AJN, American Journal of Nursing:
I have no doubt about the skills of the medics in our military, described by Edward J. Halloran in his Viewpoint, "Men, Medics, and Nursing" (June), and further discussed in Letters (September). I have worked with many military-trained personnel during my 35-year career as an RN. Yet I have problems with the author's suggestions.
A debate regarding the basic level of education required to qualify to take the National Council Licensure Examination for RNs (NCLEX-RN) has raged throughout my career, and it has yet to be resolved. Nursing has not established an educational standard. Graduates of associate degree programs and diploma schools as well as baccalaureate degree programs all take the same examination. (The exam itself bothers me, too. I sat for two days, took six tests with 200 questions each, and had to pass all of the exams to become registered. The current exam has a total of 200 questions.) Why bother obtaining a BSN if it's not required for many nursing jobs?
The requirements for becoming medical doctors, lawyers, architects, engineers, and other professionals are well established and have not varied, except for improvements in the quality of the education. Nursing needs to pick one educational standard and stick with it. Choose the bachelor of science in nursing (BSN) and be done with it. The associate degree programs can be used to complete prerequisites and start clinical bedside training prior to transferring to a baccalaureate program. This would help to weed out students who are unlikely to complete the BSN program.
Yet Dr. Halloran suggests adding another level of educational nonequity to the mix. Most medics receive an initial year of training with continuing education throughout their military service. That shouldn't qualify them to be RNs. If the military wants to further educate its medics to meet eligibility to take the NCLEX-RN, then it would be tax money well spent.
Don't foster more levels of entry—foster standards. This is why this associate degree–prepared nurse with bachelor's and master's degrees in health services administration is trying to enter an RN-to-BSN program. I want to at least practice what I preach.
Lisa K. Hardee, MAHS, RN, CGRN
Chapel Hill, NC