# paramedic to rn bridge_excelsior program



## Righteous

Does anyone know what the validity is for the online excelsior program. I've been searchin the web for a while, but no success in finding accurate information.

From what I understand you take an online class(at your leisure) do some clinicals and take some rn equivalent national registry. 

I live in georgia and I'm being told that excelsior nurses are no longer being hired. Can someone elighten me or point me in the right direction for the information I need. If I can't get a job, what's the point of paying for an expensive bridge program?


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## TransportJockey

Some states will no longer register RNs who did a program through Excelsior. NM was moving in that direction when I moved. Its usually cheaper, though a little longer, to just do an ADN program at a community college. And that way you know you can get a job when you're done with school


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## Journey

Righteous said:


> I live in georgia and I'm being told that excelsior nurses are no longer being hired. Can someone elighten me or point me in the right direction for the information I need.



Contact the Georgia Board of Nursing for the correct information.


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## medicRob

Righteous said:


> Does anyone know what the validity is for the online excelsior program. I've been searchin the web for a while, but no success in finding accurate information.
> 
> From what I understand you take an online class(at your leisure) do some clinicals and take some rn equivalent national registry.
> 
> I live in georgia and I'm being told that excelsior nurses are no longer being hired. Can someone elighten me or point me in the right direction for the information I need. If I can't get a job, what's the point of paying for an expensive bridge program?



Georgia repealed. One of the nursing sites that I administrate had a big debate over this, and many were pissed. Georgia will not license RNs who have completed excelsior's program. I can't say I disagree with them. I spent 2 solid years in clinicals, labs, and class 5 days a week and even weekends in some situations. During these two years, I did clinicals in many areas: nursing homes, Emergency Rooms, CVICU, NICU, Neuro ICU, Nephrology Units, OR, Med/Surg, and many others. Moreover, many employers will not hire you when they find out you completed your nursing education online. 

In my humble opinion, I don't feel that anyone other than an AAS or ASN RN should be allowed to take nursing courses online. The only reason I feel the AAS and ASN would be able too is because the skill set between BSN and AAS/ASN are the same. The only difference is management, research, education, and community health. 

If you really want to be an RN, go to the NLNAC's website, locate an accredited campus program in your area, and enroll.


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## whatw14578

i did my RN program through them and had no problem getting a job after the fact. everyone learns different. you will have to put in the study time, but if you do. you will be just fine. i say go for it. lots of us in Florida have


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## medicRob

whatw14578 said:


> i did my RN program through them and had no problem getting a job after the fact. everyone learns different. you will have to put in the study time, but if you do. you will be just fine. i say go for it. lots of us in Florida have



Try getting a job in critical care.


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## usalsfyre

medicRob said:


> Try getting a job in critical care.



While I can't say I disagree with your premise (and for that mattter, have the same issue with RN's "challenging" the NREMT-P) it can be done. A well known CCT educator was able to go through CRNA school after Excelsior's RN and BSN programs.


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## Journey

It is not the fact the program is online but the fact the program is totally online and lacks in labs and clinicals.  

However, I think this program is great for some LVNs who  have been clinically trained for most of the skills in nursing and have experience taking care of several patients in a hospital or some LTC facilities. I would not recommend Excelsior to a Paramedic who has never worked as an LVN in a hospital.  They may be okay finding a job in the ED but will still need  extensive precepting and will have to be carried by the other RNs for a long time.  Paramedics probably should have been excluded from the group that can take the Excelsior program and it be left open to only LVNs.



usalsfyre said:


> While I can't say I disagree with your premise (and for that mattter, have the same issue with RN's "challenging" the NREMT-P) it can be done. *A* well known CCT educator was able to go through CRNA school after Excelsior's RN and BSN programs.



The key word here is "A" meaning one. I also believe he did not work very long as a nurse and went straight to CRNA which is a specialty with a limited focus and 1:1 patient care in one area.

Most RNs who challenge the Paramedic exam will still be working as a nurse under their nursing license and the Paramedic cert is just a loop to jump through that defines an ambulance. Those that do choose to work just as a Paramedic will disclose their education to their employer so they can adjust the orientation on the truck. For those who have gone to the FD or ambulance services as a Paramedic, it doesn't seem to be an issue.


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## whatw14578

righteous go for it. dont let anyone talk you down. if you put in the effort and do the work you will be ok. and you can work in any part of nursing with your degree even CC. i do and so do many others. the bottom line will be is that you can always find people to talk down about the program. just like when i took it. but once you go through it and pass everything you will be working just like any other new grad. i did my AS in paramedic/EMS right out of high school (2003) and the medic to RN program not long after. i was all finished by Jan 2006. and know many others who have done it as well. including lots of military medics.


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## Journey

whatw14578 said:


> righteous go for it. dont let anyone talk you down. if you put in the effort and do the work you will be ok.



Be careful about the information you give out.
Only if his state accepts it will it be okay. The best advice is to contact the BON of that state prior to initiating the program. It the state does not accept it, he may have to move to another state for 2 years to gain reciprocity and endorsment.



> you can work in any part of nursing with your degree even CC



Technically you could work any area that requires an RN licence but you may not be the best candidate. There is no shortage of applications to the critical care areas and they probably will not pick someone who has never worked in a hospital and has not done any clinicals.


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## medicRob

usalsfyre said:


> While I can't say I disagree with your premise (and for that mattter, have the same issue with RN's "challenging" the NREMT-P) it can be done. A well known CCT educator was able to go through CRNA school after Excelsior's RN and BSN programs.



I don't really like the idea of RN's challenging NREMT-P either. I, myself went through 4 years of RN school, and 1 year of EMT-IV school followed by 2 years of Paramedic school. I wouldn't have done it any other way.


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## MusicMedic

In California the Nursing board here doesn't recognize the Excelsior program as a valid program...


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## usalsfyre

Journey said:


> The key word here is "A" meaning one. I also believe he did not work very long as a nurse and went straight to CRNA which is a specialty with a limited focus and 1:1 patient care in one area.



Never said it was the norm, and he's also an exceptionally smart and motivated individual.




Journey said:


> I would not recommend Excelsior to a Paramedic who has never worked as an LVN in a hospital. They may be okay finding a job in the ED but will still need extensive precepting and will have to be carried by the other RNs for a long time. Paramedics probably should have been excluded from the group that can take the Excelsior program and it be left open to only LVNs.



I know multiple RRTs who have gone this same route. Do you recommend against it for them? Or is it an inborn bias against paramedics. 



Journey said:


> Most RNs who challenge the Paramedic exam will still be working as a nurse under their nursing license and the Paramedic cert is just a loop to jump through that defines an ambulance. Those that do choose to work just as a Paramedic will disclose their education to their employer so they can adjust the orientation on the truck. For those who have gone to the FD or ambulance services as a Paramedic, it doesn't seem to be an issue.



Doesn't matter, what's good for the goose is good for the gander. I refuse to advocate for ANY shortcut program into any profession.


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## usalsfyre

medicRob said:


> I don't really like the idea of RN's challenging NREMT-P either. I, myself went through 4 years of RN school, and 1 year of EMT-IV school followed by 2 years of Paramedic school. I wouldn't have done it any other way.



Very glad to see someone who did it right. I can also say I think those who go the Excelsior route are cheating themselves out of education.


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## Journey

usalsfyre said:


> Doesn't matter, what's good for the goose is good for the gander.



True. When ambulances and FDs only want warm bodies with a Paramedic patch they should accept them. However, since many Paramedic programs are not getting their students job ready with skills and the clinicals can vary greatly for experience, there shouldn't be that much of a problem. At least an RN who has been trained in a traditional program will have at least 1000 (1500 average) hour of clinicals and that includes multiple patient contacts. The Paramedic student may have very little previous experience except for a BLS ambulance and may not even have an interest in medicine but is merely satisfying a work requirement to be a FireFighter or to live out some action hero fantasy.  When the EMS industry itself only views the Paramedic cert as just an extra add on, why should it be any different for RNs?  Close the loopholes by advancing education  across the U.S. This is what other professions such as Respiratory Therapy and Radiology did to keep RNs from challenging their certs.


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## medicRob

Journey said:


> True. When ambulances and FDs only want warm bodies with a Paramedic patch they should accept them. However, since many Paramedic programs are not getting their students job ready with skills and the clinicals can vary greatly for experience, there shouldn't be that much of a problem. At least an RN who has been trained in a traditional program will have at least 1000 (1500 average) hour of clinicals and that includes multiple patient contacts. The Paramedic student may have very little previous experience except for a BLS ambulance and may not even have an interest in medicine but is merely satisfying a work requirement to be a FireFighter or to live out some action hero fantasy.  When the EMS industry itself only views the Paramedic cert as just an extra add on, why should it be any different for RNs?  Close the loopholes by advancing education  across the U.S. This is what other professions such as Respiratory Therapy and Radiology did to keep RNs from challenging their certs.




My interest had always been in medicine. Surprisingly, I never really developed a taste for fire, and never wanted a part of it. It was the medicine that attracted me. My interest in EMS all began when I took a first responder class, at that point, I knew I wanted to be a paramedic. 

I was particularly fortunate to be part of an exceptional paramedic program which trained us to see each patient as a textbook and realize that the patients we were going to be seeing on a daily basis were a far cry from the textbook, healthy 20 year old depicted, in terms of both anatomy and physiology. Moreover, in keeping with the times, my program also had a "home health" component, which surprised me as a nurse.. I am proud to say that "Home health" component has now become a required part of the state's paramedic checkoff sheet in some capacity. Once I finish the push with the local University to require nursing level general education as pre-requisite for its paramedic program, I intend to work with a local trauma center to drastically redefine the role of the Paramedic in the emergency department by taking advantage of a few articles in TN Code Annotated that allow for more control over skills by the overseeing medical director, allowing paramedics with formal degrees and hours in Anatomy & Physiology as well as microbiology to function in a capacity that is more like an RN with regard to skills that can be performed in the ED.


Copy of the checkoff sheet: 
http://health.state.tn.us/Downloads/PH3806.pdf


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## Journey

medicRob said:


> My interest had always been in medicine. Surprisingly, I never really developed a taste for fire, and never wanted a part of it. It was the medicine that attracted me. My interest in EMS all began when I took a first responder class, at that point, I knew I wanted to be a paramedic.



That is excellent that you have put much effort into your education and training. I wish all would do that.

However, there are also exceptions to TN and EMS as well. Memphis FD is an example of that when they started their own inhouse training program to mass produce Paramedics.


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## medicRob

Journey said:


> That is excellent that you have put much effort into your education and training. I wish all would do that.
> 
> However, there are also exceptions to TN and EMS as well. Memphis FD is an example of that when they started their own inhouse training program to mass produce Paramedics.



True. However, let's remember, they are the ONLY non accredited Paramedic program in the state. All the others are accredited. Here is my evidence:


On the following page, click education, and approved institutions.
http://health.state.tn.us/EMS/personnellicensure.htm

You will see that all programs EXCEPT the memphis training academy that host Paramedic level programs are CAAHEP Accredited.

(edit) There is one more, "The Southeastern institute". However, there are rumors circulating amongst the powers that be in TN, whom I have spoken too directly that in the very near future, ALL paramedic programs are to be accredited by one of the two accrediting bodies for paramedic education. This will take care of medic mills.


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## Journey

medicRob said:


> True. However, let's remember, they are the ONLY non accredited Paramedic program in the state. All the others are accredited.



Yes, but Memphis is a new program which appeared within the last two years. Once the exception is made it is difficult to keep others out. Accreditation is great and a good start but California (all accredited Paramedic programs) is good example that it is not the end all to every problem in EMS.  AMR's medic mill is also accredited as are the other private techs in that state which are expensive and mass produce.


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## medicRob

Journey said:


> Yes, but Memphis is a new program which appeared within the last two years. Once the exception is made it is difficult to keep others out. Accreditation is great and a good start but California (all accredited Paramedic programs) is good example that it is not the end all to every problem in EMS.  AMR's medic mill is also accredited as are the other private techs in that state which are expensive and mass produce.



The new standards take effect in TN in late 2011. Hopefully, the accredation requirement will as well.


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## Shishkabob

Journey said:


> However, there are also exceptions to TN and EMS as well.



And there are exceptions in nursing.   And, *gasp* RTs! What's your point?  Get off your high horse.


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## Journey

Linuss said:


> And there are exceptions in nursing.   And, *gasp* RTs! What's your point?  Get off your high horse.



I have no idea what point you are attempting to make with the high horse comment unless you are again trying to make this a personal attack. The exception right now in nursing, which this thread is about, is the Excelsior program and has already been discussed. That program would even allow a very new Paramedic such as yourself to enroll.   Do you have something to add to that?  As you stated to another forum member, read the first few pages. 

The conversation with MedicRob and I pertained to TN and the Memphis FD starting their own Paramedic program.  RTs (Radiology Technologists or Respiratory Therapists) increased their education requirements for what had been certs to prevent RNs from challenging their tests or requiring them to meet the same standards as anyone else wanting to be in the profession or to perform a certain skill which can still be an issue in Radiology.


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## usalsfyre

Journey said:


> Close the loopholes by advancing education  across the U.S. This is what other professions such as Respiratory Therapy and Radiology did to keep RNs from challenging their certs.



We've been down this road before. One thing you and I agree on is that as long as FDs are heavily involved in transporting EMS they have a vested interest in keeping it down to a tech-level certification program (no different than rope rescue or hazmat, just longer). 

One of the reasons EMS is so much further along in most of the rest of the third world is they all have a national health service and EMS is not revenue driven. I'm at a loss for how to change this though.


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## Veneficus

usalsfyre said:


> One of the reasons EMS is so much further along in most of the rest of the third world is they all have a national health service and EMS is not revenue driven. I'm at a loss for how to change this though.



Third world?

Have you looked at the US lately?

It has no value on education.

A near 10% unemployment rate (similar to some of the poorest countries on earth)

It has no meaningful export to speak of. 

A crushing debt.

An ineffective over extended military.

Spends billions on healthcare that cannot get better outcomes than people spending significantly less.

It is not exactly the epitomy of modern society. 

But really, it is not government supported healthcare that is going to be a game changer. A majority of Healthcare dollars come from medicare/medicade, which means most healthcare spending is already done by the Govt.

There are 2 changes that will be required in order to fix EMS issues in the US. The first is providers will have to take it upon themselves to get educated prior to any benefit from it. After a majority of providers are they can start making demands. In order to do that, they will have to step out of the role of a glorified taxi with BLS, ACLS, and PALS protocols. 

The second step is beaten ground, just like all other licensed providers they will have to have a role unique to them that adds value so they can petition for reimbursement. 

If a fire department were to equally implement such tasks, it too could benefit from the new revenue stream and maintain its already substantial public support. 

Maybe when some of the fire service dinosaurs who still linger on and stagnate the whole fire profession finally die off, I think there will be a steady shift towards degrees. 

I once asked my high school guidence councilor when she said I was too smart to be a firefighter: "When your life is on the line, from fire, a medical emergency, or a car accident; Who do you want coming to the rescue? The gy with a few hours of vocational education or the smartest person you can find?"

I think with the dwindling fire service positions, what is being asked of the firefighters, and the growing competition for those spots, that the average education and therefore value of education will increase.


