In this episode of the Ask Nurse Alice podcast, host Alice Benjamin discusses the story of Eliana Tinnenbaum, a 16-year-old who recently graduated from Arizona State University's accelerated nursing program. Alice shares how this achievement sparked controversy and divided opinions among people. While some praised Eliana's academic prowess, others questioned the appropriateness of someone so young entering the nursing profession. Alice explores the different perspectives surrounding this milestone and emphasizes the importance of congratulating individuals for their achievements, regardless of their age.
Jump ahead to listen:
[00:00:27] Controversy over young nursing graduate.
[00:04:38] Young nurse's eligibility dilemma.
[00:08:19] Adolescents as nurses.
[00:11:23] Licensing and age requirements.
[00:15:11] Emotional challenges for young nurses.
[00:19:13] Job demands and adolescent maturity.
[00:21:40] Incorporating adolescents into healthcare.
[00:25:19] Younger nurses and professional growth.
[00:29:48] Impact of 16-year-old nurses.
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[00:00:29] You're listening to Ask Nurse Alice presented by nurse.org where Alice Benjamin combines no nonsense advice with thought-provoking interviews. Hello and welcome to the Ask Nurse Alice podcast. This show we talk about anything and everything nursing and healthcare related. I'm your host,
[00:00:57] Alice Benjamin, clinical nurse specialist, family nurse practitioner, and chief nursing officer at nurse.org. On today's show, I wanted to talk about the 16-Year-Old Nursing School graduate from Arizona State University, apparently the first ever in history to graduate that young.
[00:01:14] Now, I want to preface this by saying I actually shared this story on my Instagram Reels and boy, it got people talking. It really, really did. I didn't realize how kind of divided,
[00:01:29] not that we're divided, kind of sort of. But people were on the idea of someone so young graduating from nursing school and being honored in that sense, right? Because we love people who are academic, smart. Listen, I'm all about graduating from high school early,
[00:01:47] entering into college, and all those things. I mean, it's really a lot to be said, and individuals should be congratulated. I mean, academically, like they are off the charts, super smart. I love it. I love it. Love it. Love it. Love it. I'm all about AP
[00:02:01] classes and all that kind of stuff. However, I don't know if it was because of the profession in which the degree is related to that maybe caused some of the controversy. Because we've heard a lot about teenagers graduating from college early and going on to have all of
[00:02:23] these wonderful and amazing jobs. But the 16 year old in this story, who by the way, her name is Eliana Tenenbaum, 16 year old recently graduated from Arizona State University in their accelerated nursing program as the youngest nursing student ever to graduate from the program.
[00:02:41] In fact, she earned her BSN before she even got her driver's license. She actually entered into the program when she was 15. Side note, some of you all who are saying it's too hard to get
[00:02:51] a nursing school, if she can do it, you can do it. I'm just going to say that. But anyways, I talked about this story because first I wanted to be very clear because when it went to
[00:03:00] mainstream media, it said like, you know, youngest nurse ever 16 years old, let's be clear. She graduated nursing school that does not make her a nurse. We understand that in order to become nurse is a protected title, it's a licensed professional. So you must meet certain criteria like
[00:03:19] graduating from accredited school, meeting certain requirements, having background check, pay your fee, you know, apply to a state and pass the NCLEX exam and meet all of this criteria before you can actually call yourself a nurse. I should kind of have some beef with that
[00:03:36] because when people graduate from school, I know you're excited to want to call yourself a nurse, but you can't call yourself a nurse until you actually pass your exam. Same goes for APNs. I
[00:03:44] know a whole bunch of people that finish their programs, I'm going to say program or keep it general and say, you know, already nurse practitioner is already on their ID profile, baby, you just graduated yesterday. Degree hasn't even posted, you're calling yourself an
[00:03:58] APN, it's a protected title. You must pass certain criteria. So I'm just saying that all that applies. So we can't call her a nurse yet because she's not met the full criteria, but she
[00:04:07] has graduated nursing school which that alone is a big thing because listen, I struggle with mouth drug calculations. These these nursing exams are not easy. Understanding all of the content, the theory, being able to demonstrate and meet the requirements of all the papers,
[00:04:32] clinical hours, preceptorship and all that little lot that goes into nurse school. It's hard. It's hard and for someone so young to do it, Kudos hats off to her. Super smart. So here is
[00:04:44] where the it gets a little touchy for some people. Nurses, we are definitely the largest segment of healthcare workforce. We need a lot of help. We need as many nurses we can to provide
[00:04:57] for all of the people that are out there, right? We know this is a hard job or working short staff. We need more people. However, someone like Eliana who is 16, she finished her nursing degree.
