let's pretend that we agree to disagree on the adn vs bsn debate and start all over again with nursing education. let's call it a "professional registered nursing degree program."
first, answer the poll question: do you believe that the rn's educational needs--both clinical and theoretical--are fully served by today's adn or bsn education programs?
then, tell us what types of courses today's nurse needs in order to be best prepared to enter the workplace.
You're not missing anything Deb, but it has been suggested to move more towards that type of program as opposed to a university/community college based program. Hospital programs have gone by the wayside in favor of university degrees. Primarily this started because of the move towards nurses taking over their own education, and getting away from hospitals that were using nursing students as cheap labor. Perhaps now that things have changed it might be time to move towards hospital-based diploma type programs again, and maybe get more clinical time in.
I've no opinion on that yet.
No, the solution is not to go back to diploma programs, but to advance forward as the other health care professions have done, and to move toward a BSN as the entry into practice and require an internship, before and after graduation to fine tune the clinical skills necessary to work in the field.
This has worked for ALL THE OTHER HEALTH CARE PROFESSIONS. If you haven't noticed, these other professions enjoy a much higher pay than nurses, and command far more respect that nurses do. Nursing is the only profession that seems to have an abundance of individuals who possess an attitude that they deserve the title of a professional but think that they shouldn't have to attain the education that other health care professinals have.
The other health care professional programs also contain classes that cover subjects like starting your own business, the politics of health care, etc. I think that these classes would greatly benefit nurses, as well as a class in Employment Law, and Administrative Law, like I took in the Legal Nurse Program. I had already left bedside nursing when I took this class, and I wish that I had taken it while I was still working. Nurses need to know how to use the law and learn what their legal rights are. Nurse are so naive when it comes to what their employment rights are, that we are easy pickings for adminstrators.
These are classes that "arm" nurses with the knowledge of how to maneuver around the management and administrators in the hospital. THEY take classes when they are in school, to learn how to manipulate the nursing staff. They also go to seminars to learn how to stop union activity, how to break the union when they have been voted in, and how to minimize and neutralize any power that the unions has accomplished and won.
This cannot be acomplished in a two year ADN or Diploma program. There is more to classwork for nursing than Anatomy, Biology, and Chemistry. These classes are also necessary to survive in the workplace, and if more nurses were educated in these matters, and knew how to work the system the way managers and administrators "work" the nursing staff, there would not be the rampant dissatisafaction in nursing that there is today.
There should also be more stringent methods, like personality tests, to screen out the "martyr marys" in nursing. Those who for years, have fought against nurses unionizing, taking more power in there practice, and feel that it is blaspheming to ask for more money and better benefits as nurses. These issues are the main reasons of new grads leaving the profession for greener pasteurs. Nurses who aren't more assertive in the workplace, and put up with disrespectful behavior, poor working conditions, etc. just continue the problems from generation to generation. We have never learned how to deal with these conditions, and how to work the legal aspects of the workplace.
New grads are looking at staying at bedside nursing for a minimun number of years, and are looking to get graduate degrees and have more control, and better pay for their work. Ask any nursing student what their long and short term goals are. It is not staying at bedside nursing or remaining with only a diploma or ADN degree. I have. I was also originally a diploma grad and learned really quick who was at the bottom of the food chain. It was the nursing staff, hand down.
We will never have any power because we have never learned how to play the game.
The other health care professional programs also contain classes that cover subjects like starting your own business, the politics of health care, etc. I think that these classes would greatly benefit nurses, as well as a class in Employment Law, and Administrative Law, like I took in the Legal Nurse Program. ...
These are classes that "arm" nurses with the knowledge of how to maneuver around the management and administrators in the hospital. THEY take classes when they are in school, to learn how to manipulate the nursing staff. They also go to seminars to learn how to stop union activity, how to break the union when they have been voted in, and how to minimize and neutralize any power that the unions has accomplished and won.
