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.
I find it somewhat ironic actually, that nursing is perhaps the only profession who views having more education as a negative. Education is a positive, in and of itself, whether or not you agree with the whole BSN debate.
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 believe this is false. Strongly experienced nurses DO have the edge--IF, they are truly "strongly experienced."
This whole molding issue is inverted as well. Mentor and precept, by way of those that are strongly experienced, and it will work. Again, you are using some outlier anedotes--like we all can do. :) The thing is, what is the new approach to nursing administration truly molding???? IMHO it is attitudes that are about the bottom line--money and political gaming.
Sure, nurses can get tougher through experience. This is what happens. You get stronger, or you get out of it. Why? To be a strong advocate and deal with the loads of nonsense, you must become strong. "Difficult to work with" is very relative and subjective. Could it really mean that the "mold" doesn't fit with their corporate spin or the mere lip-speak of true advocacy for patients, while really what they want is knuckling under to side-stepping true advocacy?
The hypocrisy in nursing "leadership" is astounding to me. "Be a critical thinker and advocate!"
In fact, when nurses even carefully take that approach in real clinical events, all of a sudden they are "difficult to work with" or are, (gasp!) deemed "confrontational."
Well, confrontational isn't necessarily a bad thing at all.
It's like "Sure you should speak up." But it is only lip-service. Those that in fact speak up are unfairly dubbed as confrontational or difficult. So here is a common type of oppression in nursing--the threat that in doing what you are taught and believe in, you will be on your way out! Why? Well you were "confrontation" or "difficult" or "not a good fit." A lot of this is PURE rubbish. Yes, some may not fit or be truly difficult, or seem to enjoy rubbing others the wrong way---but they are a lot fewer than the reality. See, that kind of thing is hard to objectively measure. So all that has to be done if you find someone isn't a "good little robot" or somehow is a threat to the "influential others" is to make arguments, trouble, or keep saying over and over, this person is "difficult" or "confrontation," when the reality may in fact be that they are indeed critical thinkers and they are strong patient advocates. What I am seeing is that administrations really don't want strong patient advocates. They want remote-controlled adroids for nurses.
Sure, new BSNs can be "molded." I submit that a lot of this kind of "molding" is not good for patients, nurses, or hospitals. It's the kind of molding that favors playing "good" office politics, not the heart and soul of real nursing.
Nursing leaderships across the country continue to think out of "proposed perception boxes," rather than objective or even soundly intutitive reasoning.
Here's a basic example, then I must go.
Many years ago, in order for a nurse manager to lead a unit area, he or she had to have strong, clinical experience in the particular area. He or she had to be willing to jump in and get his or her hands dirty as a strong leader in the particular area--still working, at times, along with the staff. No, he or she was not counted in the numbers, but she or he got up and jumped in and taught, directed, supported. Shoot. There aren't even many nursing supervisors that do that today. In the last 15 years in particular, I have seen supervisors that are an embarassment to nursing. They haven't a clue as to how to stabalize stituations, support patients and nurses, and jump in and be effective.
No, somehow they all have been taught that the administrative distance is the best approach. Furthermore, they have been taught that all they need is a masters in business or the like, along with a RN. Doesn't matter, for example, if they have strong crtical care experience in order to manage a critical care unit. These people cannot even begin to relate with their staff.
So here is what they do. The get a couple of "influential others" to act as their eyes and ears clinically, and these "distant" managers follow a lot of what these influential others PERCEIVE or tell them as Gospel truth. And since they are often more senior (forget the more senior may mean they are the longest soldiers there--at 1 to 3 years--and of that directly out of school), they decide that they don't need any mutiny, so they give them this incredible amount of covert or overt power. Forget bias and other factors. Nursing Managers now are often generals that lead from distant lands--and they are clueless about the things that really do matter, but as long as they keep the budget and staffing in-line, hey they are doing a "great job."
And all this personality-based, subjective nonsense, along with the unit cultural dictates from the "influential others," has lead to quite a mess.
Oh and to limit expense of precepting new BSNs, they hire them in internship cycles. A lot of stuff too is computer-based, and the hospitals get a nice write-off.