[00:05:11] However, she's not eligible to take the NCLEX exam and become a licensed nurse until she's of age 18 as a registered nurse. That's what it is in most states. So there's going to be like a two-year
[00:05:24] window in which she has this nursing knowledge but isn't able to apply it. So what is Eliana going to do during those two years? Now, I get it. She can go do other jobs. She can work on the
[00:05:36] CNA. She can work in the healthcare field. She can work in the healthcare field, but she can't work as a registered nurse. Now here's the thing. Eliana has said that she wants to go
[00:05:48] and get her doctorate. Is she really going to be able to go proceed and get her doctorate if she doesn't yet have her RN? I don't know. I don't know. But anyway, that's not what this podcast was
[00:05:58] going to be about because some people want to go for the doctorate. Some don't. Some believe it's worth it. Some believe it's not. Some people think it's our duty to do it as a nurse.
[00:06:07] Listen, teach it on. But I'm not going to talk about doctorate school. I'm talking about what's Eliana going to be doing these two years in which she's finished her BSN but is not yet eligible
[00:06:17] to take the NCLEX. Is she going to retain her knowledge? How is she going to maintain it? What is she going to do? Right? Also back up a little bit and say her father is a physician. So she
[00:06:28] grew up basically being a little helper in his office, right? That's his kid. So she's coming into the office. She's helping. Now I read somewhere that she was able to give injections at the age of
[00:06:37] four. I don't know who she's injecting at the age of four. Like somebody was doing something they weren't supposed to be doing. But anyway, she had a lot of exposure to it. I'm sure her dad imparted
[00:06:47] lots of knowledge. She had to see things. Probably a lot of HIPAA was violated. He was teaching his daughter stuff. I don't know. I mean, I care but I don't care. I'm just giving
[00:06:56] some background here. And then her mother is PhD prepared in statistics and things like that. So she comes from a little Brandiac family. She really does and I'm all for it. But now let's get
[00:07:08] to what are the barriers of someone that young becoming a registered nurse and now then being responsible for the lives of other people? I don't know how many of y'all are parents out there.
[00:07:23] I'm a parent. I got a 16 year old. He has no business taking care of somebody else. I know that. So not saying how she conducts herself is exactly how my 16 year old conducts himself.
