March 14, 2009, 8:26 pm

The Future of Nursing Education: Do I Detect Ageism?

ImageChef.comDo you know how much it costs to be a major Nascar sponsor?

Around $25 million!

No, I didn’t hit the jackpot in Reno, but it would be pretty cool to actually sponsor a driver!

I could always go half-sies with Budweiser over Kasey Kahne and call it….


It’s a Nascar-free weekend; they take a “brake” (get it?) after five weeks.

Unfortunately I do not, and I’m having withdrawls.



Calling all nurses! Don’t forget Change of Shift is here on March 19th! Hit that contact button up top and send in your submission, the theme is….wait for it….Nursing! I know you have been writing up a storm, so share it with your colleagues!


You should have been there when I realized I could obtain a PhD in Nursing without getting a Master’s degree first.

I was thrilled.

There is nothing wrong with having an MSN, it’s just that my personal goal is a doctorate, specifically a PhD.

Well, nursing is full of debates and the BSN-to-PhD is apparently one of them.


I came across an editorial from a 2003 edition of the American Journal of Nursing discussing the BSN-to-PhD degree program.

The writer, Editor-in-Chief Diana J. Mason, PhD, RN, FAAN doesn’t think it’s a good idea.


Well, let’s look at why.


Ms. Mason recounts a time in her career when she accepted a position teaching pediatrics.  She had never practiced pediatrics and did not know much about the specialty. She notes that, “I felt like an imposter.”  She vowed to never teach outside her area of expertise and to maintain a nursing practice while teaching.

Sounds good.  Now what has that got to do with BSN-to-PhD programs?

Ms. Mason is concerned that utilizing a direct BSN-to-PhD program would produce nurses with minimal clinical experience teaching at the beside and having nursing clinical instructors without clinical background teaching clinical skills is not a good thing.



But here’s where she goes off track.  I quote from the editorial (emphasis mine):

Nursing faculty tend to get an associate’s or bachelor’s degree first and practice for several years before returning to school for a master’s degree. They then practice for several years more as advanced practice nurses before completing the doctorate through part-time study—particularly if they have families who need their salaries. According to the AACN, by the time they are ready to enter tenure-track professorships, they are, on average, 46.2 years old and have only about two decades in which to teach.

Is it me, or is there a hint of ageism here?

What is wrong with teaching for “only” two decades?  What is wrong with not starting the teaching portion of a career until the average age of 46.2?

If a clinically competent teaching force is the goal, what is wrong with this? Am I missing something? You have nurses who have decades of experience on the floors/units with the nursing students. Not to mention that not all MSNs practice as nurse practitioners; some of them begin teaching with the Master’s degree.


Let me answer some of Ms. Mason’s questions, from a personal standpoint.

  • “What would nurse educators prepared via the BSN-to-PhD route really know about clinical nursing practice?”

Ms. Mason assumes that a BSN-to-PhD candidate goes straight through their education with nothing but their basic nursing clinical rotations as experience.  Not all BSN-to-PhD candidates are newbies.  Some of us, in fact, will have four decades of clinical experience before we even get to the PhD program.

  • “How could they teach the subtleties of hands-on care that are apparent to an experienced nurse—how to know simply by looking at a patient that his condition is deteriorating? Or how to motivate a postoperative patient to get out of bed for the first time?”

By using exactly what Ms. Mason is worried they won’t have – hands on experience.  The intuition that allows a nurse to know  patient is deteriorating comes from exactly that, experience.  You can teach the theory, you can teach the clinical. You cannot teach intuition, but you can impart what you have learned from your intuition over the years and that is often more practical than anything that comes out of a book.

  • “Would generations of student nurses really benefit from three or four decades of teaching from a nurse who’s not at a proficient or expert level of practice?”

No.  But they would certainly benefit from two decades of teaching from a nurse that has four decades of clinical experience.

And finally, a response to this comment in the editorial:

Proponents note that not all faculty must teach clinical courses; instead, they argue, some faculty spend much of their time conducting research. But researchers who haven’t practiced are unlikely to investigate the concerns that are important to practice.

Try telling that to the Nurse Researchers from the Magnet hospitals I met in Reno this week, who work with the bedside clinical nurses in conducting research that is precisely directed at concerns important to practice.


I have yet to see a BSN-to-PhD program that will accept any nurse who has not made a mark in the profession.  Please correct me if I am wrong, but anyone can apply with clinical experience, it is the nurse who can demonstrate something “extra” that gets accepted.

God willing, I have something “extra” to demonstrate.


Assuming I am accepted into a BSN-to-PhD program in the fall of 2010, I will be 53 years old when I start and 57 when I finish.  I will have, by the end of that time, 37 years of clinical experience at the bedside.

I intend to do research, and I intend to teach.  And I do not intend to retire.  So, if I put in my “two decades” of teaching/research I’ll be 77.  If I put in three decades I’ll be 87.

Why on earth would an experienced nursing workforce who chooses to use their experience for the good of the up-and-coming generation of nurses, be considered a detriment because of their age?

The answer to Ms. Mason’s dilemma is simple: BSN-to-PhD programs should not accept nurses without at least a decade of hands on experience.  Better to have a nurse educator with experience who only teaches “two decades” as opposed to a nurse educator who can teach “three or four decades” with minimal experience.


