BSN and Associate Nurses are Neck and Neck. Will this change?

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    The allnurses 2015 Salary Survey results will be hitting the site June 14th with interactive graphs and statistics. Based on the data obtained from more than 18,000 respondents, one of the preliminary results we found was that 39% of nurses have a BSN while 39% have an ADN. Are BSN-educated nurses set to overtake those with an ADN?

    BSN and Associate Nurses are Neck and Neck. Will this change?

    AACN published The Impact of Education on Nursing Practice in 2015 which discussed multiple studies about ADN and BSN education. One of the more important statements is about Magnet status. Hospitals that have attained Magnet status, are recognized for nursing excellence and superior patient outcomes, have moved to require all nurse managers and nurse leaders to hold a baccalaureate or graduate degree. Hospitals in the process of applying for Magnet status must show plans to achieve the goal of having an 80% baccalaureate prepared RN workforce by 2020.

    Then there are the studies that show that hospitals staffed with more BSN prepared nurses have better patient outcomes. This has been a hotly debated topic on AN. Here is one references:

    In an article published in the March 2013 issue of Health Affairs, nurse researcher Ann Kutney-Lee and colleagues found that a 10-point increase in the percentage of nurses holding a BSN within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients—and for a subset of patients with complications, an average reduction of 7.47 deaths per 1,000 patients. The study is titled “An Increase in the Number of Nurses with Baccalaureate Degrees is Linked to Lower Rates of Post-surgery Mortality.”

    One of the more prolific threads on AN was titled the difference between ADN and BSN nurses that was started in December 2014.

    Many individual healthcare facilities have created policies that will affect the increasing number of nurses earning a BSN. Due to internal policies, the management at many hospitals across the US have been requiring currently employed LPNs and RNs with diplomas and ADNs to earn BSN degrees within a specified time frame. Many non-BSN nurses are being given an ultimatum. Is this right?

    It is still being debated

    So...what’s your opinion? Is getting a BSN on your agenda?

    How is the comparison between the number of ADN and BSN RNs at your place of work?
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    146 Comments

  3. by   Pangea Reunited
    ASN is enough for me as I'm content to go traipsing about causing sentinel events. I've even considered forgetting some of what I've already been taught.
  4. by   ICUman
    I feel the thread title is misleading…suggesting it is a competition, when it is not. These nurses are not neck and neck. ADN and BSN nurses work together as a team and are good at it, at least in my hospital they do.

    As for the mortality reduction from BSN provided care, it puzzles me how so many fluff courses on theory (as frequently published on this site), can supposedly save more lives than ADN nurses. Hopsitals are more concerned with getting that shiny magnet status, and looking good to the public, than they are with reducing mortality. Otherwise, BSN would have been mandated long ago.

    Nonetheless, I do feel a BSN is necessary to remain competitive in the acute care job market and the squeeze will get even tighter with time. BSN also provides options for graduate school, so there is benefit to patient and professional.
    Last edit by ICUman on Jun 7, '16
  5. by   macawake
    Many individual healthcare facilities have created policies that will affect the increasing number of nurses earning a BSN. Due to internal policies, the management at many hospitals across the US have been requiring currently employed LPNs and RNs with diplomas and ADNs to earn BSN degrees within a specified time frame. Many non-BSN nurses are being given an ultimatum. Is this right?
    I don't think that asking the question if it's right or not is relevant. It is what it is. If employers require a BSN then that's what they do, no matter what anyone might think about such a requirement.
  6. by   ICUman
    Also if hospitals are requiring it then they should reimburse for it. I'm not paying thousands of dollars just to make their numbers look better for free.
  7. by   verene
    I plan on completing a BSN because of the job market I'm in. That being said working with both BSN and ASN prepared nurses I see experience in-role and innate personality traits as having a higher impact on who is a "good nurse" than the degree they earned.

