paramedic to rn bridge_excelsior program

Veneficus

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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.
 
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rook901

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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.

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.

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.

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.

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.

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.

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

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(deleted by me)
 
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Journey

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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.
 

Veneficus

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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.
 

Journey

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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.
 

rook901

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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.

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.

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.
 

Veneficus

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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.
 

Journey

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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.

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.

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.

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.
 

MidwestFF

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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
 

Journey

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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

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

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.

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.

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.

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?

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?

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?


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.

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

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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
 

Veneficus

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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.

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)

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.


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.

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.

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.

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.

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.

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.
 

Journey

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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

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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
 

Handsome Robb

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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.
 

ExpatMedic0

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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 :p ), merely curious.
 

Carlos Danger

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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 :p ), 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

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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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