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.
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.
Scope of practice is a separate concept from the professionalization of the occupation.
To help clarify the differing scopes of practice let me give you an example. Law is an old profession that is varied in application due to regional legal differences. Although schools may vary in quality, their educational standards and format are firm.
Practice plays a part in professionalization of the occupation but the latter does not rely upon the former.
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.
It is not the duty of nursing schools to dictate to the economy what the demands are, instead the economy dictates the demand to the nursing schools.
Schools are not behind the professionalization of the occupation, although they do play a significant role. In fact, oddly enough, the nursing educational system is largely part of the force holding back the professionalization efforts.
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.
Do you have any statistical references as to how the recruitment of BSN nurses will harm the financial stability of the business or can you refer to economical principles that would point to how increasing the educational standard would fiscally harm them?
I just do not see how it can adversely affect the fiscal stability of the facility if they take measured and sensible steps to increase their recruiting standards, in fact I believe there are sound fiscal reasons as to pursing such action.
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.
Look, I understand that everyone starts out as new. My issue is the bogus hiring of new, non-experienced RNs over experienced RNs, even if they have, as yet, to finish their BSN (were ADN or Hospital-diploma RNs) and/or if they have been out of practice for a while. Again, my key phrase was strongly experienced RNs. If budgets are tight, bring it those with the strong experience--if you want--add the caveat that they must be matriculated in a BSN program. But they shouldn't be passed over for a non-experienced RN--particularly in a down economy. These are the folks you can, in most instances, bring up to speed quickly--who should have sound clinical judgment if they are strongly experienced in said area/s, and who can be considered, eventually as mentors and preceptors to new BSNs as they come in. What many places are doing are these "internships" of six months for new GNs/BSNs. That's all great, but guess what, statistically it is true that it takes a good two years of full-time practice to really even begin to know what you are doing and why, as it pertains to various and individual patients and conditions. You build this judgment over time and practice. There is NO WAY around that.
Imagine for a second being a highly and strongly experienced RN, but having had to take a hiatus from nursing for some very serious reasons, only to be brushed past by new GN/BSNs. It's totally screwed up.
Again in the end, it is going to bite places in the butt--and their patients also.
I hope the baseline for nursing practice becomes BSNs too--but in the right way for the right reasons.
PS, I hear a lot of nonsense about wiping butts and so forth. Listen, in my experience, this is the very least of all the stressors from working in a university-based, crazy ICU. It's a lot of whining--reminds me of dads that fuss about changing their baby's diapers. Give me a break already. It's basic care, so what. You have to deal with and move on to more important stuff--cause believe me, there are so many other demanding things for nurses to be concerned about in these settings. I mean it's important, but not as important as dealing with a cardiac index of 1.0 for God's sake, or a Hgb of 2 in a bleeding patient--or in my view, anyone for that matter.
I have been vomitted on, bled on PLENTY OF TIMES, crapped on, sputum-slimed, peed on (usually male babies, lol), you name it. This is the least of the stress in my humble opinion.
I think a few years down the road though, the profession's and hospitals approach to this is going to screw them over, but for now they think it's cool to take the gamble.
And to the poster below, Wow. My BSN costed no where near what my ADN costed. LOL. Of course the university is a private and expensive university, which I choose for future goals. Gee, I only wish the two were the same in cost. But honestly, good for you that your BSN was so reasonable. :)
Look, I understand that everyone starts out as new. My issue is the bogus hiring of new, non-experienced RNs over experienced RNs, even if they have, as yet, to finish their BSN (were ADN or Hospital-diploma RNs) and/or if they have been out of practice for a while. Again, my key phrase was strongly experienced RNs. If budgets are tight, bring it those with the strong experience--if you want--add the caveat that they must be matriculated in a BSN program. But they shouldn't be passed over for a non-experienced RN--particularly in a down economy. These are the folks you can, in most instances, bring up to speed quickly--who should have sound clinical judgment if they are strongly experienced in said area/s, and who can be considered, eventually as mentors and preceptors to new BSNs as they come in. What many places are doing are these "internships" of six months for new GNs/BSNs. That's all great, but guess what, statistically it is true that it takes a good two years of full-time practice to really even begin to know what you are doing and why, as it pertains to various and individual patients and conditions. You build this judgment over time and practice. There is NO WAY around that.
