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.
Finally, at least in NYC, BSN RNs do not make that much more than ADN grads, especially bedside, and they still deal with all the goo, poo, spew and everything else the later has to as well.
Same thing here in upstate NY. BSNs maybe make a dollar or two an hour more. I am a LPN that has just graduated with my associates. Despite the economy, I was offered two jobs at major hospitals. Most of my classmates also have jobs.
To the op, maybe I missed it, but what about the LPN level? We have to remember that nursing involves more than acute care. Who will take care of those in LTC? These days they are mainly staffed by LPNs with some RNs in charge.
Honestly if BSN was the minimum requirement, I would not be a nurse today. As a mother of five that was laid off, I could not stay out of work for 4 years to obtain that degree. I supposed it you utilized PCTs, CNAs, LPNs and other supportive staff to the max it could be possible.
I think there are some great points made here about why it probably would not work.
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:
Are you serious? I love my jobs, really I do, but no way would I be a nurse if I could earn $15-17 an hour more doing something else enjoyable.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
To the op, maybe I missed it, but what about the LPN level? We have to remember that nursing involves more than acute care. Who will take care of those in LTC? These days they are mainly staffed by LPNs with some RNs in charge.
*** I am not speaking for the OP but usually those who are advocating for the BSN as entry for RN feel that the associates degree is the appropriate degree for LPNs.
Honestly if BSN was the minimum requirement, I would not be a nurse today. As a mother of five that was laid off, I could not stay out of work for 4 years to obtain that degree. I
*** Don't expect that argument to have any influence on the BSN only advocates. I am in the same boat as you. Without the community college ADN program I could not have become an RN either but they don't care about the thousands of people for whom that is true. It's all about limiting the kinds of people who can be RNs, degree inflation, and the deeply ingrained feeling of inferiority that is pervasive in nursing. You can easily see this in the BSN as entry to practice and the DNP as advanced practice crowd.
If they get their wish for the BSN (they already have succeeded with the DNP) I suspect we will see a huge influx of new BSN grads from places like the Philippines to fill the huge gaps.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
1. Since there is presently no problem with unfilled openings in nursing, I don't see any reason why we would worry about getting nurses. In the future, if the hospital wants to retain staff, maybe they should work on that rather than in sourcing or pressuring nursing schools to pump out new grads.
*** The key work is "presently". However this is a very temporary situation. When the economy improves a little nurses in their tens of thousands, those who have put off retirement, those who were and would prefer to be part time but became full time r/t their spouses not having any work, are going to leave the bedside. I have been a nurse long enough to have seen this before. Back in 1994 & 1995 there where no nurse jobs at all for new grads and experienced RN where having a heck of a hard time as well.
The reason we should worry is that whenever the shortage gets too bad we import foreign nurses by the thousands. These nurses are not usually in a position to be advocates for better working conditions and wages.
1. Since there is presently no problem with unfilled openings in nursing, I don't see any reason why we would worry about getting nurses. In the future, if the hospital wants to retain staff, maybe they should work on that rather than in sourcing or pressuring nursing schools to pump out new grads.
*** The key work is "presently". However this is a very temporary situation. When the economy improves a little nurses in their tens of thousands, those who have put off retirement, those who were and would prefer to be part time but became full time r/t their spouses not having any work, are going to leave the bedside. I have been a nurse long enough to have seen this before. Back in 1994 & 1995 there where no nurse jobs at all for new grads and experienced RN where having a heck of a hard time as well.
The reason we should worry is that whenever the shortage gets too bad we import foreign nurses by the thousands. These nurses are not usually in a position to be advocates for better working conditions and wages.
And lets not forget all the people that are now upset because they are looking for jobs and having to compete with those being still imported even without a shortage. We have nurses willing to work in LTC because of the economy, but as soon as that gets better, you will find not many willing to work there - especially with a BSN. I think you and I are on the same page. A BSN miniumum sounds good on paper, but in reality - well that's a whole other animal. Perhaps we need to look at why others states that have tried this, stopped it??? I believe it was North or South Dakota.
*** Don't expect that argument to have any influence on the BSN only advocates. I am in the same boat as you. Without the community college ADN program I could not have become an RN either but they don't care about the thousands of people for whom that is true. It's all about limiting the kinds of people who can be RNs, degree inflation, and the deeply ingrained feeling of inferiority that is pervasive in nursing. You can easily see this in the BSN as entry to practice and the DNP as advanced practice crowd.
If they get their wish for the BSN (they already have succeeded with the DNP) I suspect we will see a huge influx of new BSN grads from places like the Philippines to fill the huge gaps.
If this happens then nurses will be worse off because the trend I've noticed with imported nurses is that they will accept less $$$ and poor working conditions if it means a green card.
My last job was a union job but for the two years I was there the DNS and administrator claim they can't fill the three slots for evening shift. Instead they use agency nurses from the Philippines and pay them $9/hour less than the union nurses and they also have no benefits. OT has been cut a lot. When I started OT was plentiful, it wasn't uncommon to be able to get 2-3 OT shifts per week with more being available if you could stand the work. This dried up to only being able to get an OT shift if someone called out last minute and you just happened to be around. Nurses at my job had to get per diem jobs in other facilities because the agency nurses were used to fill in.
The agency nurses are under the thumb of the DNS. They have no rights or benefits. They don't complain about a lack of supplies, the extra paperwork, or the acuity of the residents. I'm not trying to insult them but a lot of what is going on is that people are doing a lot of paperwork to make it seem like the work is being done but the truth is that corners are being cut and quality of care has gone from O.K to absolutely crappy.