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## whatw14578

its at 12% in north florida. but the Com college has had a record enrol. this past 2 years. so many people are going back to school. good for them


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## rook901

Wow, this thread is on the off-topic fast track. 

To the OP: Excelsior is a very valid option, but you definitely need to check with your state's BON before enrolling to ensure that it is accepted. In some states, as has been mentioned, you cannot be licensed with your Excelsior degree in hand. For some other states, you will have to work a certain number of hours as an RN in another state before being licensed (can't remember which states require this).

(Edit: This is a good list to refer to for each state's requirements.)

If going through a traditional program is doable for you, I'd say go the traditional route simply because it is more structured and does not afford you the luxury of spending up to five years to complete. However, for me, a traditional program wasn't an option if I wanted to continue working at my full-time job. So, I did Excelsior and didn't look back.

As for the "try getting a job in critical care" comment and the comment about employers not hiring you based on your online education - that's complete nonsense. Employers do not care which school you went to, so long as it's accredited by AANC or CCNE and your degree meets their minimum requirements (diploma vs ADN vs BSN). As for critical care jobs, there are many EC grads employed in critical care, and I can be counted among them. I frequent a nursing discussion site with a very active distance education forum, and I'm in touch with several EC grads that have gotten jobs in critical care. If you have prior experience in EMS, especially as a paramedic, you've got a huge leg up on ANY new grad RN with no previous experience that's shooting for a critical care position.

Clinicals only take you so far. I completed half of an LPN-to-RN program before dropping out and going Excelsior (had to drop out because the program was very disorganized - they would change the clinical schedule on a weekly basis, which didn't work out very well with my employer). Completed rotations in med/surg, OB, geriatrics, peds and psych before I left. Clinicals were a joke. Most of the time was spent writing care plans and reading through charts. We spent about two hours out of a six-hour clinical day doing patient care, and we didn't do anything more advanced than setting the flow rate on an IV pump or giving an IM injection. This was in a program where we were already expected to have a baseline of nursing knowledge (LPN), so I can only imagine what was going on in the regular RN program. I realize that not all programs are so underdeveloped in clinical experience, but it's one example where clinical experience in a traditional program does not mean that the program is superior to Excelsior.

In Excelsior's program, you're required to complete a two and a half day clinical exam (CPNE) where there is no teaching or coaching. You either know what you're doing or you don't. If you don't, you fail. Do not pass Go. Do not collect $200. This is great for washing out those who don't know what they're doing, but it's also a really bad deal, as you're out $2000 + travel expenses. 

On the pro side for traditional program clinicals, going to a traditional program means that you are doing your clinicals in local hospitals and getting exposure to nurse managers who may offer you a job before you graduate. That's definitely a big benefit over Excelsior.

In the end, RN school only teaches you enough to keep you from killing someone. It doesn't matter if you're coming out of a diploma program, an ADN, a BSN, or an accelerated MSN for non-nursing BS students, you're still all going to go through the same hospital and unit orientation. Again, as long as you've got your unencumbered RN license, the hospital really doesn't care.


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## rook901

Sidenote: I don't even want to get into a BSN vs ADN debate, and I believe that my previous post might open up that pathway. BSN's do have an advantage over ADN's in the job market, and Excelsior only offers the ADN to non-RN's. So, there is that to consider when choosing a nursing program.

I believe that BSN should be the entry level for RN's and that you should complete a BSN rather than an ADN if you're able to. Just making the point that Excelsior is a very valid option right now for those that are otherwise unable to go to a traditional program.


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## medicRob

> As for the "try getting a job in critical care" comment and the comment about employers not hiring you based on your online education - that's complete nonsense. Employers do not care which school you went to, so long as it's accredited by AANC or CCNE and your degree meets their minimum requirements (diploma vs ADN vs BSN)



Not nonsense at all. In fact, many critical care units in my area will not hire excelsior graduates if they can help it. 





> In the end, RN school only teaches you enough to keep you from killing someone. It doesn't matter if you're coming out of a diploma program, an ADN, a BSN, or an accelerated MSN for non-nursing BS students, you're still all going to go through the same hospital and unit orientation. Again, as long as you've got your unencumbered RN license, the hospital really doesn't care.



I am going to have to disagree with this as well. A good RN program prepares you to do more than "not killing people". I was able in my nursing program to take classes on year 4 such as "Cardio-respiratory concepts of critical care nursing" to name a few that really gave me a leg up in critical care and prepared me for issues that I would face in my career. I was part of a very involved nursing program and while I will not disagree with you that I was scared on my first shift as an RN, there was never a point where I didn't feel confident in carrying out the tasks required of me. 

If you feel that your nursing program only prepared you to "not kill people", then perhaps that wasn't the best nursing program.. Our clinicals were quite involved and consisted of more than writing care plans and charting.. We performed procedures, administered meds, did nursing rounds, and worked as an integral part of the nursing team. We were given the opportunity time and time again to  perform critical skills, were given the ability to critically think, and were exposed to a variety of pathologies and physiological alterations over those 2 years of clinicals. I'm sorry if it hurts your feelings, but if I were in an ICU, I simply would not trust an excelsior RN to be my nurse. I would barely feel comfortable with one in med/surg, let alone critical care.


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## Journey

rook901 said:


> As for the "try getting a job in critical care" comment and the comment about employers not hiring you based on your online education - that's complete nonsense. Employers do not care which school you went to, so long as it's accredited by AANC or CCNE and your degree meets their minimum requirements (diploma vs ADN vs BSN). As for critical care jobs, there are many EC grads employed in critical care.



That will depend entirely upon the hospital and how progressive it is. There are many ICUs which are little more than a glorified tele or med-surg holding unit.  The system I work for has 10 hospitals and we haven't hires an Excelsior grad in over 10 years with the exception of the LPNs who made the transition while employed with us. We don't have to hire EC grads. There are enough BSN grads applying who did their clinicals at our hospitals to choose from.   You also have to consider there are states that just don't want EC grads period. 




> If you have prior experience as a paramedic, you've got a huge leg up on ANY new grad RN shooting for a critical care position.



Probably not. The 2 week CCT course does not even come close to making a Paramedic qualified for the Intensive Care Units. A new grad RN will at least have A&P, Pharmacology and the basics of nursing to work with as they go into a new grad program to teach them the fundamentals of Critical Care. Right now, the internships are few and far inbetween with the BSN grad still being the best candidate at the Magnet hospitals.

But, at least with the Excelsior program you are not taking a college seat from someone who really wants to be a nurse and will take the program seriously to be a good professional. I guess you can consider that an advantage.

Edited after seeing your later post.


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## rook901

medicRob said:


> If you feel that your nursing program only prepared you to "not kill people", then perhaps that wasn't the best nursing program.. Our clinicals were quite involved and consisted of more than writing care plans and charting.. We performed procedures, administered meds, did nursing rounds, and worked as an integral part of the nursing team. We were given the opportunity time and time again to  perform critical skills, were given the ability to critically think, and were exposed to a variety of pathologies and physiological alterations over those 2 years of clinicals. I'm sorry if it hurts your feelings, but if I were in an ICU, I simply would not trust an excelsior RN to be my nurse. I would barely feel comfortable with one in med/surg, let alone critical care.



It really doesn't hurt my feelings. It's simply ignorance. I'm not going to get into an argument about it. The school does not make the nurse. The individual makes the nurse. I've worked with some LPN's that I've felt were more competent than some BSN-educated RN's.

My statement about preparing RN's to not kill people was an attempt at humor that apparently fell short. But there is some truth behind the joke. Much more is learned in the first year on the job than is learned in school, regardless of the length or depth of education.

I'm very impressed by your individual clinical experiences, but not all schools are created equal. My LPN-to-RN program's clinical requirements fell far short of my expectations. I also have a friend who is in her last 6 months of an accelerated non-nursing-BS to MSN at UT Memphis, and her experiences echo mine. Maybe it's a Memphis thang.

I'm sure that there are some traditional programs that are superior to Excelsior, but that does not mean that all traditional programs are superior.


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## medicRob

rook901 said:


> It really doesn't hurt my feelings. It's simply ignorance. I'm not going to get into an argument about it. The school does not make the nurse. The individual makes the nurse. I've worked with some LPN's that I've felt were more competent than some BSN-educated RN's.
> 
> My statement about preparing RN's to not kill people was an attempt at humor that apparently fell short. But there is some truth behind the joke. Much more is learned in the first year on the job than is learned in school, regardless of the length or depth of education.
> 
> I'm very impressed by your individual clinical experiences, but not all schools are created equal. My LPN-to-RN program's clinical requirements fell far short of my expectations. I also have a friend who is in her last 6 months of an accelerated non-nursing-BS to MSN at UT Memphis, and her experiences echo mine. Maybe it's a Memphis thang.
> 
> I'm sure that there are some traditional programs that are superior to Excelsior, but that does not mean that all traditional programs are superior.



UT is a fantastic school, and they turn out some very good nurses. Also, the school does make the nurse. Let us not forget, if we all went into nursing school, knowing the material, what is the point of nursing school? The school most definitely makes the nurse. 

To sum it up, if you want to be a competent RN, don't take shortcuts, go to RN school, be it AAS/ASN/ADN or BSN on campus with real CFE's, labs, and facilities. There is no ignorance about it. I work at a MAGNET hospital that is nationally recognized for its trauma and critical care nursing and I am willing to bet money that 9 out of 10 excelsior graduates could not get a job at this facility, critical care or otherwise. I wouldn't trust an excelsior graduate to collect a CBC in the right tube, let alone working as First, Second, or even Scribe nurse in a code. 

That's all I'm gonna say on that. Regardless of my opinion, I do wish you good luck in any and all of your endeavors in both career and education.


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## Journey

rook901 said:


> But there is some truth behind the joke. Much more is learned in the first year on the job than is learned in school, regardless of the length or depth of education.



Nursing school gives you a foundation of fundamentals and basic skills. It seems you might still be expecting it to be an end all course like an EMT class. That is not the case since nursing is such a vast profession.  However, it is true some schools do prepare you better than others. But, then even with clinicals that may not be outstanding, as least there are clinicals. Often a Paramedic who enters the hospital after finishing the Excelsior will have no idea what to expect and many will hold the title of RN but will never work as one. The knowledge learned may not be wasted but they did not get the benefit of caring for patients in many different levels of care.

The Excelsior also takes a lot of discipline. The program is not for procrastinators or those who cannot learn on their own. You may find  more who didn't complete the program than those that did.


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## rook901

Journey said:


> That will depend entirely upon the hospital and how progressive it is. There are many ICUs which are little more than a glorified tele or med-surg holding unit.  The system I work for has 10 hospitals and we haven't hires an Excelsior grad in over 10 years with the exception of the LPNs who made the transition while employed with us. We don't have to hire EC grads. There are enough BSN grads applying who did their clinicals at our hospitals to choose from.   You also have to consider there are states that just don't want EC grads period.



I did explicitly mention in my previous post that there are some states that do not license Excelsior grads, and even provided a link to a comprehensive list with individual state requirements. I also explicitly mentioned the benefit of exposure to local nurse managers if going through a traditional program.

As for not hiring Excelsior grads because you have plenty of BSN grads, I have to question whether it's that your hospital system isn't hiring Excelsior grads in particular or that it isn't hiring ADN grads in general. I'm willing to bet that there is not a hospital-wide prejudice against Excelsior specifically.

I already mentioned in my previous post that BSN is preferable and that I believe that BSN should be the entry level to nursing. I personally chose Excelsior because it was a way for me to get my RN without giving up my full-time job. YMMV.




Journey said:


> Probably not. The 2 week CCT course does not even come close to making a Paramedic qualified for the Intensive Care Units. A new grad RN will at least have A&P, Pharmacology and the basics of nursing to work with as they go into a new grad program to teach them the fundamentals of Critical Care. Right now, the internships are few and far inbetween with the BSN grad still being the best candidate at the Magnet hospitals.
> 
> But, at least with the Excelsior program you are not taking a college seat from someone who really wants to be a nurse and will take the program seriously to be a good professional. I guess you can consider that an advantage.
> 
> Edited after seeing your later post.



An Excelsior new grad RN will also have A&P I&II, Pharmacology (integrated into each course), and the basics of nursing. My point was that a new grad ADN RN with EMS experience will have a leg up over a new grad ADN RN with no previous experience, regardless of the school.

As for Excelsior grads not taking a nursing program seriously and not being "a good professional", I'll dismiss that as uninformed garbage. Excelsior is not an easy way out. It's just as difficult as a butt-in-seat program. All exams are proctored at Pearson Vue testing centers -- the same center that administers NCLEX. So, you won't find the cheating and sliding through that you find in B&M programs. You either know the material or you don't.

I don't really have the energy or the desire to sit here and defend Excelsior. I don't really care one way or the other about anyone's opinions on the program. It got me the job that I wanted, and it's getting me into my BSN completion program, and that's all I care about. HR didn't bat an eye at my education. My NM didn't bat an eye at my education. I have the same signature on my paycheck and the same pay rate on my paycheck as the other ADN's on my unit. If you want to continue to spout off about a program that you know very little about, then carry on.


----------



## rook901

medicRob said:


> The school most definitely makes the nurse.



No. The individual's desire to learn and comprehend the information, and to continue learning makes the nurse. Plenty of RN's scrape their way through a BSN program and come out barely able to pass the NCLEX, let alone function on the floor. It all depends on the individual. As I said, I've worked alongside some LPN's that were far more competent than some BSN's. That doesn't mean that I trust LPN's more than BSN's. It's on an individual basis. If you write off an entire group of people based on what school they attended, then you're just being an elitist. The kind of person that has that mindset is the same kind of person that feels that they couldn't learn a thing from a CNA or an ED tech just because of their title.



medicRob said:


> To sum it up, if you want to be a competent RN, don't take shortcuts, go to RN school, be it AAS/ASN/ADN or BSN on campus with real CFE's, labs, and facilities. There is no ignorance about it. I work at a MAGNET hospital that is nationally recognized for its trauma and critical care nursing and I am willing to bet money that 9 out of 10 excelsior graduates could not get a job at this facility, critical care or otherwise. I wouldn't trust an excelsior graduate to collect a CBC in the right tube, let alone working as First, Second, or even Scribe nurse in a code.



See above. There is plenty of ignorance in elitism.

As for Excelsior grads not being able to get a job at your facility, could it be because Magnet facilities tend to hire BSN's over ADN's, due to the need to have a certain percentage of BSN nurses? It has nothing to do with Excelsior beyond the fact that Excelsior's primary RN program is an ADN. I think you're heavily skewing the facts here to favor your argument. I've already conceded that BSN is preferable. But, an ADN is an ADN is an ADN.

I've wasted more time than I intended to, but I did want to address your reply. Carry on, folks.


----------



## Journey

rook901 said:


> I did explicitly mention in my previous post that there are some states that do not license Excelsior grads, and even provided a link to a comprehensive list with individual state requirements. I also explicitly mentioned the benefit of exposure to local nurse managers if going through a traditional program.
> 
> As for not hiring Excelsior grads because you have plenty of BSN grads, I have to question whether it's that your hospital system isn't hiring Excelsior grads in particular or that it isn't hiring ADN grads in general. *I'm willing to bet that there is not a hospital-wide prejudice against Excelsior.*
> I already mentioned in my previous post that BSN is preferable and that I believe that BSN should be the entry level to nursing. I personally chose Excelsior because it was a way for me to get my RN without giving up my full-time job. YMMV.



