NY State may require nurses to obtain 4-year degrees

Nursing Students ADN/BSN

Published

But some worry that an already severe shortage will become worse.

New York is mulling over a requirement that would force all RNs to earn a bachelor's degree in order to keep their RN certification-a step that critics worry could serve as a body blow to a profession already facing a severe shortage.

Under the state Board of Nursing proposal, RNs with associate's degrees would have to earn bachelor's degrees within 10 years, or their RN certifications would be downgraded to that of licensed practical nurse. That would make nursing somewhat like teaching in New York state; certified K-12 teachers need master's degrees or must obtain one within three years of starting a job. It would also add years and thousands of dollars to the difficulty of becoming an RN...

Full Article: http://www.rochesterdandc.com/news/0413BA3TIOG_news.shtml

A BSN as entry into practice would cinch up the pipeline and reduce the number of new grads coming out of school every year. We are a dime a dozen. Eventually, hospitals will be forced to realize that they need to work on that four letter word, RETENTION, not recruitment. A standardized entry into practice would unify us, as it unfies PTs, OTs, and Pharmacists. Not to mention MDs.

Right now they have us right where they want us. Professionally and educationally divided. The equivalent to being barefoot and pregnant. Not to mention powerless, and invisible. Canadian nurses may have their problems, but they have a unified voice, and are unionized with a national association. That is the last thing that hospitals want. We play right into their hands when we fight changing the entry into practice, and remaining the least educated of health care professionals.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Although it has been awhile since I lived in Canada (1990) Canada may have a unified voice but they are still weak weak weak. Canada still had the lowest paid nurses in the continent (Ontario were the highest paid nurses in the country) and the patient to nurse ratio was pathetic (1RN:12PTs with no CNA's on a general floor)hopefully it has changed now? Canada may have ne organization CNA for all nurses they do not decide the patient ratio or the rate of pay or benefits. Those are up to the union and each hospital has its own union.(as I said before things may have changed you can tell me that)

You are right although the requirement is there, the respect is not and the pay also does not justify the extra education either. I think the problem in Canada and the US is that we need a union like the teamsters. Currently each hospital has its own union rather then one union for all nurses. When the teamsters speak, everyone listens .

I agree in theory though that with a minimum of a BSN and a unified front, Nurses should be able to call the shots an be empowered to demand respect if it is not given.

Take some twins and have one go through an ADN program and one go through a BSN program. When they both have exactly 365 days of clinical, stop and compare them. Now, if it still a logical fact that more education actually means anything at all, who do you think will be the better prepared, more knowledgeable nurse to actually provide bedside care?

Hate to break it to you Randy, but twins are not carbon copies of each other, nor are they two-halves to one person, nor do they share the same personality. In fact they are individuals that can and do lead separate lives, in fact they may even choose careers completely different from each other. The fact that they may share similar or extremely close physical resemblance (this may or may not be the case with fraternal twins), they may share idiosyncrasies (perhaps more so than you would have with another sibling), however this does not mean they necessary hold the same interests. In addition, twins were also not put on this earth to be experimental lab rats.

Whether ADN or BSN, how one will function as a nurse, whether they are twins or not, will be up to THE INDIVIDUAL. Individual factors such as ethics, initiative, assertiveness, life experience and yes, even education (not necessarily what they learned in a nursing program), perceptions, etc, are all factors that come into play on how well an individual will excel in their chosen profession. This does not only apply to nursing, but to all professions. I can guarantee you, that had my twin sister chosen nursing as a profession (which she did not), even if we had the same educational level, she would not be the same nurse I am. Based on our individuality, there would be differences.

Dawn, who happens to have a sister that she shares a birthday with, and is grateful her parents recognized that their daughters were INDIVIDUALS.:biggringi

Excellent post and great points brought up here.

