Is the RN--->BSN push a clever way to get older nurses out of the way

[Nola009]

As in certain "Baby Boomers" who wont retire? Wont we NEED a faster RN producing mechanism (hello again, ADN programs!) in order to provide enough nurses to care for this huge group of people due to retire soon?? Just wondering...

[TiffyRN, BSN, PhD]

It seems as though there is a belief that by continuing to have an ADN pathway that we are ignoring the findings of those studies. Based on those studies, it would seem likely that there were aspects of BSN education and curriculum that had the potential to produce better outcomes.

So the argument is that those aspects should be part of every nurse's education, which I think most agree with. I think the disagreement lies in the idea that ADN programs that incorporate those aspects as a result of that research still aren't providing sufficient education, they need to have the letters "BSN" after their name, which would mean that it's not actually about the education or their related outcomes.

Ok, this I don't hear from a lot of the ADN as entry level defenders. For the most part, I hear arguments that the studies are flawed. Sadly, this is from a group that is (by and large) not versed in the intricacies of research. This sounds sad.

What you, MunoRN are contending is worthy of attention. For myself, as as 1992 ADN graduate, I had little to no theory, NO research, virtually no community nursing (oh, we had to attend ONE AA meeting). These are the aspects I found greatly deepened my nursing knowledge in the last couple of years and I am sad that people are fighting so hard against it.

[Susie2310]

Ok, this I don't hear from a lot of the ADN as entry level defenders. For the most part, I hear arguments that the studies are flawed. Sadly, this is from a group that is (by and large) not versed in the intricacies of research. This sounds sad.

How do you presume to know how well versed in knowledge of research people who say the studies are flawed are? Many of the people who have posted on AN in opposition to various studies methods/conclusions have a minimum of a BSN and have taken college statistics and a nursing research course.

[TiffyRN, BSN, PhD]

How do you presume to know how well versed in knowledge of research people who say the studies are flawed are? Many of the people who have posted on AN in opposition to various studies methods/conclusions have a minimum of a BSN and have taken college statistics and a nursing research course.

Actually, this is an excellent point. Without some kind of certification, it is very difficult to asses the knowledge of any given person on any given topic. Several ways we have available are: college transcripts, college degrees, licensure exams, specialty certifications, and to some degree, work history.

When it comes to more the slightly more advanced nursing topics (research, community, theory); hospitals are looking to hire those who have knowledge on those topics. They could in-depth interview everyone and quiz them extensively as well as examining their work history (sorry new grads, you're out of luck). Or they could take the easy way and look at the degree behind the name. Is an outright guarantee? No, certainly not.

I do admit that my assumption, that by and large (not exclusively, I chose my words carefully) ADN nurses are not versed in research and statistics is based in my personal experience. I had no statistics or research training or knowledge (prior to BSN courses) and the only nurses I have ever spoken with that did had a minimum of BSN level. So, yes, this was an assumption, but I thought I couched it well due to this.

I am well aware there are people with a variety of backgrounds that come into nursing through ADN programs and this may not be their only knowledge base. I went to community college with a classroom full of second career students, I was one of few under 21 in my class.

[cinlou, BSN, MSN, RN]

Some of what has been said about previous education and exposure to research community health and statistics depends on when you went to school and where. I think someone said earlier something about standardization which is not a bad thing.

Back in the 70's when I received my LPN I did clinical rotations through community and public health, we touched upon research and statistics, certainly not in depth but we were introduced to it in LPN school.

Many patients I took care of that were nurses had been LPN's that were grandfathered into an RN role.

Today I was at an advisory RN meeting and the public nurse stated that the only students she had at her clinic were BSN students, and she wanted to see more ADN students rotate through. I was actually pretty surprised about this since I had that rotation as an LPN. My program was 5 days a week, 8 hours a day and 10 months long.

Today it is becoming harder and harder to even find clinical sites that will take any students. In Phoenix AZ one university has close to 300 students of all levels that they can not even get placed in clinical sites so they are looking throughout the state to get clinical sites. If some of these colleges are more willing to pay facilities to take their students those facilities will take them and not their local community college students. It is like a bidding/lottery out there just to get students experience.