Actually it is a statewide prejudice against Excelsior. 

The hospital is a large teaching facility and has magnet status. Most of the BSN programs do their clinicals wiith us so we have plenty of well qualified candidates.  We will hire ADNs (from the local community college) for the med-surg floors but not for the ICUs or specialty teams such as Flight.  We reward education and there is a difference in pay even if it is not that much. Those who hold the BSN can get their MSN paid for by the hospital with a contract for service. This gives the nurses more opportunity for advancement throughout the system.  Why would we want Excelsior grads for entry level positions when we have so many other candidates?   If we want ADNs there are plenty of grads from the local colleges. 




> An Excelsior new grad RN will also have A&P I&II, Pharmacology (integrated into each course), and the basics of nursing. My point was that a new grad RN with EMS experience will have a leg up over a new grad RN with no previous experience, regardless of the school.



We take everything into consideration when hiring ICU RNs with a BSN. Being a Paramedic and emphasizing a few skils which may also come with some street medicine learned bad habits may not be to your advantage. That usually comes out in the interview. 




rook901 said:


> As for Excelsior grads not taking a nursing program seriously and not being "a good professional", I'll dismiss that as uninformed garbage. Excelsior is not an easy way out. It's just as difficult as a butt-in-seat program. All exams are proctored at Pearson Vue testing centers -- the same center that administers NCLEX. So, you won't find the cheating and sliding through that you find in B&M programs. You either know the material or you don't.



Some ask "how can I become a nurse without going to nursing school?

Or, as you stated, you didn't want to do the clinicals because of your opinion of the paperwork. Yes, the information in the chart is very important and nurses must find time to read through them. The more charts you read the faster you can scan and comprehend the data. 



> Clinicals were a joke. Most of the time was spent writing care plans and reading through charts.



Taking shortcuts is not always the best especially when you have no idea what a profession might be like or you have some preconceived picture based on some stuff you hear at an EMS job or on some forum.

I'm glad you have a job and I hope you can make it a career.  But, you need to accept that others with a solid education who are not EC grads may get the job that you want someday. Don't bash the education or those who prefer not to make excuses or take shortcuts to be a professional.


----------



## rook901

Reading comprehension is not your strong suit. Ignoring misinformed posters is not my strong suit. But, on that note, I'm outta here.


----------



## Journey

rook901 said:


> Reading comprehension is not your strong suit. Ignoring misinformed posters is not my strong suit. But, on that note, I'm outta here.



It is not being misinformed. When it comes Excelsior College or choosing any college for a career goal, it should be about being informed. You have just been told about different situations in different areas where the EC grad will not have an easy time getting the job of their dreams or even an RN license for various reasons.  This should tell the prospective student of EC they need to do their homework  to see what the requirements for licensure are in their state and what the hospitals in the area are looking for on a nursing application.


----------



## Journey

usalsfyre said:


> I know multiple RRTs who have gone this same route. Do you recommend against it for them? Or is it an inborn bias against paramedics.



Did see this comment  but I think I made my point pretty clear in another post. The EC should be only for LVNs with hospital experience.  However, RRTs may not have much problem with a traditional nursing program since they know what to expect in a hospital and aren't afraid to do the clinicals in one as well as knowing the reasoning behind the paperwork. Since RRTs have degrees with the same prerequisites as nursing, if they decided to enter the nursing program, it wouldn't be that much prep work. Also, the number of RRTs who have Bachelors degrees is growing which means they can qualify for the accelerated 2nd Bachelors or an entry level MSN program. There is no need for them to go backwards to an ADN program. Someone who already has an Associates should also be considering the Bachelors. 

Don't take it so personally. I know just from reading the threads on this forum that some in EMS like the shortcuts to their education to be a Paramedic. Why do you feel so picked on when you know what the education is like in EMS?  If you promoted more education for EMS, this might not have to always be a discussion in every thread. You also wouldn't feel the need to compare yourself to all the other professions and nursing students who have obtained their education the traditional way at a college with clinicals. 

The EC program is one that nursing should have slammed the door on long ago. If it had mandatory clinicals of no less than 1000 hours with qualified instructors in a hospital situation, then maybe it might be salvageable.


----------



## SerumK

Most NMs I know say they give Resume's with Excelsior on them the same chuckle they give to University of Phoenix and ITT Tech... before filing said resume in the circular filing bin.

There's way too many new graduate nurses... a massive glue. The shortage is a myth. About 1/3 of the graduates in my area are still unemployed after 7 months. What do you think your hiring prospects will be if you are some online for-profit graduate whose school isn't even accepted in many states when there is already an excess of grads from reputable accredited brick and mortars?


----------



## rook901

Getting bored today, so I'm back for more punishment. 



SerumK said:


> Most NMs I know say they give Resume's with Excelsior on them the same chuckle they give to University of Phoenix and ITT Tech... before filing said resume in the circular filing bin.



Considering that you are a BSN student who is not yet a practicing nurse and has no input whatsoever in the hiring process at any facility, I question how many conversations you've actually had with nurse managers about Excelsior College. Sorry, but I'm fairly certain that you just made that story up.

I'll just leave this here: "Allnurses.com - Excelsior Grads - Where are they now?". You may all feel free to ignore whatever date ranges and individual posts you'd like. 

Those unfamiliar with the politics of nursing and nursing education may be impressed by the chest-puffing in this thread. As an EMS forum, this isn't the ideal place to discuss nursing education. If comments similar to the ones posted in this thread were posted on a nursing-oriented website, one would not be able to keep up with the brutal replies.

*Excelsior definitely has its caveats*. It is far from a perfect program. Many state boards of nursing have various issues with EC, and I did offer a link to state requirements in my first post. Most state boards of nursing do not have an issue with Excelsior. It is one of many valid paths to a nursing career. It goes through the same accreditation process as any other NLNAC-accredited program. Its NCLEX pass rate is higher than the national average. I wish that I could find the link to the independent study that the Georgia Nurses' Association presented to the GA BON to defend Excelsior, as the study showed that EC grads were rated by their workplace preceptors as equal to or higher than traditional new grad RN's.

I'm fairly certain that the opinion of the NLNAC and the opinions of 34 BON's trumps the opinions of a few posters on EMTlife.com.  (sidenote: of the 16 states that have specific regulations for EC grads, 8 allow endorsement after varying numbers of hours of RN experience).

When it's all said and done, however, I did say in my first post in this thread that a traditional program is preferable, and that a BSN is even more preferable for various reasons. But, the school does not make the nurse. Period.


----------



## Journey

rook901 said:


> I'll just leave this here: "Allnurses.com - Excelsior Grads - Where are they now?". You may all feel free to ignore whatever date ranges and individual posts you'd like.



As I already mentioned you can always find a forum with like opinions just like this one.

Also, if you read through the posts, most are working LVNs who probably were employed by the same hospital and got grandfathered into some positions just like the LVNs at my hospital system did 10 - 15 years ago. 

I will say it again, for a working LVN, EC might not be a bad way to go especially if the hospital they are currently employed with support them. For a person brand new to nursing and has never worked in a hospital, I would not recommend it.  I would hate to be a new grad with no hospital experience relying just on the EC ADN especially for the next 5 years.


----------



## rook901

Journey said:


> Also, if you read through the posts, most are working LVNs who probably were employed by the same hospital and got grandfathered into some positions just like the LVNs at my hospital system did 10 - 15 years ago.



I did read through the posts. All of them. Most were LPN's. *Many *were Paramedics. Some were hired into their same unit. Many have brand new jobs. Dismiss 20 pages of EC grads' experiences if you like. I'm just putting it out there for review.



Journey said:


> I will say it again, for a working LVN, EC might not be a bad way to go especially if the hospital they are currently employed with support them. For a person brand new to nursing and has never worked in a hospital, I would not recommend it.  I would hate to be a new grad with no hospital experience relying just on the EC ADN especially for the next 5 years.



I wouldn't. All EC grads have a basic medical or nursing background as obtained through their career before entering the program. All EC grads are vetted by the CPNE, which tests your ability to function as a first day new grad RN in a hospital setting. All EC grads are going to get the same on-the-job orientation and training that traditional students are going to get following employment. Most of the ones that just don't get hospital nursing are going to be washed out by the FCCA or the CPNE.

No new grad, EC or traditional, is going to be able to hit the hospital floor running on their own on day one. A small number of EC grads may actually make it all the way through and still just not get it, and may not survive in a hospital environment. The same holds true for traditional ADN's and even traditional BSN's or direct entry MSN's. Some people just can't make it when they hit the real world after graduation, regardless of what program they attended.

Tell me a story about one EC grad that _you personally know_ offline that isn't capable of working as a competent RN in a hospital, and I'll tell you stories about five that I personally know offline that are successful, competent RN's in the hospital setting (two of which are medics with no nursing background prior to EC). As a bonus story, I'll tell you about a traditional BSN that claimed to have several years of ICU experience that didn't know her *** from a hole in the ground. 

As to your very last statement, I do agree with the 5 year comment, although not just for EC grads. It's only going to be a matter of time before ADN's, regardless of what program they went through, are going to find fewer and fewer jobs available to them as more hospitals are requiring BSN's. Anyone who gets their ADN and doesn't progress to BSN is going to be left behind in the years to come, in the same way that LPN's in many parts of the country have been left behind in employment opportunities.


----------



## rook901

Also, I'll just leave this here for your review. It probably doesn't count for much, though. National League for Nursing - Centers of Excellence.


----------



## Journey

Like I said before. Be happy you have a job where you are. You may not have been so lucky somewhere else.

I do know several Paramedics who went through the EC program and who will never work as an RN unless they can find a decent internship that will give them experience with the basics of nursing. They also are not too vain to admit the program did not provide them with the needed clinicals. Actually, it provided them with none.  The most dangerous providers are those who don't know just how much they don't know but yet keep plodding along believing they are the best thing ever without a thought of how much they might be cheating the patient.


----------



## rook901

Journey said:


> Like I said before. Be happy you have a job where you are. You may not have been so lucky somewhere else.



True for anyone with an ADN these days.



Journey said:


> I do know several Paramedics who went through the EC program and who will never work as an RN unless they can find a decent internship that will give them experience with the basics of nursing.



If they didn't understand "the basics of nursing", how did they even pass the NCLEX? I'm *not *saying that passing a test makes you a good nurse, but there is a baseline of knowledge that's required to pass. Additionally, I'm not sure how someone that doesn't understand the basics of nursing could pass the CPNE, which presently only has a 62% pass rate.



Journey said:


> They also are not too vain to admit the program did not provide them with the needed clinicals. Actually, it provided them with none.  The most dangerous providers are those who don't know just how much they don't know but yet keep plodding along believing they are the best thing ever without a thought of how much they might be cheating the patient.



This can be applied to any program and any healthcare provider. The first thing that comes to mind are direct-entry MSN programs. You've got your BS in an unrelated field? Great! Here's two whole years of nursing education. You're now a Master's-prepared nurse with your CNL certification. Go get 'em!

Yes, I realize that these types of programs do have clinicals. Just shooting off on a tangent here to address your comment on the potential of dangerous providers that may not realize that they don't know everything.

In either case, EC or CC, ADN or BSN, MSN or direct-entry FNP, a new RN should find employment with a facility that will offer a comprehensive orientation/preceptorship. 

I'll stick to my crazy belief that the opinion of NLNAC and 34 state Boards of Nursing outweighs any opinion on an internet forum.


----------



## Journey

rook901 said:


> I'll stick to my crazy belief that the opinion of NLNAC and 34 state Boards of Nursing outweighs any opinion on an internet forum.



You seem to put alot of weight into the nursing forum where you seem to be  getting all of your statistics from.

Most of those 34 states have added a minimum amount of clinical hours which must be completed before the EC grad will be considered. 

Under no circumstances should one ever advocate for a nursing program that has no clinical hours and it is a big shame on the nursing profession to have allowed this program to continue. Nursing needs to move on to the BSN for entry and leave this mess behind them. 

Passing a test is not very difficult. It is the nature of the work environment that fails most people who have never worked in a hospital. 

You might want to take a look at the number of clinical hours an entry level MSN program has. You will find they may have just as many clinicals as the ADN program at a community college.  Considering you are advocating for one that is only an ADN and offers nothing for clinicals, you don't have much to brag about.


----------



## medicRob

rook901 said:


> No new grad, EC or traditional, is going to be able to hit the hospital floor running on their own on day one. .



No one from my program had a problem as we had worked the units in clinicals for several months before day one. I thought you were done with this thread? For someone who claims EC is as good a program as a traditional nursing school, you sure do spend a lot of time defending it (just a thought)...


----------



## SerumK

rook901 said:


> Considering that you are a BSN student who is not yet a practicing nurse and has no input whatsoever in the hiring process at any facility, I question how many conversations you've actually had with nurse managers about Excelsior College. Sorry, but I'm fairly certain that you just made that story up.



Do you usually make a habit of calling people liars as it suits your emotions? I bet that endears you to many.

I spent many years on my prereqs and researching what path to my RN. talked to the NMs I knew personally and many more that were friends of friends to figure out what school would be the best avenue. I looked at Excelsior, primarily as a backup, but decided against it.

Universally, they all said they wouldn't touch an Excelsior grad when there were so many students from local reputable schools. 34 states may accept Excelsior... but usually with many more hoops to jump through. Our state makes Excelsior grads take an extra 750 hours of clinical!


----------



## rook901

Journey said:


> You seem to put alot of weight into the nursing forum where you seem to be  getting all of your statistics from.



The comment regarding the NLNAC and the BON's that accept Excelsior is not from the nursing forum. EC is accredited by the NLNAC. This is not up for discussion. 34 states approve Excelsior without additional requirements. This is also not up for discussion.



Journey said:


> Most of those 34 states have added a minimum amount of clinical hours which must be completed before the EC grad will be considered.



See above. This statement is completely false.



Journey said:


> Under no circumstances should one ever advocate for a nursing program that has no clinical hours and it is a big shame on the nursing profession to have allowed this program to continue. Nursing needs to move on to the BSN for entry and leave this mess behind them.



Again, I'll defer to the opinion of the NLNAC and 34 state Boards of Nursing. They all disagree with you in regards to the adequacy of EC. As for moving on to BSN for entry level, I agree with this and have stated this multiple times. Although I did take the faster route to RN licensure, I will eventually wrap up my BSN completion program. More education is always a good thing.

You are putting a lot of emphasis on this "no clinical hours" argument while ignoring the fact that all EC grads come in with a healthcare background, and all EC grads do complete a pass-or-fail clinical performance examination in which there is no teaching or coaching involved, and where the student has virtually zero room for error.



Journey said:


> Passing a test is not very difficult. It is the nature of the work environment that fails most people who have never worked in a hospital.



Passing a test is not difficult, but passing NCLEX does show some basic level of understanding in regards to the field of nursing. That was my point. I clearly stated that passing it does not make one a good nurse.



Journey said:


> You might want to take a look at the number of clinical hours an entry level MSN program has. You will find they may have just as many clinicals as the ADN program at a community college.