I see you quoted me and can understand where you are coming from, but this is why I agreed with Linda's "ABC community college" theory:

A nurse in your area of Michigan may have no trouble in finding a job, as you put it, but I don't think that the problem is the # of jobs available.

As someone else on this forum stated it, and I can't do it as well as they did, but it went along the lines of that there isn't so much of a nursing shortage as there is a shortage of decent nursing jobs.

My hospital is a major University teaching hospital that churns out new grads every year eager to take whatever critical care opening is offered to them and agrees to any terms and shifts just to get in the door.

My point here is that pumping out hundreds of new grads at "ABC community college" and the local univeristy isn't helping the problem either.

It just gives local facilities a big pool of nurses to go through like water because so many come and go after they see how bad the jobs are that are available to them.

Nursing isn't the glamorous and dramatic "ER" T.V. show after a good year or so in the field.

Hospitals welcome new U.S. grads as well as new foreign imports because both are much more likely to accept whatever is thrown at them, be it low wages or unsafe patient assignments.

And they will continue to do so for a while without complaining. But eventually, they catch on as well, and leave for greener pastures.

No worries. The hospital's nursing recruiters simply go to another job fair hustling students at the local university or community college, then it's off to Canada and/or the Phillipines for another fresh new crop.

Hospitals want people they can easily intimidate and push around.

Seasoned nurses tend to know too much and complain too much.

They want med/surg nurses willing to take 8 patient assignments with little or no CNA help and they want ICU nurses willing to take 3 open hearts without complaining.

If that's what you are looking for, then yes, there really is a major nursing shortage with plenty of jobs and the schools can't keep up with the job openings.

My point is that if there was this torrent of nurses being graduated from ABC community college, and that hospitals had all these new grads at their disposal than it would not be necessary to recruit on foreign soil. The average age of a nurse if 47 in the states (pretty much the same in Canada). You'd think with this vast flow from ABC community college that age would be lower.

Nurses are not just leaving the profession because of burnout, although many have. There are also more opportunities for nurses, they are not just at the bedside anymore. Women are not just entering this profession the way they used to, although I am rather glad to see more men entering the profession, I'd like to see an end to the "nurses are women with an altruistic nun-like calling" stereotype. I'm not in entire agreement with the statement "that there is no nursing shortage, just a shortage of good nursing jobs," depending on what one wants for themselves, and what one is willing to do, we can create our own opportunities. I think we are all in agreement that nursing isn't the glamourous profession portrayed on ER (or similar shows), but neither is it the subservient yes-person role also portrayed.

The city I live in, which is in Canada, should not be affected by the nursing shortage, unless there is a population explosion here, which I don't see happening, in fact, I think the population in this city will actually decrease. The reason for this is that the University in this city (remember only BSN entry level since 2005), could more than fill the needs here, unless, of course there are more attractive offers elsewhere for these nurses, in fact this would be THE ONLY reason for a nursing shortage in the city I live in. This situation would not be true in other areas of Canada that will be affected by a nursing shortage, and not simply because BSN has been made the entry level, more factors than that coming into play.

I will agree with you RN34TX, that hospitals do want nurses who will not complain and just do what they want, and it is easier to intimate and coerce compliance from new grads (in general), whether they are home grown or foreign imports, whether they are BSN or not. They do not want to deal with nurses willing to speak up, they want people who will shut up and do what they want. Part of that problem is that most nurses do not know the laws and legislature that govern their practice, this is not just a problem with new grads, I've encountered experienced nurses both in Canada and in the US that lack an understanding for the laws and legislature that governs their practice. In fact this needs to be part of a nurses education. Another problem is the lack of protection for nurses under current laws and legislature. Even SBONs hold nurses accountable for things such as staffing practices at their facilities (hey, you accepted the assignment, not that you necessarily were given much choice), when the fact is we don't have a say in how a facility staffs their units (only one state has legislated staffing ratios), like somehow they are protecting the public by blaming the nurses for a facilities' staffing practices. Not every state even has Safe Harbor. Not every state has Whistle Blower protection. Michigan dosen't even have a Nurse Practice Act. None of this will change with a BSN entry level.

