March 25, 2011

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Does higher education lure nurses away from the bedside?

June’s guest, Donna Cardillo, MA, RN looks at higher education and whether it lures nurses away from the bedside.

There is a widespread belief among nurses that once a nurse has a BSN or MSN, he or she will no longer want to work at the bedside. In other words, the degreed nurse will not want to “dirty” his or her hands and will seek to move on to management, administration, education, or something else. That viewpoint has always fascinated me because the implication—intended or not—is that a nurse with minimal college preparation is the only one who will find direct care appealing. This perspective trivializes the bedside role implying that it’s only for the uneducated—ouch!  It also implies, whether one realizes it or not, that direct patient care is menial and not worthy of the nurse with an advanced college degree. On the contrary, the more a nurse knows about the science behind the practice and the bigger world of nursing and healthcare, the more interesting and meaningful the work can become.

Let me be clear on a few things. This discussion has nothing to do with who the “better” nurse is. That debate is outdated and irrelevant. Nor does it have to do with what should be minimal entry to practice. This post is specifically about the notion held by some nurses that furthering their education (or other nurses doing same) will change their perspective and passion for direct care and, in effect, draw them away from the very thing that drew most of us into the profession.

So back to my point, which is that higher education can only enhance the bedside experience for the individual nurse rather than repel her or him from it. For starters, I personally know and regularly encounter hospital (and alternate care setting) nurses providing direct care who have BSNs, MSNs and yes, even some with doctoral degrees. Most love what they do and have no current or future aspirations to move on. I’m not talking about advanced practice nurses here, although some of them are at the bedside as well.

Another compelling point is that many second career nurses are entering the profession. My own informal research has shown that second career nurses are staying at the bedside longer than traditional first career nurses and they are planning to stay there for the foreseeable future. That’s interesting considering the fact that most second career nurses are coming into the profession with previously obtained advanced degrees (bachelor’s, master’s and even a few doctoral degrees) in non-nursing majors along with additional degrees in nursing and prior work experience including management experience in many cases. They are enjoying the direct care role, finding it both challenging and rewarding.

Simply stated, there is no evidence to support the belief that higher education lures nurses away from direct patient care. And perpetuating that belief demeans the true value of what we do. If you think nursing care is only wiping, cleaning, administering medication, doing procedures, and following orders, I could understand that you might think that way. But if you see bedside care for what it truly is—the high level, critical thinking, life-saving, clinically astute, evidence-based, complex, collaborative, primary care role—then anyone could see how an advanced degree would only support and enhance that role.

Nursing practice is constantly advancing so it makes sense that advanced education would only help the bedside nurse to keep up. Higher education gives one a broader sense of self and life. Education helps you to communicate better. It does not make one nurse better than another but rather makes the individual nurse a better version of him- or herself. When bedside nursing is recognized and appreciated by individual nurses for the vital and substantive role that it is, this discussion will no longer be needed.

Donna Wilk Cardillo is the Career Guru for Nurses and “Dear Donna” columnist for Nursing Spectrum, NurseWeek, and www.nurse.com. Donna is also an ‘Expert’ Blogger at DoctorOz.com. She is author of The ULTIMATE Career Guide for Nurses, Your 1st Year as a Nurse, and A Daybook for Beginning Nurses. Ms. Cardillo is creator of the Career Alternatives for Nurses® seminar and home-study program. You can reach her at www.dcardillo.com.

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17 thoughts on “Does higher education lure nurses away from the bedside?”

  1. mdb46rn says:

    I have a master’s degree in nursing education, and I agree that the additional training has made me a better bedside nurse. Though I did decide to also take on the role of a university nursing clinical instructor, I can’t imagine completely giving up direct patient care. More formal research on this subject would prove enlightening.

  2. mw75rn says:

    I am originally a diploma nurse who returned to school, graduating with a BSN in 1980. I have worked at the bedside for most of the last 30 years.

  3. Anonymous says:

    My nursing career started with an assosiates degree. I further advanced to a BSN, MSN and MHA degree. I am not currently doing bedside nursing but believe me when I say that really is my passion.

  4. Anonymous says:

    I’m a second career nurse with a BSN. My ultimate goal is to teach nursing students while still practicing at the bedside; and not as an advance practice nurse, but as a staff nurse. Unfortunately, there is no incentive in pay for nurses to advance their degree beyond the BSN and stay at the bedside. While I love nursing and greatly desire to stay at the bedside, one must still consider the cost/benefit factor when deciding to persue another degree, esp. if you have debt from a previous degree.