  • Healthcare Today
    Healthcare Today

    March 14, 2009 at 10:34 pm

    The Future of Nursing Education: Do I Detect Ageism? // Emergiblog…

    What is wrong with having doctorally prepared nurses who are older? Is ageism infecting nursing education?…

  • Candy

    March 14, 2009 at 10:48 pm

    Amen! This is exactly why experienced RNs should be encouraged to enter this type of program. Who’s to say any nurse getting an MSN will work at the bedside OR teach? Many leave both sides of nursing and become managers… Think back at your first year of practice. The nurses who taught you the most weren’t necessarily those with the most advance degrees. It was far more likely to have been the nurses who had been at the bedside for a lot of years. You will be in the position to BE that person for an entire generation of students. Hell, even teaching what you know for 10 years would be fantastic! (I sent this link to Diana…)

  • Judy@StrawCottage

    March 15, 2009 at 4:56 am

    Sounds like a problem with admission requirements not individual fitness for the program.
    We nurses sometimes have difficulty thinking outside the box, don’t we?
    And I admire your spunkiness-starting the program at 53!

  • Diana Mason
    Diana Mason

    March 15, 2009 at 10:10 am

    You have misinterpreted the editorial. I was objecting to programs that take ONLY generic nursing students with no prior nursing experience and fast-track them through a BSN to PhD without requiring any non-academic clinical experience. I am fully supportive of BSN-to-PhD programs that are for RNs with associate degrees and some clinical experience. So reread my arguments with the frame of a non-RN, generic nursing student who goes through directly from the BSN to PhD without any non-academic clinical experience. Is that the nurse you would want teaching you? Is that the nurse researcher who will conduct the most clinically meaningful research? I agree that this person could partner with facilities that are undertaking clinical research, but that is the exception instead of the rule. Most academics have their own programs of research that may or may not involve the input or participation of practicing nurses.

    The issue of how many years one has to teach and do research after acquiring the PhD is not one of ageism. The argument that PROPONENTS of direct generic-BSN-to-PhD programs have offered is that when a nurse takes the time to practice and then get back in the academic journey, the investment of money and time in the pursuit of academic preparation does not result in the same payoffs in teaching and research years as in other disciplines that prepare people with doctorates in a shorter period of time. While I understand this argument. I would rather have highly qualified (read: clinically knowledgeable) faculty to teach for 2 decades than clinically naive faculty teaching for 3.

    This issues is getting more attention as efforts to increase the pool of faculty escalate. I fear a generation of nurse educators who have little or no real world clinical experience or understanding of the research priorities that those in practice need addressed.

    So for those of you who are already RNs with associate degrees, the direct BSN-to-PhD option is a great opportunity and should be pursued unless you want to be an advanced practice nurse (in which case, the same argument about clinical experience at that level applies). Of course, the DNP provides a clinical doctorate, but I don’t advise nurses to pursue that degree if they want a research career. The PhD is the degree that prepares you for research. If you want a career in teaching and want to pursue a tenured position, get the PhD.

    Hope this has clarified these issues.

  • Candy

    March 15, 2009 at 10:43 am

    Great response and clarification.

  • RehabRN

    March 15, 2009 at 10:59 am


    Pretty interesting when the author weighs in on the blog about the article…you don’t see that much in the blogosphere, which tells you Kim has a really REALLY big following.

    Nevertheless, what about those RNs who come to nursing as a second career? I’m one of them, and yes, I’ve pondered teaching, but I’ve also seen nursing instructors (not insignificant amounts) with EdDs from very prestigious colleges (i.e. Columbia, etc.).

    What about those people? Some are engaged in research, but also, don’t you think there’s a place for them in teaching nurses? Nursing education is very multifaceted and I think you can learn a lot from varied faculty, whether they’re PhDs, DNPs, or EdDs.

    Yes, as in any industry, there is some ageism. There are lots of issues, too, because not everyone wants to sacrifice family, etc. to get their PhD, and getting one (any terminal degree really) requires people willing to make the sacrifice.

  • Kim

    March 15, 2009 at 11:01 am


    Thank you so much for commenting on my Emergiblog post! Your response did clarify some issues, and it seems that we feel the same way. To be honest with you, until I ran across the editorial, I had no idea that there were PhD programs that would actually take a newly minted BSN with minimal clinical experience and my ignorance shows in my post. I was under the impression that getting into a PhD program was quite competitive and that age/experience were valued. Of course my knowledge is limited to two PhD programs here in California, and again, it shows in my post.

    I appreciate you taking the time to clarify what I misunderstood and I will post this response on Emergiblog (in addition to sending it via email) so that other commenters can see it.

  • marachne

    March 19, 2009 at 9:54 pm

    Huh, Kim, I could’ve sworn I told you that I was in a BS to PhD program when we first started conversing…

    I started to write a long rant in response to Dr. Mason’s comments here, but I realized that I was going on for so long that I’d be better off making it a blog post. So I will. And let you know when it’s up.

  • KM13

    March 20, 2009 at 11:52 am

    Hi Kim!

    I would be interested to hear from the group what you all think about the MSN-Clinical Leader programs. These are programs that accept students with BS or Masters in other fields who want to start a second career as a nurse. I am debating going back to school and currently have a MPH. I work in health education right now and love to work with patients which is why I am thinking over this career shift. Any thoughts?

  • marachne

    March 21, 2009 at 10:26 pm

    OK, full response, to both Kim and Dr. Mason at my blog:

  • marachne

    March 21, 2009 at 10:28 pm

    Posted a response to both Kim and Dr. Mason at my blog:

  • EMR

    March 28, 2009 at 7:33 am

    I do not understand how does it affect the working of a nurse if she gets old ? Nursing is a noble deed and should not be affected by the age factor.

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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