Should BSNs be paid more?

[edcampbe]

I know ADNs and BSNs both sit for the same NCLEX exam, both have approximately four years of education, and at best have negligible differences (over time) in their nursing skills. BSNs take courses than broaden their overall knowledge; however, ADNs have more clinical experience prior to entering the workforce. Should there be a differential for BSNs, or should the reward for obtaining a BSN lie in the ability to advance one's career?

I'm not trying to start an ADN vs BSN bashing, I'm just curious to see what you all think.

[Spidey's mom, ADN, BSN, RN]

Shhh... Don't tell, but I've never done a rectal temp and I've been a nurse for years...

Ok, NOW back to the topic.... :chuckle

Shhhh . . .don't tell but I did a rectal temp last week and I've been a nurse for 7 years. One of our docs insists on initial rectal temps for newborns and for babies who come into the ER.

What was the topic? :)

Oh yeah, should BSN's be paid more than nurses with an AA Degree? No, not if they are doing the same job.

steph

[SmilingBluEyes]

I do rectal temps rather frequently....

on newborns.

[SmilingBluEyes]

woops I digressed dint I?

[underwatergirl]

Ali gator,

As a patient that is what I have seen every time. I am not lieing to you about it, to even post something like that on this board would be as good as being dead. So I would only do it to shed some light on situations. I DO BELIEVE there are excellant BSN nurses out there and as stated I have met some as a co-worker...I can only wish to meet some as a patient in the future. I do agree there is good and bad at every level of nursing.

I am truelly sorry to the nurses I have offended, I just want to share my personal experience with you all. Again I know they are out there, I just wanna met it as a patient.

Now back to the BSN entry level...perhaps I am fighting with a group for the wrong causes but this is what I see happening if entry level BSN was put into play...

First off, huge huge nursing shortage, even after the baby boom, and schools attempt to send out those nurses.

I see the problem of nursing shortage only continue...because how many classmates have you nurses had that are no longer in nursing, because it wasn't what he/she expected...So instead of ideally at 2 yr program and nurse spends 4 years in school, only to have them leave the profession.

Ok lets talk about pay...if you compare nursing with other careers, even one's that require a BSN, we are by far the top of the pay scale...we do make good money, Now I AM NOT SAYING, we shouldn't make more...but making a BSN entry level, one of two things will happen, nurses still won't stand up and fight for better treatment, we must unit, you think by going to all BSN that will happen??? I don't think so at all, we still kill our young and demoralize our co-workers, why would we unit. Another thing that could and most likely will happen, is by putting all nurses on the same level, instead of competition with pay/benefits...there will be one solid go around. Your a new nurse you get this...no matter where you work in a given location. I like the competiveness. I like knowing that, I will very likely be able to fight for my edge at this point in time with nursing, I like that very much so.

The biggest thing it seems nurses want is respect...that only leads to better working conditions. Again respect is something that is earned. But in addition to that...lets look at this...if we keep the different levels of nursing, we will have more nurses to lobby for better working conditions, to inform and show the public of our value. If we go to only BSN entry level...what happens with patient care...how overworked will be? It isn't the education that makes or breaks our respect and working conditions, it is us UNITING to demand better. Just because your a BSN, an employer isn't going to treat you any different or better...that respect that nurses deserve will only come with making the public aware of our valued roles in healthcare...not an entry level degree.

This entry level of nursing does impose on LPN's, we are still nurses...we still have many capabilities that most RN's don't recognize us for...if you go to entry level nursing...that means...LPN's are now CNA's and maybe MA's. Because what are core things in a nursing job...assessment, medications, treatment and patient advocacy. A LPN can assist with assessment, some they can do by themselves(not initial assessment). LPN's can adm. medications, even now they are training for IV pushes with Meds. LPN's can do several treatments...in fact I can't think of any except in severly acute care settings or NG insertion...which guess what...the hospital across the street from me, has LPN's doing those to. Now where are there RN's...well they are doing great things like total patient assessment...there time is utilized best there, I think that is good, because it is the RN's knowledge base regarding A&P that can help or break an assessment. Don't get me wrong, us LPN's are capable too, but I feel as if a patient with several major disease process occuring, should have an RN doing that assessment, if I am assigned to do, I will check everything abnormal with my RN. So if we go to entry level nursing...the state's legislation will include things such as med pass and tx...possible even ADL's. So I feel that would be wasting the time of our highly intellegant skilled RN's...not that he/she isn't capable or doesn't want to...I just like to see nurses used in facilities where their skills are used to the fullest extent. That to me a team nursing...a CNA, (possibly) MA, LPN, RN, and Physician....everyone's capabilities are used to the fullest extent.