My issue was not whether or not the MSN has clinicals. In fact, I specifically stated that I understand that they do have clinicals. My point was echoing your issue with the dangers of healthcare professionals who think that they know more than they actually know. Schools are throwing the title of Master's-prepared nurse on someone with "just as many clinicals as the ADN program at a community college" (your words). An ADN-equivalent nurse with a Master's in Nursing. This can lead to an overinflated opinion of one's abilities.

Am I going to raise up a pitchfork and decry direct-entry Master's programs because of this? No. Those programs are accredited and state-approved, and I trust accreditation committees' and state boards' opinions more than I trust my personal opinion in the matter of nursing education.



Journey said:


> Considering you are advocating for one that is only an ADN and offers nothing for clinicals, you don't have much to brag about.



At what point did my posts turn into bragging? 



medicRob said:


> No one from my program had a problem as we had worked the units in clinicals for several months before day one. I thought you were done with this thread?



You took a full patient load on day one of your new job, with no unit orientation aside from working on the unit in clinical rotations during school? And this is a Magnet facility? Wow. A Magnet facility with no orientation for new hires. That seems like a pretty high-risk practice.

And I did say that I was done with this thread. But, I also said in my first post today... er.. yesterday.. that I was bored and I was back for more punishment. 



medicRob said:


> For someone who claims EC is as good a program as a traditional nursing school, you sure do spend a lot of time defending it (just a thought)...



I'm failing to see why claiming that a nursing program is adequate would preclude me from defending said program. That seems rather bass-ackwards, doesn't it? I think this is nearing the "grasping at straws" tier of debate. If someone were on this forum bashing _your _school and making grossly misinformed statements with no hard information to back those statements up, I believe that you would probably throw your two cents into the mix.



SerumK said:


> Do you usually make a habit of calling people liars as it suits your emotions? I bet that endears you to many.



Believe me when I say that the only emotion I have when reading some of these posts is pure amusement.



SerumK said:


> I spent many years on my prereqs and researching what path to my RN. talked to the NMs I knew personally and many more that were friends of friends to figure out what school would be the best avenue. I looked at Excelsior, primarily as a backup, but decided against it.
> 
> Universally, they all said they wouldn't touch an Excelsior grad when there were so many students from local reputable schools.



Universally? 100% of every nurse manager that you supposedly spoke to regarding EC said that they would not hire an EC grad? As with test questions, whenever the word "always" or "never" is thrown into an answer, that's a huge red flag. I just don't buy your story. 

Fortunately, this is the internet, and you aren't required to back up your claims with hard information. Perhaps that's where I'm going wrong here. I need less hard facts and more fabrication!

Also, you're implying that EC is disreputable. I will once again defer to the NLNAC and 34 states Boards of Nursing that have determined that EC is a reputable program.



SerumK said:


> 34 states may accept Excelsior... but usually with many more hoops to jump through. Our state makes Excelsior grads take an extra 750 hours of clinical!



Wrong. 16 states have various regulations regarding EC grads, some of which include additional clinical time. The other 34 do not. Your state, Colorado, is included in those 16 states that have additional regulations on EC grads.


----------



## rook901

While this article is geared toward politics, I believe it's still an interesting read, and very appropriate for this thread.

How Facts Backfire - The Boston Globe



> They already have beliefs, and a set of facts lodged in their minds. The problem is that sometimes the things they think they know are objectively, provably false. And in the presence of the correct information, such people react very, very differently than the merely uninformed. Instead of changing their minds to reflect the correct information, they can entrench themselves even deeper.
> 
> “The general idea is that it’s absolutely threatening to admit you’re wrong,” says political scientist Brendan Nyhan, the lead researcher on the Michigan study. The phenomenon — known as “backfire” — is “a natural defense mechanism to avoid that cognitive dissonance.”


----------



## Akulahawk

rook901 said:


> The comment regarding the NLNAC and the BON's that accept Excelsior is not from the nursing forum. EC is accredited by the NLNAC. This is not up for discussion. 34 states approve Excelsior without additional requirements. This is also not up for discussion.
> 
> 
> 
> See above. This statement is completely false.
> 
> 
> 
> Again, I'll defer to the opinion of the NLNAC and 34 state Boards of Nursing. They all disagree with you in regards to the adequacy of EC. As for moving on to BSN for entry level, I agree with this and have stated this multiple times. Although I did take the faster route to RN licensure, I will eventually wrap up my BSN completion program. More education is always a good thing.
> 
> You are putting a lot of emphasis on this "no clinical hours" argument while ignoring the fact that all EC grads come in with a healthcare background, and all EC grads do complete a pass-or-fail clinical performance examination in which there is no teaching or coaching involved, and where the student has virtually zero room for error.
> 
> 
> 
> Passing a test is not difficult, but passing NCLEX does show some basic level of understanding in regards to the field of nursing. That was my point. I clearly stated that passing it does not make one a good nurse.
> 
> 
> 
> My issue was not whether or not the MSN has clinicals. In fact, I specifically stated that I understand that they do have clinicals. My point was echoing your issue with the dangers of healthcare professionals who think that they know more than they actually know. Schools are throwing the title of Master's-prepared nurse on someone with "just as many clinicals as the ADN program at a community college" (your words). An ADN-equivalent nurse with a Master's in Nursing. This can lead to an overinflated opinion of one's abilities.
> 
> Am I going to raise up a pitchfork and decry direct-entry Master's programs because of this? No. Those programs are accredited and state-approved, and I trust accreditation committees' and state boards' opinions more than I trust my personal opinion in the matter of nursing education.
> 
> 
> 
> At what point did my posts turn into bragging?
> 
> 
> 
> You took a full patient load on day one of your new job, with no unit orientation aside from working on the unit in clinical rotations during school? And this is a Magnet facility? Wow. A Magnet facility with no orientation for new hires. That seems like a pretty high-risk practice.
> 
> And I did say that I was done with this thread. But, I also said in my first post today... er.. yesterday.. that I was bored and I was back for more punishment.
> 
> 
> 
> I'm failing to see why claiming that a nursing program is adequate would preclude me from defending said program. That seems rather bass-ackwards, doesn't it? I think this is nearing the "grasping at straws" tier of debate. If someone were on this forum bashing _your _school and making grossly misinformed statements with no hard information to back those statements up, I believe that you would probably throw your two cents into the mix.
> 
> 
> 
> Believe me when I say that the only emotion I have when reading some of these posts is pure amusement.
> 
> 
> 
> Universally? 100% of every nurse manager that you supposedly spoke to regarding EC said that they would not hire an EC grad? As with test questions, whenever the word "always" or "never" is thrown into an answer, that's a huge red flag. I just don't buy your story.
> 
> Fortunately, this is the internet, and you aren't required to back up your claims with hard information. Perhaps that's where I'm going wrong here. I need less hard facts and more fabrication!
> 
> Also, you're implying that EC is disreputable. I will once again defer to the NLNAC and 34 states Boards of Nursing that have determined that EC is a reputable program.
> 
> 
> 
> Wrong. 16 states have various regulations regarding EC grads, some of which include additional clinical time. The other 34 do not. Your state, Colorado, is included in those 16 states that have additional regulations on EC grads.


Don't count California in that "34" that "do not" have regulations regarding EC grads. EC isn't accredited in California. I would be quite surprised to find out that an EC grad is readily reciprocally licensed without going through a LOT of work to prove an equivalent education (including clinical time) that CA will accept.


----------



## rook901

Akulahawk said:


> Don't count California in that "34" that "do not" have regulations regarding EC grads. EC isn't accredited in California. I would be quite surprised to find out that an EC grad is readily reciprocally licensed without going through a LOT of work to prove an equivalent education (including clinical time) that CA will accept.



Per your very special request, California was not included in the list. Feel free to reference the comprehensive list that I linked to on page 3 of this thread.


----------



## medicRob

rook901 said:


> While this article is geared toward politics, I believe it's still an interesting read, and very appropriate for this thread.
> 
> How Facts Backfire - The Boston Globe



Now, did Tony the tiger tell you this when he handed you your nursing degree?


----------



## rook901

medicRob said:


> Now, did Tony the tiger tell you this when he handed you your nursing degree?



Judging by your juvenile response and the continued lack of hard evidence to support any of your ignorant claims, I'll assume that you have no further counterpoints to present.


----------



## medicRob

rook901 said:


> Judging by your juvenile response and the continued lack of hard evidence to support any of your ignorant claims, I'll assume that you have no further counterpoints to present.



Either that or I do not feel that excelsior RNs are worthy of the title. It has been my experience that the only individuals who defend online courses and shortcuts are those who have taken those shortcuts and went through those online courses that have something to lose if the program is no longer accepted.. You speak of the campus program you attended being a joke, I see it all too often.. you can't find someone to blame for your inability to become competent or to make it through, so you blame the instructor or the program. Let's be real, you probably went to excelsior because you couldn't cut it in real nursing school. 

If excelsior is such a great program and prepares its nurses so well, then why are there states that will not accept its graduates? My education stands in all 50 states and so long as I meet the state requirements for reciprocity, my RN is good in every one of them. There is no state I cannot practice in. Do you think these boards of nursing have went so far as to say that they will not accept an excelsior graduate simply because they do not like the word "Online"? These individuals have had a wealth of experience in both clinical nursing and administration.. They have decided that they want no part of these, "Shortcut" nurses and as such, I applaud them for this. Excelsior's nursing program is a joke in the medical community. The students have NOWHERE NEAR ENOUGH CLINICALS OR LAB EXPERIENCE, which accounts for 50% if not more of the learning in a nursing program, so you can defend it all you want, but it is quite evident that excelsior is a joke. NLNAC can accredit the program all they want, but if you can't get a job after graduating the program and there are states that will not accept its graduates, then the NLNAC's opinion doesn't mean jack..


----------



## Shishkabob

medicRob said:


> If excelsior is such a great program and prepares its nurses so well, then why are there states that will not accept its graduates?



Because, and don't take this the wrong way, the people higher up in the BONs are like you:  They don't see much merit in online based programs and as such don't consider it 'real' education.



If people are so for evidence based medicine, I want to see a study that shows a provider educated online is worse than a provider educated in a traditional system.



I learn best by someone audibly telling me.  Others need to watch.  Still others need to do.  People learn differently... why is that bad?


----------



## Journey

Linuss said:


> Because, and don't take this the wrong way, *the people higher up in the BONs are like you: * They don't see much merit in online based programs and as such don't consider it 'real' education.
> 
> If people are so for evidence based medicine, I want to see a study that shows a provider educated online is worse than a provider educated in a traditional system.
> 
> I learn best by someone audibly telling me.  Others need to watch.  Still others need to do.  People learn differently... why is that bad?



As I stated in another post, online education itself is not bad and even in the traditional programs there are some theory courses which are online. Those "higher up in the BON" have also helped design and impliment some of the programs into the traditional system.  It is also the educated providers who are pushing for EVM and EVN which is now becoming more obvious as more BSNs are in the workforce. 


It is usually those who do not have experience in education that will continue to push for minimal stanards and criticize those who have become educated and placed themselves "higher up". Education and advancement are not bad things. 

How can you be an advocate for a nursing program that has no lab or clinicals? Is this typical of EMS also?  The traditional nursing programs, including the MSN entry and the BSN as well as the ADN, should have at least 1000 hours with most having around 1500 hours of clinicals.


----------



## clibb

Linuss said:


> Because, and don't take this the wrong way, the people higher up in the BONs are like you:  They don't see much merit in online based programs and as such don't consider it 'real' education.
> 
> 
> 
> If people are so for evidence based medicine, I want to see a study that shows a provider educated online is worse than a provider educated in a traditional system.
> 
> 
> 
> I learn best by someone audibly telling me.  Others need to watch.  Still others need to do.  People learn differently... why is that bad?



+1

Another question. Where do nurses from the US rate in the world compared to other countries?


----------



## medic417

medicRob said:


> Either that or I do not feel that excelsior RNs are worthy of the title. It has been my experience that the only individuals who defend online courses and shortcuts are those who have taken those shortcuts and went through those online courses that have something to lose if the program is no longer accepted.. You speak of the campus program you attended being a joke, I see it all too often.. you can't find someone to blame for your inability to become competent or to make it through, so you blame the instructor or the program. Let's be real, you probably went to excelsior because you couldn't cut it in real nursing school.



Wow cheap shot there.  Trying to dog me on a topic I have not entered in.  Excelsior weeds out more students than traditional programs.  The few that actually finish have earned the I guess you could say privilege to be known as your equal.  The hospitals here have no problem hiring those with the fortitude to put forth such an individual effort.  

As to online programs I have hired many from them because they tend to be very dedicated individuals.  I have worked with many.  Occasionally you get one that obviously just tests well but is lousy but I have seen it less with online programs than I have with standard programs.  

To blindly presume the method you chose is the only correct way to get from point a to point b is frankly a prime example of ignorance.


----------



## Journey

clibb said:


> +1
> 
> Another question. Where do nurses from the US rate in the world compared to other countries?



You are giving a +1 and also advocating for minimal standards along with a health care profession such as nursing which should have significant patient contact experience by way of clinicals. Just eliminate the clinicals? 

Again, is this typical of EMS also? The least amount of education with as few or no clinicals?  Only the minimal standards to just get a certification or license? 

Right now the U.S. has fallen behind other nursing programs with only the ADN as the entry.


----------



## medic417

clibb said:


> +1
> 
> Another question. Where do nurses from the US rate in the world compared to other countries?



The Philipines must be the best because they come to the USA and fill many of the RN jobs.


----------



## rook901

medicRob said:


> the NLNAC's opinion doesn't mean jack..



This statement alone proves beyond a doubt that you are absolutely blinded by your own arrogance. You believe that your personal opinion and experiences with education outweighs the opinion of an entire commission of nursing professionals with far more education and experience than your own.



medicRob said:


> Either that or I do not feel that excelsior RNs are worthy of the title.



See above.



medicRob said:


> It has been my experience that the only individuals who defend online courses and shortcuts are those who have taken those shortcuts and went through those online courses that have something to lose if the program is no longer accepted.



I already have my RN license. If Excelsior loses state approval or NLN accreditation, it will not be retroactive. If you need proof of this, reference California's decision to continue accepting Excelsior students who were enrolled in the program prior to their decision to revoke state approval.

Again, if this were about your wonderful traditional school and folks were posting their absolutely meritless opinions on the quality of a program that they have no intimate knowledge of and have no part in the review process of, I'm sure that you would step in.



medicRob said:


> You speak of the campus program you attended being a joke, I see it all too often.. you can't find someone to blame for your inability to become competent or to make it through, so you blame the instructor or the program. Let's be real, you probably went to excelsior because you couldn't cut it in real nursing school.



I am competent and have made it through an accredited RN program. I have passed the NCLEX. I am employed as an RN. I don't see how this equates to my ability to not "cut it".

Excelsior is a real nursing school. It is accredited and state approved. I'm sorry that you're unable to accept this into your limited scope of what reality is.

I already stated the reasons for my dropping out of a traditional LPN-to-RN program. It was because of the disorganization of clinicals and the interference with a full-time job. If I had the opportunity to sit in a classroom for two years and have everything spoon-fed to me and have my hand held during clinicals, I would have went that route. That's why I recommended going through a traditional program in my VERY FIRST POST IN THIS THREAD. 



medicRob said:


> If excelsior is such a great program and prepares its nurses so well, then why are there states that will not accept its graduates? My education stands in all 50 states and so long as I meet the state requirements for reciprocity, my RN is good in every one of them. There is no state I cannot practice in. Do you think these boards of nursing have went so far as to say that they will not accept an excelsior graduate simply because they do not like the word "Online"? These individuals have had a wealth of experience in both clinical nursing and administration.. They have decided that they want no part of these, "Shortcut" nurses and as such, I applaud them for this.



