RN, ADN, BSN, LPN, LVN, ....... Does it matter??

llg, PhD, RN · May 21, 2009

The multiple entry routes for the RN role are a problem that holds the profession of nursing back ... but I don't think most will be going away soon. It's a problem we are going to have to live for a while longer -- and not let it overwhelm us. We need to acknowledge the reality of the mess and move on.

llg, PhD, RN · May 21, 2009

Sorry ... technical problems caused multiple positings.

llg, PhD, RN · May 21, 2009

Sorry ... technical glitch.... multiple posts.

Tessaprn · May 21, 2009

Yes it matters. Some require more education and clinicals. Some can perform procedures that others cannot. Some can supervise and some cannot. There is a difference between doctors. They have different levels and types of specialities.

melsman1904 · May 21, 2009

To address the issue with being recognized as a true professional:

As nurses, if we focus more on carrying ourselves in a professional manner and less on what others think, our patients will reap far greater benefits. Professionalism is more than a particular degree or certification. It is a culture that can only be perpetuated if we, the professionals, maintain the right behavior. I have found that focusing on the important aspects of a task, in this instance-- acting professionally in all settings, usually produces the desired results independently of other factors. It is our job to act professionally, to encourage professionalism among our colleagues, and to exude professionalism to those outside of nursing.

SteffersRN87, BSN, RN · May 21, 2009

i hope that you pro-bsn people do not take offense to this. i am a diploma graduate. i went to a hospital-based nursing program, where we had a lot of theory and clinical packed into two years...

nursing concepts 1 & 2 - 8 to 16 hours of theory & 16 hours of clinical per week (15 weeks each)

med/surg (15 weeks) and specialities (8 weeks each) - 16 hours of theory & 16 hours of clinical per week

leadership & transitions - 24 hours of clinical for 6 weeks

i feel that i received an excellent education. my class had a 95% nclex pass rate. and, i felt clinically prepared and into the swing of things as a gn. now, i began as a gn with a few bsn grads, and i was not impressed. i feel that many bsn programs do not put emphasis on clinical experience but rather theory. theory is a good thing, but you really need the practice to be well-prepared and in nursing that counts. furthermore, i feel that a lot of bsn programs put emphasis on things that are not really of the highest importance for preparing students to be professional nurses. many bsn graduates that i began working in the icu with were stumbling over taking a blood pressure while i was pushing drugs in a code.

now, i am not sure as to whether or not bsn programs teach their students to hate on use diploma and adn nurses, but it really needs to stop. first of all, we all have the same title, rn. some of us have more time put into our educations. i think that we need to stop this arguement here and now. we all do the same job out of school and then go from there. just because you have a bsn does not mean that you a better than anyone else, and the minute that you feel so i hope you are proven wrong.

if we didn't have diploma and adn programs, we would not have people in their 30's and 40's with families becoming nurses as their second career. we would not have economically disadvantaged people coming into the profession. we need to realize that diploma and adn programs help the nursing shortage. nursing is diverse. we should keep all educational options open.

now, on the lpn/lvn issue. that should not even be classified into the same categoy as this blog. they have a different scope and role than rn's. not sure if they informed you of that in your bsn programs or not. but they have a valuable role, especially in ltc. they are the ones passing medications and giving care to 30 or so patients. if you want to be the rn giving out 30 medications during the day, then continue with your argument to get rid of them. a nurse is a nurse is a nurse. end of story. if you prefer titles, then please identify yourself as a rn or lpn/lvn.

nursing is a profession. according to the oxford english dictionary - "a profession is a vocation founded upon specialized educational training, the purpose of which is to supply disinterested counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain"

marilynmom, LPN, NP · May 21, 2009

i hope that you pro-bsn people do not take offense to this. i am a diploma graduate. i went to a hospital-based nursing program, where we had a lot of theory and clinical packed into two years...
nursing concepts 1 & 2 - 8 to 16 hours of theory & 16 hours of clinical per week (15 weeks each)
med/surg (15 weeks) and specialities (8 weeks each) - 16 hours of theory & 16 hours of clinical per week
leadership & transitions - 24 hours of clinical for 6 weeks

i had more clinical hours than that in my bsn program. i always had at least 24 hours of clinicals a week for 2 years. my last semester when we did 36 hours a week of clinincals for leadership for 16 weeks.

now a year out and working in the real world, i feel all my "bookwork" and knowledge has helped me much more than my clinicals ever did---knowing and understanding the problem has served me far better than skills most anyone can learn after you do them a couple times.

i started in the icu as did a lot of my classmates and other new grads....i didn't know any who couldn't take a bp and most of us new grads pushed code drugs just fine thanks. and even if someone is struggling at first with something is that not ok? most of the medical residents i work with struggle everyday to learn and understand things too.

