It used to be that nurses did not have to go to college; we were instead trained by hospitals. Then the education requirement changed and community college replaced hospitals. And now, it is changing to that some hospitals will only hire nurses with college degrees. Undoubtedly, the education requirement will continue to increase in the future.
The downside to this is that it will make this profession harder to get into. And those who are in the profession will constantly need to adapt by going back to school. The upside to this is that it will provide us with more skills to do a better job.
you seem to have economics confused with a hard science, when in fact it's more like a soft science crossed with a religion. Why did take physicists to figure out that behavioral economics matters, that there is a point at which increasing leverage leads to instability and so on? There are very technical subjects within economics, but when random Internet folks (even if they're nursing grad students) start throwing around generalities like "the free market" (with the implication that it always does so-and-so), then the conversation is about to go off the rails.
In all of your studies, have you pondered the peculiar incentives that drive the American healthcare system?
Is there a healthcare system in the industrialized world that's less regulated than the American healthcare system? Is there a healthcare system that costs much more than half per capita what we spend? How many of them have equivalent or worse outcomes, statistically?
Who mentioned free market?
You answered my question anyways, thanks for playing.
Specializes in ER - trauma/cardiac/burns. IV start spec.
I have a question for all those that think BSN entry should be required for all nurses. How are you going to advance professionalism in the nursing field when our scope of practice is determined on a state by state basis? When I graduated the only place I could work with my license was in one of 3 states, I could not have gone to say Nevada without retaking that states boards. Our nursing scope of practice differs by location and by hospital. My state board says that RN's can suture but the hospital I worked for would not let us do any suturing. That fact was not lost on our ER Docs, they tried to get the hospital to let us suture but the hospital refused even though the Docs were willing to foot the bill for the "class". There is no national "scope of practice for nursing" perhaps that is the first change that should be addressed.
As I have stated before I have my ASN from the nursing school run by a University. Critical thinking and time management were drilled into us from the first day. We had to write papers and do research. When we began clinicals (and we had classes during the same time frame) we had to know about every medication we were dealing with - if you blew your medication preview you received a critical zero and risked getting kicked out of the program. 2 critical zeros and not only were you out of the program you could NOT return for a minimum of 1 year (providing that there was an opening).My paper on PTSD became part of the future psych classes. One of my patients during general clinical round was very confusing so I had to do some major digging into her medical history; nothing was adding up; found out that she had neurosyphilis. My clinical instructor had held that part of her info back from me to see if I could "do some critical reasoning" as to her diagnosis. I tell you this as there seems to be a train of thought that ASN/ADN's do not have these skills, that these skills are for BSN trained nurses.
In my area the 4 year program has a passing rate of 86% the 2 year has a 100% passing rate (for the NCLEX) and the students from the BSN graduated without hands on experience, no direct patient care prior to graduating. When they came into the hospital that put them far behind the curve. As I said before one BSN in the ER was too afraid to work a code after 12 weeks of orientation, 7 on nights. She was not going to be alone, she was part of the code team but she broke down because she was not ready. It was not the first code she had been in on but it was the first one she was going to actually have to work. Other nurses (ASN) were running the codes after that same time frame. She was not the first BSN to have problems with the ER but she left because she was "not comfortable" with the protocols. We had other BSNs that left because they were not put in charge. It seems that, at least in my experience, most BSNs think they are better than the rest of us because they have more education.
Obviously not all nursing programs are equal either. Perhaps before you MANDATE an entry level education the education should be standardized. But again before the education is standardized perhaps the Scope of practice for nurses should be standard no matter what state you work in.
Professionalization of nursing has nothing to due with clinical practice.
With all due respect, "professional" is a squishy concept. Are entry level generic business people professional? If not, do they cross some threshold of professionalism at some point in their advancement? How about people who own their own businesses? Do they need a specific number of employees? If they're independent consultants, is it a function of their hourly rate? Does education play a part? Is Bill Gates, an undergrad dropout, less professional than an MBA? Than an MSW? Or is it different for a skills-oriented job, like nurse, MD, or commercial scuba diver?