[00:07:33] But I'm just saying there are some things that we need to consider because for all intensive purposes, he's a minor. She's a child. If we really want to be honest, can't even go
[00:07:43] to rate it our movies without parental guidance or permission. She is not able to access use or control substances. She really can't even make any medical decisions for herself without parental input. You know, there's something like she's a kid. Let's just be honest. I mean,
[00:08:02] I know 16 year olds might be some people might say, oh you're calling her a kid. She's a teenager. Okay, a little bit adolescent. Whatever word you'd like to use. He's not an adult. At what
[00:08:13] point do we say, you know what? You finished nursing school. Go ahead. Get your license. Go take care of people. At what point do we say that's okay? And at what point are we like
[00:08:24] you're still an adolescent. You're not an adult. Certain decisions and things you cannot do yet for yourself. So how can we give you the license to now then do these for other people? There's a lot
[00:08:37] that comes with being a nurse guy. It's not just path to NCLEX. Now I can do this. You're licensed to take care of people, but there's a lot more. And I think things have been set in
[00:08:45] place to say like most nurses who take care of people are adults. Adults for a reason, although not all adults have common sense, you would hope and believe thought that by the age of adulthood that someone is fully physically and mentally developed in a way emotionally
[00:09:01] developed and emotionally intelligent and able to exercise the thought process, critical thinking, judgment skills, and all of those things to properly take care of a person because it's not just the tasks but we have to think about critical thinking. Okay, so that's really where
[00:09:17] I'm wanting to take this to the critical thinking part of it. I know she's smart, I know she's smart, but there are some things that you just don't learn in a textbook. You just don't learn in the classroom saying these are lifelong experiences and when it comes to
[00:09:28] adolescents developing their personalities, if we look at the Erickson stages of development, she's not fully there yet. She's just not. I'm not being mean. It's not that I don't want her to become a nurse. I actually would love for her to become a nurse and
[00:09:42] she's well on her way. She finished nursing school, but I'm just saying there are some barriers some things that we just need to consider because once you open the floodgates, if she
[00:09:51] gets to become a nurse at 16, everybody gets to become a nurse at 16. You don't just get the cherry pick which the case may be and I would hope that there's no characteristics of her that are
[00:10:03] making that are influencing people's decisions. I'm just saying I'm just putting it out there as she maybe looked a little different if we'll be having the same conversation but I'm not going to go there right now. Let's talk about what if any barriers exist for a 16-year-old to
[00:10:18] become a nurse? Well, we know that Ileana has surpassed the education requirement. Obviously, she graduated from high school early. She did an accelerator program. She entered nursing program at 15, graduated 16. Obviously, very intelligent, very smart, did all her assignments,
[00:10:36] met all the criteria that she's earned and she does deserve those kudos. But licensing, she hasn't quite met the age requirement. In most places, you have to be 18 years old to apply for
[00:10:46] RN license. So this means that she would have to wait for two years. So what is she going to do in those two years and how she's going to retain her knowledge and then a lot changes
[00:10:54] in healthcare? How is she going to stay current with those things so that she remain successful and not only just passes the NCLEX, the NCLEX is just an exam but also retains enough knowledge to be able to adequately and safely take care of patients at the bedside. Clinical
[00:11:11] requirements, she's obviously completed her clinical requirements in the program. Now it's an accelerator program so I don't know how much of those hours were actually clinical setting with actual patients or if how much of it was simulation because we also know that all those
[00:11:27] simulations have been very helpful and meeting the needs of our learners. We know that there's nothing like learning from an actual patient and actual clinical setting, not just the actual disease process in skill set that we're going to see interacting from a live patient to with the
[00:11:43] nurse but also the dynamics, the push and pull that happens in the healthcare environment, managing patients, their families, difficult conversations. Like there's a lot more to that learning experience that I believe patients that we learn from our clinical experience.
[00:12:02] It's just an exposure to the profession in the field in which you're entering, right? I think that's very, very important. Now let's talk about work hour restrictions. She's 16. Now I'm not necessarily an expert in this field and it probably varies from state to state
[00:12:16] but usually 16 year olds need a work permit and it's not just because they're in school but because they are minors and there are labor laws to make sure that we are not abusing young workers.