Just to amplify... There should be other courses such as interpersonal communication and group dynamics, principles of management and supervision, cultural diversity in the workplace, to name a few. While having the bedside data down, it doesn't do much good if you can't work with others or struggle with cultural nuances with patients.
Also, I suspect that at least at the line management level, the supervisors are promoted from within the ranks. Just looking at some of the threads on this board, you see scads of posts regarding the meatheads that are running the place. If you start inculcating the rising nurses in basic managment and supervision, perhaps they'd be better prepared to do that work. And even if they never wish to enter the management ladder, then having a working knowledge of how management thinks will help immensely in negotiating problem resolution.
These sorts of considerations are why I suggested that using the NCLEX exam as the be-all-end-all goal for nursing programs was short of the mark. Certainly, you want nurses entering the field to be squared away so they will cause no harm to the patients. But that strikes me as a minimalist goal. Isn't it also a requirement to bring them into the field with the knowledge that will facilitate into a more effective workforce?
Just to amplify... There should be other courses such as interpersonal communication and group dynamics, principles of management and supervision, cultural diversity in the workplace, to name a few. While having the bedside data down, it doesn't do much good if you can't work with others or struggle with cultural nuances with patients.
Excellent suggestions. People are so keen an students being able to do tasks like start IVs, do foley's etc. That's only part of what nurses do.
I think there are bits of truth in everyone's posts here. But for the life of me, having a "manager" who went the Diploma-ADN-BSN-MSN route and had no clinical time other than what they had in school, is just crazy! They may be book-smart but have no idea whatsoever what nurses are really facing. They are part of the problem when they should be an advocate for the nurses they are managing.
They cannot have a clue about what two fresh post-op admits does to the nurse's load and the patient care of his/her assigned load. If only one of any of those patients needs anything other than what the books say they would need, well, the shift, the patient care, the time to give just plain attention to the patients, is totally gone. Because the paperwork is going to drown them and I go again to JACHO requirements and keeping them and the litigators happy.
Someone reminded me the other day of what chart papers we had in the old days: Doctors' order sheets; I & O sheet; meds; and long notes. There are so many things to keep track of now, patient care suffers, IMHO! And the very mention of JACHO implies a threat of "losing our accreditation" if we don't comply to every little, and I do mean little, new thing they decide to impose upon us.
If a nurse wants to follow the track to attach more of the alphabets behind their name, power to them. But there should be a prerequisite of several years of "real" nursing before they are even considered for such a program, unless they are entering a research program where there's no patient care involvement or another field where they won't be in the position of negatively affecting practicing floor nurses who are running their a**es off, trying to do what someone else says they can do in a finite amount of time.
No, the solution is not to go back to diploma programs, but to advance forward as the other health care professions have done, and to move toward a BSN as the entry into practice and require an internship, before and after graduation to fine tune the clinical skills necessary to work in the field.
This has worked for ALL THE OTHER HEALTH CARE PROFESSIONS. If you haven't noticed, these other professions enjoy a much higher pay than nurses, and command far more respect that nurses do. Nursing is the only profession that seems to have an abundance of individuals who possess an attitude that they deserve the title of a professional but think that they shouldn't have to attain the education that other health care professinals have...
There should also be more stringent methods, like personality tests, to screen out the "martyr marys" in nursing. Those who for years, have fought against nurses unionizing, taking more power in there practice, and feel that it is blaspheming to ask for more money and better benefits as nurses. These issues are the main reasons of new grads leaving the profession for greener pasteurs. Nurses who aren't more assertive in the workplace, and put up with disrespectful behavior, poor working conditions, etc. just continue the problems from generation to generation. We have never learned how to deal with these conditions, and how to work the legal aspects of the workplace.
Lindarn, BSN, CCRN
I agree with Lindarn. Nursing Academics have been trying to make a B.S.N. the standard for forty years. Other professions seem to be able to freely change their education requirements whenever they choose, where as nurses get violent opposition when they try to do so. I have to wonder, who is trying to keep nurses from getting a higher eduaction?