Is the point really to form a modern guild, where there are barriers to entry, which keeps the practitioners' population small and thus salaries high, and gains the practitioner prestige because he was able negotiate the barriers, like an athlete?
Is it really just a matter of playing the game?
I think there are benefits to getting a bachelor degree that transcend simply learning immediately-applicable skills. That is what trade schools are for. The point is to gain life-long skills such as critical thinking, a more-than-trivial understanding of ethics and its underpinnings, the skills that are needed to understand a research paper, the ability to comprehend systems, some idea of how people are managed, etc.
To those who think it's vital to have more clinical skills is vital if we want nurses to be able to hit the ground running as soon as they graduate with a nursing degree — fine. But that is not the point of a BSN (or an advanced practice degree).
You answered my question anyways, thanks for playing.
So then, the market should be fettered in a particular way? Oh, do fill in the details for us. You will be a good candidate for the Nobel in economics if you succeed. Why not start here?
As I have stated before I have my ASN from the nursing school run by a University. Critical thinking and time management were drilled into us from the first day. We had to write papers and do research. ...
Obviously not all nursing programs are equal either. Perhaps before you MANDATE an entry level education the education should be standardized. But again before the education is standardized perhaps the Scope of practice for nurses should be standard no matter what state you work in.
That is quite reasonable. There are a lot of people in for-profit, non-regionally-accredited trade schools who do not get nearly the education that you got. Yet, if they pass the NCLEX in your state, they work under the same scope of practice. Something is wrong with that picture.
Speaking as a "newly minted BSN" I actually tend to agree with the idea that nursing schools need to slow their roll a bit.
Far too many graduates are leaving school without jobs waiting for them but with heavy loan burdens. This isn't good for the economy.
I don't care much for arguments that these new nurses don't know anything. No new nurse knows anything and it's been that way forever. As long as there is an adequate number of experienced nurses to precept the graduates, we'll be fine.
From what I have seen, it takes a graduate nurse with average critical thinking and time management skills about a year to become competent in most units in the hospital I work at. This hospital is enormous, one of the 10 largest in the country. The checks and balances and fail-safes are such that in most areas of practice only very rare errors escape systemic correction. The more acute settings just aren't open to hiring graduates, but as those positions get filled from within, positions in less acute areas become available, and they will hire them. So there's a sort of revolving door in effect.
Anyway, my hope is that all newly hired nurses will be BSN prepared. It's just good for the profession. That said, they had better be humble and willing to learn from that ADN who was wiping butts and passing meds before they were born. And those ADNs and diploma nurses should not be forced out. This is another reason to turn the spigot back a few notches on the number of graduates leaving these schools. Call it grandmothering, or whatever.
Of course, going along with this is the idea that nursing schools should stop offering two year degrees entirely and make the BSN the baseline for RN preparation and that this should be standardized across the country.
My BSN cost about the same as a ADN would. i was a very talented and great student in hs and had large scholarships towards college. I also got a BSN because in MANY large cities many hospitals are BSN only and because it would be more useful in pursuing another degree should I go that route one day. ( I mean even out of nursing completely).
Hospitals are not pushing the BSN standard, that is a nursing initiative, hospitals are just reacting to it. Worst case is that they are attempting to hire BSN nurses purely for marketing reasons, not a bad thing actually.
Market forces tend to work themselves out, don't you worry about that. Nursing managers have their reasons for hiring certain people and they will pay the price, or reap the rewards, for such decisions. Darwinian principles tend to play a large part in deciding which business models succeed and which fail.
I hear you, but I believe that the admins in the hospitals see this as financially sensible. It isn't if they took more time to consider what they are doing.
Like I said, it will bite them in the butts. They could benefit from some re-thinking. Maybe they should read at least some excerpts from K. Schulz's book, Being Wrong: Adventures in the Margin of Error.
Haven't read most of the thread but where new grads run into problems where I work is not because of lack of clinical skills. Many vertarns miss foleys and caths. And anyone can show you a few times how to insert a NG tube or use the IV pumps, which VARY at any hospital. Where they , the pts, and the rest of the staff runs into issues is due to lack of knowledge. Not sure how much it varies by ADN, diploma or BSN as that would require a massive study with hundreds of participants.