I can't say why it's not approved in all 50 states. I'm sure that some part of it has to do with the fact that there are older nurses who have a very narrow mindset as to what education should be. I do believe that there are people on BON's that see the word "online" and assume it is a bad thing. You're an excellent example. If someone like you were to make it onto a BON or an accrediting agency's commission, you would crucify any online-based programs that attempt to gain recognition. Your blind post regarding the "online" paramedic program in another forum proves this. You failed to note that said online program had a hands-on component, but you immediately dismissed it without even reviewing it, by saying "Nothing about an online paramedic program seems legit. Stop looking for shortcuts and get with a campus-based program". You equate the word "online" to "shortcut" every single time.

I'm certain that another small part of the picture is lobbying on the part of in-state schools and a loss of in-state tuition. If you don't believe this, then that's one more strike against your narrow scope of reality. The reason that it IS approved without additional requirements in 34 states is not because it hasn't gone through the same rigorous review process as every other school that's approved by the state. Politics does play a part in it. Excelsior is the biggest out-of-state source of RN grads for every state except New York, where the program is located.

Excelsior is not a shortcut. To make this statement is to show, once again, your complete ignorance of the program. Pass-or-fail one-shot exams that require motivation and hundreds of hours of self-study for each course, and that are proctored at the same facility that administers NCLEX is not a shortcut. A pass-or-fail clinical performance examination that does not offer any hand-holding or coaching, that tests your ability to function as a new grad RN, that has a 62% pass rate (that is, only 62% of people pass it after completing the didactic portion of the program) is not a shortcut.



medicRob said:


> Excelsior's nursing program is a joke in the medical community.



Provide proof of this. Excelsior's nursing program is only a joke to individuals like you who have a limited view of what education is. Fortunately, you do not speak for the medical or nursing community.

If the program is a joke, tell me why the Georgia Nurse's Association fought so hard to reverse the GA BON's decision to revoke state approval? Is the GNA also a joke to you and the nursing community?


----------



## Journey

medic417 said:


> The Philipines must be the best because they come to the USA and fill many of the RN jobs.



Is this a cheap shot at Filpino nurses?

Do you have anything to actually comment on about their nursing education system?


----------



## Journey

rook901 said:


> Excelsior is not a shortcut. To make this statement is to show, once again, your complete ignorance of the program. Pass-or-fail one-shot exams that require motivation and hundreds of hours of self-study for each course, and that are proctored at the same facility that administers NCLEX is not a shortcut. A pass-or-fail clinical performance examination that does not offer any hand-holding or coaching, that tests your ability to function as a new grad RN, that has a 62% pass rate (that is, only 62% of people pass it after completing the didactic portion of the program) is not a shortcut.



If the pass rate from EC is only 62%, it just shows they have no control over who enters their program. How many have  wasted their time and money with EC when they could have been  getting real clinical experience and not just one of the weekend preps to prepare for this "clinical performance" test?


----------



## rook901

Journey said:


> If the pass rate from EC is only 62%, it just shows they have no control over who enters their program. How many have  wasted their time and money with EC when they could have been  getting real clinical experience and not just one of the weekend preps to prepare for this "clinical performance" test?



This is the pass rate for the CPNE. Not the pass rate for NCLEX. NCLEX pass rate for Excelsior grads is higher than the national average.

The washout rate at Excelsior is equal to or better than the washout rate at a traditional program. The only difference is that the washout is typically at the end during the CPNE. I suppose that they could incorporate "mini-CPNE's" in some way, and that may be something that comes about as the program evolves. But, somehow, I doubt that this would change your opinion of the program as they would likely not be 1000-1500 hours of hand-holding clinicals.

As for wasting time and money on EC, it's no different than the traditional student nearing the end of their studies that fails a course twice and has to either start the nursing program completely over or is dismissed from the program altogether.


----------



## akflightmedic

Journey said:


> Is this a cheap shot at Filpino nurses?
> 
> Do you have anything to actually comment on about their nursing education system?



I didn't see it as a cheap shot...I saw it as a very poignant response and very much on topic.


----------



## medic417

Journey said:


> Is this a cheap shot at Filpino nurses?
> 
> Do you have anything to actually comment on about their nursing education system?



No it is a compliment as they are well prepared and are quickly hired at many hospitals which leads to the logical conclusion that their educational standards for RN exceed those of many USA RN programs.  I do not see how you came up with your twisted interpretation of my statement.


----------



## akflightmedic

medic417 said:


> No it is a compliment as they are well prepared and are quickly hired at many hospitals which leads to the logical conclusion that their educational standards for RN exceed those of many USA RN programs.  I do not see how you came up with your twisted interpretation of my statement.



Or....hospitals do not really care WHERE you get your education or HOW as long as you have RN behind your name...no?


----------



## medic417

akflightmedic said:


> Or....hospitals do not really care WHERE you get your education or HOW as long as you have RN behind your name...no?



Honestly in most jobs I find they do not care about anything beyond the proper license or certification.  Few ever ask about or check on the school.

So I presume you may be correct which then leads to the presumption that really all these pages that people typed in their opinions with limited facts are just a complete waste of internet space.


----------



## Journey

medic417 said:


> Honestly in most jobs I find they do not care about anything beyond the proper license or certification.  Few ever ask about or check on the school.



From the other threads, this statement seems to be true more of EMS than nursing. Degree does matter as an RN if you are applying to a hospital seeking Magnet status. As already mentioned, some ICUs prefer BSNs. It also matters for some internship programs the new RN might apply to. It will also matter if the RN wants to apply to a specialty unit such as a flight team. 

It is really a great feeling to know you have completed a 4 year program that has a good reputation for high standards. If you have never done this, you might not know this feeling. Next to raising a family, it is a great accomplishment to do something that can give you and your family a secure future. Too many only want a job now and don't care about establishing a career or much about the future especially if entry is low.  Some just seek shortcuts and will often go through life taking shortcuts  to get by with just doing the minimum.

Why do so many on this forum seem to not view quality education with any importance?  There should be more emphasis on something other than just getting a cert. 



> I do not see how you came up with your twisted interpretation of my statement.



You did not elaborate or provide any information in your post which would indicate otherwise. Considering the nature of the posts surrounding it, your post seemed to follow more inline with an insult. I believe the recent post by akflightmedic shows that.


----------



## SerumK

I'm not surprised to see a certain poster, defender of the status quo for EMS education in other threads, defending EC because he thinks it is about Online vs Offline.

It isn't largely that.

Excelsior is the "medic mill" of nursing schools. Any other school doens't have to brag about "34 states" because everyone who is reputable is good in 50. It's such a big scam that other scammers have latched on to squeeze some more money out of the suckers who go for it. Google "The College Network" to learn about one of them.

WHAT WOULD YOU SAY ABOUT A MEDICAL SCHOOL WHOSE DOCTORS COULD ONLY PRACTICE IN 34 STATES?

What would people say if you could earn a Paramedic certification with NO practicals or clinicals? :unsure::unsure::unsure:

Additionally... MedicRob needs to realize that NLN is being abandoned by the reputable BSN programs because of NLN's recent trend in handing out accreditation like candy to degree mills and for-profit career schools. CCNE is the way now. My school abandoned NLN for this reason. We are CCNE. I go to one of the top two schools in my state, the other of which is doing the same thing. They have CCNE but their NLN hasn't expired yet.

Lastly, as to Excelsior "weeding out" more than others. HAHAHAHAHAHHAHAHA that is pure proof that MedicRob is blind to the world we live in. Schools like Excelsior do the EXACT same thing as ITT-Tech, University of Phoenix, Concord Career College, etc: they are FOR PROFIT so they get as many students paying as possible, then drop them out and keep their money. It's all about making $$$ for the shareholders.

Real schools weed people in.  My school (a non-profit) has a 5% acceptance rate and a 96% graduation rate for their RN program. They can do that because there are way more QUALIFIED people who want to be nurses than there are seats. They choose the best. The rest of the qualified people (many of them overly so) go to other schools and become RNs. It's the undesirable students who can't get in anywhere else who get suckered into ITT-Tech, University of Phoenix, and Excelsior College.


----------



## SerumK

medic417 said:


> Honestly in most jobs I find they do not care about anything beyond the proper license or certification.  Few ever ask about or check on the school.



In nursing, that isn't quite the case. Many positions state BSN preferred or required. 

From everyone I've talked to, where you got your degree matters minimally once you have 3-5 years of experience. However, in the current economy WHERE THERE IS *NO *SHORTAGE OF new grad NURSES, it can be everything. When there are 400 applicants for 8 new grad slots, you better believe it matters. In the same way that BSNs are getting hired more easily than ADNs, the more reputable schools are hired preferentially over the less reputable schools.

I researched this thoroughly before choosing my school. I chose based on what would give me the best education and the best competitive advantage in the job market. I don't want to be like my friends who went before me to ADN programs and took 8-14 months to find work. I don't wan to be one of the daily posts on a nursing forum wondering why after 200 applications over the course of a year, they have no interviews, but have a TON of student debt from their for-profit degree mill.


----------



## Shishkabob

My bad Serum, I forgot that your non-complete education at a different school made you more of an expert on how different schools are run. 

Apparently you know how everyone learns best and we should just do it that way, right?


----------



## usalsfyre

Considering medicRob has a BSN, consistently argued against EC from the outset of this thread, had enough respect for paramedicine and education to complete a 2 year medic program rather than challenge the test and works for one of the most respected CCT programs nationwide, I think your attacking the wrong poster...

The problem I have with EC is the lack of supervised clinical experince. As myself and others have pointed out over and over paramedicine is not nursing. Meaning we can't claim to be so specialized nurses can't tranfer over, but we in turn can go out and be nurses. It has NOTHING to do with online delivery. 

All that said, the arrogance you display is astounding. There are EC graduates that could run circles around most new BSNs. Your a babe in the healthcare woods, cooling the attitude would go a long way towards furthering yourself.


----------



## Shishkabob

> I think your attacking the wrong person.





Eh? Me? I didn't attack Rob.


----------



## usalsfyre

Linuss said:


> Eh? Me? I didn't attack Rob.



No not you, Serumk. If you keep getting in the way like this, I'm gonna have to let your preceptor know  .


----------



## SerumK

usalsfyre said:


> Considering medicRob has a BSN, consistently argued against EC from the outset of this thread, had enough respect for paramedicine and education to complete a 2 year medic program rather than challenge the test and works for one of the most respected CCT programs nationwide, I think your attacking the wrong poster...



INDEED! I meant to type Rook, but I was all worked up and put the name of the poster I agree with instead of the one I disagree with! :unsure:

I apologize! I'd go change it but there appears to be an editing limit of 15 min.


----------



## Journey

usalsfyre said:


> All that said, the arrogance you display is astounding. There are EC graduates that could run circles around most new BSNs. Your a babe in the healthcare woods, cooling the attitude would go a long way towards furthering yourself.



I don't believe it is arrogance. Presenting comments which do not support minimal standards should not be viewed at arrogant.

EMS is very different and I have read through some of the posts on other threads supporting 3 month program. There are probably many excellent Paramedics by U.S. standards  who have graduated from those programs. If you believe that is proof enough to allow a few months of training continue to be the standard for EMS, great. By knowing the standards that exist now, these so called medic mills are producing excellent Paramedics, then maybe EMS shouldn't change anything and the medic mill is more than adequate.  

For the nursing profession expectations are being raised and just the minimum may  not do. The profession has to move forward and not backward by continuing to accept grads from a program that has no clinicals and allows people who may  have no hospital experience enter the profession so easily. 

SerumK also has a very valid argument about nursing school accreditation and especially the CCNE.  If the  accrediting organization is no longer keeping up with the trends, it is time for a change. Isn't this an issue also where EMS just relied on approval from the state and accreditation from a tech school association rather than CAAHEP?


----------



## Journey

Linuss said:


> Apparently you know how everyone learns best and we should just do it that way, right?



Because you don't feel comfortable with doing clinicals or feel you can not learn anything with hands on practice does not mean they should be tossed out just to accommodate you.  There has to be some standards set especially when there are certain skills and assessments along with patient care experience that should be obtained.  Right now in EMS it seems you can find a program to accommondate what you want and that is acceptable in EMS.  That doesn't mean other professions should lower their standards because of what you expect by your experience with EMS programs.  Even the non-medical professions have standards that must be obtained before they get their degree and certifications. Some people may not like working with computers but if it is required for the degree and to be in a profession then they may have to reconsider their major. 

As mentioned before, there is nothing wrong with online education for some classes, but in a health care program that typically requires at 1000 - 1500 hours of clinicals, there should be some consideration about the significance of these hours. For some LVNs who have worked many patient care areas of the hospital, maybe they can be evaluated for less hours but what about the LVN who works in a doctor's office?   Arguing across the board for lower standards with no clinical hours seems to not have the patient care part in mind but just wants to do the least possible to get a cert. 

There are some in nursing who take pride in their profession and don't want to see it eroded by nursing mills. Maybe some have EMS backgrounds and haven't always known the medic mills to produce outstanding Paramedics all the time and don't want nursing to follow that path.


----------



## rescue99

Journey said:


> There are some in nursing who take pride in their profession and don't want to see it eroded by nursing mills. Maybe some have EMS backgrounds and haven't always known the medic mills to produce outstanding Paramedics all the time and don't want nursing to follow that path.



EC isn't exactly a mill. Take a look at the requirements! CAT does not favor suck ups and won't pass a failing grade! For a well seasoned Medic with the right science background, EC is an acceptable avenue to nursing. I know many who have done it and they typically run circles around most other nurses regardless of the degree they hold.


----------



## Veneficus

Journey said:


> By knowing the standards that exist now, these so called medic mills are producing excellent Paramedics, then maybe EMS shouldn't change anything and the medic mill is more than adequate.


 
I would just like to point out that because of what US EMS is today, as well as how it is viewed and utilized, these programs are adequate. 

Obviously I think it should be different, but let's be real for a minute. When your average 911 service measures its effectiveness in response times, and touts "life saving medications" with a ride to "definitive treatment" (I am still trying to figure out what The F*** that means) as there are a host of things EDs cannot treat at all, I have to say, 3 months to learn how to backboard somebody and run an ACLS or PALS algorythm may be extremely excessive.

Before we can change education, we must change perception.

Back to the point of various schools, I chose to come to my school, I would choose it again, there are many that think it is somehow lesser than a US school, but I would put any of our students against any US student of equal time and bet all I had they would come out the better with rare exception.

So I am sure there are other schools without a big name behind them that can say the same.

But one of the obstacles I see are people who view healthcare simply as a job and have no passion for it. 

In the last 2 years I have seen a secretary where I taught EMS field hundreds of calls in a few months from people seeking to "quickly" change careers to something health related. 

Everyone on TV and on the internet keep seeing how healthcare jobs will be more in demand as the population ages. "Recession proof" careers.