I recently read Nursing Against the Odds , and the author, Suzanne Gordan, talks about how the nursing profession would benefit if a college degree became the standard for nurses. Gordan argues that the "lack of education" card has been played as an excuse to pay nurses less than they are woth, and subject them to terrible working conditions. I'm not making some sweeping overgeneralization, arguing that a B.S.N. would solve all of nursing's problems. I do, however, believe it would be a step in the right direction. Teachers (who used to need only an A.A.) dicovered that by raising their eduaction requirements to a B.A., they greatly served their own professional and economic interests. Why not nurses?
I've been told by other nurses that I'm "wasting" my time on a college degree, and that I "don't need" all those "fluff" classes (History, Philosophy, etc.) that are going towards my B.S.N. Quite frankly, I'm very disturbed by the lack of respect for higher education expressed by these individuals. If somebody wants to go for an A.D.N. or diploma, great...but I'm sick of being told that there's a "better way" to become a nurse other than the path I've chosen, and that a B.S.N. is nothing more than "elitism."
Please keep in mind, I'm not attempting to disparage anyone, or imply that nurses who do not have a B.S.N. are not good good nurses. I'm respectfully stating my opinions for everybody's consideration
Many people are uninformed enough to think that anyone can be a nurse... why not set them straight? (I love to see the looks on their faces when I say that three Ivy League schools have...gasp...nursing programs.)
I'm slowly becoming aware that I'm one of the types hospitals despise...I'm assertive, certianly not a martyr. I think it would serve the profession if martyrism was discouraged. This is not suggesting that nurses shouldn't be compassionate, but one does not need to be a door mat in order to be compassionate. Total self-sacrifice never makes anyone a better person. Nurses need to take care of themselves, first and foremost.
I think that these classes would greatly benefit nurses, as well as a class in Employment Law, and Administrative Law, like I took in the Legal Nurse Program. I had already left bedside nursing when I took this class, and I wish that I had taken it while I was still working. Nurses need to know how to use the law and learn what their legal rights are. Nurse are so naive when it comes to what their employment rights are, that we are easy pickings for adminstrators.
These are classes that "arm" nurses with the knowledge of how to maneuver around the management and administrators in the hospital. THEY take classes when they are in school, to learn how to manipulate the nursing staff. They also go to seminars to learn how to stop union activity, how to break the union when they have been voted in, and how to minimize and neutralize any power that the unions has accomplished and won.
I think these are excellent suggestions that need to be included in any nursing program.
Again, I'm reminding everyone to just think in terms of what nurses need, and really try to forget what other professions do or what regulations colleges want fulfilled. Forget ADN. Forget BSN. Forget Diploma.
The real question is: Has the debate over which educational program is best for professional nurses become irrelevant? Because what we're hearing from the new grads themselves is that all of them fall far short of what the new grad really needs to know.
I think one of the sources of this problem is quoted earlier--too many other institutions have been allowed to define the nursing profession and chart its course.
As I read your responses, I can't help but notice that no one disagrees that there's such an animal as too much clinical. It seems to be the Gen. Ed. requirements that everyone is disagreeing about here--how much is too much? how little is too little?
And who defines that? Colleges? Hospitals? Community need? Or nurses?
And if nurses are not deciding the profession's fate, we can't really be said to be autonomous, can we?
Specializes in ICU, PICC Nurse, Nursing Supervisor.
I think we could do without some of the general ed classes like History, Gov and PE (:barf01: for heavens sake). I dont need this crap to be a well rounded nurse.. What I do need is courses on legal issues in nursing or more clinical time in a more diverse atmosphere. Maybe more courses that really focus in on a certin part of nursing like Emergency nursing or Hospice.... I know some of you will disagree with this but I dont think we need such a intense course as algebra (which I am taking now and it sux more than anything that has ever sucked before). This could be replaced by a course created specially for nurses and it could focus on just what we need . Instead I sit day by day through piecewise functions ,logs, composition and inverse functions:barf01: :barf01: ...