[00:12:30] So, you know, labor laws depending on your location, there may be some regulations that limit the number of hours of the type of work that she can engage in because she's in a minor. So these laws could affect her ability to work in healthcare settings. So if she's
[00:12:45] working 12 hour shifts, really it's 12 and a half, right? If you include the lunch. And then what happens if she don't finish her charting? She stays over. Can they make her stay over? She's a minor. Like will they need parental permission? Like how is that working? And then
[00:12:58] if something does happen at work, is she counseled herself or do her parents need to be present? How would we be able to be sure that she could function as a nurse and you know she'd have to be treated like an adult. So there's some difficult conversations that
[00:13:12] will have to occur and we can't just like, oh, she's an adolescent. We can't talk to her like that or how do we shield her from things that we often protect children from? So we have
[00:13:22] people that come in for sexual abuse, violence and other things like that. Death and dying. And you know, these are things that typically as an adult maybe we're in a situation where maybe we're supposed to right have the mental and emotional capacity be able to handle these
[00:13:38] things, be able to communicate in a way in which you know some heavy, heavy things. Can we expect a 16 year old to be able to manage that? Is a 16 year old going to be able to manage
[00:13:50] death the way we would? People go into cardiac arrest and I'm expected to jump into CPR and help save a dying life. Is that okay to expose the 16 year old to something as traumatic as that?
[00:14:03] Is that going to affect her developmentally, emotionally? It affects us as an adult. So what more are kids? Sorry, adolescents. And then like I said, the coaching and counseling process, how does that happen with a minor when my son gets in trouble at school? What she does?
[00:14:21] The principal calls me. I got to be there for this coaching and counseling. And then the principal guy tells me stuff about my son to make sure that I make sure he does what
[00:14:30] he needs to do. How is that going to happen if Ileana, if she's allowed, if we're allowed to practice at 16, if she missed something, didn't do something? Is the manager going to just
[00:14:41] counsel her or does her parents need to come in, be a part of it? She's a minor. Also, financial challenges. So you know what? I don't know how she paid for school. I'm going to
[00:14:53] be quite candid. I know I got two loans. Does she have two loans or did her dad pay for it? Did her parents pay for it? Maybe that doesn't matter. Maybe that's not so much a barrier for her.
[00:15:03] But let's just say she did get student loans to go to school. Are they making her pay student loans if she's not yet able to work in the profession in which to pay them back? That's interesting.
[00:15:13] Listen, we're about to get hit with this resumption of student loans. Does Ileana have them? Like, I don't know. I'm just, I don't know. But that would be interesting.
[00:15:23] That would suck to go to school, get a student loan to go to school and then not be able to work to pay the student loan because hey, they're not allowing me to because of my age. I don't know.
[00:15:33] Who knows? I'm just throwing that out there for a point of consideration because we're not, although we're talking about her, this is something that could very well be applicable to other people. Should we open the floodgates and say, yes, 16 year olds should be allowed
[00:15:45] to become nurses. But let's get here. The emotional and mental preparedness. Yes, y'all. Nursing can be emotionally and mentally demanding. And considering whether you're emotionally prepared to handle the stresses and responsibilities that come with
[00:16:03] patient care. So some of that stuff comes with age and experience. I'm not saying that everybody just can sure of age adult, whether you're 18 or 21 that you're able to do all these things. Because we know some people, not everybody's there, right? Common sense is always
[00:16:19] a common. But what are we going to do or how do we assess that a minor has met the emotional or mental readiness to take on such a stressful job? Like could you imagine Ileana being
[00:16:35] there during COVID with a bunch of dying patients and being given skills that she had to learn on the fly? Like, are we okay with exposing our minors to something like this? That's all. So like,
[00:16:49] I'm not discriminating. Because listen, we had we had some good conversation on on Instagram. Am I good friend, the Cedar nurse? I love her. She's amazing. Make sure to follow her. We had some great dialogue and she brought up some great points. But about how we
[00:17:03] shouldn't discriminate or stereotype people who can and cannot do a certain job. Now, I understand exactly where she's coming from. But I was actually framing this as for as more of a minor because she's all because minors are a protected population. They are. That's why
[00:17:19] they need parental permission, parental consent. You just can't go up in anybody's kids' space and say whenever, da, da, da, da, da, da, da, da. Oh no, they're a kid you're not supposed
[00:17:26] to. And so I pose the question on Instagram, like should we allow 16 year olds to become nurses and take care of people? I personally would prefer not to have a 16 year old take care of me
[00:17:40] just because listen, I know where my 16 year old is. And I know what I was thinking at 16 years old. And and I understand things are different. But I grew up in an area where we played outside.
