RN or BSN?

live4today, RN · Jul 29, 2003

Originally posted by Cynthiann
..............So, from what I gather from your comments you are saying that BSN nurses are not as good as other nurses? Do you think straight BSN programs are worthless unless it's a RN-BSN program?

Cynthiann........Just starting out as nurses, ADNs have a much easier time of adapting to patient care than BSNs from what I have seen with my own eyes in working with new BSN grads and having precepted them before.

That is NOT to say they do not eventually become just as good as any other nurse who chose a different path of becoming a licensed nurse.

NO......I do NOT think straight BSN programs are worthless provided those nurses in the BSN programs are receiving excellent clinicals at least for the last two years of their program.

Too much textbook and not enough clinical is NOT a good thing for any student hoping to become a nurse. A good mix of both is good, but more clinical should be stressed to prepare them more for the immediate introduction into being a licensed nurse.

The time to learn clinical skills is NOT while being precepted especially since Preceptors are NOT paid as Instructors to train graduate nursing students in this capacity.

I'm ALL FOR higher education and certification if that's what the job requires, or simply if that is what an individual wants for themselves. Heck, I'm going back to college myself, so why would I down that opportunity for anyone else. :nono: NOT!

If you feel going straight to a four year school for the nursing program suits you best, then I wish you well in your endeavors. As I said before, the choice of routes in becoming a nurse is up to each person making that choice. I cannot speak for what is best for you or anyone else, but from my own professional perspective over the years as a RN, BSN grads do not have an edge over other grads when it comes to direct patient care, etc. In time they become stronger, but the transition from the BSN program into the hospital setting as an inpatient nurse is a more challenging for them than it is for ADN grads and Diploma grads.

Where I currently work, I have heard quite a few BSN grads interning there say to me they wish they could have had the same training as the ADN grads they are orienting with because they notice how much more prepared they are, and less afraid to approach patient care than they are. Many of them have voiced how "lost" they feel in the clinical setting.

This may not be true for all BSNs....I'm sure of that......but for the average BSN grad, I'd bet it is.

Good luck to you in your nursing endeavors no matter what educational route you take! :)

Dixen81 · Jul 31, 2003

Is ADN preferable to Diploma?

fergus51 · Jul 31, 2003

Oh God, another ADN BSN thread:) A BSN is a better idea right off the bat if you know you will need it in the future because you want to teach, be in management, work in community health or get a masters in any advanced practice role (like it or not, these types of positions are limited if you don't have a bachelor's degree). You can still get an ADN and work while getting your BSN, but it seems to take longer that way and be more expensive.

With an ADN/Diploma or BSN you are equally qualified to write the NCLEX and work as a bedside nurse. There is no such thing as "just" a bedside nurse, and I really don't understand the negative reaction to that. An ADN is an associate's degree, a diploma is a diploma. Not the same as far as "level of degree" or whatever you want to call it, but equal in terms of preparation to be a nurse.

Cynthiann · Jul 31, 2003

Originally posted by fergus51
Oh God, another ADN BSN thread:) A BSN is a better idea right off the bat if you know you will need it in the future because you want to teach, be in management, work in community health or get a masters in any advanced practice role (like it or not, these types of positions are limited if you don't have a bachelor's degree). You can still get an ADN and work while getting your BSN, but it seems to take longer that way and be more expensive.

With an ADN/Diploma or BSN you are equally qualified to write the NCLEX and work as a bedside nurse. There is no such thing as "just" a bedside nurse, and I really don't understand the negative reaction to that. An ADN is an associate's degree, a diploma is a diploma. Not the same as far as "level of degree" or whatever you want to call it, but equal in terms of preparation to be a nurse.

My exact point, but apparently I got flamed for it.

seewhiterabbit · Aug 1, 2003

I am going the long route. I am going for my BSN because I know for certain that I want to go on to graduate school at some point.

I have heard from other nurses and nursing students that ADN nurses have more hands on experience or something like that, whereas BSN nurses have a little more theory...I don't know if this is true..but that is what I heard. If it is true then it just seems it will take the BSN nurse longer to get into the groove....I guess....

Hardknox · Aug 1, 2003

Originally posted by fergus51
Oh God, another ADN BSN thread:) A BSN is a better idea right off the bat if you know you will need it in the future because you want to teach, be in management, work in community health or get a masters in any advanced practice role (like it or not, these types of positions are limited if you don't have a bachelor's degree). You can still get an ADN and work while getting your BSN, but it seems to take longer that way and be more expensive.

With an ADN/Diploma or BSN you are equally qualified to write the NCLEX and work as a bedside nurse. There is no such thing as "just" a bedside nurse, and I really don't understand the negative reaction to that. An ADN is an associate's degree, a diploma is a diploma. Not the same as far as "level of degree" or whatever you want to call it, but equal in terms of preparation to be a nurse.

Thank you for this, Fergus. I couldn't find the "beating a dead horse" smilie and was waiting for some one to comment on this done-to-death topic. I suggest anyone interested in this topic do a search---we have had this subject closed and started up again over and over.......nothing changes.

goingCOASTAL · Aug 2, 2003

Hi; new guy here.

I've seen such a debate on other nursing forums before, and it's amazing how a simple phrase can unleash all sorts of hot buttons. Anyway, here are my thoughts on the situation.

Little bio on me first: Male, early 30's, ADN, exp. includes: "bedside", supervisory, management.

Even with my "leetle" degree, I've done it all . . . but don't let my bio fool you. At my facility, BSN + old fashioned "BS" gets promoted over experience and competence anyday. In essence, advanced degrees and kissing lots of admin boo-boo gets one the promotion at my hospital.

