Now, even the *chaplains* are dressing up as doctors

[JeffLebowski]

The problem now that they've broken through the white coat lines is that now NO color coat will denote "physician" any more, don't kid yourselves that we'll just transition to gray or blue coats and that'll be respected. Heck, they successfully spat on our historical claim on the white coat, it'll be a piece of cake for them to say, "oh come on no patient equates a gray coat with a physician".

---

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[UCFMOP]

You're still confused. There is not much difference between a RN with a BSN and a RN with an ADN. They are both RNs, have the same license, roles and responsibilities.

An LPN has no degree, and they usually do not work in hospitals. They are not able to do higher level assessments needed to make decisions about acutely ill patients, as RNs must do. There is a difference between RNs and LPNs. There is very little difference between BSN-RNs and ADN-RNs. The difference is a few liberal arts and nursing leadership classes.

What situations requires "higher level assessments"?

 

[Farmer Jane]

What situations requires "higher level assessments"?

Oh good grief. Assessments in acute care require a higher level of skill and knowledge than an LPN possesses. That's why you will rarely find hospitals that hire LPNs these days. There is nothing wrong with being an LPN, it's just not a sufficient level of education for acute care.

 

[UCFMOP]

Oh good grief. Assessments in acute care require a higher level of skill and knowledge than an LPN possesses. That's why you will rarely find hospitals that hire LPNs these days. There is nothing wrong with being an LPN, it's just not a sufficient level of education for acute care.

So....what exactly is the higher level of skill and knowledge?

 

[Farmer Jane]

So....what exactly is the higher level of skill and knowledge?

I have absolutely no desire to play your game.

 

[UCFMOP]

I have absolutely no desire to play your game.

....I am not playing a game. I am merely asking if you could elaborate on something. What is wrong with that?

 

[zenman]

Let me add to the confusion. I taught in both ADN and BSN programs, in the same school. The ADN was created as a "technical" nurse to ease the nursing shortage back in the 50s. (Don't give me any lip about the word "technical"). OTs and PTs followed suit with their "assistants." However, they remain "under" PTs and OTs in a manner which nursing has not followed.

Now, in the school programs I taught in, ADN students were taught "basic nursing care," whereas BSN students were taught to care for more complex illnesses. BSN students also did community health acute and long term care, school health, management and critical care. ADN students had 4 semesters of clinical; BSN students had 5.

In the work setting you might see anything or anyone hired for any position, but that's a larger workplace issue...and one I don't have to deal with.

 

[handetalc]

take comfort in knowing that pretty soon you will be the boss and can **** on all the posers trying to pretend they are doctors.

i am going to be the kind of doctor that says to people in rounds, "if you're not an MD i don't care what you have to say."

yes i will be a huge ass and do not care. my time is coming soon

if you are indeed being serious, then unfortunately you are insecure and tool-ish

 

[Farmer Jane]

Now, in the school programs I taught in, ADN students were taught "basic nursing care," whereas BSN students were taught to care for more complex illnesses. BSN students also did community health acute and long term care, school health, management and critical care. ADN students had 4 semesters of clinical; BSN students had 5.

Where and when was this? Are you sure you're not confusing ADN with LPN? LPNs are basic nurses. RNs are just plain nurses, qualified to care for acutely ill patients, regardless of their degree. The idea that ADNs do not learn and acute and long term care is ludicrous. This is why I am so often disheartened with the nursing profession as a whole--what other group tells blatant lies about each other?

ETA: Sorry about the derail from the white coat issue.

 

[zenman]

if you are indeed being serious, then unfortunately you are insecure and tool-ish

And he might wind up like this guy: http://www.courier-journal.com/arti...ho+lost+staff+privileges+sues+Jewish+Hospital

 

[zenman]

Where and when was this? Are you sure you're not confusing ADN with LPN? LPNs are basic nurses. RNs are just plain nurses, qualified to care for acutely ill patients, regardless of their degree. The idea that ADNs do not learn and acute and long term care is ludicrous. This is why I am so often disheartened with the nursing profession as a whole--what other group tells blatant lies about each other?