[00:17:50] I just want to play. I want to have fun. I want to live my life. I want to experience things. I don't necessarily want the responsibility, let alone just having a job but having a job
[00:18:00] that is so demanding and having a job that and listen, we know it's not just physically demanding. It's mentally demanding. It's emotionally demanding. Can we really expect for a 16 year
[00:18:10] old to be able to take on those on the on that? What happens when you get a whole bunch of 16 year olds applying? What if you're now don't be mad? I love y'all and I've been there.
[00:18:23] We like to have a skill mix on the unit seasoned novice nurses to balance things out, to balance things out, right? Knowledge experience, use of technology. We got to balance it out. We usually put the newer nurses on the night shift. What happens if we have newer
[00:18:39] nurses and 16 year old nurses? First off are the 16 year olds going to be allowed to work night shift like that? And then what happens if your unit gets flooded by 16 year old nurses?
[00:18:50] I'm not saying that 16 year olds are catty cry a lot or anything or emotional. I'm not saying that but I know a couple of that. How are you going to mention the behavioral and emotional
[00:19:01] and legal things that come with incorporating younger people on the team in the hospital setting? It's just something and I'm not saying look, I could be wrong. This may work out beautifully
[00:19:13] but I just need somebody to walk me through it. Just walk me through it. Just help me understand what's going to be the structure of the process to make sure we get the outcomes we want. I
[00:19:20] just want to know because it's just new and with anything that's new there can be some reservation but reservation is likely so just to protect the safety and integrity of the profession.
[00:19:29] That's all. I'm not saying I don't want young people to take care of nurses. I was innately showing the characteristics of a nurse before I became a nurse and this very well could be her
[00:19:38] absolutely but I don't know her. So it's all cool, makes news, youngest nursing school graduate at your school that's great but how does that translate into performance outside of the classroom? That's all because that's really what it was about.
[00:19:54] Nobody's asking you how young were you when you graduated, how are they, what's happening at the bedside? How they say I could show you better than I can tell you.
[00:20:03] I need to see it. I need to see it. So if I would love for, we've spin off another conversation but let's talk about this. What does it look like for us to incorporate
[00:20:14] adolescents into the healthcare workforce? Because I'm going to tell you this, we have some adults that are having a hard time so what more if we incorporate someone who's younger who doesn't have the life experience perhaps may not be emotionally or mentally developed maybe
[00:20:37] so even going through some growing pains themselves because women are 16 and still growing. I mean we're also growing some of us are growing outwardly instead of upwardly but still you know what I'm saying, there's lots of changes, lots of changes happening and
[00:20:51] I'm not saying it can't happen but I am going to say that I am going to be one of those who are very reserved about doing so because there's a lot that has to change guys. We can't just
[00:21:00] say oh she graduated at 16, she should become a nurse, yes she should, she deserved it, she went to school, she got a good grade. It's more than that. It's more than that and I
[00:21:07] think that's something that stunts the growth of the nursing profession guys. We got to get, we got to think like leaders. We have to think about not just us and our nursing circle but we
[00:21:22] got to think about how nursing impacts and spirals other professions and other leaders and other disciplines and legislation. We do because I'm just going to ask this question for everybody that said oh yes she should practice as a nurse. How many of y'all have lobbied for legislation to
[00:21:38] change the age of workers? Have you because you might have to if you want her to become a nurse at 16? I'm just saying, shade no shade but to whom much is given, much is required so just as much as we
[00:21:50] are wanting things as nurses and this goes for a whole bunch now, now I'm on a soapbox. Nurses complain about a lot of stuff. I know because I've done it, I've done it myself,
[00:21:59] that's how I know but at some point you realize that you can't complain about something unless about a problem, unless you want to provide solutions. You do, you have to provide solutions
[00:22:11] because no one's coming to save you. We have to save ourselves so if we're going to save ourselves we have to clearly identify what it is we want to happen in order for us to get there. So if
[00:22:23] we know the outcome we want, we need to reverse engineer and say well this needs to happen, that needs to happen, this needs to happen, this needs to happen for us to get here.