Bear in mind, most unit managers have at least their BSN, yet they have very little power to effect changes on their units, they are not empowered at all. In fact the ones that hold the real power are not nurses at all. New CEO named to a new facility in West Bloomfield Michigan, previous experience: ran a hotel. Right, we all know how similar hospitals and hotels are.

Unless there is an incentive for health care facilities to retain nurses, they won't. What they will do is lobby strongly to be allowed have more UAPs perform the functions of a nurse, with the added bonus of making the RN accountable for them. We are accountable according to SBONs and state laws and legislature for what we "delegate," despite the fact that we have no input as to who is hired, how they are trained or their qualifications for the job, and whether or not they are competent. We can file incident reports up the whazoo on a UAP and that does not mean a facility will necessarily fire them.

Hospitals don't have any incentive now to retain nurses, and you can bet your bottom dollar that they do not want to retain nurses. If it is not in their best interests to do so, you can bet they will fight any legisature that they do not see as being in THEIR BEST INTERESTS, and that includes staffing ratios or any other legislature that will make them accountable for patient outcomes. Until health care facilities are held accountable for their role patient outcomes, they have absolutely no incentive to retain nurses, nor to ensure that qualified staff are providing care for their patients. A BSN entry level will not change this. In fact I'm surprised they are not lobbying more strongly for a BSN entry level, that way they would have less nurses at the bedside and a great excuse for hiring more UAPs, of course, still leaving the RN holding the bag. Careful folks, in the future it may not be an RN at your bedside taking care or you or your loved one.

A BSN as entry into practice would cinch up the pipeline and reduce the number of new grads coming out of school every year. We are a dime a dozen. Eventually, hospitals will be forced to realize that they need to work on that four letter word, RETENTION, not recruitment. A standardized entry into practice would unify us, as it unfies PTs, OTs, and Pharmacists. Not to mention MDs.

Yep, Linda cinch up that pipeline right now and you will have 1 BSN RN to 40 patients responsible for UAPs that will be providing care to the critically ill. Just think of all the dimes the hospitals will save.

A standardized entry would unite nurses:lol2: :lol2: :lol2: :lol2: :lol2:

As nurses we have a common goal in providing safe, competent care to patients, yet we still, for the most part, cannot stand together as a group to further that common goal.

I don't believe your hypothesis would/could become a theory.

Three sets of twins in my HS graduating class. Two sets identical and one faternal with a brother in the same class.

One set of twins barely graduated and their brother who was in the same grade is now a Pharmacist. The twins were "held back" in grade school.

The other set of twins one did very well the other common laborer. Both seem to be happy.

Third set of twins. Faternal. One sister teacher. The other a CardioThoracic Surgeon. First woman president of the National Association of Cardio-Thoracic Surgeons. MUSC.

You really bounced off four walls here as nothing you wrote has any bearing to what I wrote.

My comment was an attempt to show that in spite of all logic, some people still are wondering around lost in the wilderness. I'll explain it a little for you. If you wanted a more realistic comparison, in order to study any differences in educational level, you could study twins (as many researchers have done). Their genetic similarity is why twins are excellent subjects for research. And they do have the option to participate or not. Rats do not.

But, there really is no need to do such a study, as everyone (except some nurses) knows that every course (liberal arts or science) they take will make them better prepared.

Whether ADN or BSN, how one will function as a nurse, whether they are twins or not, will be up to THE INDIVIDUAL. Individual factors such as ethics, initiative, assertiveness, life experience and yes, even education (not necessarily what they learned in a nursing program), perceptions, etc, are all factors that come into play on how well an individual will excel in their chosen profession. This does not only apply to nursing, but to all professions. I can guarantee you, that had my twin sister chosen nursing as a profession (which she did not), even if we had the same educational level, she would not be the same nurse I am. Based on our individuality, there would be differences.