Now lets look at the economy...you go to entry level BSN, how many nurses are out of work, RN-ADN's and LPNs...regardless of what you say it will affect us too...Look at nursing homes, what nurse is of the highest usage and demand for those...that would be LPN's...so if an LPN can no longer be a nurse due to this new entry level of nursing then he/she looses his or her job...nursing homes are in serious demands of nurses. Honestly, with a RN Charge, a nursing home is very capable of the use of LPN's as the team leaders/nurses for patients. Due to the chronic patient health. I still feel there should always be an RN in house, but we won't go there...Annette doesn't agree with many nursing homes due to those issues.

What I think alot of people are missing...is we can have that respect and edge on professionalism that so many of us want, we can have it right now...what it takes is nurses uniting...standing up...making the public aware. I would love to publish a nursing chronical...such as "A day in a nurses life" In that chronical, include the behind the scenes things patients don't see, you advocacy for them, the healthcare process, the demands put on nurses, facilities overworking nurses. The fact that everyday we expose ourselves to countless germs, infectious diseases, patient violence, patient hatred towards us...we already deserve the respect and professionalism...EVERY level of nursing deserves that...but the public doesn't see us, they only see one aspect of it.

I constantly have debates with friends of mine regarding what he/she has percieved from a nurse and the way the healthcare team should work. You know 9/10 they don't realize how many patients a nurse has...or the fact that you give them instructions and they don't follow it and now they are not better but some how that is your fault. Many patients are so clueless as to the nursing profession...Seriously ask your family and friends who are not involved in healthcare...right there you shall see the reason why we are not respected.

Again, I don't agree with entry level nursing cause it will affect everyone, including CNA's, MA's and LPN's and esp. the RN-ADN's. Realistically it is impossible for at least another 20 years due to the baby boom.

You know I gotta say this, I love debates...I love the way all of nurses are going head to head with each other on this...it is very eye opening and amazing...I love seeing different opinions and aspects in nursing.

Annette

[underwatergirl]

Wow beginning to realize how much I can type...LOL

I did want to tell you guys this...in my practical nurse program...there was a mandatory requirement for each skill or assessment to be performed. If that clinical time didn't present that oppurtunity, we returned when the oppurtunity was presented....

Before I finished school, I think I had to do well over 100 injections, 5 foley caths, on female and male, 10 drsg changes of each sterile and nonsterile, do countless med passes....we had to go back to a clinical rotation to complete those task...I liked it, it was well worth it. Now doing foley caths is like nothing...just like IV's...I worked in an outpatient surgery center I was the pre-admissions nurse, from EKG's to Phelebotomy, to IV insertion...I did so many I think I can do them in my sleep now...LOL

So I guess I am kinda of amazed that the RN programs don't mandate those things at all. But with the right preceptor a new grad nurse can have a good start as a nurse.

Annette

[sbic56, BSN, RN]

So, what's the difference between an oral and a rectal thermometer? Joke... and don't ask; I'm not telling (here)

[SmilingBluEyes]

[quote name=underwatergirl

Before I finished school, I think I had to do well over 100 injections, 5 foley caths, on female and male, 10 drsg changes of each sterile and nonsterile, do countless med passes....we had to go back to a clinical rotation to complete those task...I liked it, it was well worth it. Now doing foley caths is like nothing...just like IV's...I worked in an outpatient surgery center I was the pre-admissions nurse, from EKG's to Phelebotomy, to IV insertion...I did so many I think I can do them in my sleep now...LOL

So I guess I am kinda of amazed that the RN programs don't mandate those things at all. But with the right preceptor a new grad nurse can have a good start as a nurse.

Annette

Well frankly the clinical/technical experience sounds like my RN program (ADN). We did LOTS of procedures in clinicals----we had plenty of time to practice, doing 12 hour shifts for 2 semsters, and 8s during the other 3.........

But let's face it....RN's are not techincal nurses........technical skills can be picked up in practice. The "whys" are AT least as important as the "how", IMO. So, many RN programs focus a lot more on those "why's" (rightly so) as the "hows" can be picked up quite quickly on the job.

[underwatergirl]

Well frankly the clinical/technical experience sounds like my RN program (ADN). We did LOTS of procedures in clinicals----we had plenty of time to practice, doing 12 hour shifts for 2 semsters, and 8s during the other 3.........

