Nurses & Business Management, Business Plan Example

Executive Summary

This paper explores the best path of gaining a wider knowledge base as an RN. In this examination there are a myriad of ways to endeavor to accomplish such a feat but this paper will narrow that focus to the following: college programs and real world experience. In this way, the RN student with only college level education can gain experience from professionals who have been in the field and have seen and experience a wide array of medical phenomenon, and if the RN chooses to follow the path of higher education, this knowledge base will help to fuel future emergencies. The paper will present the argument that both paths are necessary in order for an RN to gain a wider knowledge base, as, through both paths a culmination of experience and knowledge proves to foster a more equipped RN, and a more equipped RN is better able to focus their energies and their intellect to the task at hand.

Introduction – Overview of Decision Problem

Problem Statement

In making decisions between two different paths (college vs experience) there are many factors to consider. One such factor is money. It costs money to go to college. A college degree (in reference to a masters or higher) is not always covered by government grants. As such, loans become a necessity. Student loan rates are increasing. The average price of a single credit hour is somewhere in the range of $500. A graduate level course is anywhere from three to five credits. Thus, a course costs anywhere from $1,500 to $2,500. This is an estimate for a single course of study. All graduate programs require a course load of 30-50 credit hours depending on the course of study. Overall, the cost of a graduate degree is somewhere around the $40,000-$60,000 range. In considering the proper course of action between the two differing factors, the cost of education is imperative to consider. There are however, other factors to consider such as scholarships and work study (if the institute approves of such programs). Not only this, but education takes time away from worldly experience. Weighing the options of time is a crucial element. Time in educated may take necessary time away from experience; even with options such as shadowing, or interning at a hospital as part of the credit hours and school curriculum, the next phase of education is employment and an employer will look to the resume that has the most experience. Therefore, choosing education over experience may have a detrimental effect.

Being a nurse with a practice (DNP) or having a research doctorate comes with the responsibility of always staying up on current research in one’s field. Not only current research, but research that spans the breadth of the field of nursing-meaning that new practices that are being implemented with efficacy in different cultures and that may prove beneficial in others, should be researched, developed, and implemented (“The Essentials of Doctoral Education for Advanced Nursing Practice,” 2006, p. 11). These new innovations may be seen as alternative paradigms and are the cornerstone of DNP and as such separate the degree from other degrees.

DNP programs are part of a supervised program that in turn helps students learn through “specific learning objectives” related to DNP specific requirements. Part of this appeal is that the program offers in-depth look into student practices as they relate to research and as they are evaluated by experts in any given field. The cross-discipline approach of DNP allows for further understanding of nursing as a whole under the umbrella of scientific and philosophical approaches. Human wellness and prevention should not be studied in a vacuum because that causes using the same approach over and over again when there medical science is advancing in stride with modern technology (Klebanoff& Hess, 2013, p. 4).

In choosing experience over education, possible problems that may ensue include being paid less, being overlooked for promotions, and being stuck in a stationary position with no room for improvement without education. The bonus to experience includes being hired above other without experience, and knowing what to do in emergency (or otherwise) situations because of that experience. Experience in the field of medicine revolves around the idea that with it comes its application and this application in turn helps to save lives. Without experience the nubile nurse may negatively affect a patient’s outcome or stay.

General Problem

The general problem that exists is what approach is better for a new graduate RN to gain a wider knowledge base. This can be accomplished by either getting more schooling or gaining more experience. Delving into this dichotomy, lets examine a few more avenues of experience: an RN may gain different levels of experience depending on the job they take. Working at an inner-city hospital vs a county hospital presents varying degrees of emergency. In an inner-city hospital, it is more than likely that the RN will gain working knowledge of gunshot wounds, stab victims, etc. while at a county hospital more of the emergency situations will deal with the local jobs such as factory workers and farmers. These types of injuries may include bailer accidents, tractor accidents, or machinery in which limbs are severed. Thus, although triage will be a focus in either environment, the injuries and the treatment will be very different.

What Event Triggered the Situation?

The idea to make RN’s have advanced degrees began during the turn of this century. Studies (including those conducted by the Institute of Medicine and the Carnegie Foundation for the Advancement of Teaching) pointed out that there’s an indelible link between the level of a nurse’s education and their patient’s outcomes. This link was very hard for the medical field to ignore in perpetuity. Therefore, a movement of having RN’s gain their baccalaureate degree was called for. Academic progression was needed not just for the job security of the nurses but for the patient’s wellbeing.