I call BS. No career is recession proof. Yes healthcare demands will increase but healthcare dollars must decrease. So that doesn't mean everyone with a degree will be hired. 

With 10,000 applicants from a "quick career" change program how does somebody who used the same program as a nontraditional way to advance their healthcare career set themselves apart on a piece of paper or electronic sorter that will get maybe 5 seconds consideration?

As an anecdote, one of my good friends applied for a position that wanted either a BSN or a paramedic with some kind of 4 year health degree. 

When he called to check on the status of his application he was told the computer automatically disqualified him because he did not have a bachelors listed. 

He has a PhD in physiology. Which was listed. 

You can see how having certian things on your app like graduated from EC can automatically get you sorted into the "quick career change no contribution" crowd in the circular file.

Not everyone will have that experience depending on location and reputation.


----------



## rook901

SerumK said:


> INDEED! I meant to type Rook, but I was all worked up and put the name of the poster I agree with instead of the one I disagree with!



No need to get worked up. This is the internet. It's not really that serious.



SerumK said:


> Excelsior is the "medic mill" of nursing schools. Any other school doens't have to brag about "34 states" because everyone who is reputable is good in 50. It's such a big scam that other scammers have latched on to squeeze some more money out of the suckers who go for it. Google "The College Network" to learn about one of them.



I will not disagree that TCN is a scam, but TCN is not Excelsior. To use this as an argument is to also call Indiana State University, Regis University, Angelo State University, and others degree mills due to TCN "latching on" to those universities' distance programs.



SerumK said:


> WHAT WOULD YOU SAY ABOUT A MEDICAL SCHOOL WHOSE DOCTORS COULD ONLY PRACTICE IN 34 STATES?



First, I would say stop yelling. Second, I would say that you're comparing apples and oranges. Please review the process for individual states' approval of U.S. medical schools. It is in no way comparable to to the method of states' BON review of nursing schools. Also, entry into medical practice as an MD or DO is pretty much universal in the U.S. You do not have multiple levels of entry into practice with different educational requirements for each level.



SerumK said:


> What would people say if you could earn a Paramedic certification with NO practicals or clinicals?



You're failing to recognize that all students who enter EC already have relevant clinical experience AND that they do complete a "practical" in the form of the CPNE.



SerumK said:


> Additionally... Rook [ed: corrected this for you] needs to realize that NLN is being abandoned by the reputable BSN programs because of NLN's recent trend in handing out accreditation like candy to degree mills and for-profit career schools. CCNE is the way now. My school abandoned NLN for this reason. We are CCNE. I go to one of the top two schools in my state, the other of which is doing the same thing. They have CCNE but their NLN hasn't expired yet.



This is an outrageous lie and shows your lack of understanding of the accrediting agencies and accreditation process. Please do your research, stop fabricating lies to support your fragile arguments, and cite your sources. There are plenty of articles available that compare and contrast CCNE vs NLNAC accreditation. You will not find any article that implies that NLNAC is "handing out accreditation like candy to degree mills". Your statement has absolutely no merit and shows your desperation.

In short, CCNE accreditation is for Baccalaureate and Graduate programs. NLNAC is for nursing programs across the spectrum, from LPN to Doctorate. NLN accreditation is more expensive than CCNE, so that is a factor for schools to consider. CCNE does not accredit diploma or ADN programs at all.

Feel free to review this list of schools who are in candidacy status for NLNAC accreditation. You'll find plenty of BSN, Master's, and Doctoral programs from reputable schools awaiting approval.

Programs that have renewed their NLNAC accreditation in the past few years have included Colorado State's BSN, Tennessee State University's BSN and MSN, Vanderbilt University's MSN, CUNY Staten Island's BSN and MSN, Texas A&M's BSN and MSN. This comes from spending about 3 minutes on the NLNAC accredited school search. I'm fairly sure that if the NLNAC had a reputation of accrediting degree mills, these schools would not continue seeking NLNAC approval.



SerumK said:


> Lastly, as to Excelsior "weeding out" more than others. HAHAHAHAHAHHAHAHA that is pure proof that Rook [ed: again, edited for you] is blind to the world we live in. Schools like Excelsior do the EXACT same thing as ITT-Tech, University of Phoenix, Concord Career College, etc: they are FOR PROFIT so they get as many students paying as possible, then drop them out and keep their money. It's all about making $$$ for the shareholders.



I'm not even sure how to address the ignorance of this statement. It does not benefit a for-profit school to somehow string a student along through an entire program, take all of their money, and not allow them to graduate. It would make more economic sense for them to graduate the student and then try to recruit them into a graduate program or post-Baccalaureate certificate.



SerumK said:


> Real schools weed people in.  My school (a non-profit) has a 5% acceptance rate and a 96% graduation rate for their RN program. They can do that because there are way more QUALIFIED people who want to be nurses than there are seats. They choose the best. The rest of the qualified people (many of them overly so) go to other schools and become RNs. It's the undesirable students who can't get in anywhere else who get suckered into ITT-Tech, University of Phoenix, and Excelsior College.



While your school's statistics are impressive, they do not represent the average U.S. nursing program and this information is irrelevant to the conversation.

However, it looks like you have a pretty good chance of graduating, but you could also be that 4%. I believe that your opinion of nurses who did not follow your particular educational path will change once you start working under them and figure out how much you really don't know.


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## rook901

(deleted by me)


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## Journey

rook901 said:


> You're failing to recognize that all students who enter EC already have relevant clinical experience AND that they do complete a "practical" in the form of the CPNE.



That is why  the programs I have provided links for are so popular. They can teach you everything the CPNE tests you on in one weekend. Most offer just enough to pass. There have been many discussions about Excelsior for several years on different forums and in areas of healthcare. There are also forums with many threads that offer links to weekend courses for those who are in EMS and have no hospital experience.   It is amazing to see how many people are in a panic over this practical test because they lack the clinical experience and resort to paying big dollars for workshops, seminars on "how to pass a test", DVDs and numerous study guides.  You can go back to any nursing forum and read how some, many are also Paramedics, who are freaked out about some of the simplest things which would have been practiced and observed many times in a clinical situation. 

http://www.clinicalprepexam.com/

http://www.cheducation.com/

http://www.cpneworkshop.com/

http://www.chancellorsonline.com/asn/clinical_prep.html

http://www.necpneworkshop.com/

You also fail to realize there is not a set amount of clinical experience required for entry into EC. A brand new Paramedic from a 600 hour certification program can have the necessary sciences but may only have the clinical experience from the 300 hours in the Paramedic program which might not be much as all especially for hospital patient care. 

For the LVN working in the hospital, the clinical situation might be different but then, again, that will vary with whatever area they are working in.


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## Veneficus

*nontraditional education*

I am not sure I would use test prep courses and materials as the a measure of quality education or not.

They have existed in medicine probably since standardized testing. 

I have seen these courses and materials for everything from the USMLE to the ASVAB. It is a side effect of standardized testing, and I expect the market will only be expanding for them.

In my not always humble opinion, in about 8 months of test prep I could probably use test prep material and get somebody who has never studied medicine a passing USMLE score.

The only solution to passing the test vs learning the material that I see is to use subjective testing and things like oral board exams. 

Otherwise, everyone who can pass the same standardized exam is equal by measure. As such there could be a strong argument made (not that I agree) that anyone should be able to test out of just about anything.

Standardized testing is a poor measure of education or ability. But it is so ingrained in US education that from proficency testing and up, it is the rule, not the exception. 

That being said, I see the value of US education at all levels being dumbed down to: "What do I need to pass the test?" 

That is the very bread and butter of the test prep business and people will pay top dollar for it.


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## Journey

The CPNE is the skills portion of the testing for EC. It is troubling that a weekend course can teach everything that will be on the EC test to anyone regardless of experience and substitute for over 1000 hours of clinicals which involves direct patient care.


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## rook901

Journey said:


> That is why  the programs I have provided links for are so popular. They can teach you everything the CPNE tests you on in one weekend. Most offer just enough to pass.



Please stop pretending to be an expert on a nursing program that you only have cursory, second-hand knowledge of. Have you attended any of these CPNE workshops? Do you know what they entail? Did you know that there is an expected level of familiarity with the CPNE critical elements before attending these workshops? Have you read the ~500 page CPNE guide even once? Have you memorized all of the critical elements in the 23 general areas of care?

The CPNE workshops will not teach you everything you need to know in one weekend. If you do not study the 500 page manual over and over, practice your labs over and over, practice your areas of care over and over, and work on your care plans until you have arthritis from writing, then you will not pass the CPNE.

I attended a highly-praised third-party workshop several months before my CPNE. While I did learn some interesting tips and did get to clarify some things that I was unsure about, and while there was a lot of good information presented, there is no way that anyone could use that weekend as their only preparation.

If it was really as easy as attending a weekend workshop and waltzing through the CPNE with no other preparation, do you think that the CPNE pass rate would be 62%? Come on. That's just ridiculous.



Journey said:


> It is amazing to see how many people are in a panic over this practical test because they lack the clinical experience and resort to paying big dollars for workshops, seminars on "how to pass a test", DVDs and numerous study guides.  You can go back to any nursing forum and read how some, many are also Paramedics, who are freaked out about some of the simplest things which would have been practiced and observed many times in a clinical situation.



It is amazing to you, because you are unfamiliar with what is involved in taking the CPNE. You have so many areas of care as well as lab sims that you cannot make a single mistake on. It's not that students are incompetent or lack clinical experience (although this may be true in some cases). It's that the CPNE is the final step before completing the degree and that there is so much pressure to pass.

When I took my CPNE, I had four years of LPN experience under my belt, including med/surg, psych, and urgent care. I realize that four years is not much, but I was very confident in my abilities before I even prepared for the CPNE. I still practiced my labs several times a week and I set up a mock patient room to practice PCS's several times a week. When it was go time, I was still sweating bullets. Not because I was incompetent. Not because I hadn't spent nearly couple hundred hours practicing my skills. Not because I was unfamiliar with the critical elements. But, because I knew that when I passed, I would finally be done. And I knew that if I had failed, then my hundreds of hours of preparing had been done the wrong way and that I would have to start over.



Journey said:


> You also fail to realize there is not a set amount of clinical experience required for entry into EC. A brand new Paramedic from a 600 hour certification program can have the necessary sciences but may only have the clinical experience from the 300 hours in the Paramedic program which might not be much as all especially for hospital patient care.



If said Paramedic is not capable of working as the equivalent of a new grad RN on a med/surg unit, he or she will likely not pass the CPNE. Additionally, one would hope that this Paramedic would be working and gaining experience during the time that it takes him or her to complete the program. While ambulance experience is not equivalent to med/surg experience, there is the opportunity to develop your skills.

If you want to continue to bash a program that has been reviewed by a commission and boards of many, many nurses with a much higher level of education and experience than your own, then I welcome you to petition the NLNAC to revoke accreditation. I don't think you'll have much success.


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## Veneficus

Journey said:


> The CPNE is the skills portion of the testing for EC. It is troubling that a weekend course can teach everything that will be on the EC test to anyone regardless of experience and substitute for over 1000 hours of clinicals which involves direct patient care.



Not as scary as a couple week program that is going to make up for everything a person was supposed to learn in the first 2 years of medical school.

But they do exist and people do use them to great effectiveness.

Like I said, I don't agree with it, but I know it goes on.


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## Journey

rook901 said:


> It is amazing to you, because you are unfamiliar with what is involved in taking the CPNE.



With the skills in that lab you should not be making mistakes. In any clinical lab or practical, you would be corrected and expected to perform without mistakes also.



rook901 said:


> When I took my CPNE, I had four years of LPN experience under my belt, including med/surg, psych, and urgent care. I realize that four years is not much, but I was very confident in my abilities before I even prepared for the CPNE.



I have also stated several times in this thread that the EC might work for an LVN with hospital experience. You are getting very defensive about something that I have agreed with. You are the one who keeps brings up agruments to justify your skills as an LVN. The LVNs were the techs of the nursing industry and do have skills unless your program was  different. 



rook901 said:


> If said Paramedic is not capable of working as the equivalent of a new grad RN on a med/surg unit, he or she will likely not pass the CPNE. Additionally, one would hope that this Paramedic would be working and gaining experience during the time that it takes him or her to complete the program. While ambulance experience is not equivalent to med/surg experience, there is the opportunity to develop your skills.



Paramedics typically work on an ambulance and not in the hospital. They may never have to set up an IV  pump or do the things on the CPNE. It might even vary from state to state what a Paramedic can do in their own profession with limited meds and skills.  They could probably try to find someone to teach them the skills but they may get little opportunity to practice with a patient.  The exception might be those working flight but even that has its limitations. 



rook901 said:


> If you want to continue to bash a program that has been reviewed by a commission and boards of many, many nurses with a much higher level of education and experience than your own, then I welcome you to petition the NLNAC to revoke accreditation. I don't think you'll have much success.



My state has already stated they will not accept EC grads and have not for quite some time. You're also not offering up much of a challenge since I do belong to associations that want to see an improvement in nursing.  If you want to make nursing a career you should also join professsional associations to advance the RN rather than advocating for everyone to take shortcuts and bypass clinical requirements. 

I have also not given out any education or title on this forum since I discovered from the very first post  I did from a Yahoo! link that this is an EMS forum for EMTs.   I did continue posting on the two recent threads about nursing since there seems to be not much understanding about RNs or any of the other allied health profsssions here. This is probably due to their limited experience inside a hospital and the fact that many EMT or Paramedic programs are taught at a tech school and not with other professions at a college or university.


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## MidwestFF

Not to beat further on a dead horse but:

I feel that one of the reasons that many regulatory bodies have is the aspect of the online classroom and learning environment with little to no in person contact. As I am currently attending college for the second time things are very different now as opposed to what they were almost 20 years ago. Then you had to show up for class, email was just a novelty and most professors would not let you tape record their lectures. Now attendance to most lectures is optional and the professor will not only let you record the lecture they will normally email the whole thing to the students complete with audio and video synced to relevant Power Points. I have also seen a TA come to class for a lecture and essentially hit 'play' and the so called lecture will be displayed on a screen in absence of the professor. Although this is a accredited brick and motor school that I attend (I have seen this at two local state universities as well) what is the difference of being in a classroom to watch a screen as opposed to doing in the comfort of you own home?

For many their only option is the non-traditional online classroom so they can attend their lectures at 1400 or 0200 to get them into their schedule. I have done several online courses through the local universities and many times they take more work and you have to be more disciplined in order to pass your proctored exams. With today's primary and secondary schools moving to computers on every students desk at what point does the classroom turn into daycare, the teacher to attendant, and the possible learning take place only on the computer?

As for the clinical requirements I do think exam or otherwise there should be a minimum of hours that every student should have to perform in the health field at the initial levels. Do I think a RN going from a ASN to BSN degree should have to complete clinicals, to a point yes, but it should be minimal. For example my wife is currently a ASN ICU RN with a with a number of years experience at the critical care level, her employer was pushing for her to get her BSN, which we checked into. It was not the cost of the classes which we found disturbing it was the fact that most programs wanted 1200+ hours of clinicals. On the surface this does not sound like a bad thing but think of the loss of income. The hospital wants a free ICU nurse for 1200 hours about (think $40,000 in salary, or $60,000 due to overtime because that would be in addition to her normal shifts) in exchange for a BSN my wife would make an extra $1.00, yes one dollar an hour in for the BSN degree. Who here is benefiting from the BSN other than the patients? When you calculate the cost of tuition and the loss of income the return on investment would be greater than 10 years! The point I am trying to make is no matter what your situation you must earn a return on investment for furthering your education, else what is the point.