  5. Anonymous says:

    Evidence that higher education is associated with non-bedside roles is found in comparing the ed. levels of those at the bedside with the ed. levels of nurses in non-bedside roles. Most people advance their education to open up additional job opportunities.

    Also, note that only 1 of the first 4 posters is actually working 100% at the bedside and plans to stay there. Nurses value bedside roles, but often choose other roles when given the opportunity.

  6. Anonymous says:

    I posted previously as the second career nurse. I also wanted to mention that the nursing profession has failed to stress the importance of having current (RN) bedside clinical experience to teach nursing students. While I attended a very good SON, most of my instructors were PhD prepared with very little current bedside experience or they were practicing NPs. The instructors who had current bedside experience were limited to clinical instructor role.

  7. Anonymous says:

    It only makes sense to me that you want the people preparing students for the staff nurse role to be currently working in that area. There is too much focus on the PhD to teach in a SON. While I respect the PhD as a research degree, I do not think that it necessarily makes someone a better educator. I think a person with a MSN in Education who currently works at the bedside makes the best teacher for students who are about to enter the role of staff nurse.

  8. Anonymous says:

    I would like to comment that the nurses having more than one degree will not always choose to leave the bedside nursing for personal and professional reason. I, for one, have three degrees, two bachelors, one in education, one in nursing and a masters in nursing. I have not yet made the choice to leave the bedside because I still enjoy educating my patients/family members and still enjoy the relationships I have made with the patients/family members while they or family members were hospitalized

  9. Anonymous says:

    Sometimes it is just education for education’s sake. I don’t know what I will do with my MSN/MHA when completed,but know that it will make me a better nurse for my patients. Nursing is a fascinating career because of the various places one can find oneself employed-hospital, community, corporate, education, etc. Those that speak poorly of educational advancement tend to be jealous in my experience and feel “stuck” where they currently are for various reasons.

  10. Anonymous says:

    I agree that furthering your education can only enhance your experiences. I graduated with a BA in heathcare management/now enrolled in a BSN prog. I feel that having a BSN will enable me to provide better care because of my increased knowledge base. Don’t get me wrong,many bedside nurses provide wonderful care and do not have an advanced degree. I personally feel in order to provide the best possible care I need my patients to know that I am qualified and dedicated to their care and safety.

  11. Dr. T says:

    In my experiences since obtaining my graduate degree, many organizations are reluctant to hire me as a clinical bedside nurse when they see the credentials on the CV. I am not sure why this is the case. It is very disheartening because I love emergency and critical care nursing and believe that to be an effective educator I must stay clinically astute.

  12. Anonymous says:

    As a second-career ADN RN, I am resentful that my previous BS and MS degrees are not recognized as valid in nursing because they are not BSN/MSN degrees. We want people to come to nursing, but fail to acknowledge and respect the life and work experience they bring with them.

  13. Anonymous says:

    With an associate degree in nursing science (ASN), BS in health arts, Master’s in Health Admin, and more than 30 years emergency, critical care, psych and surgical speciaty nursing experience, I am back pursuing an MSN. Although I value the education I have had, the MSN (with bridging courses)greatly expanded my knowledge & understanding of nursing, and enhanced & improved my practice. Experience is one thing – but advanced education, research and EBP at the bedside is key to quality care.

  14. Anonymous says:

    what isn’t mentioned is the simple fact that bedside nursing requires shift work/weekends & holidays- getting away from the bedside in order to experience a more “normal” life was the reason i got into other areas of nursing- in addition, i don’t believe 50+ year olds have the stamina for rotating shifts……..my opinion

  15. RN,MSN says:

    Interesting post. I hold a MSN degree, work at the bedside, and I am in my 50’s. I work three, 12 hour shifts/week. I love the flexibility of my work schedule which allows me to work a day or two at another job which is not direct patient care. I also found that I have much more earning power in my current roles. If I took a job as a nurse manager or director I would make less money. For those who can, bedside nursing provided flexibility to do other things you enjoy.

  16. Anonymous says:

    Let’s be honest, most of the nurses posting here do not work full-time at the bedside as a general nurse. Being the nurse educator means that you sought out advancement and are not at the bedside passing out medications and performing treatment day in and day out. This article had no statistics to support it. Therefore it is an opinion. Let’s see some hard statistics.

  17. Houston we have a problem says:

    I think that there is a huge disconnect between what we need and what the new nurses ADN and BSN have as entry in to practice knowledge. We need the most skilled and knowledgeable practicioners at the bedside to manage the increasingly complex patient care delievry load and models. I am a MSN prepared nursing leader, I persued advanced education to obtain this position but that was after nearly 20 years of patient care. New grads are completing BSN and immediately enrolling in MSN programs.

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