Hire strongly experienced RNs, cultivate supportive preceptors as much as possible, and then bring new BSNs on with strong preceptors on a rolling-admission basis.
Bottom line. Staff with strongly experienced RNs, cultivate those with teaching, preceptor, and mentoring skills--nurture them--so that they can teach and support and nuture the new nurses!!!! Do this is such a way so that the staffing ratios are not sub-optimal.
Finally, develop better objective systems for nurse-employee evaluation across the board. So much in orientation is all about subjectiveness, it's ridiculous. Bring on nurse educators that would help to establish more objective systems of evaluation, and who have a vested interest in leading nurses to their full potential.
I say, drop the lip-service, roll up the sleeves, and get busy.
One more thing--the managers and nurse educators and the whole of administration MUST be on board with zero tolerance for any kinds of horizontal or vertical violence--open or covert. So much of what goes on is covert--and the managers look the other way, b/c they "depend" upon their "influential others." In general, currently it is a pathological system that is in place in terms of leadership.
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.
No.
Professionalization of the occupation has nothing to do with the SOP.
Professionalization of the occupation is not the same thing as personal professionalism.
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.
Discrimination to both parties is rampant.
Only with debate can one hash out the issues manifest in the professionalization efforts.
It is doubtful that any effort will be successful, let alone seriously pursued, that would have nurses go back to school to increase their level of education.
Asystole, I get your point about schools not dictating to the economy. My point was that nursing itself needs to get clear on this, "grandmother" the existing ADNs and mandate BSN preparation for all nursing schools, and the schools need to comply. I wasn't very clear, I apologize.
I also very much agree with the poster who said that this perennial debate among nurses about degrees is mind boggling. A mandate from the ANA, enforced by regulation would also have the effect of putting this to rest.
Again, the issue is not "who is better". The issue is raising the standard.
Only with debate can one hash out the issues manifest in the professionalization efforts.
It is doubtful that any effort will be successful, let alone seriously pursued, that would have nurses go back to school to increase their level of education.
But we're not always very good at debate at least here at AN. A few people see the issue clearly and are prepared to engage in good, clean, critical dialog. The rest tend to snipe from the sidelines, offering little to the conversation beyond hand wringing and condescension.
That said, I agree completely that efforts to send ADNs back to school are not likely to see much success. I'd add that to do so would actually be unnecessary and, it could be argued, unfair.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
As a ADN graduate 34 years ago I don't see what going back to school at this point in my career can give me over my clinical bedside expertise. My meaning about bickering is about hearing this montra in the late seventies about the phasing out of LPNs, diploma grads. ADN was the degree of the time and after 34 years you can not convince me that I need a few more college english course or leadership courses when I have been a manager and a director of various ICU's/ED and a cath lab and at one time director of all three.
My ADN program at the time had leadership, ethics, pharmacology, micro and biochem. We went the straight 2 years through summer break....both of them and it is mandatory. We had weekend clinicals, rotations, and preceptor-ships that were mandatory as well as Community Clinics that were mandatory.......the BSN was, at the time, the Level for Nurse practitioner and I did not want to be a nurse practitioner. I had the finest education provided at the time to be a nurse. I strongly feel the "dumbing down" of the ADN programs to churn out new grads only to saturate the market is a premeditated plan to decrease staffing costs by the administrators/hospitals. But that is strictly only ny opinion.
Here were are 35 years later and still having the same argument. I have since gotten a BSN which I feel didn't change my practice nor my experience.......the hospital paid for it and wanted me to get it....so I did. But I had a pretty full career by then in spite of not having a BSN. I agree that nursing needs to agree on a single entry level of education. Because frankly.......I am tired of hearing this subject, but also to maintain the credibility in a competitive market and stay up with the times. It is becoming more apparent the need for it to be the BSN.
Making ADN grads go back to school will not happen. Number one the facilities will have to pay for it and we know that will never happen and you can't take a nurses license away that has been practicing with for years.....lawsuits will follow. They will be grandfathered.