Dusky, you have good points but it's not about individuals or individuality. It's about providing a basic level of knowledge for the masses. Individuals can then go out and make a name for themselves. Some people will never be much good; others will be superstars. But, you need to start at one chosen level...hopefully equal to other professions.

I compare teachers, as my wife is one, to nurses. One deals in very complex life and death situations where you are often the last remaining barrier between a patient living or dying and the other just plays with your children's head. Which one do you want to have the highest possible BASIC education?

Teachers have to have a 4 year degree (and many have masters) They do not spend all their time fighting about their entry level, but on other more productive items. I wish we were the same. But it's up to you younger guys; have fun with it!

Specializes in ER, ICU, L&D, OR.

But, there really is no need to do such a study, as everyone (except some nurses) knows that every course (liberal arts or science) they take will make them better prepared.

And dont forget the knowledge that comes from experience. Probably the most important of all.

My point is that if there was this torrent of nurses being graduated from ABC community college, and that hospitals had all these new grads at their disposal than it would not be necessary to recruit on foreign soil. The average age of a nurse if 47 in the states (pretty much the same in Canada). You'd think with this vast flow from ABC community college that age would be lower.

Nurses are not just leaving the profession because of burnout, although many have. There are also more opportunities for nurses, they are not just at the bedside anymore. Women are not just entering this profession the way they used to, although I am rather glad to see more men entering the profession, I'd like to see an end to the "nurses are women with an altruistic nun-like calling" stereotype. I'm not in entire agreement with the statement "that there is no nursing shortage, just a shortage of good nursing jobs," depending on what one wants for themselves, and what one is willing to do, we can create our own opportunities. I think we are all in agreement that nursing isn't the glamourous profession portrayed on ER (or similar shows), but neither is it the subservient yes-person role also portrayed.

The city I live in, which is in Canada, should not be affected by the nursing shortage, unless there is a population explosion here, which I don't see happening, in fact, I think the population in this city will actually decrease. The reason for this is that the University in this city (remember only BSN entry level since 2005), could more than fill the needs here, unless, of course there are more attractive offers elsewhere for these nurses, in fact this would be THE ONLY reason for a nursing shortage in the city I live in. This situation would not be true in other areas of Canada that will be affected by a nursing shortage, and not simply because BSN has been made the entry level, more factors than that coming into play.

I will agree with you RN34TX, that hospitals do want nurses who will not complain and just do what they want, and it is easier to intimate and coerce compliance from new grads (in general), whether they are home grown or foreign imports, whether they are BSN or not. They do not want to deal with nurses willing to speak up, they want people who will shut up and do what they want. Part of that problem is that most nurses do not know the laws and legislature that govern their practice, this is not just a problem with new grads, I've encountered experienced nurses both in Canada and in the US that lack an understanding for the laws and legislature that governs their practice. In fact this needs to be part of a nurses education. Another problem is the lack of protection for nurses under current laws and legislature. Even SBONs hold nurses accountable for things such as staffing practices at their facilities (hey, you accepted the assignment, not that you necessarily were given much choice), when the fact is we don't have a say in how a facility staffs their units (only one state has legislated staffing ratios), like somehow they are protecting the public by blaming the nurses for a facilities' staffing practices. Not every state even has Safe Harbor. Not every state has Whistle Blower protection. Michigan dosen't even have a Nurse Practice Act. None of this will change with a BSN entry level.

Bear in mind, most unit managers have at least their BSN, yet they have very little power to effect changes on their units, they are not empowered at all. In fact the ones that hold the real power are not nurses at all. New CEO named to a new facility in West Bloomfield Michigan, previous experience: ran a hotel. Right, we all know how similar hospitals and hotels are.