I could list PLENTY of "nursing" components in the OR, and i'm not even an RN! (But i won't since i'm on call and i need sleep in a bit)
Taking into consideration that there are at least 7 school in this area i live in, and all of them have days in the OR.
Yes, we have LPN students come to the OR but they only observe - a totally passive experience. Please give me an example of higher order nursing judgement being used during an operation (i.e. critical thinking skill applied to emotional or physical needs of the patient.)
Please give me an example of higher order nursing judgement being used during an operation (i.e. critical thinking skill applied to emotional or physical needs of the patient.)
Perhaps if this were in the OR/Periop board, i would.
The canadian's have the right idea! My LVN program had a month at the end of the program of nothing but one on one preceptorship. It REALLY makes a big difference. I had ADN and BSN grads on orientation with me once we got hired, and they all couldn't believe the skills, confidence and compitency that the graduate VN's had. This concept would be great to put into the RN programs! The ADN and BSN programs need to learn something from the LVN programs, and focus more on real life learning! LVN programs have few pre-reqs and focus highly on clinical skills and critical thinking. This aspect definately needs to be implemented more in the ADN and BSN programs, less on the general eds and research, management, etc. Putting a nursing student through a management class is not going to place them in a management position if they do not have the personality/experience/professionalism to take that role!!!! As an ADN student I can honestly say the same problems are evident in LVN ADN and from what I hear BSN programs.
I would like to see any BSN progam be 5 years because I do not think these programs give their students enought hands on experience. They put their students at a decided disadvantage.
I know a hospial recruiter here who makes several resruiting trips to Canada every year to recruit RN's. You know why? She said that Canadian RN graduates have an entire semester (at the end of their training) of all clinical so by the time they graduate, they can work effectively on a floor and it is as if they have already had a real solid orientation to actual nursing. They are much more comfortable stepping into a patient assignment.
I think the idea of all BSN nurses was a stab at making nursing look "more professional" to the lay person. I think it backfired, frankly.
I would encourage any potential nursing student to ultimately get a college degree: BSN or otherwise. I have a non-nursing Bachelor's, because nursing was my second career. But instead of a BSN, I have chosen to enhance my education with advanced certifications in my field. These are a whole lot more helpful to me and what I want for a career.
Everyone's needs are different. I truly also feel that NO ONE should become an administrator until he/she has done extensive floor nursing. You can't be an effective leader (or professor) until you know how to be a "real nurse." The last person who should be making decisions for nurses are nurses who are clueless and so many top level administrators are truly clueless. Some have never done much if any patient care. Don't get me started..........
Bottom line is that a BSN for all nurses is NEVER going to make our profession look better. Until nurses learn how to stand up for themselves and out profession, nothing will change, regardless of the path one has chosen to nursing.
In Australia, nurses have a one year residency following a four year program. I know that some hospitals are experimenting with this idea here in the U.S. I think residency programs would make a world of difference. New grads are just thrown onto the floors after finishing school. Physicians are not just thrown out and expected to be up and running right after they graduate. Why should nurses?
There's nothing in my B.S.N. program that I think I could do without. I'm getting a great deal of clinical time, spread out over three years, and a very well-rounded education to boot.
Just to amplify... There should be other courses such as interpersonal communication and group dynamics, principles of management and supervision, cultural diversity in the workplace, to name a few. While having the bedside data down, it doesn't do much good if you can't work with others or struggle with cultural nuances with patients.
Also, I suspect that at least at the line management level, the supervisors are promoted from within the ranks. Just looking at some of the threads on this board, you see scads of posts regarding the meatheads that are running the place. If you start inculcating the rising nurses in basic managment and supervision, perhaps they'd be better prepared to do that work. And even if they never wish to enter the management ladder, then having a working knowledge of how management thinks will help immensely in negotiating problem resolution.