ETA: Sorry about the derail from the white coat issue.

No, RN. There is a difference btw ADN nurses and BSN nurses. Anytime one group has more education than the other it makes a difference. A nurse with a BSN will know more; a nurse with a MSN even more; a physician even more, etc..

Now, the fact that nursing education is messed up is another argument. The ADN vs BSN issue is a thorn in our sides. Yes, we messed up with the knee jerk creation of the ADN degree, IMO. If anyone thinks not, go tell the teacher that's teaching your kid to knock off a few years of their education.

Google "NSU Shreveport" if you want to see the degrees. It's easier to see the difference when one school is teaching both.

FYI, I've been a CNA, LPN, ARMY medic, BSN, MSN, etc. and I've worked with some LPNs that I'd want over some RNs. But we're talking bell curve here, not the outliers.

 

[DO2Be2013]

No, RN. There is a difference btw ADN nurses and BSN nurses. Anytime one group has more education than the other it makes a difference. A nurse with a BSN will know more; a nurse with a MSN even more; a physician even more, etc..

Now, the fact that nursing education is messed up is another argument. The ADN vs BSN issue is a thorn in our sides. Yes, we messed up with the knee jerk creation of the ADN degree, IMO. If anyone thinks not, go tell the teacher that's teaching your kid to knock off a few years of their education.

Wait a minute, I though all (or almost all) WWII-era nurses were Diploma trained. The move toward university-based nursing programs evolved later (yes I know a few like Yale existed before then). If you're talking about the 1950's, weren't most nurses still getting diplomas (not BSNs) and the creation of an ADN degree program would've be an "upgrade" in an academic sense over the in-hospital apprentice-type programs?

Your response makes it seem like BSN nurses were the norm until the 1950's when nursing made a knee-jerk decision to "knock a few years off their education" by creating the ADN. But in comparison to diploma programs the ADN would've been comparable or better, right?

 

[Farmer Jane]

Exactly. Diplomas were once the standard nursing education.

 

[zenman]

Wait a minute, I though all (or almost all) WWII-era nurses were Diploma trained. The move toward university-based nursing programs evolved later (yes I know a few like Yale existed before then). If you're talking about the 1950's, weren't most nurses still getting diplomas (not BSNs) and the creation of an ADN degree program would've be an "upgrade" in an academic sense over the in-hospital apprentice-type programs?

Your response makes it seem like BSN nurses were the norm until the 1950's when nursing made a knee-jerk decision to "knock a few years off their education" by creating the ADN. But in comparison to diploma programs the ADN would've been comparable or better, right?

I didn't say anything about diploma nurses. Here's a little history.

"Associate degree education for nursing began as part of an experimental project at Teachers College, Columbia University, New York in the 1950s. In her doctoral dissertation, Dr. (Mildred) Montag proposed educating a technical nurse for two years to assist the professional nurse, whom she envisioned as having a baccalaureate degree."

http://nursing.adelphi.edu/about/history.php

But I don't want to hijack this thread. It's been beaten to death on allnurses. Please visit that site. I can only offer the voice of reason

 

[Farmer Jane]

Her vision is not what actually happened, and in no way reflects the reality of nursing roles and education. I am gobsmacked that you would present it in such a way. You should know better.

 

[SansNom]

The real point here is that while both ADNs and BSNs are RNs and perform the same functions, BSN-trained nurses have more education (only some of it being nursing education - comm. health nursing etc., and the rest being liberal arts, humanities, essentially the "core" of a baccalaureate degree).

In addition, BSN nurses post their quals with the BSN, RN fashion because, plain and simply the connotation of having a Baccalaureate degree is far stronger than having an Associate's degree.

Let me clarify and de-controversialize: I am not saying BSN > ADN, I am clarifying that they do in fact have some more nursing edu (arguably theoretical coursework like comm. health) and more overall education. I am also only saying that the perception is that BSN > ADN because of the length of education; despite being the same Nursing material, it is not the same edu...ADN = nursing material alone; BSN = nursing material + liberal arts and core curriculum + research / theoretical nursing. Finally, the fact that it's a baccaluareate raises its prestige (not its qualification) because our education system places Bacc > Assoc. degrees.