Unless there is an incentive for health care facilities to retain nurses, they won't. What they will do is lobby strongly to be allowed have more UAPs perform the functions of a nurse, with the added bonus of making the RN accountable for them. We are accountable according to SBONs and state laws and legislature for what we "delegate," despite the fact that we have no input as to who is hired, how they are trained or their qualifications for the job, and whether or not they are competent. We can file incident reports up the whazoo on a UAP and that does not mean a facility will necessarily fire them.

Hospitals don't have any incentive now to retain nurses, and you can bet your bottom dollar that they do not want to retain nurses. If it is not in their best interests to do so, you can bet they will fight any legisature that they do not see as being in THEIR BEST INTERESTS, and that includes staffing ratios or any other legislature that will make them accountable for patient outcomes. Until health care facilities are held accountable for their role patient outcomes, they have absolutely no incentive to retain nurses, nor to ensure that qualified staff are providing care for their patients. A BSN entry level will not change this. In fact I'm surprised they are not lobbying more strongly for a BSN entry level, that way they would have less nurses at the bedside and a great excuse for hiring more UAPs, of course, still leaving the RN holding the bag. Careful folks, in the future it may not be an RN at your bedside taking care or you or your loved one.

Yep, Linda cinch up that pipeline right now and you will have 1 BSN RN to 40 patients responsible for UAPs that will be providing care to the critically ill. Just think of all the dimes the hospitals will save.

A standardized entry would unite nurses:lol2: :lol2: :lol2: :lol2: :lol2:

As nurses we have a common goal in providing safe, competent care to patients, yet we still, for the most part, cannot stand together as a group to further that common goal.

First, I strongly agree that nurses need to learn the basics of Employment Law for their own protection. Ignorance of Employment Law are the main reason that nurses are pushed around and bullied as easily as they are.

And I am glad that someone else realizes the ultimate goal of hospital is to allow UAPs to take over the hospital, and leave the RN to "babysit" them.

Our job, as RNs is to get out and educate the public, write to our elected officials, and band together, as the nurses in California have done to protect their patients.

I know that hospitals have no incentive to retain nurses. Unit managers have no power, because the nurses under her/him, also have limited power to support a goodd nurse manager. And the hospital powers that be have worked hard to reduce as much power and control that nurse managers have.

What is the solution? First, nurses need to take it upon themselves to educate themselves in Employment Law. How? Local community colleges that have Paralegal programs offer classes in Employment Law as a choice for the Paralegal Students. These are inexpensive. If this is not an option, or unavailable, Kaplan College offers on line Legal Nurse and Paralegal classes. There are other on line programs for paralegals, as well. Contact these progams, and enroll for the Employment Law class. If Administrative Law is also offered, take that as well. It covers all aspects of Administrative Law, that includes things like Appeal Porocess, in hearings before Regulatory Agencies, like the Board of Nursing. I took these classes as prt of the Legal Nurse Certificate Program at Spokane Community College. As part of the Admistrative Law Class, for the final take home exam, I wrote up a fictional appeal concerning a nurse who had lost her license for stealing drugs from the hospital where she worked, and has successfully gone through rehab. She was appealing her license suspension and trying to get it back.

It forced me to research the issue, the appeals process, and overall was a real education. My point is, that this is the knowledge that nurses need to survive in the workplace today. This will go along way to minimize burnout in new grads, who are being chewed up and pit out.

Bedside nursing is seen as an undesirable occupation, and new grads are just gritting their teeth, and putting in the minimum amount of time before they can move on to grad school, etc, and get a more desirable position.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Dusky, you have good points but it's not about individuals or individuality. It's about providing a basic level of knowledge for the masses. Individuals can then go out and make a name for themselves. Some people will never be much good; others will be superstars. But, you need to start at one chosen level...hopefully equal to other professions.

I compare teachers, as my wife is one, to nurses. One deals in very complex life and death situations where you are often the last remaining barrier between a patient living or dying and the other just plays with your children's head. Which one do you want to have the highest possible BASIC education?