Imagine for a second being a highly and strongly experienced RN, but having had to take a hiatus from nursing for some very serious reasons, only to be brushed past by new GN/BSNs. It's totally screwed up.
Again in the end, it is going to bite places in the butt--and their patients also.
I hope the baseline for nursing practice becomes BSNs too--but in the right way for the right reasons.
PS, I hear a lot of nonsense about wiping butts and so forth. Listen, in my experience, this is the very least of all the stressors from working in a university-based, crazy ICU. It's a lot of whining--reminds me of dads that fuss about changing their baby's diapers. Give me a break already. It's basic care, so what. You have to deal with and move on to more important stuff--cause believe me, there are so many other demanding things for nurses to be concerned about in these settings. I mean it's important, but not as important as dealing with a cardiac index of 1.0 for God's sake, or a Hgb of 2 in a bleeding patient--or in my view, anyone for that matter.
I have been vomitted on, bled on PLENTY OF TIMES, crapped on, sputum-slimed, peed on (usually male babies, lol), you name it. This is the least of the stress in my humble opinion.
I think a few years down the road though, the profession's and hospitals approach to this is going to screw them over, but for now they think it's cool to take the gamble.
And to the poster below, Wow. My BSN costed no where near what my ADN costed. LOL. Of course the university is a private and expensive university, which I choose for future goals. Gee, I only wish the two were the same in cost. But honestly, good for you that your BSN was so reasonable. :)
The decision to hire new grad nurses over veteran nurses would be highly influenced by the experience of the hiring managers, the corporate vision of the unit or hospital, the staffing needs, and the fiscal stability of the facility.
New graduate nurses are high risk, they are expensive in that you must invest in their training and pay for their errors, not to mention a significant turn-over rate. Some of the advantages are that you can train the nurse to be the type of nurse that you wish, with your standards. New nurses also offer the obvious benefit of being rather inexpensive in their salary, although their training does require lengthy loyalty to fiscally break even. Having a higher BSN/MSN ratio can also be a powerful marketing tool to be used by the facility.
There are many reasons why one might chose to hire a new graduate BSN nurse over a seasoned nurse but without evaluating each facilities and each unit's needs, we are spinning our wheels.
A universal truth is that new graduates are expensive, if the nursing manager's hiring practices are falling short of the established goals, fiscal demands will quickly force a change in practice.
Do you have any statistical references as to how the recruitment of BSN nurses will harm the financial stability of the business or can you refer to economical principles that would point to how increasing the educational standard would fiscally harm them?
I just do not see how it can adversely affect the fiscal stability of the facility if they take measured and sensible steps to increase their recruiting standards, in fact I believe there are sound fiscal reasons as to pursing such action.
Again, my issue is with hiring new, GN/BSNs over strongly experienced RNs--even if the strongly experienced RNs have been out of practice for some time.
In doing this, they are taking more time to bring BSN/new grads up to speed (Seriously a good 2 years is really what is needed. Geez even medicine gets this.), and putting patient populations in hospitals at risk. B
ring the strongly experienced RNs in FIRST, get them up to speed. Required that they be matriculated in a BSN program of study. If appropriate cultivate those that show true adult education/preceptor talent--and those with truly giving and supportive attitudes towards new nurses, and then employ your internship programs for GN/BSNs. (Choosing preceptors, in my opinion, depends upon the individual nurse, b/c clearly a number of strong nurses are still not talented and sensitive preceptors for adults learners--the GN/BSNs.)