 

[Farmer Jane]

The real point here is that while both ADNs and BSNs are RNs and perform the same functions, BSN-trained nurses have more education (only some of it being nursing education - comm. health nursing etc., and the rest being liberal arts, humanities, essentially the "core" of a baccalaureate degree).

In addition, BSN nurses post their quals with the BSN, RN fashion because, plain and simply the connotation of having a Baccalaureate degree is far stronger than having an Associate's degree.

Let me clarify and de-controversialize: I am not saying BSN > ADN, I am clarifying that they do in fact have some more nursing edu (arguably theoretical coursework like comm. health) and more overall education. I am also only saying that the perception is that BSN > ADN because of the length of education; despite being the same Nursing material, it is not the same edu...ADN = nursing material alone; BSN = nursing material + liberal arts and core curriculum + research / theoretical nursing. Finally, the fact that it's a baccaluareate raises its prestige (not its qualification) because our education system places Bacc > Assoc. degrees.

That's a very accurate summary. Thank you.


Moral of the story: doctors need not tear down nurses; we do it all by ourselves.

 

[Danbo1957]

Nurses are fun.

 

[Regnvejr]

Moral of the story: doctors need not tear down nurses; we do it all by ourselves.

LOL. I LOVE nurses, they keep me out of heaps of trouble.

 

[SansNom]

That's a very accurate summary. Thank you.


Moral of the story: doctors need not tear down nurses; we do it all by ourselves.

No problem. Now without dousing the flames in this clear thread-hijacking I would just add my point that as a potential patient, I'd argue for the BSN standardization as the entry-level b/c I'd argue that unless your ADN has real life experience a 23 Y.O. BSN could relate to me better than a 23 Y.O. ADN simply because college is a life experience.

I would argue that empathy, therapeutic communication skill, engagement and rapport with the patient, etc. are more readily trained in the BSN b/c they have a well-rounded education (but I'm speaking of the traditional college grad...not non-trads). I'd also say that I have no problem with an ADN learning or applying those skills if they came to the ADN as an adult or career-changer because they have life experience. So I guess my only beef with an ADN would be a young ADN (i.e. trad. college aged / mid-20s).

I'd also say that part of the argument should be that nursing is a serious commitment, and standardizing to the BSN weeds out people who aren't dedicated to it - most BSN candidates have a tough time getting into the nursing school since finishing the core coursework doesn't automatically allow you to take nursing courses, you must apply. By ensuring the dedication of students in a nursing track I think in the future we strengthen our pool of nurses. I mean, non-trads who become physicians understand the sacrifice of its being a post-grad program. I don't think that asking people who will be taking lives into their hands everyday to go through the four-year BSN is asking too much, so I think it should be the future entry-level.

 

[Farmer Jane]

I happen to agree, and I say that as an ADN who will be a BSN in a few weeks. For the sake of the profession, we should elevate our standards of education. That said, I also think BSN programs need to be far more academically rigorous. It should be damn hard to become a nurse. I went into my BSN completion program excited to return to college and learn. I didn't. The required nursing coursework was so ridiculously fluffy I did little but roll my eyes. I didn't learn a blessed thing, and not for lack of trying. It's honestly been a frustrating and disappointing experience.

Also, if we want to make BSN the entry level for RN, we need to create more BSN programs and make them accessible, because otherwise we just won't have enough nurses. I ended up in an ADN program myself because my dh and moved across the state (I had completed most of my gen eds and was at the very beginning of a BSN program) and the nearest BSN program was too far and too expensive. I had the grades and the desire, but no money and an ancient car, so I entered an ADN program, became a nurse, and eventually moved back to an urban area and completed my BSN. Point is, I would have happily completed a BSN program to begin with, but it wasn't available to me. Now, I realize one could easily say that if you have the drive you'll find a way, but honestly I think that leaves out a large number of people who would become excellent nurses--especially people who have life experience and are starting second careers. They simply can't pick up and move, for a future career that will result in a comfortable but not amazing income (note: I'm not complaining about the pay--I'm just saying it's not so great that it's worth moving your family).