We all decry the individuals who don't continue their education but at the same time what they do makes financial sense if there is no return on investment other than more alphabet soup, minutely more job security, massive debt, and loss of income while attending school.

I personally can only hope that there will be accredited nursing schools out there that I can take at least partially online once I complete my medic and gain some more field experience. Do I want alphabet soup, no; I want the education and experience behind the credentials. My point being education will continue to evolve, we may not like it but it will, it has been and shall always be the student that makes the difference in any class no matter whether it be Paramedic, RN, or MD; at our level the instructor is only a guide, facilitator, and to point out our weaknesses via exams so that we may further our studies in the areas that we are weak. Like it or otherwise I see the computer taking the place of the facilitator in our lifetime, it will be up to the students to make the most of what technology will offer.


FF


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## Journey

MidwestFF said:


> it was the fact that most programs wanted 1200+ hours of clinicals. On the surface this does not sound like a bad thing but think of the loss of income. The hospital wants a free ICU nurse for 1200 hours about (think $40,000 in salary, or $60,000 due to overtime because that would be in addition to her normal shifts) in exchange for a BSN my wife would make an extra $1.00, yes one dollar an hour in for the BSN degree. *Who here is benefiting from the BSN other than the patients?* When you calculate the cost of tuition and the loss of income the return on investment would be greater than 10 years! The point I am trying to make is no matter what your situation you must earn a return on investment for furthering your education, else what is the point.
> 
> We all decry the individuals who don't continue their education but at the same time what they do makes financial sense if there is no return on investment other than more alphabet soup, minutely more job security, massive debt, and loss of income while attending school.



So often in these debates the patients are forgotten. 

RNs who work at a hospital that is expecting them to advance their education to BSN or at least obtain certain certifications usually have no reason to cry poor. 

For Indiana, this is an example of benefits for RNs.  This is in addition to all the other benefits and this is not a rare package. Some hospitals and states will offer loan forgiveness and scholarships up to $40K.  

http://indianahospital.netreturns.biz/JobPosting/Benefits.aspx

*Learning and Development *
Tuition Reimbursement 
Certification Reimbursement 
Onsite Continuing Education 
Web Based Learning Opportunities 
Scholarships and Loan Forgiveness 
Internal Job Postings 
Leadership Development Program 

As far as the scheduling, RNs can work 12 hours shifts which will allow for 4 days per week free for school. Some also make a sacrifice and work all weekends for a few months, 2 - 12 hour shifts, and make the same as someone working 36 or 40 hours. If a hospital is wanting you to advance your education to benefit the hospital AND THE PATIENTS, they will be willing to work with you.  Take advantage of that an bargain with them.  If a hospital is wanting you to advance your education, don't take it to be a punishment. A higher degree can  help you in the future. I have yet to hear of a hospital that denies any RN the ability to advance their education to either BSN or MSN and will usually provide every financial benefit possible and schedule adjustments to help them. 

Hospitals have to think of the future and prepare for it because medicine shouldn't stop advancing because some believe anything beyond an ADN or two years of education is way too much learning or inconveniences the health care providers and with the patients or the advancements in medicine not really being considered. Yes, the ADN was good enough for the past 40 years but we are now entering 2011. We can't keep living 1970 forever and just doing the minimum to get by. 

More states need to follow NY and NJ with "BSN in 10". If not, next to EMS, nursing may soon be known as a profession with the lowest entry requirements and with having the least amount of education of the licensed health care professionals. Other professions are discussing the Masters and doctorate degrees while some are still debating if 2 years of education are too much and trying to eliminate clinicals to make the program even  shorter.


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## Veneficus

I think you have many good points, but I would like to respond to some with my perspective.



MidwestFF said:


> I feel that one of the reasons that many regulatory bodies have is the aspect of the online classroom and learning environment with little to no in person contact.



I think the big question is how much does that person to person contact make a difference in mentoring and the hard to measure personal guidance and universal professional development/networking make a difference?

For example, while going to school I meet many new people, my horizons are broadened, beliefs challenged, I have met life long contacts, a few friends, etc. But when I apply for that job I can reminice about also having professor X. They understand that his class was damn near impossible compared to similar classes in other places. Even if they don't like me, I get recognition for my efforts. Not to mention real recommendations.

Take your online class, you might get a grade, but a lot of the things you can use to differentiate yourself from the 10,000 other applicants is the cost. Some will find it worth it, some will not.



MidwestFF said:


> As I am currently attending college for the second time things are very different now as opposed to what they were almost 20 years ago. Then you had to show up for class, email was just a novelty and most professors would not let you tape record their lectures. Now attendance to most lectures is optional and the professor will not only let you record the lecture they will normally email the whole thing to the students complete with audio and video synced to relevant Power Points. I have also seen a TA come to class for a lecture and essentially hit 'play' and the so called lecture will be displayed on a screen in absence of the professor. Although this is a accredited brick and motor school that I attend (I have seen this at two local state universities as well) what is the difference of being in a classroom to watch a screen as opposed to doing in the comfort of you own home?



Just because it can be done this way, and probably benefits the professor, does it benefit the student? It is hard to form relationships from a video. Maybe not important for an undergrad, but certainly important for grad applications, thesis or dissertation work, etc.



MidwestFF said:


> For many their only option is the non-traditional online classroom so they can attend their lectures at 1400 or 0200 to get them into their schedule. I have done several online courses through the local universities and many times they take more work and you have to be more disciplined in order to pass your proctored exams. With today's primary and secondary schools moving to computers on every students desk at what point does the classroom turn into daycare, the teacher to attendant, and the possible learning take place only on the computer?



With the first part I can sympathize. However, with the proctored exams I cannot. Some of the things the US seems to be very entralled with is replacing people with complex roles with simple technologies and standardized testing. 

When you look comparitively at education of all levels, the US falls behind by a significant margin in primary and secondary education and despite the propaganda and advertizing, seems to be importing more and more of its high end scientists and educators from abroad. The only logical conclusion is that they cannot produce such quality themselves. So your, English, German, Indian, or Japanese PhD (or any level graduate) may be well more capable than somebody with the same degree from an American university.

I saw a number a few years ago that stated 35% of all upper educated workers in the US were born and educated abroad and hired by US companies. NOw let's say that number is even 1/2 right, since I honestly don't even remember where I saw that at. 17% is almost 1 in 5. That should speak volumes.



MidwestFF said:


> As for the clinical requirements I do think exam or otherwise there should be a minimum of hours that every student should have to perform in the health field at the initial levels. Do I think a RN going from a ASN to BSN degree should have to complete clinicals, to a point yes, but it should be minimal. For example my wife is currently a ASN ICU RN with a with a number of years experience at the critical care level, her employer was pushing for her to get her BSN, which we checked into. It was not the cost of the classes which we found disturbing it was the fact that most programs wanted 1200+ hours of clinicals. On the surface this does not sound like a bad thing but think of the loss of income. The hospital wants a free ICU nurse for 1200 hours about (think $40,000 in salary, or $60,000 due to overtime because that would be in addition to her normal shifts) in exchange for a BSN my wife would make an extra $1.00, yes one dollar an hour in for the BSN degree. Who here is benefiting from the BSN other than the patients? When you calculate the cost of tuition and the loss of income the return on investment would be greater than 10 years! The point I am trying to make is no matter what your situation you must earn a return on investment for furthering your education, else what is the point.



When I first started traveling abroad the flaw in this thinking became clear. "What's in it for me?" is not only job security, becase why pay a US trained nurse with a 2 year degree 60K when you could pay a nurse trained in the Phillipines with a 4 year degree 30K? 

Healthcare may not be outsourcable, but healthcare education certainly is. 25% of all US physicians are trained abroad. While there has been some marginal increases in US schools and class size, residencies have not substantially increased, which means sooner or later there will be a bottleneck or collapse. People won't be able to see a doctor because there are not enough, and when that happens they will settle for lesser care and education from a plethor of "mid level" providers at a lower cost. The earnings of a US trained physician will not make the schooling attractive and more and more will decide medical school isn't worth it, furhter reducing supply. 

But that aside, education promises mobility and distinction. Why hire somebody with a 2 year degree when there are so many with 4? The employer is getting more. What happens if you are forced to relocate or a hospital is merged? 

You may have 20 years on the job. Who wants to hire that person at 3-4x a person with 1-2 years experience? What is worse, how do you demonstrate you actually care about your job and are not just in a "do the minimm rut" aside from constant advancement?



MidwestFF said:


> We all decry the individuals who don't continue their education but at the same time what they do makes financial sense if there is no return on investment other than more alphabet soup, minutely more job security, massive debt, and loss of income while attending school.



But what is the financial payoff? Is there one? 

again, marketability and portability. Let's say healthcare spending is slashed in the US 10%. (modest compared to what it will likely be) 20 years bedside care at a premium price employee might be cut first. Without the advanced education, management or other lateral positions might not be available. You just went from making 40K a year to 0 and are not competative in the market place. Now you have that same debt and time loss with no income to even get back into the game. Just as bad, what if you are not competative elsewhere and you are stuck where you are? What if you have to sell a hose at a loss, or pull family to a location that severely impacts the standard of living or opportunities for children in order to maintain employment?

How do you get career satisfaction when you cannot compete for positions with better employers? Does it take a toll at home or personal life? What is that worth in dollars?



MidwestFF said:


> My point being education will continue to evolve, we may not like it but it will, it has been and shall always be the student that makes the difference in any class no matter whether it be Paramedic, RN, or MD;



Yes and no. The student plays a vital role, but I have noticed most students only rise to the minimum they are required. Surely there are exceptions, but at what point is the minimum too low?




MidwestFF said:


> at our level the instructor is only a guide, facilitator, and to point out our weaknesses via exams so that we may further our studies in the areas that we are weak.



Until a person reaches the graduate level, I find that to be largely untrue. Just my experience. In all the textbooks I saw prior to the 3rd year of my medical education, they presented absolute facts. Now my texts books say things like: "We don't really know why, these theories have been postulated, you must decide for yourself." How many RN or paramedic texts have you seen like that? I have seen no paramedic text with such things. 



MidwestFF said:


> Like it or otherwise I see the computer taking the place of the facilitator in our lifetime, it will be up to the students to make the most of what technology will offer.



That is certainly the case, but at what point does technology fail the student?

How does the student realize the technology is holding them back if they know nothing else?

Just some things to consider.


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## MidwestFF

Veneficus,

You make several excellent arguments for the role that in person classes play in ones education, but what do you do for those who are not able to work their schedule around 'the classes'? Depending on the class sometimes I enjoy the in person interaction, if all we are doing is listening to a monotone professor that has made the exact same lecture for the last 10 years then I would prefer to go online. A number of my courses that I did take in person were filled with children who refused to grow up, and brought their high school drama with them to college.

As for my wife, we were unable to negotiate a deal given the time frames required in order to complete the clinical's, attend class, and still have the income that our family requires. With multiple children it would be almost impossible to add school plus clinical's and still have a family. As I previously mentioned the loss of pay for the 1,200 hours would equate to more than $40,000 dollars for just those clinical hours not counting the time required in the classroom. The hospital was told that she would be more than happy acquire her BSN if all clinical hours were paid; which of course they were not willing to do. I see the possible benefit to the patient in some ways but not others. For instance in comparing the local Community College (ASN Program) with the local University (BSN program) the only difference on the surface is the number of general ed hours required for the degree, the nursing components of the degree are exactly the same. One could argue that the University will engage a much higher caliber instructor, but I fail to see where another 50-60 credit hours of general ed will make that much better of a nurse.

As to the outsourcing of education I can and do see that as playing a role in the medical field. I have also heard of many problems the foreign workers have caused or contributed to in the health care setting.

Health care in general is a 24/7/365 adventure, why should schools not follow the same model? There are some classes that I would have much rather taken in person but have been unable to, so my only option was to go online. Will my degree be any less because of it?

As for the standardized testing unfortunately I don't think we will be able to get away from that anytime soon. I would be in favor and support some sort of oral boards or the like that would require a synthesis of your skills prior to being granted licensure or a degree, but due to the subjective nature of this type of testing it is ripe for legal challenge in our country.

I can close by saying I am not against education of any type, I would love to be able to do more on my own. I do plan on continuing college after my paramedic associates degree in order to pursue my RN, will all of it happen in the traditional classroom, probably not, will I make the most out of what I can get whether it be Excelsior or another fully accredited collage, you better believe it!

FF


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## Veneficus

MidwestFF said:


> You make several excellent arguments for the role that in person classes play in ones education, but what do you do for those who are not able to work their schedule around 'the classes'?



Sometimes I had to settle for an online class too. But I saw it as just that, settling for less than what could have been. The endless excercise of balancing wants with needs and ideals with reality that we all must go through everyday.

Incidentally I found that individual self study classes with guidance from a professor to be much more valuable than online classes with just as much flexibility. Unfortunately those are usually only offered at Universities and sometimes only after you get to know a professor well enogh in person for them to agree to the paperwork involved on their part. 



MidwestFF said:


> Depending on the class sometimes I enjoy the in person interaction, if all we are doing is listening to a monotone professor that has made the exact same lecture for the last 10 years then I would prefer to go online. A number of my courses that I did take in person were filled with children who refused to grow up, and brought their high school drama with them to college.



With the utter failure that is primary and secondary education in the US compared with other more demanding societies, I think you will not be able to escape the high school drama in the future as undergrad is very close to the equivalent of what highschool should be.

For older or returning students is truly is a disservice. However, I also see a biological/behavioral connection. As the species of man progresses it takes more time in years to meet the minimum level of being productive in society, much less valuable.

I also saw an interesting paper written by a former classmate on the decline of play behavior particularly in early US education as having a negative effect on child development. (anthropologists have no mercy in their observations)   



MidwestFF said:


> As for my wife, we were unable to negotiate a deal given the time frames required in order to complete the clinical's, attend class, and still have the income that our family requires. With multiple children it would be almost impossible to add school plus clinical's and still have a family. As I previously mentioned the loss of pay for the 1,200 hours would equate to more than $40,000 dollars for just those clinical hours not counting the time required in the classroom.



I get what you are saying, and like I said above, it is a constant battle we all must find our own balance for. But I really think you should seperate the economic loss from the family values loss when making an argument or decision. This looks to me like you would trade the family time for 40K. I don't think that was your intention.




MidwestFF said:


> The hospital was told that she would be more than happy acquire her BSN if all clinical hours were paid; which of course they were not willing to do.



It is just like the fire service now-a-days. Why hire a fireman and pay for the education and their time when you could hire a firefighter who put themselves through paramedic at their own expense?

Like I said, it might work for your family today, but always look for the possible futures.



MidwestFF said:


> I see the possible benefit to the patient in some ways but not others. For instance in comparing the local Community College (ASN Program) with the local University (BSN program) the only difference on the surface is the number of general ed hours required for the degree, the nursing components of the degree are exactly the same. One could argue that the University will engage a much higher caliber instructor, but I fail to see where another 50-60 credit hours of general ed will make that much better of a nurse.



