practice, journals, etc. I think a step in that direction would be to start mandating bachelor's degree minimum. Besides, I think it's already starting to head in that direction nowadays at least where I live (New York) it's becoming pretty difficult for ADNs to pick up jobs because all of the jobs are requiring BSN minimum. Which is only fair.

[mamamerlee, LPN]

Why is it 'only fair' that the ADNs are being shut out?

This discussion is at least 40 years old, there was talk of 'grandfathering' even back then. It didn't make sense to most of us that, despite the differences in education, everyone took the same exams, and started at the same pay. I know there are some places who pay a premium for the degree, but overall, we all do the same work.

As a Diploma nurse, at a major teaching hospital, we rotated thru 7 different ICUs, the OR, all the various units. No, we didn't take statistics, or English comp, or even Western Civ. But when we were orienting at our first jobs, no one had to correct our spelling, either. We did get leadership training, circulated and scrubbed in the OR, assisted as best we could in the ER.

I have 35 years' experience. I can recognize the cough that comes just before someone codes due to anaphylaxis or severe fluid overload, and have the team there minutes before the pt stops breathing altogether. I learned to work without computers, without the myriad of pumps and other automatic devices.

If I am being just a bit strident, just a bit defensive, it's because I am tired of this 'discussion'. I do actually think that there should be only one entry to RN practice, and that someday that will happen.

But who wants to spend 30 - 40 - 50 thousand dollars or more on an education only to work rotating shifts, holidays and weekends forever? In general, the more educated nurses tend to drift away from the bedside far more quickly than the ADNs and Diploma grads.

Be careful what you ask for; you may get it.