So, uh, life story aside, I agree!

 

[zenman]

Her vision is not what actually happened, and in no way reflects the reality of nursing roles and education. I am gobsmacked that you would present it in such a way. You should know better.

WTF? As a person who has been there, done that I'm still amazed at comments like this. All you have to do is cruise through universities to see what is being taught in both ADN and BSN programs TODAY. It's a simple thing to do. I even gave you a current example. I was only presenting the history ( a knee jerk reaction) and why it screwed nursing up to this day.

 

[zenman]

That's a very accurate summary. Thank you.


Moral of the story: doctors need not tear down nurses; we do it all by ourselves.

And if we were smart enough we'd have one entry level and you would have all the bickering. Just compare us with teachers for example. They have to have a 4 year degree and most have to have a masters. Now nurses, who can make a difference in whether you live or die,...well I guess you get the picture...

 

[Farmer Jane]

WTF? As a person who has been there, done that I'm still amazed at comments like this. All you have to do is cruise through universities to see what is being taught in both ADN and BSN programs TODAY. It's a simple thing to do. I even gave you a current example. I was only presenting the history ( a knee jerk reaction) and why it screwed nursing up to this day.

I've been through both, and your statement was completely inaccurate.

 

[zenman]

Nurses are fun.

Actually it's sad....well, there is some fun there...for those wondering what the heck we're doing, lol!

 

[SansNom]

Also, if we want to make BSN the entry level for RN, we need to create more BSN programs and make them accessible, because otherwise we just won't have enough nurses. I ended up in an ADN program myself because my dh and moved across the state (I had completed most of my gen eds and was at the very beginning of a BSN program) and the nearest BSN program was too far and too expensive. I had the grades and the desire, but no money and an ancient car, so I entered an ADN program, became a nurse, and eventually moved back to an urban area and completed my BSN. Point is, I would have happily completed a BSN program to begin with, but it wasn't available to me. Now, I realize one could easily say that if you have the drive you'll find a way, but honestly I think that leaves out a large number of people who would become excellent nurses--especially people who have life experience and are starting second careers. They simply can't pick up and move, for a future career that will result in a comfortable but not amazing income (note: I'm not complaining about the pay--I'm just saying it's not so great that it's worth moving your family).

So, uh, life story aside, I agree!

Wholly agree with you here. I advocate standardization simply because with the ADN programs drying up there will be an even bigger surge in demand for BSN programs leading to expansion and new programs. I also think that standardizing to one degree, one curriculum will allow schools and standardization boards to focus their resources - if there is only one way to become a nurse all the resources wasted on asinine research (Aiken et al) and overlapping resources (e.g. the nursing program that was posted by zenman, NSU Shreveport, which offers three freaking degrees) can focus solely on hiring staff for a BSN program and solely on identifying, bringing in, and churning out high-quality nurses and doing research that actually improves our nursing staff and their training rather than arguing a pedantic distinction in qualification.

So I think standardization should happen, mainly because the other positive changes of strengthening the curriculum, making it applicable, creating more programs, will all become a forced hand when entry into the profession is more restricted. (In regards to your story, my point would be that with stdization would come the increased programs as you said, simply because of cases like yours where ppl couldn't get to the nearest program and there existed local demand and no ADN program to fill the need)

Oh and I'd agree that asking career switchers etc. to move is foolish and a loss to nursing, but my point would be that after a period of adjustment the sheer demand would result in more nursing schools, colleges, and programs so those people could reach their goals without uprooting their life (entirely). My view of sacrifice was putting in the work and time (4 yrs, full schooling) not having to move x-country.

 

[Farmer Jane]

Seriously, I agree with everything you said. And I especially like that you think Aiken is asinine. I recently began discussing her with my professor and really should have kept my mouth shut.

