Standard of Nurse Practice Entry

By January 11, 2016Nursing


LPN, LVN, Diploma, ADN, BSN

  • The LPN/LVN’s spend a lot of time talking about how they are in fact a nurse, and just as good as an RN
  • The Diploma and ADN’s spend a lot of time talking about how a BSN isn’t worth it because they will not be paid more.
  • The BSN’s spend time saying, “A BSN is not the SAME as an ADN and I earned this degree! It was hard!” But….you are my coworkers and I love you!

You know what I think?


Changing the BSN to the entry level of practice, as good as it might be for the profession of nursing, is not our real problem. Our real problem is our complete inability to unite at all, right now, while our patients are dying of neglect

Yeah, I said it.

Let’s count beans here.  Or bodies.

Depending on whom you want to believe, Fatal medical errors are the culprit for between 98,000 and 210,000 deaths per year.  Most of these are misdiagnosis but the ANA links unsafe staffing to medication errors by nurses.

You have been there.  You worked nights and this is the AM med pass right before you go home.  Patient A needed 4 units of insulin, Patient B needed 14.  You reversed them.  You were exhausted and taking care of 2 patients more than recommended for your unit.

And Patient A could have died of it.

While I hate to place blame, you know that the fingers will point at you.  YOU are the nurse. YOU injected the medication.  YOU didn’t follow the policy that says we draw up one patient’s insulin at a time, and we don’t shove both syringes in the pocket of our scrubs to toilet Patient C on the way to their rooms.

But Patient Satisfaction.  And adequate care…and human kindness.  Patient C was about to soil herself!

Too bad.  Your fault.

How about we do what the airline industry does? We evaluate the process.  Especially the number of staff needed to safely do the job.  When the staff to patient ratio is too burdensome, more mistakes will be made.  Care will be late or nonexistent. Satisfaction scores will go down.  Reimbursement will plummet.

And the hospital will blame you.

How about we rally behind the thing that gives us unity? BEING NURSES.

I don’t care what ‘kind’ of nurse you are.  I care that you answer when my patient yells “Nurse?” while I am in the med room drawing up that insulin. I care that you have time, because we held the facility accountable for safely staffing the unit.

And I promise to get my BSN next year.  I swear.








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Author Janie Garner

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Join the discussion 4 Comments

  • lisanem57 says:

    Great blog. In my opinion it does not matter how many letters you have after your name, well, it doesn’t matter to me. What matters to me is exactly what Janie wrote, our inability to unite as a profession. I believe there is a place for all nurses with all their degrees but if we do not unite, learn to play well in the sandbox, and get behind our concerns, nursing will remain stagnant. The beauty of nursing is not our degrees, it’s the fact that we care for others when no one else can or will. Our unique gift is our ability to authentically care for others using our nursing art and science. But if we do not work together using our significant collective strength to resolve our issues, if we do not take the wheel and direct our own profession, and if we do not care for ourselves they way we care for others our beloved profession will never be honored and admired in the way it should.

  • Cathy Marrone says:

    I love this! I have worked with outstanding to pretty awful healthcare workers with all initials and education. Experience, willingness to learn, work ethic, teamwork are more important than initials. We all have a job to take care of our patients together, period! Everyone has their reasons for their level of education. We don’t judge our patients, why do we judge each other? It’s sad. Where did empathy and understanding go?

  • Samantha Purcell says:

    Every nurse has a place and we should work together regardless of the letters behind our name. We care for the sick and injured. It’s time to unite and respect the area that each nurse works. I’m great at LTC but the RN next to me may work in a hospital. It shouldn’t matter what setting we work in, we are all Nurses!

  • Roberta Rheinschild says:

    Like many, I have been very impressed by an LVN and wondered how a Masters prepared RN managed to pass the boards. I believe that there is room for all of us. Let me say, before anyone takes umbrage to my comment, that I have the utmost respect for those in our profession who have Masters, Doctorates, and any kind of certifications.
    We don’t just need ratios! We must demand acuity tools in addition to the ratios, and care facilities of any sort need to be held accountable to both.
    Thank you Janey for this blog!

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