There are research studies, sorry don't have one in front of me, but state that simulation provides for better critical thinking skills, this does not to my knowledge separate degree levels.

There are so many different issues going on here that contribute to outcomes, I think until there is some consistency in programs it will be hard to define clear accurate and consistent research on the subject. The AZBON is looking at standardizing curriculum, it will be interesting to see how this effects future research and outcomes.

[jadelpn, LPN, EMT-B]

A clever way to get multi-year nurses out of facilities seems to be a push in a number of facilities due to having to pay them for their many years per a union contract, the years of merit based raises, back when nurses actually GOT yearly wages and other benefits that now affect the bottom line of the facility.

Most orchestrated by Master's prepared directors who have little to no bedside experience.

For a number of multi year nurses, it was a time of good bedside care. That the art of nursing was just as important as the science. That it was a humbling experience to work with the ill, the vulnerable. That a patient was not discharged until they were at the highest functional level possible, even if that were 2 weeks later.

Now, it is a push to get em up and get em out. A BSN prepared nurse can pull a rabbit out of a hat--they had to--multiple papers on theory and other subjects have most researching the most obscure to make sense. It is an alternate education based on thinking outside of the box, which equates proper documentation to ensure facilities get paid.

Most facilities don't want one to be experienced enough to really KNOW that a patient is not actually at their best to be discharged. They don't necessarily care that one is clinically skilled. They seemingly care about how it is documented accordingly so that their reimbusement rate is at an all time high. They want spin doctors, not classic bedside nurses.

The class argument is a valid one. However, most patients don't care if you are a doctorate degree, they are interested in having their needs met. Hence the disconnect. This is why "I endevour to give you the most excellent care" is amusing at best.

Because facilities have changed so much in their care models and priorities, BSN is the preference for many. Because to attempt to play mind games with patients (BSN's are more educated, therefore better nurses) with scripting and in such a rush to get them out the door within very distinct time frames--this is in deep contrast to how many clinically based education works, and how many multi-year nurses have practiced. Then it becomes a practice issue for many a seasoned nurse.

What is also laughable is the thought process that a "higher class" person gets a BSN. Interestingly, those who are in the poverty range (which really has not a thing to do with "class") can and do get such financial aid assistance that they can really go to school for close to nothing at all as far as tuition. And more seasoned nurses who are making decent wages are lucky to be able to get a loan. Which makes it near impossible to take on a more advanced degree.

Every part of nursing should have a place. Every patient would fare well with a team of multi-disciplined/degreed nurses who can work together for the good of patient care.

However, if we continue to have the power that be be the powers that have no nursing experience just a degree that says they can run the show, this mindset will continue.

[Nola009]

A clever way to get multi-year nurses out of facilities seems to be a push in a number of facilities due to having to pay them for their many years per a union contract, the years of merit based raises, back when nurses actually GOT yearly wages and other benefits that now affect the bottom line of the facility.

Most orchestrated by Master's prepared directors who have little to no bedside experience.

For a number of multi year nurses, it was a time of good bedside care. That the art of nursing was just as important as the science. That it was a humbling experience to work with the ill, the vulnerable. That a patient was not discharged until they were at the highest functional level possible, even if that were 2 weeks later.

Now, it is a push to get em up and get em out. A BSN prepared nurse can pull a rabbit out of a hat--they had to--multiple papers on theory and other subjects have most researching the most obscure to make sense. It is an alternate education based on thinking outside of the box, which equates proper documentation to ensure facilities get paid.

Most facilities don't want one to be experienced enough to really KNOW that a patient is not actually at their best to be discharged. They don't necessarily care that one is clinically skilled. They seemingly care about how it is documented accordingly so that their reimbusement rate is at an all time high. They want spin doctors, not classic bedside nurses.

The class argument is a valid one. However, most patients don't care if you are a doctorate degree, they are interested in having their needs met. Hence the disconnect. This is why "I endevour to give you the most excellent care" is amusing at best.