I think the current trend is a disservice to everyone, including the new GN/BSN, because typically there isn't a dense enough pool of talented preceptors to draw from for these new nurses. Many of new grads end up so frustrated, or even ousted prematurely. It's a sad commentary on how many hospitals are approaching nursing. What's more, the hiring freezes, or shall we say limited hiring, is putting an undue burden on these new BSNs and their patients in terms of staffing ratios. There is this crazy imbalance in the hiring processes for nurses. It's not fair to anyone.
Strong, clinical experience makes or breaks you in this field and in the field of medicine IMHO. This is why I don't want a NP with only 1 or 2 years of full-time RN experience taking care of my loved one or me. That's also what we are seeing. RN/BSN with little experience--really novice RNs going into NP or graduate nurse programs, and they haven't even developed strong clinical insight and judgment as an RN. True, some people MAY be the exception--but these are by far the outliers--and everyone wants to think of himself or herself as one of these outliers. They may even know a lot of facts, but they can't really put the small pictures and the big pictures together yet--and many of them can use practice based medicine along with evidence-based medicine to make insightful, individualized clinical decisions. I think we will see more in the way of lawsuits in the future in thig regard. They haven't had enough time and experience. I am all for didactics--without a doubt, but ascerting didactics over strong clinical experiences that help to develop sound clinical judgment is a huge mistake.
One person's opinion.
I do think it is an interesting area for more research.
Again, my issue is with hiring new, GN/BSNs over strongly experienced RNs--even if the strongly experienced RNs have been out of practice for some time.
In doing this, they are taking more time to bring BSN/new grads up to speed (Seriously a good 2 years is really what is needed. Geez even medicine gets this.), and putting patient populations in hospitals at risk. B
ring the strongly experienced RNs in FIRST, get them up to speed. Required that they be matriculated in a BSN program of study. If appropriate cultivate those that show true adult education/preceptor talent--and those with truly giving and supportive attitudes towards new nurses, and then employ your internship programs for GN/BSNs. (Choosing preceptors, in my opinion, depends upon the individual nurse, b/c clearly a number of strong nurses are still not talented and sensitive preceptors for adults learners--the GN/BSNs.)
I think the current trend is a disservice to everyone, including the new GN/BSN, because typically there isn't a dense enough pool of talented preceptors to draw from for these new nurses. Many of new grads end up so frustrated, or even ousted prematurely. It's a sad commentary on how many hospitals are approaching nursing. What's more, the hiring freezes, or shall we say limited hiring, is putting an undue burden on these new BSNs and their patients in terms of staffing ratios. There is this crazy imbalance in the hiring processes for nurses. It's not fair to anyone.
Strong, clinical experience makes or breaks you in this field and in the field of medicine IMHO. This is why I don't want a NP with only 1 or 2 years of full-time RN experience taking care of my loved one or me. That's also what we are seeing. RN/BSN with little experience--really novice RNs going into NP or graduate nurse programs, and they haven't even developed strong clinical insight and judgment as an RN. True, some people MAY be the exception--but these are by far the outliers--and everyone wants to think of himself or herself as one of these outliers. They may even know a lot of facts, but they can't really put the small pictures and the big pictures together yet--and many of them can use practice based medicine along with evidence-based medicine to make insightful, individualized clinical decisions. I think we will see more in the way of lawsuits in the future in thig regard. They haven't had enough time and experience. I am all for didactics--without a doubt, but ascerting didactics over strong clinical experiences that help to develop sound clinical judgment is a huge mistake.
One person's opinion.
I do think it is an interesting area for more research.
There are risks and benefits to hiring both populations, the hiring manager has to take into account the unique needs and vision for the facility into account when weighing the decision. Unfortunately without examining the unique needs of each facility we can not even come close to making a judgement upon better coorifice of action. I liken this debate to the debate of chili with beans or without.
When I first graduated nursing school I was offered a job in Fairbanks, AK. The hiring manager stated that she was having a hard time finding local talent, only finding older nurses who have retired and who wished to reenter the profession. She had hired a few and found in profoundly difficult to work with nurses who were essentially set in their ways and who had very little incentive to comply, since they were not working necessarily to put food on the table. She also found a rather higher turn over rate as these nurses decided to jump in and out of the profession. True story.
