Blogs

Imagine the day you pass boards you are handed a certificate that says, this new accomplishment is yours and yours alone!
To keep this accomplishment fresh, you are to tend to it, it is YOUR responsibility.
If you give over the care and feeding to anyone else, it will die.
Getting to this spot in one's life (becoming a nurse) took hard work, perseverance, and sacrifice. Why do we think that afterward, we get a free ride from employers or the society (government) to tend to our career? We need to own nursing, not the employer.
Imagine a world where we all entered nursing at the same educational level. Take a look at other professions that have NO disagreement about entry, they tend to have a different relationship with those who contract (pay) for their knowledge, skills and abilities. In these disciplines there tends not to be a problem securing enough faculty to educate the next generation. Part of that comes from they enter their profession nearly at the required level of education to choose a pathway into teaching.
We have been sold the idea that nursing is a great way for women to have a secure their future financially, and that has turned out to be a myth. Nurses are churned out ...and sadly many are finding no golden job waiting upon graduation. What a perfect time to extend education requirements...when graduates are not finding jobs...
The responsibility to tend and care for nursing is ours....not the employer.
The burden of nursing is for nurses to carry. We need to stop counting on others to meet our professional obligations of education, life long learning, and meeting OUR obligations of safe quality care for our patients.
If we are primarily motivated by outside forces, we will remain very disappointed in our chosen career.

I don't think doing away with ADN programs would solve any issue. Remember we are talking ENTRY into practice. What the nurse does with their career from the entry level is their own personal ideal. With the shortages of nursing professors and the waiting lists to enroll in nursing schools being an issue-that would need to be resolved to allow for more nurses to gain more advanced degrees. It takes a good deal of money to return to school and being that this is a majority female industry-there are more life issues that should be addressed and ease the process. It would be helpful if employers would assist more in the advancement of their nurses, especially since they use the data of BSN employees to gain Magnet status and market their hospitals to improve client base and recruit more nurses. What we are seeing, in this uncertain fiscal climate, more institutions are lowering their benefits to employees to save costs. The irony is, if you value your nursing staff, you invest in the very workforce that ensures the best patient safety scores and cost savings. At the very least pay for certifications and re-certifications in nursing. It would also be a good thing to look into more career counseling services to assist nurses in continuing their education to match needs in the institution. Unit managers do not have the time nor the inclination to assist individuals meet their goals. I agree there is a balance to offering too much and have the nurse leave the institution to move to higher ground monetarily or "better fit" after benefiting from the perks, but there are ways to ensure compliance to working out a contract after receiving said benefits. Dialog between hospital or healthcare groups should involve this issue and work on the path to gain loyalty in the nursing profession while meeting the increased staffing needs of a more highly educated group of employees who carry the burden of patient outcomes.

Ringing in from ND.
Market forces should not determine the education of a profession because the market tends to be inconsistent. As an example the newest message has been that nursing is recession proof. What a clever marketing scheme, but certainly not the foundation upon which recruiting should occur. Already those who expected something else are leaving the ranks, disappointed that the jobs that were to be secure, involve down time, low time, and a work load that was not expected, nor can be accepted. Then there is the whole responsibility and accountability issue… the market looks for cheap replaceable bodies, whereas nursing needs well educated, dedicated, and conscientious professionals.
The ND story is an example of bending to the whims of the market. We were told the market needs more nurses faster. So those who are responsible to the industry (and not necessarily nursing) sold the story of woe to the legislature that if we could make nurses faster, we could fill the empty positions, thus no more nursing shortage. Yet today, the rural areas of ND remain short of nurses for a variety of reasons.
If we count on the market we risk living with a moral detour when those who hire bend to forces that pummel them to adjust their convictions; convictions that include championing an all BSN staff, yet hiring the ADN because they are someone’s relative, friend, son or daughter. (Or championing hiring only nurse practitioners then hiring PAs.) The moral compass is not always set at due North when it comes to “market forces” even in Magnet facilities.
So, we as the profession need to be the compass, and establish once and for all, entry is BSN. “Academic progression” happens from that point forward. Allowing the market to sell us the criteria for entry is a pitch that is sustained by the ADN programs sales force. ND had an answer; the ADN degree became the entry for LPNs, the practice then was differentiated between the BSN and the ADN by virtue of licensure level.
ADN programs do not have to close, they will benefit those seeking the licensure level of the LPN.
We all know how absolutely capricious the political, economic and social forces can be.
A thought provoking book to read is American Nursing and the Failed Dream by June Harrington. (2009).

Christy, the quest to have the baccalaureate degree as the entry level for nurses really started in 1908 in Minnesota when the first BSN program was implemented. in 1940 Esther Lucille Brown was commissioned to study nursing. She was a very well known anthropologist and her recommendation was that nursing education should move into the "mainstreat of higher education." Then there was the 1965 Position Paper published by the ANA taking the same stand, then the 1985 follow-up. Sometime in the 1980's I believe, I would need t check the date, North Dakota passed a law with two levels of licensure, one for the profesional BSN and the other for the Associate. I do not believe that worked out but perhaps someone from North Dakota can ring in. At any rate, the North Dakota move did not spread like wildfire across the nation. So here we are -- 2011 and the Future of Nursing report sets as a goal 80% BSN by a certain date -- wny not 100%, because the people who wrote the report are very smart and they know the history. So why not set a goal that is ambitious but may be doable in light of market forces. In the Philadelphia area there are two large health systems that have made public that they will only consider new nurses with BSN's. They are both Magnet hospital sytems. The Magnet Program is heavily laden with education and evidence based nursing requirements and many hospitals are pursuing Magnet -- because the market is becoming more sophisticated and hospitals use Magnet status to market their services. It is a myth that professions determine their own destiny. Professions live in a context and they are shaped by political, economic and social forces. It is naive to think that ADN programs will close because the Community College system in the US is huge and meets a great need. I believe that we have spent too much time arguing about this issue among ourselves and it has been a divisive issue. Market forces will prevail and reshape nursing just like it is reshaping medicine, law and many other professions. Nurses need to understand the market an the opportuniities inherent in healthcare reform and in changing legislation on scope of advanced nursing practice. The Future of Nursing Report is evidence based and is grounded in what market forces are telling us. It is easier to change educational requirements in smaller professions; i.e., there are about 80,000 Physical Therapists compared to 3 million nurses and ther organization can drive change in a more coordinated way. We have many organizations and many competing interests, but I have no doubt that we will eventually get there -- wherever that may be.