These sorts of considerations are why I suggested that using the NCLEX exam as the be-all-end-all goal for nursing programs was short of the mark. Certainly, you want nurses entering the field to be squared away so they will cause no harm to the patients. But that strikes me as a minimalist goal. Isn't it also a requirement to bring them into the field with the knowledge that will facilitate into a more effective workforce?
I don't dispute the value of the skills you mention--as Tweety observes, starting IV's and Foleys is just part of what we do, but I do question the need for college-level management courses for entry-level nurses. I'm learning--sometimes the hard way--that every RN is a manager, but I learned the academic side of that in a chapter of my nursing course and a bit more in my "Trends" course, which dealt more with delegation, career development, etc.
What I'm learning now are the "real world" dynamics, which are mostly a matter of not being so focused on what I'm doing that I fail to notice what my co-workers are up to. (For example, I need to inform my aides that if I'm hogging the chart, it's okay to smack me upside the head. I'm lucky in that I think they know I'm not "too good" to help with baths and toileting and such. I did it a lot before I was a nurse, and I'll do it more when I'm only up to my knees in alligators.)
I do think a course like I had is important, but I question whether even a BSN needs "Principles of Management" type courses, or more than a lecture or two on cultural sensitivity.
I sure don't think matters that are essentially political, like pro-union or whether nursing is a "sacred calling" are of any relevence as to whether one is a competent practitioner.
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lindarn
1,982 Posts
No, the solution is not to go back to diploma programs, but to advance forward as the other health care professions have done, and to move toward a BSN as the entry into practice and require an internship, before and after graduation to fine tune the clinical skills necessary to work in the field.
This has worked for ALL THE OTHER HEALTH CARE PROFESSIONS. If you haven't noticed, these other professions enjoy a much higher pay than nurses, and command far more respect that nurses do. Nursing is the only profession that seems to have an abundance of individuals who possess an attitude that they deserve the title of a professional but think that they shouldn't have to attain the education that other health care professinals have.
The other health care professional programs also contain classes that cover subjects like starting your own business, the politics of health care, etc. I think that these classes would greatly benefit nurses, as well as a class in Employment Law, and Administrative Law, like I took in the Legal Nurse Program. I had already left bedside nursing when I took this class, and I wish that I had taken it while I was still working. Nurses need to know how to use the law and learn what their legal rights are. Nurse are so naive when it comes to what their employment rights are, that we are easy pickings for adminstrators.
These are classes that "arm" nurses with the knowledge of how to maneuver around the management and administrators in the hospital. THEY take classes when they are in school, to learn how to manipulate the nursing staff. They also go to seminars to learn how to stop union activity, how to break the union when they have been voted in, and how to minimize and neutralize any power that the unions has accomplished and won.
This cannot be acomplished in a two year ADN or Diploma program. There is more to classwork for nursing than Anatomy, Biology, and Chemistry. These classes are also necessary to survive in the workplace, and if more nurses were educated in these matters, and knew how to work the system the way managers and administrators "work" the nursing staff, there would not be the rampant dissatisafaction in nursing that there is today.
There should also be more stringent methods, like personality tests, to screen out the "martyr marys" in nursing. Those who for years, have fought against nurses unionizing, taking more power in there practice, and feel that it is blaspheming to ask for more money and better benefits as nurses. These issues are the main reasons of new grads leaving the profession for greener pasteurs. Nurses who aren't more assertive in the workplace, and put up with disrespectful behavior, poor working conditions, etc. just continue the problems from generation to generation. We have never learned how to deal with these conditions, and how to work the legal aspects of the workplace.
New grads are looking at staying at bedside nursing for a minimun number of years, and are looking to get graduate degrees and have more control, and better pay for their work. Ask any nursing student what their long and short term goals are. It is not staying at bedside nursing or remaining with only a diploma or ADN degree. I have. I was also originally a diploma grad and learned really quick who was at the bottom of the food chain. It was the nursing staff, hand down.
We will never have any power because we have never learned how to play the game.
Lindarn, BSN, CCRN