This is perhaps the greatest dilemma of modern education. I really don't see a easy way to solve it. 

The idea of a well rounded general education is based on the idea that people will be able to use information from outside thier academic concentration when making decisions. That is actually the original purpose of university. Unfortunately, many psychologists have discovered not everyone (infact very few) are capable of such dynamic thought processes. I think Myers-Briggs explain it very well, although not perfectly.

But because of the amount of education and training to function in today's society, education beyond primary and secondary is needed for entry into most fields. That need has been filled by Universities. 

The only solution I see, is to revamp the whole educational system based around minimum education and training in hyperspecialized job requirements while still preserving the general educational requirements as superior for the people who can actually make use of them. But in doing so, it adds higher value to a very select group of people, and concedes not everyone is capable of such dynamic thought. That doesn't exactly make people feel good about themselves.



MidwestFF said:


> As to the outsourcing of education I can and do see that as playing a role in the medical field. I have also heard of many problems the foreign workers have caused or contributed to in the health care setting.



Me too. But it doesn't change the fact they make up at least 1/4 and because we cannot produce our own in needed quantity at a reasonable price, the trend is going to be further reliance on them.



MidwestFF said:


> Health care in general is a 24/7/365 adventure, why should schools not follow the same model? There are some classes that I would have much rather taken in person but have been unable to, so my only option was to go online. Will my degree be any less because of it?



I think everything should be 24/7/365. It would employ a lot of people. I rarely get my way though. 

As for the degree being lesser. I can't say it would be lesser, only that you may miss out on things that make it more than the minimum. which I don't think is the same. I described it in my earlier post.



MidwestFF said:


> As for the standardized testing unfortunately I don't think we will be able to get away from that anytime soon. I would be in favor and support some sort of oral boards or the like that would require a synthesis of your skills prior to being granted licensure or a degree, but due to the subjective nature of this type of testing it is ripe for legal challenge in our country.



Very true, however, I have experienced such subjective testing, and I must say that with certain checks and balances, it really works well. Especially since it demands understanding over memorization and association.



MidwestFF said:


> I can close by saying I am not against education of any type, I would love to be able to do more on my own. I do plan on continuing college after my paramedic associates degree in order to pursue my RN, will all of it happen in the traditional classroom, probably not, will I make the most out of what I can get whether it be Excelsior or another fully accredited collage, you better believe it!



I think all education is valuable. But I sometimes question how much. Always remember nontraditional education is always caveat emptor.

Especially accredited, recognized, and valued by who exactly.


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## Journey

MidwestFF said:


> For instance in comparing the local Community College (ASN Program) with the local University (BSN program) the only difference on the surface is the number of general ed hours required for the degree, the nursing components of the degree are exactly the same. One could argue that the University will engage a much higher caliber instructor, *but I fail to see where another 50-60 credit hours of general ed will make that much better of a nurse.*



The BSN is not all art history and ancient literature.  So many use that as an excuse but are really just misinformed. I will post another link from your state that is part of an RN to BSN program. I personally consider each of those classes of importance especially in the very cultural diverse world we live in right here in the U.S. Granted, Indiana may not be New York or California but I'm sure even in Kansas these classes could be of benefit.  I also do not think Pathophysiolgy or Comprehensive Assessment of the Well Adult to be a waste of time.  These classes do prepare the RN to assume more out of hospital roles which might even be considered nontraditional but are part of the future as health care takes different paths in meeting the needs of a community.

http://www.indwes.edu/Adult-Graduate/BS-Nursing/Courses/

 A typical ADN is also over 80 hours by the time all the prerequisities are finished. A BSN is 120 hours. You are paying for a lessor degree but doing almost the same amount of semester hours. Why not just go an extra 30 - 40 hours and have the higher degree?  I don't think those who take the ADN see how they are actually cheating themselves.



> As I previously mentioned the loss of pay for the 1,200 hours would equate to more than $40,000 dollars for just those clinical hours not counting the time required in the classroom. The hospital was told that she would be more than happy acquire her BSN if all clinical hours were paid;



The hospital may not count classroom hours as "hours worked" but I bet they offered to pay for the classes with a scholarship or by tuition reimbursement. You can not count clinical hours as income.  This is no different than all the other health care professionals in the hospital who has to sacrifice to get their Associates, Bachelors, Masters and Doctorates. It is a sacrifice but it is not like your wife is attempting a doctorate. If she wanted to be an Accountant or Architect this wouldn't even be a discussion. She would have to obtain a Bachelors or Masters. Sometimes nursing is the easy way out and one can still earn great money with lots of travel opportunities.


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## ditchdoctorwest

I really hate to dig up a thread that is over four years old, but to be honest with you, I joined the forum just to post my thoughts on this issue. I am a Critical Care Paramedic on a ground unit in the special operations division of a very, very busy EMS system in a large metropolitan area. With that being said, I am also a RN (Excelsior Grad) in a smaller hospital's ED close to my home. I worked in a larger level one trauma center right after obtaining my ASN from EC. However, I got tired of all of the incompetent tweenie RNs from the local community college. I loved teaching them new things and educating them, being that I was a Flight Paramedic on a HEMS unit prior to working there PRN. They always came to me asking for help with "tough sticks." Anyways, to those who think that Excelsior Grads are a joke, you are only being ignorant and narrow-minded, just like all the blue-hairs on all of the BON's. Whether you like it or not, online education is the way of the future and I respect anyone that is trying to better themselves without sacrificing putting food on the table by going to a brick and mortar school with the tweenies.

Sincerely,

Ditch Doc West, RN, CEN, NRP, FP-C


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## Handsome Robb

I don't think anyone is saying every excelsior grad is a joke, but I do see why nurses complain about it...hell we :censored::censored::censored::censored::censored: and moan when an RN comes looking for answers on how to circumvent he system and challenge the NREMT-P without any formal prehospital education beyond EMT-B. 

Are their individuals that this is appropriate for in both aspects? Yes. I do think that unless you're really motivated to put in the leg work you can be just as good as an RN from a traditional program but I don't think that's the norm.

I'm looking at starting an online degree myself. My old partner started his medic to RN bridge when we were working together and ended up dropping out because he didn't like the way they were running him in circles.


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## ExpatMedic0

Is Excelsior a hybrid program or offered entirely online? I have no issues with people taking online classes for cognitive information, but there are a lot of psychomotor objectives to being an RN and a Paramedic. I am not criticizing anyone(yet  ), merely curious.


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## Carlos Danger

ExpatMedic0 said:


> Is Excelsior a hybrid program or offered entirely online? I have no issues with people taking online classes for cognitive information, but there are a lot of psychomotor objectives to being an RN and a Paramedic. I am not criticizing anyone(yet  ), merely curious.



The didactic part of the program is entirely self-study and you take the exams at a testing center.

To graduate the program however, one must pass a very rigorous 3-day practical exam called the CPNE. Imagine an NREMT practical exam on real patients that lasts 3 days, and there are many more skills one must be able to demonstrate, and the "skills sheets" are several pages long and must be done meticulously. It is a bear with a very high rate of first-time failures.

Used to be almost anyone with any kind of "clinical' credential could get into the program, including EMT's and CNA's. For quite a while now, they have only allowed paramedics, RRT's, and LPN's to enroll. When I took my CPNE, out of the 15 or so of us who were there, all but 2 were LPN's. The program is really designed with them in mind, I believe.


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## TransportJockey

Halothane said:


> The didactic part of the program is entirely self-study and you take the exams at a testing center.
> 
> To graduate the program however, one must pass a very rigorous 3-day practical exam called the CPNE. Imagine an NREMT practical exam on real patients that lasts 3 days, and there are many more skills one must be able to demonstrate, and the "skills sheets" are several pages long and must be done meticulously. It is a bear with a very high rate of first-time failures.
> 
> Used to be almost anyone with any kind of "clinical' credential could get into the program, including EMT's and CNA's. For quite a while now, they have only allowed paramedics, RRT's, and LPN's to enroll. When I took my CPNE, out of the 15 or so of us who were there, all but 2 were LPN's. The program is really designed with them in mind, I believe.



How did you find the program? Since I'm gonna be working in Podunk Texas, I'm considering it as a way of continuing my education and killing down time


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## Carlos Danger

TransportJockey said:


> How did you find the program? Since I'm gonna be working in Podunk Texas, I'm considering it as a way of continuing my education and killing down time



It was decent. It was tough, but I think anyone who is motivated and good at self-study would do fine with it. You just have to be able to make yourself study even when you have no deadline (since the program is entirely self paced), and you have to be good at reading and teaching yourself.

My advice would be to finish the exams as fast as possible, and then really study hard for the CPNE for a while before taking it, making sure you really understand the skills thoroughly and also have the critical elements memorized cold.  Also, if you don't already have an A&P course in your background, I would highly recommend taking one instead of the exam, both because the exam is ridiculously difficult and because it is such important subject matter.


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## Akulahawk

Just remember that not all states will accept the education you will receive from Excelsior. California is one of those states. I'm not saying that Excelsior will not train you well, just that  you need to be aware that some states require that you have concurrent clinical and didactic experiences to be eligible for licensure there.


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## wanderingmedic

Will programs who require an RN (like an RN to BSN, or RN to MSN) even consider EC grads? 

If you get a BSN from a reputable university after doing EC, does that negate any of the negative stuff surrounding EC? 

Does anyone know if Excelsior grads who go on from their initial RN and get a MSN or DNP will be at a disadvantage in terms of licensure?


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## Akulahawk

azemtb255 said:


> Will programs who require an RN (like an RN to BSN, or RN to MSN) even consider EC grads?
> 
> *If you get a BSN from a reputable university after doing EC, does that negate any of the negative stuff surrounding EC? *
> 
> Does anyone know if Excelsior grads who go on from their initial RN and get a MSN or DNP will be at a disadvantage in terms of licensure?


For California, I don't think so _unless_ the BSN curriculum covers all the "content" that California deems must be done concurrently with clinical and provides a clinical component at those appropriate times.

You can be a fantastic DNP RN but if your original transcripts (and subsequent ones) don't show that you meet California's requirements, you're going to have a difficult time getting licensed in California.


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## Carlos Danger

azemtb255 said:


> Will programs who require an RN (like an RN to BSN, or RN to MSN) even consider EC grads?
> 
> If you get a BSN from a reputable university after doing EC, does that negate any of the negative stuff surrounding EC?
> 
> Does anyone know if Excelsior grads who go on from their initial RN and get a MSN or DNP will be at a disadvantage in terms of licensure?



It depends on the state. 

Most states still have NO restrictions or extra requirements for EC grads. Among those states that DO have additional requirements, most are relatively minor, and some will waive any extra requirements once you have earned a BSN, or once you have worked for a certain length of time in another state or in a VA facility. I believe CA is the only state that won't license EC grads at all. Which is purely a result of the typical California elitist political stupidity.  

Your best bet is simply to call the BON's in the state(s) you plan to practice in.


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## NomadicMedic

http://www.excelsior.edu/state-board-requirements


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## Akulahawk

Halothane said:


> It depends on the state.
> 
> Most states still have NO restrictions or extra requirements for EC grads. Among those states that DO have additional requirements, most are relatively minor, and some will waive any extra requirements once you have earned a BSN, or once you have worked for a certain length of time in another state or in a VA facility. I believe CA is the only state that won't license EC grads at all. Which is purely a result of the typical California elitist political stupidity.
> 
> Your best bet is simply to call the BON's in the state(s) you plan to practice in.


California's issue with Excelsior College is that their theory and clinical subjects aren't done "concurrently." This requirement has been on the books for at least 25 years but they only really have been enforcing that since about 2003. This has also had a huge effect of preventing nurses educated in the Philippines from getting licensed there either. Topping it all off, there's been some fraud discovered in some Philippine nurses getting licensed, so now pretty much all Philippine Nurses licensed since about 2009 or so are having their transcripts gone through pretty closely just to ensure that they were actually originally licensed properly.

Correct any "deficiencies" and I would expect that EC grads could get licensed in California just as easily as a Philippine grad...


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## Handsome Robb

Akulahawk said:


> California's issue with Excelsior College is that their theory and clinical subjects aren't done "concurrently." This requirement has been on the books for at least 25 years but they only really have been enforcing that since about 2003. This has also had a huge effect of preventing nurses educated in the Philippines from getting licensed there either. Topping it all off, there's been some fraud discovered in some Philippine nurses getting licensed, so now pretty much all Philippine Nurses licensed since about 2009 or so are having their transcripts gone through pretty closely just to ensure that they were actually originally licensed properly.
> 
> Correct any "deficiencies" and I would expect that EC grads could get licensed in California just as easily as a Philippine grad...



That's pretty interesting actually. 

If you work as a nurse in another state for a few years I wonder if you could be licensed through reciprocity? I don't know anything about nursing credentials or how the whole process works though.


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## wanderingmedic

Robb said:


> That's pretty interesting actually.
> 
> If you work as a nurse in another state for a few years I wonder if you could be licensed through reciprocity? I don't know anything about nursing credentials or how the whole process works though.



to my knowledge that is not an option. CA won't license EC grads period


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## Akulahawk

Robb said:


> That's pretty interesting actually.
> 
> If you work as a nurse in another state for a few years I wonder if you could be licensed through reciprocity? I don't know anything about nursing credentials or how the whole process works though.


EC Grads (enrolled after a specific date in 2003) face an extremely difficult uphill battle to get licensed in California. Most RN New Grads from the Philippines have similar issues and it's very, very difficult for them to find a school that will host them or hold a class just to cover the identified "deficiencies" in their education. Thousands of BSN grads from there have been shuffled over to the BVNPT for evaluation and possible licensure as an LVN. Because of that, the BVNPT has a massive backlog that is affecting California LVN grads, delaying evaluation of their applications by MONTHS.


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## Carlos Danger

It really is ridiculous. 

I would bet a protectionist move by the nursing unions in CA or the educational lobby is behind the whole thing.


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## Summit

If ever again there is an actual shortage of RNs then I'm sure the rule will be reconsidered... but there is little motivation with such a massive glut of domestic new grad RNs that nobody is worried about the 200,000+ unemployed RNs in the Philippines itching to come over. They sure don't care about a couple hundred graduates from Excelsior.


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## Akulahawk

Summit said:


> *If ever again there is an actual shortage of RNs then I'm sure the rule will be reconsidered*... but there is little motivation with such a massive glut of domestic new grad RNs that nobody is worried about the 200,000+ unemployed RNs in the Philippines itching to come over. They sure don't care about a couple hundred graduates from Excelsior.


I'm almost certain that there'll be another nursing shortage, it's just a question of when that will happen. And I'm also certain that the rules will be relaxed once again. I quite imagine that at some point, someone _notable_ to the BRN complained about all those Philippine nurses "taking over" and then the "concurrency" regulation was probably noticed by the right people at the BRN, and since Excelsior College's program is _very_ different from any traditional brick & mortar program, they may have been the easy "low hanging fruit" to go after so that they'd be able to enforce that long unenforced regulation. Fast forward just a few years later and Philippine nurses start having issues with getting California RN licenses because of that very same "concurrency" issue. 

I'd be very surprised if the overall intent is to limit the number of nurses not educated in California from getting licensed there, in particular, prevent (primarily) Philippine nurses from coming over in relatively large numbers, crowding out the CA-trained new-grads.


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