But let's face it....RN's are not techincal nurses........technical skills can be picked up in practice. The "whys" are AT least as important as the "how", IMO. So, many RN programs focus a lot more on those "why's" (rightly so) as the "hows" can be picked up quite quickly on the job.

I agree with you 100%, but as in perfecting those technical skills we are also learning and understanding the whys.

It isn't the procedure but rather the rational behind it, including the implications.

[TRichter]

Thank you on behalf of those not here to defend themselves ie. aids and vocational nurses. I was both. I have worked my way up the latter by advancing my education, and along the way have gained much respect for those in the formentioned jobs. However, from the research I am doing it does look like we need to step up the education level. What happened to schools granting you admission into the program on merit, not by a so-called drawing or first-come first-in bases. Everyone, in any field, should be rewarded for advancing their aducation and for the hard work and respect they have earned. By reading some of these posts, I feel this is where we, RNs, get the reputation of eating our young and being difficult to work with. We should all be working towards the same thing, great patient care and compassion.

Also, I agree that doing vitgals, and bad baths are part of the job of RNs if they have the time. I always help my aids and LVNs if I can, THAT is TEAMWORK! When I was an LVN, I actually had a RN who said that taking vitals was not her job, she sat and read a magazine while I did the work. I will never forget how that made me feel, and vowed I would never make an aid or LVN feel they were any less important than myself. After all, we could not do our job as well or as complete if not for their help.

BSN as entry to practice has nothing to do with LPNs or CNAs, so I don't see any reason to even discuss them as far as this issue is concerned. It wouldn't affect them at all.

It's now the reality in my home province that all new RNs will be BSNs and yes, they do baths, vitals, pass meds, etc sometimes alone, sometimes with the help of LPNs and NAs. Their education doesn't put them above those tasks. LPNs and NAs are not affected by the BSN requirement because they are not RNs.

[TRichter]

If you decide to start publishing that paper or writing articles I want to know, I will be right beside you. I fight all the time for my patients. A few times the surgeon refused to listen to me, so I called the NP on the surgical team to come see the patient. The NP agreed with my assessment and called the Attending surgeon and the surgeon who would not listen in to see the patient. The patient had had an nonruptured appy, but the incision from the laporoscopy site had abcessed and the surgeon wanted thepatient discharged. Other times a fight for pain meds, PT, OT consults and the list goes on and on. I have even gone as far as telling a parent to call in an endocrinologist over the general peds head. Pediatritions were furious, said I over stepped, but my Nurse Manager said that I was advocating for the best care of my patients, the docs put tail between legs and walked away. We need to find places to wirte such articles, writing for nursing magazines willnot help. Nurses Know what Nurses do. The public needs to be educated about the many roles we play on their behalf. So again, I am going to talk to the local papers and go from their. Lets educate the public

Ali gator,

As a patient that is what I have seen every time. I am not lieing to you about it, to even post something like that on this board would be as good as being dead. So I would only do it to shed some light on situations. I DO BELIEVE there are excellant BSN nurses out there and as stated I have met some as a co-worker...I can only wish to meet some as a patient in the future. I do agree there is good and bad at every level of nursing.

I am truelly sorry to the nurses I have offended, I just want to share my personal experience with you all. Again I know they are out there, I just wanna met it as a patient.

Now back to the BSN entry level...perhaps I am fighting with a group for the wrong causes but this is what I see happening if entry level BSN was put into play...

First off, huge huge nursing shortage, even after the baby boom, and schools attempt to send out those nurses.

I see the problem of nursing shortage only continue...because how many classmates have you nurses had that are no longer in nursing, because it wasn't what he/she expected...So instead of ideally at 2 yr program and nurse spends 4 years in school, only to have them leave the profession.

Ok lets talk about pay...if you compare nursing with other careers, even one's that require a BSN, we are by far the top of the pay scale...we do make good money, Now I AM NOT SAYING, we shouldn't make more...but making a BSN entry level, one of two things will happen, nurses still won't stand up and fight for better treatment, we must unit, you think by going to all BSN that will happen??? I don't think so at all, we still kill our young and demoralize our co-workers, why would we unit. Another thing that could and most likely will happen, is by putting all nurses on the same level, instead of competition with pay/benefits...there will be one solid go around. Your a new nurse you get this...no matter where you work in a given location. I like the competiveness. I like knowing that, I will very likely be able to fight for my edge at this point in time with nursing, I like that very much so.