I am sure that manager was only feeling the effects of a rather limited and specialized market but her concerns were real.
An experienced nurse does not necessarily mean a better nurse for any given position.
I think the whole "i'm an adn and can work better than a bsn...." is old, tired and embarrassing to the nursing profession. Nurses are the only profession that I can think of that makes a big deal out of obtaining a regular, standard undergraduate degree. I was a new grad BSN student, worked like crazy in the emergency department and other areas and I have no regrets having a BSN. We need to keep our standards normal like other professions. We are for the most part responsible for other people's lives, why should we have bare minimum education requirements? I agree with another poster that stated we need to keep respect in our profession, and the only way to do that is by having the same (higher) education requirements.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
As long as we continue to bicker amongst ourselves it will be difficult to be viewed as professionals.
Whether hospitals are not hiring new grads or not hiring experienced nurses it's all about the money.......they are both expensive.
One will cost to train and will probably move on after a year and the other will cost more per hour and will not put up with dangerous staffing and working conditions.
Personally they have dumbed down the AND nursing programs on purpose to make nurses "go back" for their BSN to get the BSN even though the ADN has [passed the exact same exam as the BSN. I have a niece in an Accelerated BSN program. Her "nursing" BSN curriculum was my ADN program curriculum.
Scope of practice is a separate concept from the professionalization of the occupation. To help clarify the differing scopes of practice let me give you an example. Law is an old profession that is varied in application due to regional legal differences. Although schools may vary in quality, their educational standards and format are firm.Practice plays a part in professionalization of the occupation but the latter does not rely upon the former.
Doesn't a wider scope of practice suggest a greater degree of professionalism? I feel what makes a RN more of a professional role than mine is the fact that they have a wider SOP and take on greater responsibilities.
I think the whole "i'm an adn and can work better than a bsn...." is old, tired and embarrassing to the nursing profession. Nurses are the only profession that I can think of that makes a big deal out of obtaining a regular, standard undergraduate degree. I was a new grad BSN student, worked like crazy in the emergency department and other areas and I have no regrets having a BSN. We need to keep our standards normal like otherprofessions. We are for the most part responsible for other people's lives, why should we have bare minimum education requirements? I agree with another poster that stated we need to keep respect in our profession, and the only way to do that is by having the same (higher) education requirements.
I know I've never said I can work better than a BSN (or a ADN). I know I'm not equipped to handle the level of care that exceeds my scope of practice. I was not educated for that. I was, however, educated to the LPN level of practice. Therefore, I do believe that when a RN and I are both working as floor nurses in LTC, I can do *that* job as well as he.
Likewise, I don't feel like my extra education would necessarily make me better at a CNAs job than the CNA himself. My extra education (over a CNA) is what makes me a better LPN. It doesn't really make me a better CNA. I already had that down pat. Likewise, I'm not sure a RN education makes the RN a better LPN. It doesn't make them better at the parts of the SOP that overlap. If makes them better at the parts of the SOP that are unique to that role.
"I understand for the people who have never been to college before, or are newly in the adult working world, that it's hard to get perspective on all of this. Once you gain perspective that comes from working at least 7 years in your profession nursing or not you will come to a similar conclusion. You will feel the fool for having wasted your money and your life on more college when experience in treating patients is all that matters.
I have another bachelor degree and over 20 years in my previous career before my ADN. I certainly don't need a BSN - if you want I'll do a few more CEUs. Done. I could not be more serious.
Oh and I did graduate with highest honors..."
I wish I could "like" this twice. I have similar experiences.
Asystole RN
2,352 Posts
Scope of practice is a separate concept from the professionalization of the occupation.
To help clarify the differing scopes of practice let me give you an example. Law is an old profession that is varied in application due to regional legal differences. Although schools may vary in quality, their educational standards and format are firm.
Practice plays a part in professionalization of the occupation but the latter does not rely upon the former.