Saturday, May 21, 2016

A Lengthy Absence

Well, I'm back after a few very busy weeks. Soon after my last post it was time for final exams, and then afterward I taught a "May-mester" course--25 hours of class time in 2 weeks. Now it's time to catch my breath as I look forward to a summer of writing.

The mini-mester course was composed of RNs who are returning for their bachelor's degrees. This may seem odd to some, but the fact is, nursing has had 3 levels of educational entry for decades. Originally nurses were trained in hospital-based schools of nursing. This provided a labor supply, and guaranteed that student nurses would have practical, clinical training sites, as well as training that would teach them a specific hospital's procedures and inculcate them into that specific hospital's culture.

This passed out of fashion in most parts of the country, in part because nursing students were being treated as a source of labor more than they were being treated to an education that would have applications outside of this or that specific hospital. Also, as health care has matured, many smaller hospitals have closed specialty units such a pediatrics and obstetrics, that form key parts of a nurse's education. Interestingly, Pennsylvania has more remaining hospital-based diploma programs than any other state, although many, like a program in Lancaster PA, have converted into chartered degree granting institutions, providing a more rounded experience that includes things typical in a college education (like history, philosophy, writing, and so on).

Anyway, there are still a lot of community college-based programs throughout the U.S. So there are still lots of 2-year programs out there (although they consist of so many courses, it usually takes 3 years to get through). Many colleges and universities offer so-called "RN to BSN" programs, composed of students who may have practiced little yet, or may have been practicing for many years. Part of my teaching is in such a program.

Why do they go back to school?

In the past it was mostly to secure a promotion track with their employer, or to ready themselves for graduate school to become a nurse anesthetist, nurse practitioner, or educator. By law and custom a master's degree is required for these sorts of advanced practice roles.

Today, many return because their employers require the bachelor's degree. Research that emerged in the early 2000s found some evidence of an improved safety margin when hospitals have a larger number of BSNs working in them. That's good for patients, and it makes hospitals more competitive.

Ah, but what can one teach such nurses? After all, they are already licensed. However if the research found this additional safety margin, then there must be some additional tools we can provide these students. Over the next few posts, I'll discuss what these RNs value in their extra education. Those things speak to several important and interesting features of our health care system.

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