ADN or BSN: What's the Big Deal?

[allnurses]

I was talking about this topic with one of my younger nurse friends. She shared the following comments with me.

Quote

Funny to me that 20 years ago when I graduated with my BSN, I was told that ADN/ LPN programs were being phased out and that minimum entry level nursing positions would soon be BSN. Fast forward 20 years and it appears ADN and LPN programs are going strong.

I want to start by saying that quality bedside nursing care can be provided no matter the advanced degree or not. As a new graduate, I survived and so did my patients thanks to the care and support and knowledge of many many LPN's and ADN's. There are also plenty of not so great nurses out there with various degrees. That being said, there has been much discussion, surveys and studies done regarding the differences in the career of a BSN prepared nurse, LPN, and an ADN prepared nurse. The results of the 2015 allnurses salary survey presented that 39% of respondents held an ADN and 39% held a BSN. As we are about to release the comprehensive 2017 allnurses nursing salary results, we will see where the trends have gone.

So what's the big deal...as long as you are an RN? The title of RN whether earned through a Degree or Diploma program will allow you to provide the same level of basic nursing care as we see in hospitals, clinics and doctors offices. The BSN prepared nurse, however, has many more options that require higher responsibilities, therefore higher pay. This is due to the more in-depth coursework in physical and social sciences including public health, nursing research and nursing management. An RN with a BSN can choose a career in nursing education, public health, or clinically focus in specific diseases or adult, pediatric, geriatric care. A BSN is required to be considered for many positions or to further one's education to focus on speciality care.

In 2010, the Institute of Medicine introduced new demands on the nursing field when it set a target goal for 80% of all nurses to hold bachelor's degrees by 2020. This goal was derived from academic research indicating that patients receive better care in hospitals when the majority of nurses hold a BSN or higher. The American Nurses Credentialing Center (ANCC) devised the Magnet Recognition Program to draw attention to top healthcare facilities. This recognition means that 100% of the organization's nurse managers have a BSN or graduate degree. "Achieving Magnet status also means that there are generally a higher number of nurses holding a BSN degree for jobs in direct patient care. Approximately 50% of all nurses associated with direct patient care in a Magnet-recognized hospital currently have a BSN."

The 2017 allnurses survey results have shown some slight shifts. In 2017 the percentage of BSN prepared nurses has remained steady at 39% while ADN's have dropped by 2 percentage points. The number of MSN's have increased by 1%. Why might this be? Is there a greater demand for advanced practice nurses? Are employers encouraging and/ or supporting advancing degrees? Is retirement a factor in the decrease in ADN's? As our final results are revealed, new light might be shed on factors influencing the slight shift from last year to this year. Will the trend continue? Are you thinking of furthering your education? We want to hear from you!

We as nurses should support each other in furthering education, as well as respecting those who have years of bedside experience but might not have higher education degrees. As the field of nursing continues to grow our knowledge base will be required to change to keep up with the technology and level of care.

The 2017 allnurses salary survey results will be released soon. It will be interesting to see if the interactive survey results show pay differences based on degree as well as location, speciality and gender.

2015 allnurses Salary Survey Results

[Workitinurfava, BSN, RN]

The whole thing is backwards. I feel that even with the higher level degree, there won't be enough positions and the compensation will eventually be decreased. Hopefully we won't find tons of MSN nurses at the bedside, and not being fairly compensated (highly possible but I hope not). Right now it is the BSN, tomorrow it may be the push for the MSN. RN''s that go back to school will be lacking (BSN)clinical skills, unless they are lucky enough to be working in a environment that provides the training to get them Up to Par with what they should know and what good is book knowledge by itself without clinical skills? MSN (NP) nurses will receive clinical skill training through their program. They will be taught the proper way of things. BSN programs should mandate clinical training (going online is not enough, you need to learn the clinical skills along with the material). I say this because I know of many BSN nurses operating on the level of an ADN nurse (a nurse who has not taken the BSN courses).

[Wuzzie]

Workitinurfava said:

BSN programs should mandate clinical training (going online is not enough, you need to learn the clinical skills along with the material). I say this because I know of many BSN nurses operating on the level of an ADN nurse (a nurse who has not taken the BSN courses).

Oh do tell us how an ADN "operates" differently than a BSN. We are dying to know.

[PatMac10,RN, RN]

Good discussion!

[PatMac10,RN, RN]

RRTNurse said:

The BSN argument of "better care" was predicated on flawed studies of patient outcomes without taking into consideration confounders. It was adopted quickly by Administrators of the "Magnet Hospital" in showing hospitals that were encouraging their RN's to reach higher academic goals and thereby were showing themselves to be "employers of choice" amongst RN's and thereby improving outcomes and patient experience. Medicare and Medicaid then seized upon it and tied Magnet (and therefore academic achievement among RN's) to reimbursement.

BSN is about the money. In more ways than one. Some see through the facade of business. #Patientsbeforeprofits

Preach! I am all for higher education, but that "study" has so many flaws that I saw upon critiquing the article for a program during my ADN program. Although I don't think the BSN is just about money, I do believe money is a factor.

I think it is important to remember that all AT&T and diploma programs are not created equal. In fact, I think a lot of ADN programs are changing to prepare their students to continue their education. For example, during my ADN program We had public-health clinical rotations, although we did not have a separate public health course. We had a separate physical assessment course as well as a nursing leadership and management course. We wrote detailed apa papers, almost weekly and we also made professional presentations at local nursing symposium is in healthcare institutions.

I think it's sad that nursing education is so fragmented and inconsistent in some areas. However, I think it's pitiful that the nursing profession strives so hard to be hierarchal, like medicine tends to be. Nursing is a job that requires both humility leadership skills, along with collaboration and innovation.