Because facilities have changed so much in their care models and priorities, BSN is the preference for many. Because to attempt to play mind games with patients (BSN's are more educated, therefore better nurses) with scripting and in such a rush to get them out the door within very distinct time frames--this is in deep contrast to how many clinically based education works, and how many multi-year nurses have practiced. Then it becomes a practice issue for many a seasoned nurse.

What is also laughable is the thought process that a "higher class" person gets a BSN. Interestingly, those who are in the poverty range (which really has not a thing to do with "class") can and do get such financial aid assistance that they can really go to school for close to nothing at all as far as tuition. And more seasoned nurses who are making decent wages are lucky to be able to get a loan. Which makes it near impossible to take on a more advanced degree.

Every part of nursing should have a place. Every patient would fare well with a team of multi-disciplined/degreed nurses who can work together for the good of patient care.

However, if we continue to have the power that be be the powers that have no nursing experience just a degree that says they can run the show, this mindset will continue.

Beautifully put. What you said makes a lot of sense --- WE were taught that nursing is a science AND an art. And I agree that we all "have a place", something meaningful contribute to patient care / nursing!

[BostonFNP, APRN]

Requiring a BSN bridge wouldn't eliminate the ADN pathway. A BSN bridge typically refers to an ADN to BSN bridge in my experience. You can't bridge from ADN to BSN without ADN programs.

I wasn't very clear there; in my opinion there is no reason why the CC programs can't continue the trend of bridging/partnering with colleges and universities in providing lower cost bachelor education.

[llg, PhD, RN]

It seems as though there is a belief that by continuing to have an ADN pathway that we are ignoring the findings of those studies. Based on those studies, it would seem likely that there were aspects of BSN education and curriculum that had the potential to produce better outcomes.

So the argument is that those aspects should be part of every nurse's education, which I think most agree with. I think the disagreement lies in the idea that ADN programs that incorporate those aspects as a result of that research still aren't providing sufficient education, they need to have the letters "BSN" after their name, which would mean that it's not actually about the education or their related outcomes.

But if ADN programs incorporated all that content into their programs, they would take 4 years to complete -- unless they dropped some of the content they currently include. It would be unfair to those students to have them take all that coursework and then give them a lower credential even though they covered the same content. Then ADN nurses would be the big losers in that scenario -- having done the work, learned the material, but not gotten credit for it.

[morte, LPN, LVN]

they commonly do more than 2 years now, and don't get the credit. I think many things could be covered, in a less intense way perhaps, but at least touched on. and not add to the time constraints.

But if ADN programs incorporated all that content into their programs, they would take 4 years to complete -- unless they dropped some of the content they currently include. It would be unfair to those students to have them take all that coursework and then give them a lower credential even though they covered the same content. Then ADN nurses would be the big losers in that scenario -- having done the work, learned the material, but not gotten credit for it.

[BostonFNP, APRN]

they commonly do more than 2 years now, and don't get the credit. I think many things could be covered, in a less intense way perhaps, but at least touched on. and not add to the time constraints.

Absolutely.

[nurseprnRN, BSN, RN]

Personally I don't believe there is much difference between ADN vs Diploma vs BSN. So the BSN took organic chemistry and possibly physics for nursing, while that would be interesting and challenging I don't think it applies to bedside nursing.

Your belief is fine as far as it goes. As in religion, belief is belief, and you get to make up your own criteria for supporting factors (you saw angels, your church reports miracles, throwing a maiden into the volcano saves the village, your wearing a little bag of animal bones and colored minerals is how your gods made you a good healer, if the witch drowns she's innocent, whatever). No scientific rigor is applied for proof of faith. Anecdote is not the singular of data.

However, I can tell you plenty of times when I was glad as hell to have taken physics, two semesters of chemistry and one of organic chem, anthropology, economics, psychology, and sociology in my bedside practice. And you bet they made me a better nurse than I would have been without them.

[martymoose, BSN, RN]

However, I can tell you plenty of times when I was glad as hell to have taken physics, two semesters of chemistry and one of organic chem, anthropology, economics, psychology, and sociology in my bedside practice. And you bet they made me a better nurse than I would have been without them.

Not saying any of these classes would not be useful, but my RN_BSN doesn't require us to have any physics, any chemistry, any economics, or anthropology.

Would that mean it's inferior?