But again there was talk of "grandfathering" nurses when I started and they will be talking when I finish......I just wish a decision would be made just to stop the bickering....my degree makes me better....makes you less.
If the issue was raising the standard I think they would do it. The issue is keeping the market saturated right now to keep nurses salaries down in this economy, that is just my personal feelings and when it comes time to raise the standards for real...the real nursing shortage will be here and it won't happen again because the will need to churn out new grads to fill the spots left vacant by the dying baby boomer generation...for as much as I hate to admit it ........that day will come.
I find it somewhat ironic actually, that nursing is perhaps the only profession who views having more education as a negative. Education is a positive, in and of itself, whether or not you agree with the whole BSN debate.
Well said...in fact what I see is a growing trend of online schools and what not "dumbing down" the nursing programs. I shrink at the thought of how everyone is complaining about how much education is required to graduate. Really...you mean to actually be educated; what a thought. Florence has passed on (bless her soul) and it's 2012; lets get with it and accept educational responsibility for our profession.
it is a profession that can hold life and death in it's hands, it is a profession that works with complicated equip., it is a profession that deals with the public more and more-from families to doc's, it is a profession that must be soooo legally savy in reporting, documenting and training-it has become a profession that must be educated and do all of the above and more with skill, articulation and compassion.
busy work to pass class time-i wish:) had none of that in my bsn program. leadership nonsense....to think that is nonsense is nonsense. look beyond the class schedule and the cum. booster courses-get it into your head you will be a leader and if this hat doesn't become you-how do you feel about retail???
As a ADN graduate 34 years ago I don't see what going back to school at this point in my career can give me over my clinical bedside expertise. My meaning about bickering is about hearing this montra in the late seventies about the phasing out of LPNs, diploma grads. ADN was the degree of the time and after 34 years you can not convince me that I need a few more college english course or leadership courses when I have been a manager and a director of various ICU's/ED and a cath lab and at one time director of all three.
My ADN program at the time had leadership, ethics, pharmacology, micro and biochem. We went the straight 2 years through summer break....both of them and it is mandatory. We had weekend clinicals, rotations, and preceptor-ships that were mandatory as well as Community Clinics that were mandatory.......the BSN was, at the time, the Level for Nurse practitioner and I did not want to be a nurse practitioner. I had the finest education provided at the time to be a nurse. I strongly feel the "dumbing down" of the ADN programs to churn out new grads only to saturate the market is a premeditated plan to decrease staffing costs by the administrators/hospitals. But that is strictly only ny opinion.
Here were are 35 years later and still having the same argument. I have since gotten a BSN which I feel didn't change my practice nor my experience.......the hospital paid for it and wanted me to get it....so I did. But I had a pretty full career by then in spite of not having a BSN. I agree that nursing needs to agree on a single entry level of education. Because frankly.......I am tired of hearing this subject, but also to maintain the credibility in a competitive market and stay up with the times. It is becoming more apparent the need for it to be the BSN.
Making ADN grads go back to school will not happen. Number one the facilities will have to pay for it and we know that will never happen and you can't take a nurses license away that has been practicing with for years.....lawsuits will follow. They will be grandfathered.
But again there was talk of "grandfathering" nurses when I started and they will be talking when I finish......I just wish a decision would be made just to stop the bickering....my degree makes me better....makes you less.
If the issue was raising the standard I think they would do it. The issue is keeping the market saturated right now to keep nurses salaries down in this economy, that is just my personal feelings and when it comes time to raise the standards for real...the real nursing shortage will be here and it won't happen again because the will need to churn out new grads to fill the spots left vacant by the dying baby boomer generation...for as much as I hate to admit it ........that day will come.
And the cycle starts again..............sigh
Academic achievement has nothing to do with clinical practice.
Mandating the BSN standard has nothing to do with clinical practice.
Personal professionalism has nothing to do with professionalization of the occupation.
joanna73, BSN, RN
4,767 Posts
I find it somewhat ironic actually, that nursing is perhaps the only profession who views having more education as a negative. Education is a positive, in and of itself, whether or not you agree with the whole BSN debate.