    I also wonder if the difference in mortality rates is truly due to the education level or some other factor. Could it be that since the BSN has historically not been the entry degree that those highly motivated individuals who were willing to pursue it also are individuals highly motivated to preform well at work? Or if hospitals that could be selective and only hire BSN nurses are simply able to be more selective in general and thus have higher caliber employees overall compared to those who don't have the same competition for job openings? I wonder if the difference in performance per the mentioned survey above will remain as more and more nurses either willingly or by mandate complete BSN education.
  8. by   roser13
    It's not a race.
  9. by   RunnerNurse09
    I have less than a year to complete my bsn and will be going on to my msn right after. I think being educated is very valuable in healthcare, and I don't think it's appropriate for nursing to be behind pharmacy and physically therapy. Why should nursing be one of the few fields where an associates is acceptable? Also I know there was another thread about a bsn being "bs"....It's not. What I have learned already had made me a better thinker and nurse. We take anther health assessment course and an amazing course on genetics and genomics. Love it.
  10. by   Dogen
    I like to stress that studies that compare BSN and ADN nurses are typically correlational, not true experiments. As many people know, BSN is required in competitive markets, large cities, and many academic hospitals. It wouldn't surprise me to find that these areas also had access to higher levels of care overall than smaller areas. I have never seen a study that claims BSNs reduce mortality that included a multiple regression analysis comparing the effects of, say, percent of nurses with BSNs, number of cardiac cath labs, thoracic surgery on call hours, presence of emergency specialties (thoracic surgery, neurosurgery, ENT/OMFS, etc), and other variables that are likely to cluster together. Multiple regression analysis would allow you to compare every hospital in the country (using CMS and CDC data already available) and compare the ways that they are similar and different across multiple variables and see how having more or less of each variable tended to affect mortality. It's a standard statistical analysis for complicated systems.

    Do I know this would change things? No. But I'm pretty confident, in a back of the envelope sort of way.
  11. by   Boomer MS, RN
    Quote from Dogen
    I like to stress that studies that compare BSN and ADN nurses are typically correlational, not true experiments. As many people know, BSN is required in competitive markets, large cities, and many academic hospitals. It wouldn't surprise me to find that these areas also had access to higher levels of care overall than smaller areas. I have never seen a study that claims BSNs reduce mortality that included a multiple regression analysis comparing the effects of, say, percent of nurses with BSNs, number of cardiac cath labs, thoracic surgery on call hours, presence of emergency specialties (thoracic surgery, neurosurgery, ENT/OMFS, etc), and other variables that are likely to cluster together. Multiple regression analysis would allow you to compare every hospital in the country (using CMS and CDC data already available) and compare the ways that they are similar and different across multiple variables and see how having more or less of each variable tended to affect mortality. It's a standard statistical analysis for complicated systems.

    Do I know this would change things? No. But I'm pretty confident, in a back of the envelope sort of way.
    Linda Aiken, PhD, a well known and respected researcher out of the University of Pennsylvania, has published extensively on this subject. Here is one example: Educational Levels of Hospital Nurses and Surgical Patient Mortality And, yes, it is not a true experiment, which would be impossible for this kind of research. The investigators list their inclusion criteria. She also has published on nursing ratios that are far better in CA affect patient care. I find her that most encouraging! Research such as hers can only benefit the practice of nursing and the patients. There may not be a paper published with multiple regression analysis, but that does not diminish her findings. Critiquing a study is good though!
  12. by   Buyer beware
    Quote from Pangea Reunited
    ASN is enough for me as I'm content to go traipsing about causing sentinel events. I've even considered forgetting some of what I've already been taught.
    This comment is very bizarre. But I must say, I find your devil-be-damned approach, nonetheless, provocatively alluring.
    Last edit by Buyer beware on Jun 7, '16 : Reason: word play inclusion.
  13. by   Itsybit56
    Nursing boards for an ADN/ASN are exactly the same for a BSN. I am very concerned with nursing care related to shortage. We already have a nurse shortage nation wide. I feel hospitals only wanting BSN nurses is going to increase this shortage. The focus is wrong. We need to utilize all our nurses MSN, BSN, ASn/ADN and LPN to decrease the nursing shortage and that would improve patient outcomes and reduce deaths.
  14. by   Guest12/13/16
    I've said this in other threads and I'll say it again. What these studies really need to do is control for years of experience in comparing ASN and BSN grads. At least part of the effect of increased benefit from BSN grads has to come from ASNs (plus their years of experience) becoming BSNs. So it may look like BSNs provide better care when part of that reason could be from their experiences earned while or before working on their BSN.

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