BSN programs and liberal arts: IHE article

[polly_mer]

A history professor has advice for aspiring nurses who can't get one of the limited seats in a BSN program. 

The explicit advice ignores why many people want a BSN in a region short on BSN holders working in the field.

This is another example of the disconnect between what many students want in a college education (preparation for a well-defined middle-class job with a high probability of stability) and what many liberal arts faculty want students to want.

[eigen]

Eh, with the prevalence of accelerated BSN programs, it's not as bad of advice as it seems at the outset.

I have a number of students doing a 4 year liberal arts BA/BS degrees + a 16-18 month accelerated BSN who have found the path gives them some added additional flexibility and experiences.

It also opens up (for many of my students) the chance to jump to a mid-level practitioner position rather than a BSN as they get into college and explore career options. Given the number of BSN holders who find themselves dissatisfied and end up moving to PA / NP / MD / DO programs but needing to go back to school to fill in pre-req courses that the BSN doesn't have, there's a benefit to the approach.

Just a thought. I don't know how ingrained you are in pre-health advising these days, but it's one of my main jobs.

[dismalist]

Ah, yes. We can't sell you what you want, 'cause we don't have any left, so buy something more expensive!

Christ, Wall Street is honest compared to us.

[polly_mer]

Just a thought. I don't know how ingrained you are in pre-health advising these days, but it's one of my main jobs.

I'm not doing any pre-health advising at the moment.

When I was in charge of the RN-to-BSN program, I expected to have a lot of professionals ready for more.  I was surprised at how many people were just in school full-time as they stacked their degrees at different schools to take longer to get to the same place.

When I was advising pre-physical therapy/pre-med/pre-professional health students, almost none of them really had a good plan to get where they were going.  Instead, I ended up sending a lot of students to psychology and sport management.

Super Dinky had a category called pre-nursing, but my colleague who advised in that sighed ruefully that in her 25 years, zero students went on to nursing after declaring pre-nursing.

When I was doing scholarship interviews at Super Dinky, it was pretty clear who was serious about nursing qua nursing and who was in a more vague 'wanting to be paid good enough for helping others' category.

I'll believe you that it's not as foolish a suggestion as on first look, but it doesn't jibe with my experiences of a few years ago now when I was up on nursing education.

[eigen]

We have no nursing school, so I'm not as familiar with the RN to BSN tracks as the BS to BSN tracks.

We keep pretty close relationships with the accelerated BSN programs our students feed into, but a lot also choose to do combined BSN + MS programs as the funding can be better / better employment relative to time spent.

There's also the BS+CNA to PA route that's becoming more popular.

[polly_mer]

From watching our nursing faculty, an MSN can be a solid ticket to success as long as one picks up a couple years of full-time nursing work along the way, regardless of path.

[Aster]

I recommend that the author not write Higher Ed articles about majors or programs that he has no professional training in. The article reads like he googled much of his information.

Damn, I sure miss IHE having a comments section...

[kaysixteen]

Aster is right.

A couple of things stand out:

1) many of the 'alternative' health-related (some more related than others) career paths he suggests are simply vastly different from nursing, and a kid who really wants to be a nurse, well, may just not want to settle for any of these alternatives.
2) he minimizes the reality that while, taken as a whole, the US has a serious nurse shortage, we still have inadequate capacity to train as many RNs as we need, and, similar to med schools (we also do not have enough docs, taken as a whole), this may well be at least somewhat deliberate, designed to increase salaries of these practitioners.  Contrast with MLS library schools, for instance, which function as cash cows for unis and churn out literally thousands of new MLSs a year, many of whom simply will not be professionally employed.

[mamselle]

I remember when one of the plot lines in the "Sue Barton, Student Nurse" books was whether it was worth it to go to college to get a degree, or just go to nursing school.

One of the arguments was that a BSN was seen as a distraction from "real nursing," which had to do with patient contact, not "knowing all that science."

I also remember working on the CCU floor when the charge nurse got a pay bump for finishing her MSN, which she'd had to contract to do when accepting the promotion (because they didn't have anyone to put in the position and needed her there before her degree was done.

Time difference, uhh...6th grade (so, c. 1960s) to 1990. 

M. 

[spork]

Mintz doesn't know what he's talking about.

A large portion of BSN students are in RN-BSN programs (I don't have the data on how large). They already have an ADN and have been working in the field for varying lengths of time. The BSN represents a pay bump, more seniority, and additional job options (e.g., OR nurse on day shift vs. floor nurse on 3rd shift).