I have a question for all those that think BSN entry should be required for all nurses. How are you going to advance professionalism in the nursing field when our scope of practice is determined on a state by state basis? When I graduated the only place I could work with my license was in one of 3 states, I could not have gone to say Nevada without retaking that states boards. Our nursing scope of practice differs by location and by hospital. My state board says that RN's can suture but the hospital I worked for would not let us do any suturing. That fact was not lost on our ER Docs, they tried to get the hospital to let us suture but the hospital refused even though the Docs were willing to foot the bill for the "class". There is no national "scope of practice for nursing" perhaps that is the first change that should be addressed.
As I have stated before I have my ASN from the nursing school run by a University. Critical thinking and time management were drilled into us from the first day. We had to write papers and do research. When we began clinicals (and we had classes during the same time frame) we had to know about every medication we were dealing with - if you blew your medication preview you received a critical zero and risked getting kicked out of the program. 2 critical zeros and not only were you out of the program you could NOT return for a minimum of 1 year (providing that there was an opening).My paper on PTSD became part of the future psych classes. One of my patients during general clinical round was very confusing so I had to do some major digging into her medical history; nothing was adding up; found out that she had neurosyphilis. My clinical instructor had held that part of her info back from me to see if I could "do some critical reasoning" as to her diagnosis. I tell you this as there seems to be a train of thought that ASN/ADN's do not have these skills, that these skills are for BSN trained nurses.
In my area the 4 year program has a passing rate of 86% the 2 year has a 100% passing rate (for the NCLEX) and the students from the BSN graduated without hands on experience, no direct patient care prior to graduating. When they came into the hospital that put them far behind the curve. As I said before one BSN in the ER was too afraid to work a code after 12 weeks of orientation, 7 on nights. She was not going to be alone, she was part of the code team but she broke down because she was not ready. It was not the first code she had been in on but it was the first one she was going to actually have to work. Other nurses (ASN) were running the codes after that same time frame. She was not the first BSN to have problems with the ER but she left because she was "not comfortable" with the protocols. We had other BSNs that left because they were not put in charge. It seems that, at least in my experience, most BSNs think they are better than the rest of us because they have more education.
Obviously not all nursing programs are equal either. Perhaps before you MANDATE an entry level education the education should be standardized. But again before the education is standardized perhaps the Scope of practice for nurses should be standard no matter what state you work in.
Professionalism of nursing has nothing to do with the scope of practice.
With all due respect, "professional" is a squishy concept. Are entry level generic business people professional? If not, do they cross some threshold of professionalism at some point in their advancement? How about people who own their own businesses? Do they need a specific number of employees? If they're independent consultants, is it a function of their hourly rate? Does education play a part? Is Bill Gates, an undergrad dropout, less professional than an MBA? Than an MSW? Or is it different for a skills-oriented job, like nurse, MD, or commercial scuba diver?
Is the point really to form a modern guild, where there are barriers to entry, which keeps the practitioners' population small and thus salaries high, and gains the practitioner prestige because he was able negotiate the barriers, like an athlete?
Is it really just a matter of playing the game?
I think there are benefits to getting a bachelor degree that transcend simply learning immediately-applicable skills. That is what trade schools are for. The point is to gain life-long skills such as critical thinking, a more-than-trivial understanding of ethics and its underpinnings, the skills that are needed to understand a research paper, the ability to comprehend systems, some idea of how people are managed, etc.
To those who think it's vital to have more clinical skills is vital if we want nurses to be able to hit the ground running as soon as they graduate with a nursing degree — fine. But that is not the point of a BSN (or an advanced practice degree).
You are mixing the terms of individual professionalism and a profession as a social concept. They are related but very different.
So then, the market should be fettered in a particular way? Oh, do fill in the details for us. You will be a good candidate for the Nobel in economics if you succeed. Why not start here?
You are confusing the concept of market forces and a free market.
Asystole RN
2,352 Posts
Who mentioned free market?
You answered my question anyways, thanks for playing.