You make excellent points about the focus of nursing shifting if there were only BSN programs. An additional potential is for programs to become more competitive with one another and thereby increasing their academic rigor. That would be fabulous for everyone--the nursing profession, of course, but even more important--patients. And really, it would not be hard for ADN programs to become BSN programs. The nursing content is already there, and they're usually associated with community colleges that offer general education courses. Bring in 3-4 courses from a university and you've got a BSN program, all in one place.

 

[SansNom]

Well I haven't read Aiken I was going by your post on the assumption that it was concerning the distinction btwn ADN and BSN (which I think is academic and pointless to go through) so I really just took the name and expanded it to research that doesn't actually do anything to advance nursing But now that you (and my friend who's in nursing school) have mentioned it, albeit coming from different views, I may have to actually go read it.

I do agree with you that nursing programs need to become more competitive but it's a function of the lack of PhD nurses looking to teach I think. I mean a lot of colleges are dropping to Schools of Nursing and schools to programs, simply because the cost of finding and recruiting nursing profs is high, and sometimes because they just can't find and retain those people. So I think a key part of improving nursing programs/schools/colleges is to also incentivize nurses to get their PhDs and also incentivize PhD nurses to go teach!

Also, this is where we may disagree but I'd like to see BSN programs built out at traditional universities rather than all the ADN programs built into BSN programs at CCs. Because really, to some extent, to elevate the view of the entry-level nurse they need to gain the cache that comes with a four-year liberal arts college name (esp. if they're doing the four years of work and liberal arts for it!). I would love to see more state schools build out their progs and be able to accept more students etc. as well as train more PhD nurses.

 

[jake2]

Wow. How the heck did this become a nurse v. nurse thread. While you're all here, can we have our white coats back?

 

[zenman]

Wow. How the heck did this become a nurse v. nurse thread. While you're all here, can we have our white coats back?

No, but you can argue about who should wear one

 

[dlm13cwru]

Only doctors (MDs and DOs) should be able to wear a long while coat. We work our asses off for years in school and then in residency and I think we deserve to stand out. There are so many different profession wearing long while coats that patients are complaining because they do not know who is the real doctor. At the VA where I am training for some of my residency they make us wear large red badges stating that we are resident doctors. Attendings were black badges and other professions wear different colors so they can be distinguished. I sure 20-30 years ago when a doctor in a long white coat was walking down a hallway in a hospital patients knew they were a doctors. Nowadays you have to stop and look at the letters on the coat to figure out who it is.

 

[basupran]

I am rotating at a new hospital with a very interesting policy.

All healthcare professionals have to wear a color coded tag with large letters on them denoting them as doctor, nurse, physical therapist, etc. The tag is bigger than the ID badge so the letters hang over the bottom of the ID. There is absolutely no confusion as to who is who and I don't see anyone complaining about it bc they can't. I think something like this should be instituted at hospitals to avoid confusion. I am sure all of us can relate, but there have been way too many times where patients have confused mid-level providers such as Dr XYZ.

 

[jake2]

I thought I might revive this thread after the following experience.

I had a problem with a computer today, so I called our hospitals IT help desk. They were actually helpful for a change, and sent somebody to fix the problem.

The computer guy drops by.... and he is wearing a long white coat. One that is monogrammed with his name and "Information Technology Services" no less.

This struck me as particularly odd for some reason. In the past I have seen the following groups of people wear long white coats around the hospital: speech language pathologists, nutritionists, physical therapists, nurse practitioners, nurses, nursing students, patient transporters, phlebotomists, receptionists, unit coordinators, high school volunteers, chaplains like the ones this thread was created for, and yes, even the odd janitor or two. Given that, I guess it shouldn't be surprising that IT guys would wear white coats too, but it just seemed even odder that the patient transporters wearing a white coat. You have your own computer guy uniform: short-sleeved shirt and a tie!

The white coat officially no longer is a symbol for anything other than being employed in some capacity by a hospital or butcher. I know of no actual scientists who wear them so that is out.

 

[coralfangs]

Has it ever occurred to you guys that people choose to wear LAB coats because it's more sanitary to do so in a hospital?