Local/regional nursing "shortages" are often solved, at least partially, by immigrants who obtained their nursing training either in the USA or abroad but are willing to work in locales and at salaries that are unattractive to many U.S.-born nurses (e.g., nursing homes).

[polly_mer]

We have no nursing school, so I'm not as familiar with the RN to BSN tracks as the BS to BSN tracks.

I wonder how serious about the nursing profession those students are if they plan to be a nurse, yet don't start in a nursing program/school.

The CNA/LPN/RN route to get experience and then BSN/MSN to get a promotion/pay raise makes sense to me.

Majoring in the business/administrative side and then picking up a little experience makes sense to me since my last several rural communities were much shorter on excellent hospital/clinic administrators than good front-line nurses, who could in a pinch do what was needed in addition to their formal education.

My experience with 3+2 programs in engineering (small, rural school the first three years for physics and math, good engineering program last two years for specialization) is the students don't want to fully invest in what being an engineer means to their lives.  They don't really want to move to where the jobs are and give up their current kith and kin networks.  They want a magical job that pays well right out of college, but let's them stay in their home region.

The Super Dinky scholarship interviews often had CNAs who were applying to major in social work or psychology because a year on the job indicated nursing wasn't their life path.

If significant numbers of BS to accelerated BSN folks then go on to graduate work in something else, then that may be evidence that they should have skipped the BSN and should have taken a different allied health career path.

[Wahoo Redux]

I'm not sure what is so controversial unless Mintz is inaccurate when he catalogs the alternate career paths nursing students might take.

I suppose Mintz could have argued for more spending on nursing programs, which also seems reasonable, which I guess is your point, Polly, although that would serve the 1/3 who don't get in, which is its own boondoggle.

The one thing I would say is that, having seen how central nurses are to healthcare, I would like to see standards maintained in medical education.  If we want more nurses, fine, but let's not swell the ranks simply to avoid disappointing those who maybe shouldn't be doing medicine in the first place.  In that regard, Mintz makes some sense.

[apl68]

Back when our local Rotary Club held weekly face-to-face meetings, we hosted a couple of local high school students, drawn from the top half of the year's Senior class, each week.  By far the most common career goal that they announced was to go into nursing.  Apparently a program that puts bright high school students in touch with staff at the hospital has been getting a lot of our students fired up about becoming nurses.  That, and it's one of only a small number of educated professions (along with business, teaching, etc.) that the average prospective college student is aware of as a possibility in the first place.

Polly's observation about the attrition rate among would-be nursing students, and similar observations I've heard from others on the old fora, have long made me wonder how many, if any, of these legions of would-be nurses ever make it all the way into the profession. 

[mythbuster]

This article made me roll my eyes, hard. If the author wants to write about nursing, he should do his homework. The biggest limitation to training nurses is spaces in the hospitals for the trainees!  So the issue is not one that the universities really have any control over.
   I teach one of last pre-req requirements for students applying to our Nursing program. The students who don't make it into nursing fall into tow big groups.The good science students become Public Health or Biology Majors. The rest (and there are many), often become Health Science Admin majors, in an attempt to avoid the math based requirements of either Epidemiology or Physics.  Few of any of these students go into Public Health.
  Nursing is a popular idea for a career, but the reality is hard. It's hard work, and you have to be on point the entire time. I'm proud of my students who have become nurses, and I'm also glad that we do some weeding. The capacity could be greater, but open it up too much and I worry about the quality of nurses trained.

[Aster]

A great deal of the "nursing shortage" has for decades been very high burnout of existing nurses. Large percentages of licensed nurses just don't stick it out for more than five years. Being a nurse is physically demanding, emotionally exhausting, and financially a lot less secure than the general public thinks it is. So the nurses quit and find work elsewhere. I run into ex-nurses all the time. My mom is an ex-nurse. She burned out in 10 years. The sales lady who sold me a mattress last month is an ex-nurse. She lasted 8 years. One of my real estate agents is an ex-nurse. She lasted 2 years.

This is why the popular mainstream arguments of "adding more nursing schools!", "making it easier to be a nurse!", increasing nurse cohort sizes" are dumb. Making it easier to become a nurse doesn't alleviate the burnout rate. It only makes the burnout rate worse. And that's dumb.

It's a very similar situation for most U.S. schoolteachers. Yes, there is an unmet demand. But the underlying cause of the shortage isn't insufficient education programs, it's the ridiculously high teacher burnout rate.