This trigger was also seen by the nurses themselves as evidence in the Tri-Council for Nursing statement made in 2010 as well a recent statement by the Joint Statement on Academic Progression for Nursing Students and Graduates in 2012. Both statements were validated through the support of the college, community and medical leaders. The preference, since these studies a few years ago, seems to be shifting from hiring nurses with medical experience to nurses with a degree. This is seen in hiring practices in which studies reveal that 30% “of hospitals and other healthcare settings requiring new RNs to have a baccalaureate degree in nursing and 77% expressing a strong preference for nurses educated at this level” (AACN, 2013).

It is this trigger that has RN’s recognizing the need for furthering their education. Due to this trigger, many employers (such as hospitals) are fitting the bill for an RN’s education. They are doing this in the form of grants, and other funding sources for academic pursuit. In fact, enrollment for RN’s in the BSN (Bachelor of Science in Nursing) academic curriculum, has increased in the years following the above-mentioned studies. In the past nine years, it has increased from a rate of 31,215 students in 2003 to an increase of 288% in 2011 (AACN, 2013). This growing rate has only further increased the need to accommodate these rising numbers to such a degree that BSN programs are now including more programs (programs previously only available on campus are now being offered online). However, this does not negate the need for experienced nurses. The studies, the medical field professionals, all recognize the need for an academic background while also maintaining the need for “quality practice experience” (AACN, 2013).

Are We Imposing Constraints on the Situation?

There seems to be a split still on which is preferable: education or experience. While the above-mentioned studies show the need for nurses with education the hiring system of hospitals still lays more weight on nurses with education. Therefore, the question becomes a conundrum. Nursing is a practiced discipline that includes both direct and indirect care activities and therefore either avenue (education or experience) allows for a different approach to patient care.

Practice experiences are embedded in baccalaureate nursing programs to prepare students to care for a variety of patients across the lifespan and across the continuum of care. Experiential learning for this practice discipline is frequently called practice experiences, clinical experiences, clinical learning opportunities, clinical strategies, and clinical activities. The term practice experiences will be consistently used in this document to refer to experiential learning in any setting where health care is delivered or health is influenced that allow for and require the student to integrate new practice related knowledge and skills. Practice experiences may be augmented by simulation and laboratory experiences (AACN 2013).

The lack of full-on experience for RN’s became such an overwhelming issue for baccalaureate programs that in 2012 the AACN Board of Directors created the RN-BSN Task Force. This was to ensure that not only was there proper education for RNs but that proper or equitable experience was also being offered during their course of study at the institutional level. In an effort to curtail this lack of experience the Task Force required a hegemony of accommodations from these institutions to ensure that nurses were being offered the same amount of experience, or the same level of experience. The task force requires nurses to complete clinical training experiences as part of their degree requirements. The hope is that the nurses will use this clinical training experience to fulfill the transition between school and career.

What are the Underlying Elements of the Problem?

Further practice experiences include the aid in transition from school to work in which the following areas are addressed: “understanding, leadership development, evidence-based practice, information management and integration of technologies into practice, inter-professional collaboration and communication, clinical prevention and population health, comprehensive assessment, and quality improvement strategies” (AACN 2013). This is done so that all baccalaureate students have the necessary skills to aid them in integration.

Are there Dependencies on Other Decisions?

There are dependencies on other decisions when it comes to the debate between experience and education in how an RN can gain a wider knowledge base. The dependencies include the amount of time and money the RN wants to use in their attempt to find a secure a career. While the studies have shown that education is prized because the lack of mistakes made in the medical field by RNs with degrees, the hiring department of the hospitals want a nurse with experienced more they want a nurse with more education. It seems that both is needed in order to secure a wider knowledge base, and a knowledge base that includes a job at the end of that goal.

Objectives

Education

Objective A

In order to gain a career in nursing, nurses must not only acquire experience through schooling, but must decide how far up the academic ladder they wish to climb which in turn may detrimentally affect their standing as a job candidate.

Objective B

An RN must garner experience in order to have a relevant standing in acquiring a job.