The biggest thing it seems nurses want is respect...that only leads to better working conditions. Again respect is something that is earned. But in addition to that...lets look at this...if we keep the different levels of nursing, we will have more nurses to lobby for better working conditions, to inform and show the public of our value. If we go to only BSN entry level...what happens with patient care...how overworked will be? It isn't the education that makes or breaks our respect and working conditions, it is us UNITING to demand better. Just because your a BSN, an employer isn't going to treat you any different or better...that respect that nurses deserve will only come with making the public aware of our valued roles in healthcare...not an entry level degree.

This entry level of nursing does impose on LPN's, we are still nurses...we still have many capabilities that most RN's don't recognize us for...if you go to entry level nursing...that means...LPN's are now CNA's and maybe MA's. Because what are core things in a nursing job...assessment, medications, treatment and patient advocacy. A LPN can assist with assessment, some they can do by themselves(not initial assessment). LPN's can adm. medications, even now they are training for IV pushes with Meds. LPN's can do several treatments...in fact I can't think of any except in severly acute care settings or NG insertion...which guess what...the hospital across the street from me, has LPN's doing those to. Now where are there RN's...well they are doing great things like total patient assessment...there time is utilized best there, I think that is good, because it is the RN's knowledge base regarding A&P that can help or break an assessment. Don't get me wrong, us LPN's are capable too, but I feel as if a patient with several major disease process occuring, should have an RN doing that assessment, if I am assigned to do, I will check everything abnormal with my RN. So if we go to entry level nursing...the state's legislation will include things such as med pass and tx...possible even ADL's. So I feel that would be wasting the time of our highly intellegant skilled RN's...not that he/she isn't capable or doesn't want to...I just like to see nurses used in facilities where their skills are used to the fullest extent. That to me a team nursing...a CNA, (possibly) MA, LPN, RN, and Physician....everyone's capabilities are used to the fullest extent.

Now lets look at the economy...you go to entry level BSN, how many nurses are out of work, RN-ADN's and LPNs...regardless of what you say it will affect us too...Look at nursing homes, what nurse is of the highest usage and demand for those...that would be LPN's...so if an LPN can no longer be a nurse due to this new entry level of nursing then he/she looses his or her job...nursing homes are in serious demands of nurses. Honestly, with a RN Charge, a nursing home is very capable of the use of LPN's as the team leaders/nurses for patients. Due to the chronic patient health. I still feel there should always be an RN in house, but we won't go there...Annette doesn't agree with many nursing homes due to those issues.

What I think alot of people are missing...is we can have that respect and edge on professionalism that so many of us want, we can have it right now...what it takes is nurses uniting...standing up...making the public aware. I would love to publish a nursing chronical...such as "A day in a nurses life" In that chronical, include the behind the scenes things patients don't see, you advocacy for them, the healthcare process, the demands put on nurses, facilities overworking nurses. The fact that everyday we expose ourselves to countless germs, infectious diseases, patient violence, patient hatred towards us...we already deserve the respect and professionalism...EVERY level of nursing deserves that...but the public doesn't see us, they only see one aspect of it.

I constantly have debates with friends of mine regarding what he/she has percieved from a nurse and the way the healthcare team should work. You know 9/10 they don't realize how many patients a nurse has...or the fact that you give them instructions and they don't follow it and now they are not better but some how that is your fault. Many patients are so clueless as to the nursing profession...Seriously ask your family and friends who are not involved in healthcare...right there you shall see the reason why we are not respected.

Again, I don't agree with entry level nursing cause it will affect everyone, including CNA's, MA's and LPN's and esp. the RN-ADN's. Realistically it is impossible for at least another 20 years due to the baby boom.

You know I gotta say this, I love debates...I love the way all of nurses are going head to head with each other on this...it is very eye opening and amazing...I love seeing different opinions and aspects in nursing.

Annette

[TRichter]

It's never too late to learn. Find someone gracious enough to help, offer to do the procedures for a nurse that real busy. Teamwork is the key. We can only learn so much in school in that amount of time. I try to make it a point to learn something every day at work, even it is just a small something.

I agree with you 100%, but as in perfecting those technical skills we are also learning and understanding the whys.

It isn't the procedure but rather the rational behind it, including the implications.

[RainDreamer, BSN, RN]

During my first year of nursing school I was worried to death that I wasn't going to know enough after graduation, I felt in 2 short years there was no way I'd know enough to be able to be a nurse.

Then one of my dear instructors told me that passing the NCLEX gives you a license to LEARN, it's ok if you haven't mastered all the skills, etc before graduation because it's impossible to "know it all" once you graduate.

So ADN and BSN both pass the NCLEX, right? Ok, so that gives us the license to learn once we start working.