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.
Only a "insert bad word" starts racking up debt at age 50. It makes no fiscal sense as you will not recoup the cost by the debt affording you higher pay. If you are 20 it makes sense. Not if you are 50 unless they are going to pay you a higher salary which is not the case going from an ADN to a BSN.
Oh I don't know about that.
For every "older" or middle aged person discouraged from entering nursing because of their age, one hears of new grads at 47,50, or in one case 60 finding jobs right off the bat in this NYC market, so go figure.
Will give you that on the face of things going $18K to $25K or above into debt at "fifty" may not seem like a good idea, but consider all sorts of employers value mature employees and the skills they often bring to they bring.
Such persons usually have a better work ethic and at least when it comes to females have usually left the husband hunting, nappies and brats stage of their lives. You don't get them calling off and or demanding to be out around the holidays because "Mr. Dreamboat" has arranged a trip to ...., or simply because MeeMaw is having her annual Thanksgiving family dinner and *EVERYBODY* is going to be there.
I read the article you linked but I think the education requirement many hospitals are imposing and the new rules for degree attainment (ex: you will need a doctorate to get NP after , um 2014?, I think) down play the importance of experience on the job, the individual RN and the facilities that he/she have worked at.
There are several RN's on the floor where I work that have ADN degrees and are smarter than many of our residents and truly know how to care for our patients. Then there are some BSN 's who do not have the same experience and practical knowledge needed for floor work and it takes them years to catch up and gain that experience.
I think that the distinction is weird and the seperation is crazy as whether you are ADN, diploma or BSN, we ALL take the same NCLEX if you are a registered nurse and a new grad is a new grad-its what you do with your time working is what makes you the nurse you are-not your education background that allowed you to take NCLEX.
I am in school now. I do see benefits of solid university education for the individual and the profession.
Having sad that, I also think that SOLID experience, whether as current as people want or not, is overall more important! I am a 20 year veteran of nursing and have worked in various areas of critical care for a long time.
The thing is, money and politics are pushing the current climate. Do they want to hire more nurses? In most cases, probably. Are they restricted by the current freezes or quazi-freezes? ABSOLUTELY.
Therefore, with the Magnet push and the Nursing Professional eliteness, they are going to push the BSN thing as far as they can--use it as a key selector to get the "best" candidate for the few slots they are allowed to have open.
It's a game. Some really believe it--but in reality, they are taking the Aiken's study WAY TOO FAR.
Strong experience, even if not current, is overall more beneficial than the bachelor's degree. Doesn't matter. It isn't the agenda right now....which is why they are putting non-experienced, second degree RN (accelerated) "completers" into rolls that they should be putting highly experienced RNs into---even if they have been out for a time. Yes, there is new stuff to learn, but it is not the nursing judgment and clinical thinking that comes with strong clinical experience.
You get updated on things like computer software programs, barcoding, new systems for narcs, etc.
These things are NO big deal for a smart, experienced nurse.
It's the current political agenda spurred on by the current economics that is ruling things right now. It's a game....And I think it is a game that will ultimately end up biting hospitals and various organizations in the butt.
But like everyone, they too, sadly will have to live and learn and repeat the cycle of severe nurse shortage in the future.
How they should handle the baseline education is through the systems of Education, rather than penalizing experienced nurses who have yet to complete their BSN.
Begin reducing ADN programs. Instead, implement pre-nursing science, etc programs at community colleges. I like the idea of hospital nursing programs, but they are no longer the way of the future.
Mandate that all entry level from say 2016 or whatever is BSN, with the caveat of keeping all interested, experienced, and good RNs in nursing roles, giving them a ten year period of time to complete their bachelor's. Strongly experienced nurses should NOT be dumped from nursing application pools or not interviewed just because they have yet to complete their BSN or b/c they have been out of nursing for some time. Key words here are STRONGLY EXPERIENCED RNS.
LPNs will probably hate me, but I think baseline nursing practice should be RNs. Give preference to STRONGLY experienced RNs--especially if they are matriculated in a BSN program.
Another issue---Hospitals and such feel that they can give New GN/BSNs lower salaries, etc, then experienced RNs (even those it hot pursuit of BSN or higher). $$$$ Money AND politics are the driving vehicles. . .but all things cycle around. In a few years or so, these places, regardless of how much things are being moved out of the hospitals, are going to be screwed royally--and so will the patients.
Major prediction. Wait and see. They will be so sorry they didn't take a more balanced approach to meeting the particular political and financial agendas. But people tend to function in the "here and now" mindset--then they wonder later why they are so screwed.
BTW, people talk about unity in nursing, but look at how they can use these difference things to divide nursing and put nurses in competition with each other. BSN new grads are in completition with experienced, non-or pursuant-BSN RNS. LPNS and RNs get after each other b/c government agencies and HHAs can pit them against each other for similar jobs in homecare? What the? This is all b/c they can pay LPNs less and new GRAD BSNs less. The nursing profession is full of garbage if they keep professing the need for unity and reduction in bullying and the like, so long as it has all these different "levels" and descriptors that are used to undercut other nurses.
