Farewell to the New Underclass of Registered Nurses! 

After years of progressive Nursing engineering, Associate Degree Nurses (ADNs) were finally voted off the island. Diploma nurses have also gone the way of the dinosaur. We call this progress for the advancement of nursing as a profession.  The old RNs of yesteryear, whether diploma nurses or ADN, are no longer needed at the bedside, unless they return to school to get a Baccalaureate Degree to stay in the game.

Most organizations have already emptied their clinical ranks of LVNs, Licensed Vocational Nurses. Now it looks like RN’s  with less than a BSN are next to go.  Many RNs feel Magnet accreditation is to blame for these educational requirements.  That is only partly true.

Magnet accreditation is Designed to attract BSN nurses to facilities with higher nursing standards. In spite of common belief, Magnet does not have ADN to BSN ratios for accreditation by the ANCC. (American Nursing Credentialing Center). I cannot imagine it was intended to penalize existing RN’s with Associate degrees.

However, Magnet does expect Nurse Managers, and Nurse Leaders to have a BSN.   Hospitals define their own internal educational advancement goals for nurses, then benefit by meeting those stated goals. Hospitals working toward meeting Magnet standards have already adopted new-hire preference for BSN nurses. Some ADN nurses are accepted, provided they are actively enrolled in BSN programs. Filling vacant nursing positions has been a struggle for as long as I can remember.

The main driving force for the BSN standard into nursing comes from the Institute of Medicine. In 2010, new demands were raised requiring the nursing profession to have 80% of all nurses to hold bachelor’s degrees by 2020.  My hospital has accepted that request. Notified in writing: all RN employees must have a BSN at the turn of the decade. Several nurses chose to go back to school to stay onboard, many others chose otherwise. On January 1, a sizable number of ADNs with several years of valuable experience will be leaving.

I appreciate the intended goals set for our profession.  I am proud of our nursing heritage and the advances we have made in the last 100 years of Nursing Practice. New nurses entering the profession will follow this honorable call to service and advance our practice. Doctorate level nurses will increase with this new push for advanced degrees also. The great nurses of my generation will step aside to let them nurse on. The next 100 years of Nursing could see technological miracles we cannot even imagine.

As two pathways into the profession are closing, I fear there may be fewer people drawn to the field due to higher educational costs and time commitments. There are people from all walks of life who are called to be caregivers and comforters to the sick.  Many middle aged adults enter the field as a second career, to give back to their fellow humans.  The Diploma and Associates programs were a fast track to the bedsides of those who would benefit from such love.

ADN nurses, bridging to earn the BSN, are getting a pretty good deal though. Most, if not all, school expenses are reimbursed by hospital employers. Many hospitals offer tuition reimbursement for advanced clinical education too. My hospital is among the best for this. The future is actually bright for Nursing.  What gives me pause however, is how we are failing to honor Nursing’s past at this mile marker.  We will say goodbye to some talented nurses needlessly, as healthcare plunges into an unknown future.

I think we need to  find a better alternative for hospital nurses. Many have only a few years left to go, before they would have finished their careers naturally.

Seriously …What’s the rush?

Average age of nurses is steadily increasing. 53% of working nurses today are over the age of 50.  I see no value in sending anyone off into the sunset before their time.  We might get another  10 or 15 good years out of them. . In the twilight years of our nursing careers, many older nurses stay in it for the pure love of caring for people. Experienced hospital RNs, regardless of their degree, help new nurses stay safe and secure as they grow into their careers.  I feel it would be a tremendous waste of talent to let good nurses slip away too soon. We really should be asking them to stay!

It could benefit us to grandfather these awesome nurses instead. (or shall I say “grandmother”) Let them finish their careers with dignity. Let’s respect the years they have already given us, by allowing them to choose when it is time to lay down the stethoscope.