I personally don't see it as a problem if people choose to wear long lab coats because it means less chances of getting **** on your clothes.

Back when I worked at the clinical lab (which is on the 3rd floor of the hospital), everyone was required to wear lab coats... from the director to the janitor. Because you don't want to have **** like urine samples or vajayjay mucus getting onto your sweater.

Today, I still wear my lab coat religiously as long as I am not wearing scrubs simply because I don't want to have **** on my shirts, ties, and sweaters.

Have you noticed how people just put the urine cups and vagina-swab tubes everywhere on the counter or on the desk? That **** is nasty. Give me a lab coat anytime and give everyone who works there a lab coat please.
As long as you are in a hospital, you would never know what hit you. Hell, an IT came into one of my patient's room one day to fix the monitor. Normally you would think, "why would he need to wear a lab coat". Well, the patient is autistic and he likes to smear feces everywhere. Hmm.... need I say more.
Basically... you never know.

 

[McGillGrad]

As soon as I am not required, I will be wearing a suit and just take off the jacket and tie, and roll up the sleeves to see patients. No reason to wear a white coat as a physician.

Anyone is welcome to wear a uniform (white coat and all), but I prefer to be professional and wear a suit.

 

[Cruzinman]

On the locked Psych ward they have to lock up the white coats. Otherwise, the inmates will get a hold of them to pose as a health care workers and get buzzed off the floor.

 

[Dwindlin]

On the locked Psych ward they have to lock up the white coats. Otherwise, the inmates will get a hold of them to pose as a health care workers and get buzzed off the floor.

http://www.youtube.com/watch?v=qpDpjxITJFY

Edit: I suck at forums...can't figure out how to embed the video.

 

[koennen]

Has it ever occurred to you guys that people choose to wear LAB coats because it's more sanitary to do so in a hospital?


I personally don't see it as a problem if people choose to wear long lab coats because it means less chances of getting **** on your clothes.

Back when I worked at the clinical lab (which is on the 3rd floor of the hospital), everyone was required to wear lab coats... from the director to the janitor. Because you don't want to have **** like urine samples or vajayjay mucus getting onto your sweater.

Today, I still wear my lab coat religiously as long as I am not wearing scrubs simply because I don't want to have **** on my shirts, ties, and sweaters.

Have you noticed how people just put the urine cups and vagina-swab tubes everywhere on the counter or on the desk? That **** is nasty. Give me a lab coat anytime and give everyone who works there a lab coat please.
As long as you are in a hospital, you would never know what hit you. Hell, an IT came into one of my patient's room one day to fix the monitor. Normally you would think, "why would he need to wear a lab coat". Well, the patient is autistic and he likes to smear feces everywhere. Hmm.... need I say more.
Basically... you never know.

I agree with your comments. If I was a health care worker in a hospital, I would not want to get **** on my clothing either. But I really don't think that rationale explains why non-physician health care workers want to wear long WHITE lab coats.

I would be curious to see what would happen if a hospital dictated that only physicians could wear long white lab coats and all that all other health care workers (including PAs and NPs) could wear a long lab coat of any other color of their choosing. That would address the purported rationale for wearing a long lab coat. A lab coat doesn't have to be white to protect your clothing. But, how many people think that all of the non-physician health care workers (especially the PAs and NPs) would be ok with that? Yeah ... right.

 

[markglt]

if you don't have to go through med school and the usmles'.....no long white coat for you!

 

[Double Bonded]

here are a few selections that nurses might be interested in for the coming season (when long white coats go out of fashion):


it's short, it's elegant, and it doesn't get in the way paging that intern to room 34 at 3:00 am

this is a classy, timeless look that says "my diploma is saved on my hard drive under Local Disc C -> Stuff -> Lakeside Community College ->Graduation pix/docs"

this is a sort of retro-throwback sort of situation, made mostly for the winter months when a busy nurse needs to put some more distance between him/herself and the patient with ringworm

This last selection is my favorite. It consists of an elegant, yet subtle feature that provides grace and charm intermingled with power and dominance.

 

[markglt]