I just did a case and was paid LPN rate, yes, as a favor for someone--with the caveat that this is THE ONLY time I will do this. DYFS needed and RN for the case, but their reimbursement was LPN grade. What in the world?
Many people have, in my view, wisely, changed their majors from say nursing to teaching or CS, etc. Hook up with a university with strong coops, you can be much better set than say carring $60,000 + debt and not getting a job.
There is too much leveling associated with reimbursement and nurse-employee cost-fixing.
The horizontal violence will continue. People will continue to see this as ridiculous, and will move into other fields.
Like I said. This is going to jump up to bite people in the butt big time. They will take two steps forward with the BSN agenda, but end up have to take five steps back---b/c there will be such a limit of nurses.
I have loved so much of nursing; but I would advise people to go into education, social work, certain kinds of computer/IS rather than nursing right now. Very sad.
I believe the idea of professionalizing nursing is to consolidate and raise the minimum education for entry into the profession, not to add more levels of nursing at varying levels of education.
Most likely when the bar is advanced to the BSN all of the ADN nurses will be grandfathered in and new nurses will have to achieve the BSN standard. Similar to the advancement of the nurse practitioner programs to DNPs from MSNs.
There is some discussion of that. But there is also a lot of talk (and formal proposals) that keep the ADN/Diploma as an entry-level option, but would require a BSN within a certain number of years to maintain the license (the "BSN in 10" proposal, for example). Others propose the ADN/Diploma as OK for entry level roles such as staff nurse, but require the BSN as minimal for managers, educators, Charge Nurses, community health nurses, etc.
So in a future without LPNs (or even ADNs) who staffs all the nursing homes? The assisted living facilities? The substance abuse clinics? Who passes meds to 300 inmates a shift in the jails and prisons? Not many people who go through a four year program are going to want to do any of this. And no employer is going to be willing to pay the wages a professional BSN would demand to do these jobs. Do you really want to hand the former LPN role in these settings over to some UAP? I have a suspicion that those of you who favor eliminating the LPN work primarily in acute care. I don't think you understand there is a vast, vast realm of nursing BELOW the acute. And I doubt many of you really want to work there....
While I don't appreciate the underlying hostility of Brandon's post, I do agree with one of the key points. We should establish separate licensure for BSN's and ADN/Diploma grads. With separate licenses and separate scopes of practice, the differences between the two would be more clear. People fall back on the "same NCLEX" argument to justify the non-support of higher education all to easily. It's a lazy argument, but one that holds enough weight for people who don't want to advance their education or support the education of others. We should eliminate it by developing a separate NCLEX.
Do not think any state BON is going to sit down and break up RNs scope of practice into types of education obtained. It would be just too difficult, complicated and result in massive confusion. For the record diploma nurses are often (or at least were) put on par with BSN graduates in some clinical settings. ADN nurses may have a degree but often diploma nurses had programs that were longer in duration and heavy with clinical content. Besides there already are two different nursing boards for two different nurses, RN and LPN. There is no reason why acute care facilities cannot bring back LPNs other than they have broken up much of the work such nurses could do and given it over to various UAPs whom are cheaper to employ.
The average ADN program may have reached three years in some areas, but that is mainly because one or more semesters are spent taking various "pre-nursing" courses before being formerly admitted into the school. If remedial work is required that pushes things back even further. Diploma programs OTOH one started nursing education from day one, and in some cases usually required certain college or advanced high school courses such as general chemistry be completed before applying. If one did not have the required previous course work when applying to a diploma school, step out of the line and allow others who did move forward.
In certain areas if current hiring trends continue there are simply going to be closings of ADN programs. That or associate degree programs are going to have to partner up with BSN schools (Queensbrough CC now has an relationship with Hunter-Bellevue to allow certain students to persue their BSN ), and or find some way to get their grads employment
Here in NYC several facilities (NYU-Langone, NYP, North Shore-LIJ, Mount Sinai amoung a few) do not hire ADN new grads per their recuriting information. Have friends who work for the recently aquired by NS-LIJ Lenox Hill hospital and ADN staff nurses are being pushed/told in no uncertain terms to get their BSN.
There is some discussion of that. But there is also a lot of talk (and formal proposals) that keep the ADN/Diploma as an entry-level option, but would require a BSN within a certain number of years to maintain the license (the "BSN in 10" proposal, for example). Others propose the ADN/Diploma as OK for entry level roles such as staff nurse, but require the BSN as minimal for managers, educators, Charge Nurses, community health nurses, etc.
Two underlying problems often come up with requiring persons to obtain their four year degree post ADN/diploma graduation.
First there is often a reluctance for various personal, financial or otherwise for many to return to school once they have been out/started working. If lots of new grads didn't see the worth of going for a BSN when choosing a NP, they probably aren't going to see that much value after working as a RN for awhile.