Teachers have to have a 4 year degree (and many have masters) They do not spend all their time fighting about their entry level, but on other more productive items. I wish we were the same. But it's up to you younger guys; have fun with it!

Randy, your post just begged for a reply from a twin:D

I do however think that the nursing profession will eventually progress to having one entry level for RNs. It's happened elsewhere, including Canada. The question will be the when, how it is done, and will it meet the needs of the public. It will also take more than standardizing the entry level to change a lot of what is wrong in the nursing profession.

BTW mom is a teacher.

It will also take more than standardizing the entry level to change a lot of what is wrong in the nursing profession.

True, but wouldn't it be great to have this one thing behind us and working on the others.

True, but wouldn't it be great to have this one thing behind us and working on the others.

I think it would be wiser to have a few things taken care of first before that move. Be careful when one hands you a rope, it may be the one you hang yourself with.

Right now, in this time and place, I don't think it would be wise, unless of course you want 1BSN RN to 40 (or so) patients with a lot of UAPs. That "nurse" taking care of your loved one may not be a nurse. Timing will be everything for our patients. If you don't have an RN at that bedside, whether Diploma, ADN, or BSN, they will be of little use to the patients they are trained to provide care for.

Hospitals right now have no incentive to retain nurses, period. Until they do, not much of anything will change. Right now, you do have Diploma and ADNs that have met a basic educational requirement and standard for licensing, they can and do provide quality care. We can argue all we want about who provides better beside care, it's a moot point, since how an RN delivers care will be up to that individual RN.

I think it would be wiser to have a few things taken care of first before that move. Be careful when one hands you a rope, it may be the one you hang yourself with.

Right now, in this time and place, I don't think it would be wise, unless of course you want 1BSN RN to 40 (or so) patients with a lot of UAPs. That "nurse" taking care of your loved one may not be a nurse. Timing will be everything for our patients. If you don't have an RN at that bedside, whether Diploma, ADN, or BSN, they will be of little use to the patients they are trained to provide care for.

Hospitals right now have no incentive to retain nurses, period. Until they do, not much of anything will change. Right now, you do have Diploma and ADNs that have met a basic educational requirement and standard for licensing, they can and do provide quality care. We can argue all we want about who provides better beside care, it's a moot point, since how an RN delivers care will be up to that individual RN.

Hospitals will never have an incentive to retain nurses, until "ABC Community College", and "St. Elsewhere Hospital School of Nursing", quit churning out new suckers, (aka new grads), every 6 months. It is in their best interests to push out the more expensive older, more experienced nurses, (who complain about short staffing, and unsafe working cnditions), and bring in new ones for making $5 an hour less.

A BSN would slow the pipeline, forcing hospitals to bend over backwards to make the older nurses stay. There are over 500, 000 experienced nurses in this country not working in nursing. If on fifth of them came back to work at bedside nursing, there would be a glut. Also, staffing ratios (which include only RNs in the ratios), would prevent the jobs going to LPN/LVNs, and UAPs.

JMHO and NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Most 4 year RNs were what we used to call "desk nurses". Those were thenew graduates.

Then there were the "seasoned" ones who had been at it a while.

The ones who were in it just for the paycheck, such as it was, were the ones who were the desk nurses.

Then those of us who were the care takers and hands on Nurses were the ones out on the floor working with the CNAs!

Nursing is a team effort, but sadly some of the the ones with all the degrees seem to stay at the desk area.Most new Nurses could be mentored by some of the dedicated CNAs and learn quite a bit.

In my mind, degree doesn't mean practical knowledge.

We are short enough already. 4 year degrees are nice, but experience could be just as important as time spent at a desk.

I think that if Nurses spent more of their time at seminars that are offered around the country, this important knowledge could be obtained.

NY State requires very little in cont. ed needs before renewal. Some of the other states have it right in their requirements.

Those opting to attend could in turn share this info with others.

macspuds30

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