Objective C

A nurse with more experience may stand out among the candidates for a job, but a nurse with both experience and schooling stands a better chance at gaining a potential job.

Summary of Key Objectives:

Alternatives

Description of Alternatives:

Selection

Alternative 2 seems to be the best selection. This allows an RN to gain both experience and schooling. Since experience is now a part of the school’s curriculum an RN may gain experience in this way, but also by getting a degree, gaining experience through the degree, acquiring a job and getting experience on the job, then going back to school seems to be the best choice in gaining as much experience and schooling as possible. This way, all avenues of possibility are open to the RN.

Consequence Table with Original Values: Experience/Education

Ranking Alternatives: Experience vs. Education

Scoring Model: One out of Four

Weighted Scoring Model: Percent value per Objective & Alternative

Consequences

The consequences of the alternatives are as follows:

Alternative 1: the RN may stay in school while opting out of real-life experience which may have a negative effect on the RN’s job offers. While clinical hours as part of the curriculum are great, they do not always translate to real-world experience which is something that an employer will seek in a potential candidate. Thus, while staying in school to the graduate level may garner them theoretical basis, the lack of experience may prove to be a mistake.

Alternative 2: the RN may gain experience then go back to school only to find that the time they lost has been detrimental to their mental capacities and they do not function cognitively well at an institute of higher learning. This is seen with older generations that go back to school and are made to incorporate different technologies into their repertoire; they find it hard to adapt and incorporate therefore making getting a higher level of education more difficult especially if the RN is maintaining their RN status (working while getting an education).

Alternative 3: the RN gains a lifetime of experience but their pay and position does not reflect this experience as they were passed over for promotion due to lack of education, which at times may be state required for certain upper level positions, especially at hospitals.

Risk Profile: RN alternatives: Education vs. Experience vs. Time

Implementation, Monitoring and Control

The recommended alternative will be implemented according to this plan: after gaining a nursing degree acquire a job. This may be easier since the program for the degree required clinical hours as part of the curriculum. After staying with the job for a number of years (anywhere from 2 to 5 years would be beneficial as it shows commitment, and it allows for a certain level of experience to ascertained) apply for an advanced degree. This advanced degree can be a specialized degree so that the RN field of study can be narrowed (such as pediatrics). After going through the course and the curriculum, then apply for a new position at the old job, or a position with a doctor or hospital somewhere else. Key individuals for the plan include hiring managers, school officials, colleagues, bosses and professors for recommendation letters, then the new hiring manager at the next job.

Summary

Out of the three varying alternatives listed above, the one that seems to be the most viable is alternative 2. Thus, an RN gains experience through a BN degree in required clinical hours as part of the academic’s curriculum then stays on for a graduate degree. This ensures that the RN has at least a modicum of experience in a real-life setting as an education. This will ensure that the nurse gets the necessary experience to get their foot through the door and land a job (with their clinical hour requirements) then once their metaphorical and physical foot is through the door, the nurse till then climb the corporate ladder with aplomb because of their advanced degrees. Degrees will also allow the RN to specialize in a specific area of the medical field. This seems to be an area of imperative change that is needed.

Education prepares nurses for what to anticipate in the medical field, but experience prepares nurses for what to do while they’re in that situation. One is mental, the other tactile. The combination of this dichotomy is the best alternative when facing the problem of how an RN can gain a wider knowledge base. It seems that knowledge in both realms (education and experience) is the necessary double-edged sword that’s needed to advance in the medical field.

References

AACN. (2013). Expectations for practice experiences in the RN to baccalaureate curriculum. Retrieved from http://www.aacn.nche.edu/aacn-publications/white-papers/RN-BSN-White-Paper.pdf

Jarrin, O. (2007). An integral philosophy and definition of nursing. School of Nursing. Retrieved from http://digitalcommons.uconn.edu

Klebanoff, N., Hess, D. (2013). Holistic nursing: focusing on the whole person. American Nurse Today, 8(10), 1-5.

“The Essentials of Doctoral Education for Advanced Nursing Practice.” (2006). American Association of Colleges of Nursing. 1-27.

Swartz, M.K. (2014). Critical theory as a framework for academic nursing practice. The Journal of Nursing Education, 53(5), 1-276.