Why is there this big push to "eliminate" or "phase out" alternate forms of nursing education? I've always felt that one of the most beautiful things about nursing is that it gives many people, with many different backgrounds and situations, the opportunity to pursue The dream of becoming a nurse via multiple educational pathways.

Yet, nursing continues to tear itself apart in some aspects, declaring and insinuating that one type of nurse is somehow "better" than another. I look at occupational therapy. That went to from requiring a bachelors agree to a masters degree, similar thing with PT, from Bachelors to Doctoral degree. Not that these were necessarily bad things, but the job roles saw no major change... At least not that I'm aware of, please correct me if I'm wrong. I hope that never becomes the case with becoming a entry level registered nurse. Though it wouldn't be a surprise if it happened in the next 40 years, the way nursing organizations seem to breed and encourage degree creep.

[smartnurse1982]

What is the big deal?

Staying employed of course.

Adn acute care positions are harder to come by.

I always get negativity for saying this,but i think Adn programs should start thinking of the future employers of the students.

The majority of new ADN's will end up in non acute care settings,so why not focus on the skills for those settings?

[PatMac10,RN, RN]

smartnurse1982 said:

What is the big deal?

Staying employed of course.

Adn acute care positions are harder to come by.

I always get negativity for saying this,but i think Adn programs should start thinking of the future employers of the students.

The majority of new ADN's will end up in non acute care settings,so why not focus on the skills for those settings?

Personally, I believe that Places of employment and organizations that refuse to hire ADN nurses should think about this. They are the ones supporting this "propaganda".

In many areas of NC, ADN nurses can get acute care jobs like anyone else. Every area is different. In fact, at one of the states biggest hospitals in the capital city, the community college has their health science education building on the campus of the hospital and the majority of their new grad nursing cohorts come from this community college, despite the fact that this hospital is in between 3-4 university that churn out nurses like rabbits have babies. Lol!

At many of the institutions in NC and other places, they indicate that BSN is preferred, but that ADN graduates can be hired under a clause agreement, where the ADM nurse agrees to complete a BSN in 5 to 7 years. That is a much better compromise than to blatantly, ignorantly (lol), and somewhat Discriminatively, declare that ADN graduates won't be hired at their acute care facility.

The percentage of ADN grads (especially in the last 5 years) who are returning to complete their BSN is steadily increasing, in my area.

[BostonFNP, APRN]

PatMac10,RN said:

They are the ones supporting this "propaganda".

How is it propaganda?

1. In most of the country, having a BSN over an ADN is preferred for hiring.

2. There is a growing body of data which supports BSN+ outcomes.

We may not like it, but its not propaganda, it's a fact.

[Dodgern]

AntonioErvin said:

Let me just say that I have seen great ADN nurses, and horrible BSN nurses, and vice versa. IOM 2020 initiative is what is directing the BSN movement. In order to be a "MAGNET" Hospital you must have a nursing staff that has @ least 80% BSN. I personally think all nurses should have @least a BSN, because it shows that all nurses have the same schooling.

How long have you been an RN?

I have 28yrs under my belt. BUT I'm a lowly Diploma RN.

Frankly, there should be a group of us who are "grandfathered" in because of the amount of experience we have.

I have no desire to be in management so that shouldn't be a problem. I am a certified GI RN ~~~CGRN and have been so for about 8yrs.

There are BSNs who are book smart but have no bedside experience Whereas, us older non-degreed RNS have years of experience at the bedside and can run situational rings around the degreed RNs.

You want to be management, have at it. But allow the rest of us to continue to work as we always have.

[Dodgern]

Ummm....there are still Diploma nursing programs around.

[Wanna-bee]

Wow... there seems to be some bitterness stirring with in this topic. The way I see it is.... if it is a requirement to increase your education, then just do it. Don't get caught up in the insecure feelings of not being duly educated. If you are experienced, then no one can deny it; if you are not experienced, then everyone can see that too. Insecurity is not a good look, especially if you are a good nurse. Just do it !! You got this !!

[rzyzzy]

BostonFNP said:

How is it propaganda?

1. In most of the country, having a BSN over an ADN is preferred for hiring.

2. There is a growing body of data which supports BSN+ outcomes.

We may not like it, but its not propaganda, it's a fact.

I'd have to say there's a "growing body"of the phrase "bsn's have better outcomes" being parroted by those who've never actually bothered to read the data.

As for the hiring "preference" of employers, it's entirely possible that may come back to them with unintended consequences.

I.E., ADN's get locked out of hospital jobs after graduating & find they like non-hospital work just fine.

Non-hospital employers now get first-crack at ADN's & at least a certain percentage advance to BSN or higher, without giving hospitals an opportunity to snatch them back. There is an "opportunity cost" associated with degree snobbery that hasn't been quantified - I suspect it's also present in a portion of those whose first nursing degree is LPN/LVN. When you discriminate, you end up with less - no way around it.

[NYCNative21]

This is my main worry when pursuing my ADN. I'm worried that when I graduate which will be around 2020 or 2021, it will be harder to find a job. Seeing that majority of employers are now requiring BSN in order to land a job worries that my ADN degree will not be that beneficial when the year 2020 comes around. Of course my plan was to get my ADN and then do an online bridge program for my BSN but now according to the new guidelines, it seems this may be a pointless route to take. I'm halfway to 30 now and I want to get my career started but I'm at the point of not pursuing this nursing career anymore. Its more of a pain in the butt to just get into a program, graduate and then find a job. Not sure how anyone else feels but the wait game eventually just gets old.