I'm so glad to be away from that place and if what is going on at my old job is the future of nursing then I won't be a part of it.
Disclaimer: I'm not claiming that every place does what my old job did....just an example of what may happen. I am 100% sure that there are plenty of foreign agency nurses working in nice places and providing excellent care.
Specializes in acute rehab, med surg, LTC, peds, home c.
I think it would be dangerous to have nurses graduate and start prescribing and diagnosing right out of school. I would even dare say disasterous. I dont think ther is any substitute for actually practicing as an RN first. Maybe if they practiced while in school for the MSN, kind of like a residency.
I believe that as long as there is even one American nurse who WANTS to work but is unable to find employment it should not be justafiable to hire foreign-trained nurses whose accents are too hard to understand. I am from the East Coast, and when I first moved to the 'heartland' and then to the South, the locals had a hard enough time with me!!!
As I noted much earlier, these issues have been around for at least 40 years. The ANA should pick a date, say 8-10 years down the road, and say that there will no longer be diploma/ADN programs. The schools might protest, but as nurses it seems we would rather gossip and undermine each other than to band together and protest. Then give anyone under 40, or with less than 10 yrs experience, about 8-10 years to get their degree, and those over 40/10+ years, get 'grandMOTHERed' in.
Also, years ago, it was suggested that the RNs be divided into 2 groups, and those with less than a BSN would not be eligible for management roles.
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.
SO WHAT DO YOU THINK ABOUT IT???
Nothing....nothing at all. Because it is entirely unrealistic, and has little to do with what real nursing entails.
Pharmacists now have to be PharmDs, and PTs need a Masters. Has it helped pts or patient care? Not at all . In virtually every facility that I have been in since the PT mandate, it is impossible to get one's pt seen within a reasonable time frame, and regularly. It used to be that PT saw them promptly and at least daily......today, it is a total crapshoot whether they will be seen at all. And the turf wars between MDs and PharmDs have been monumental, and perpetually pull Nursing into them, since like any other "doctors" they can not possibly ever speak to one another, but insist on going through nursing.
Secondly, I am sure that if someone commissioned a study on care provided by people with medical degrees doing all care (bathing, toileting, PTing, prescribing and administering meds, ordering tests and care and providing that care, that the pts will have awesome outcomes. But that does not mean that it is practical, economically feasible to do so nor that the number of personnel needed would be educated to that point or available. As long as physical care of the pt needs to be done and provides good assessment, someone with a certain amount of knowledge needs to be hands on doing that care to properly assess the pt. And we have to have an adequate number of them, or the pts will not (as in PTs care) get cared for, and have an optimal outcome.
To the OP (who may not be around, given the age of the thread). There is nothing to prevent you from getting a medical degree and focus your practice and providing care, ambulating your pts, feeding them, and bathing them along with MD duties such as prescribing. I am sure that they will have good outcomes, having a well educated PCP that gathers his/her own data as well as providing care. Why not do that?
*** The key work is "presently". However this is a very temporary situation. When the economy improves a little nurses in their tens of thousands, those who have put off retirement, those who were and would prefer to be part time but became full time r/t their spouses not having any work, are going to leave the bedside. I have been a nurse long enough to have seen this before. Back in 1994 & 1995 there where no nurse jobs at all for new grads and experienced RN where having a heck of a hard time as well.
The reason we should worry is that whenever the shortage gets too bad we import foreign nurses by the thousands. These nurses are not usually in a position to be advocates for better working conditions and wages.
There was never a nursing shortage and there never will be. The only shortage was a shortage of RNs who were willing to work under the conditions that hospitals provided. You seem pretty intelligent so I feel pretty certain that you can see that its just a convenient excuse to keep the nursing market flooded with folks who don't have bachelors degrees. I am not opposed to a union because I agree that is the only way nurses will prevent further input of nurses from other countries who are definitively not in a position to advance their personal or professional interests.
I also think that an MSN as an entry would not be a torture although I see no present need for that. Heck, when I log onto hospital career websites, there is no shortage of openings for PTs. Also, I noted with sadness that one website had "professional" positions listed and then another category with "nursing" positions. Ouch.
Pharmacists now have to be PharmDs, and PTs need a Masters. Has it helped pts or patient care? Not at all . In virtually every facility that I have been in since the PT mandate, it is impossible to get one's pt seen within a reasonable time frame, and regularly.
Secondly, I am sure that if someone commissioned a study on care provided by people with medical degrees doing all care (bathing, toileting, PTing, prescribing and administering meds, ordering tests and care and providing that care, that the pts will have awesome outcomes.
The question to be asked isn't whether or not it helps the patient. The studies show that an increased level of education does. The real question is what it does in terms of protecting professional role function for the providers. I see PT doing very little that a nurse couldn't do but turn it into something that you need a PhD to do and you suddenly protect your job.
I am going to disagree on the second point. I think they would do a terrible job of providing nursing care but that's just based on my torturous experiences where doctors actually try to do those things.
kcochrane
1,465 Posts
Same thing here in upstate NY. BSNs maybe make a dollar or two an hour more. I am a LPN that has just graduated with my associates. Despite the economy, I was offered two jobs at major hospitals. Most of my classmates also have jobs.
To the op, maybe I missed it, but what about the LPN level? We have to remember that nursing involves more than acute care. Who will take care of those in LTC? These days they are mainly staffed by LPNs with some RNs in charge.
Honestly if BSN was the minimum requirement, I would not be a nurse today. As a mother of five that was laid off, I could not stay out of work for 4 years to obtain that degree. I supposed it you utilized PCTs, CNAs, LPNs and other supportive staff to the max it could be possible.
I think there are some great points made here about why it probably would not work.