Sandbox wars: Diploma vs Degree, let’s give it a rest.
Professional nursing versus technical nursing, the battle still goes on in some corners and perhaps in many corners of the nursing world. Today very few diploma schools of nursing exist. They have given way to community colleges and large academic centers that offer degree programs for nursing, ranging from the Associates Degree through the Doctoral preparations. During the 1980’s the diploma-degree battle was fierce and there was no loss of contention between the two academic tracks. Diploma nurses tooted more in-hospital clinical time prepared them to better care for patients where degree students boasted a more rounded and professional educational foundation which increased their professional standing and authority as a clinician.
Recently I was asked to read an Op-Ed out of the January – February 2008 issue of Wound, Ostomy, and Continence Nursing (WOCN) by a nursing colleague which dealt with this very issue. At hand the concern regarded clinical certification in the field for only degree nurses. The Op-Ed was written by Mike D’Orazion ET, who clearly was experienced in the field but had not obtained a nursing degree, and he was clearly disappointed with the WOCN society’s stance on certification only going to those candidates with degrees. In response to his Op-Ed, J. Beitz PhD, RN, CS, CNOR, CWOCN purports that nurses who have been trained at the Bachelorette level or higher should be the only candidates eligible to seek a clinical certification in the WOCN arena, citing research studies that support her opinion. Beitz went on to say that basically patients experienced better outcomes when the care they received came from “professional” (Degree) nurses and not “technical” (Non-BSN) ones.
I would like to see the research that supports this perspective that degree nurses for lack of better terms provide better care. I don’t agree with this. At the bedside level where the rubber hits the road the knowledge and application of knowledge is what counts. Much of the theoretical content of nursing I have found has little application at the bedside. The denominators of all excellent nurses included time management skills, clinical expertise, and the understanding of the science of medicine, which all are learned through experience and clinical training.
The configuration and quantity of letters after a person’s name does not automatically translate into quality, excellence, and competency. To think otherwise would be foolish and myopic. In my twenty years of nursing practice both at the bedside and at leadership levels I have experienced several nurse colleagues with many certifications and degrees listed after their name that are not qualified or competent. To become a master of one’s craft certainly takes a minimum of training and experience on the short end. However to truly become a master it takes years of practice and continued learning. Most nurses today that are not at the bedside which include many managers, directors, and CNOs who all have several letters after their name are no longer clinically competent. The argument of degree versus diploma is nothing more than ego when it comes to bedside nursing and caring for patients. I too have several letters after my name: RN, BSN, MPA, CEN, CCRN, CATN. I also went to a diploma school before I obtained my degree. My undergraduate and graduate time has not made me a better clinical nurse. My continuing learning of clinical medicine and the application of that clinical training is what has made me the excellent nurse I am today.
For those nurses who seek administrative positions in healthcare I would argue that higher education through the obtainment of degree status is the course to take. Developing a knowledge base regarding managerial applications, business plans, human resource management, recruiting, statistical analysis, strategic design, etc. are the areas of additional competence that one needs in order to function at the administrative level.
I should think by now these sandbox arguments would have become extinct. It is disappointing to see otherwise.
About the Author
Mike Pringle is the creator of Mike’s ViewPoint, where he provides his perspective on various Healthcare issues. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. Mike has held positions ranging from department staff and Nurse Manager to Executive positions.