Next regardless of whether one goes straight for the BSN or does so after obtaining an ADN or diploma the educational requirements are still the same. Some people aren't academically inclined towards four year college work, which often is one of the reasons they chose a lesser degree in the first place. Suppose after being licensed one could shop around for an online RN-BSN program that wasn't too difficult but there are pitfalls there as well. Some simply cannot function without the structure of physically attending classes.
It all comes down to what will happen after the ten years or so (assuming extensions are built into the scheme) pass and the ADN RN still does not have her or his BSN, what then? Are you going to take their license away? Suspend it until proof of BSN is submitted. Can tell you know that is going to make some lawyers very happy.
There was a time when treating patients could be done by a barber. Plenty of barbers did a perfectly good job of applying leeches. Why do they get so much education now? Are all of you, "BSN is no better than anything else" people going to SuperCuts for your medical care?
Just because one level of education is adequate now does NOT mean that a bit more would make for better nurses in the future.
Saying in the future nurses should have more education DOES NOT EQUAL saying, "ADNs and LPNs are wayyyy too stooopid to take care of patients."
CLEARLY it's not necessary if the majority of nurses provide 100% competent care without it. That's just common sense.
It's also common sense that competent care now can be improved to even better care tomorrow. Why settle for merely competent? It's sad that as nurses we'll settle for merely competent, and as long as we aren't killing people right and left there's no reason to improve.
Well, I'm hostile because the implication of many pro-BSNs here is that the existence of ADNs who share the same license are somehow an embarrassment and preventing them from being takenseriously. If that's how they feel about ADNs, how do they feel about LPNs?
I don't have an MSN. Or a PhD. My education is INFERIOR to someone with a MSN or PhD or JD or MD or MPH. It doesn't mean that *I* am inferior. It doesn't mean that I'm a crappy nurse because I only have a four year degree instead of a 6+ year degree. But if I want to get offended, I could go tell all of the CRNAs that I'd be just as good at administering anesthesia as they are, after all, nurses used to do all the anesthesia long before it required a masters degree. And they better not dare hurt my feelings by saying that they have more school than I do. If a plain old RN could do anesthesia 100% competently back then, there's obviously no reason for it to require a masters degree now. Right?
It all comes down to what will happen after the ten years or so (assuming extensions are built into the scheme) pass and the ADN RN still does not have her or his BSN, what then? Are you going to take their license away? Suspend it until proof of BSN is submitted.
Or we could just do it the easy way and grandfather anyone with a current RN license in.
I have never said I'm "as good" as a RN. What I have said is that I resent the implication that my lower level of education is somehow holding other nurses back in *their* career. I also question the wisdom of making the BSN the sole entry to being a licensed nurse. No one has been able to answer who will staff
LTC once if the LPNs are no more.
There's a reason LPNs dominate in certain fields of nursing. RNs don't want to do the job and employers are not willing (or able) to pay RN wages to do them. The need for a bedside nurse below the level of BSN is not going away anytime soon. Why does it have to be one or the other? Why can't there be multiple levels of nursing? Why are some people offended by the prospect that certain areas of nursing simply do not require a university education?
I have never said I'm "as good" as a RN. What I have said is that I resent the implication that my lower level of education is somehow holding other nurses back in *their* career. I also question the wisdom of making the BSN the sole entry to being a licensed nurse. No one has been able to answer who will staff
LTC once if the LPNs are no more.
There's a reason LPNs dominate in certain fields of nursing. RNs don't want to do the job and employers are not willing (or able) to pay RN wages to do them. The need for a bedside nurse below the level of BSN is not going away anytime soon. Why does it have to be one or the other? Why can't there be multiple levels of nursing? Why are some people offended by the prospect that certain areas of nursing simply do not require a university education?
The same nurses who staffed LTC and other sub acute facilities before the advent of LPNs and ADN nurses would go back to staffing those facilities...
Besides, I would imagine that the entry level for registered nursing would go to the BSN standard and that LPNs would be left alone.
I appreciate the LPNs, Brandon. But I must say working in a prison or substance abuse clinic would not be something that I would think is beneath me. It is consider within community and public health, so I would bite. LTC facilities are rough though (not the patients, the number of patients given to one nurse. I don't think that is beneath me either, that is just rough though and I appreciate those who do it.
DoGoodThenGo
4,133 Posts
Oh I don't know about that.
For every "older" or middle aged person discouraged from entering nursing because of their age, one hears of new grads at 47,50, or in one case 60 finding jobs right off the bat in this NYC market, so go figure.
Will give you that on the face of things going $18K to $25K or above into debt at "fifty" may not seem like a good idea, but consider all sorts of employers value mature employees and the skills they often bring to they bring.
Such persons usually have a better work ethic and at least when it comes to females have usually left the husband hunting, nappies and brats stage of their lives. You don't get them calling off and or demanding to be out around the holidays because "Mr. Dreamboat" has arranged a trip to ...., or simply because MeeMaw is having her annual Thanksgiving family dinner and *EVERYBODY* is going to be there.