Mrs.BSN71109 · May 21, 2009

I hope that you pro-BSN people do not take offense to this. I am a diploma graduate. I went to a hospital-based nursing program, where we had a lot of theory and clinical packed into two years...
Now, I am not sure as to whether or not BSN programs teach their students to hate on use diploma and ADN nurses, but it really needs to stop. First of all, we all have the same title, RN. Some of us have more TIME put into our educations. I think that we need to stop this argument here and now. We all do the same job out of school and then go from there. Just because you have a BSN does not mean that you a better than anyone else, and the minute that you feel so I hope you are proven wrong.
Nursing is a profession. According to the Oxford English Dictionary - "A profession is a vocation founded upon specialized educational training, the purpose of which is to supply disinterested counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain"

Wow, I think you lost the point of this discussion. The question that was asked is whether still having ADN, and diploma nurses are preventing nursing from being seen as a profession. I do not doubt your education or that of an ADN this is not a BSN vs. ADN and Diploma nurses discussion. The fact remains that many people looking in do not respect nurses as they should because of the lack of clarity about how one becomes a nurse, which is the only point.

In my BSN program I was not taught to "hate" on ADN or diploma nurses I applaud everyone’s academic achievements however I wish nursing was more uniform so the profession can be seen as just that. Just as you quoted from the oxford dictionary it speaks of a "vocation founded upon specialized educational training, the purpose of which is to supply disinterested counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain" .... The point being all nurses do not get paid the same out of school and the educational training is not the same, so with that said where does that leave nursing. I do not suggest that ADN or Diploma nurses are not competent because during my many hours of clinicals I interacted with a majority of ADN nurse who were very knowledgeable.

And as far as not being impressed with BSN nurses, that’s unfortunate you had that experience, and perhapes that was just your individual finding. BSN nurses take 5 classes that set them apart:

* Leadership and Management

* Community Health

* Research

* Nursing Seminar

* Intro to Nursing

Yes there is a concentration on theory, however BSN programs require more clinical hours and have stricter requirements to remain accredited that other nursing programs, no that doesn’t make BSN nurses better, however it does make them more prepared for bed side nursing according to evidence based practice.

Multicollinearity, BSN, RN · May 21, 2009

Oh jeez. Here we go again.

I wish we had one educational path to RN licensure. I'm not saying what that one degree should be...just that it should be one, so the profession could be unified.

keljoromo · May 21, 2009

Hello All,

I graduated as an Associate Degree Nurse back in 1990 and I was definitely well prepared for bedside care and yes I ran circles around the BSN grads at the time. I am still an ADN although I will complete my BSN in December (yep, 19 years later).

My feeling is that although ADN and Diploma nurses are well prepared to be RNs (Diploma nurses generally being some of the best clinicians out there) I do believe that as we move into the future, nursing must move towards the BSN as a standard entry point in order fully emerge as a profession.

The leadership and professional engagement that the BSN programs encourage and foster are so necessary to the future of nursing. Individual nurses, especially those fabulous nurse experts at the bedside, must become vocal advocates for our profession and must become involved in shared governance and public policy.

For me, I didn't understand how much I needed the BSN until I started doing the BSN program and then I realized the pieces that I had been missing (I only started the BSN because I promised my Dad 20 yrs ago that I'd someday finish and well, since I'm in my 40s I figured now or never!)

IMHO, The ADN and Diploma make us great patient advocates, the BSN makes us great nursing advocates. To move towards the BSN entry anyone already in the profession would of course be grandfathered (respiratory therapy did this successfully with their on the job trainees in the 1980s). Perhaps ADN and Diploma programs could be continued but there would be a requirement that the BSN would be obtained within maybe 10 years of starting practice...any thoughts??

Keljoromo:specs:

keljoromo · May 21, 2009

P.S. I also think this issue will continue to divide nurses along ADN, Diploma and BSN lines and the division is great for hospitals and administration because it keeps us divided. I think a standard entry would be a unifying factor within nursing. Of course we would continue to specialize (yep just like doctors) with various certificates and masters programs.

keljoromo