[00:22:31] And then once we do that we've got to identify the people who are going to help us do this, do that, do this, do that so we can get here instead of just complaining in some staff meeting
[00:22:38] and some unit practice council about we should have this and we should have that and we should because it sounds like we're entitled and don't want to do the work. I'm just saying. So back to Ileana, 16 year old youngest nursing school graduate ASU.
[00:22:50] Who dosed on her for her academic achievements? I love it, I love it, I love it. I would like to make sure that as much as we are encouraging people to enter into nursing school
[00:23:00] then we provide them the support systems to make sure that they are not only successful with passing through school but they can become successful and safe practitioners. So I'd like to see what are we going to do as a profession to help make sure that Ileana maintains her
[00:23:13] skills and knowledge set until she's able to apply for her NCLEX to become a registered nurse. And then two for those of you who believe that she should be allowed to practice as a nurse because she's graduated from nursing school, what are the practices and policies and things
[00:23:30] that need to put in place in order to make that happen? And let's talk about not just making that happen but let's look at bigger pictures and think about what are all the potential
[00:23:41] things that could happen once we do this? How is this going to spiral? How is this going to impact other professions? Is this going to also impact people of other disciplines? Is the healthcare setting pretty soon going to be run by CEO Tour 16 and 17 who graduated from
[00:23:59] Harvard with business degrees and business law and stuff like that? Let's talk about it because once we, we can't just say oh her by herself, we have to think of nursing and the healthcare
[00:24:11] profession and how this is actually going to change. And do we want 16 year olds then becoming directors and managers and chief nursing officers and things like that? Hmm, we didn't think about
[00:24:20] that did you? You thought oh well she could just come in but she's just going to be a worker bee. Why? Who ever wants to come into a profession at entry level and stay there?
[00:24:30] Just as studious and academic as she was to get to where she is to finish school by 16? You don't think someone's going to come in like oh I'm 16, I'm about to become chief
[00:24:39] nursing officer and work their way up and try to do that? We have to think about those things. So we started this off with a 16 year old graduate nurse school but let's think about it,
[00:24:47] let's take a bigger picture. What's going to happen when we allow 16 year olds to actually become licensed registered nurses? They enter into the profession. How is this going to impact the workflow, the dynamics, the politics of the organization? How is this going to impact
[00:25:00] legislation with can they work night shift, can we counsel them, can we not counsel them? Like does a parent need to be around? Are they handling controlled substances? Are they not allowed like do they got to get the charge nurse to help them
[00:25:12] give a viking in? Like why is that going to happen because she can't even drink, she can't even smoke a cigarette. How are we going to then allow her to give fentanyl and you know oxycodone and stuff to a patient with a broke hip? Okay and then
[00:25:26] labor laws, gotta talk about labor laws and just the whole patient outcome. What's going to happen with the patient? Is it quality of the health care going to go up? Is it going to go down? Is it going to be different? Or should people who finish nursing
[00:25:37] school at this early age be allowed to work in certain specialties and not others? Let's talk about it. I'd love to hear what you think. Send me your comments and feedback. I'd love to hear it. NurseAlpha, nurse.org. Let's start this conversation. And guys,
[00:25:48] I think this is an interesting conversation. So let's talk about it more. Share this podcast with your friends, your classmates, your colleagues, your director. Like let's really dig into this and see what does this look like. And if you like today's topic,
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[00:26:17] I'm your host Nurse Alice. You can follow me on all social media at Ask Nurse Alice. And guys, until next time, please, please, please make the choices and be kind to one another. And luva my friends. Thanks for listening to Ask Nurse Alice. Visit nurse.org
[00:26:33] for nursing career, education and community resources.