It has not been impossible for me to "excel" with my ADN, but most ADN's that I know (including myself) that have moved up the nursing "ladder" did so on the "who-ya-know" express elevator. Ergo, my experience has shown me that if you don't have friends at the top, you better go for the degree if you desire a career in nursing management. It's not impossible as a Diploma or ADN (have had puh-lenty older managers with 'em), but it's certainly MUCH easier with your BSN and/or MSN.

Currently, I am a "bedside" nurse and prefer it that way. I have had little management that I had confidence in (it's hard when you know more than they do clinically) and want nothing more of their political culture. I am mulling over the idea of going back to school to eventually get my MSN (maybe PhD???) and go back and teach . . . (am currently frustrated with the emphasis in healthcare of "smiley" customer service over clinical performance). There are things such as happiness and normal blood pressure readings that are more important than wage per hour.

Besides that, I really enjoy "bedside" nursing, and really laugh at the perception that in order to improve professionally, we have to "trancend" that lowly order. It's like cab drivers no longer driving. We are nurses first, regardless of our training, and are united in the fact that we must first provide safe, competent, and healing care for the sick . . . period.

If I do go into teaching, it will be because I love my career enough to pass it on . . . and not because I have lofty perceptions of myself being too good to wash out a bedpan. Regardless of what I do with the rest of my nursing career, the most important role I will play is as a licensed professional healthcare provider playing a role in the recovery of my patient -- everything else can only compliment that role.

Advice to the RT student? If you want to perform a role as a RN in patient care, an ADN is sufficient. It prepares you for the same licensing exam, and study after study has shown no significant difference between the pass rate (ergo: competence) between ADN prepared candidates versus BSN. Most places are so desperate for RN's that there is often no pay difference and no hiring preference for traditional nursing, though sometimes this is different for certain specialties.

If you seek roles outside of traditional nursing, then I would advise seeking higher degrees since they tend to impress those more who hire. And for some roles as teaching and research, I do agree that the higher degree is better overall.

lindarn · Aug 11, 2003

I am about to ruffle a few feathers. I was originally a diploma nurse from a school in NYC. I moved to California in 1979, and two years later I started the BSN program at Cal State Long Beach. Why did I pursue a BSN? Because I realized a few short years into my career as a nurse how woefully under prepared I was as a diploma nurse.

I am not talking about my clinical skills- I am talking about surviving in the world of business that nursing and hospitals have become. Nurses are the least educated medical professionals in the hospital and have the most need to BE more educated. We should be ashamed of the 19 th century educational preparation that nurses continue fight for.

When I was taking my BSN classes, I did a paper in my senior year about the BSN/ADN/Diploma debate. We can say all we want to that the public thinks the world of nurses, but turn around and ask them if we should be making a professinal salary commensurate with the education that we do have, the inconvenience to our and our families lives, and the constant threat of work ending injuries. Nurses have a rate of on-the-job injuries second only to construction workers. Ask the public that question. Unfortunately, and I hate to bust your bubble, but the public equates worth with education, something that nurses are severely lacking!

We educate ourselves like blue collar trailer trash and then wonder why we are payed, compensated, and treated as such. We get what we ask for.

At a time when physical therapists already have a masters as entry into practice, I have just recently heard that they are going to a doctorate as entry into practice. Occupational Theraspists also have a masters as entry into practice, as do social workers. Pharmacists have a doctorate as entry into practice. They all enjoy far higher salaries than RN's do, along with the professional treatment, and much more respect.

Nurses seem to think that their statutory title of RN should bring them the professional salaries that other medical professionals enjoy, but the fact of the matter is we haven't earned it. As we say in Brooklyn, that and 50 cents will get you on the subway. As we are finding out, it is worthless.

We are neophytes and quite unprepared when it comes to dealing with the hospital administrators. When we ask for more and higher wages and benefits, I wish I had nickel for every time I heard from administrators, patients, the public, "what do you expect? You only went to school for 2 years! And you what, they are right.

I can hear the whining now! "But I only could go the school for 2 years! I didn't have the money to go into a BSN program". Lets face it folks- people got into nursing because it is one of the easiest ways to make a buck, compared to PT's, OT's, Speech therapists, pharmacists, etc. I include other career fields as well. In these fields there is no choice- Bachelors degree, or higher. When someone really wants to be a PT, OT, pharmacist, dietician, etc, they figure out a way the be able to complete the educational requirements and complete the program. Nursing, on the other hand, always wants the easy way out- it has become the welfare of women's professions. It is the first choice of welfare- to work moms who would be otherwise ill- prepared to enter other fields. This may sound nice, but the nursing profession has suffered from a lack of support and appreciation. Nurses are incapable of seeing big picture. Nursing will never come into its own as a profession because of it lack of, and appreciation of higher education.

I makes no differance to me if BSN's have less clinical skills than diploma and ADN graduates. I don't recall doctors being skilled enough to perform brain surgery and heart transplants right after they graduate from medical school. That is what residency and internships are for. Even PT's and OT's have an internship after they graduate from school. And they have master's degrees. There is more to professional practice than technical skills .

As to pay scales, there is no reason the BSN's should not be paid more. I don't care if they are doing the same job. Teachers with master's degrees teaching in the same school, with the same years of experiece, teaching the same grade, make more money than teachers who only have a bachelors degree. Period. There is nothing to debate. Education is appreciated and rewarded.

We don't get paid more because hospital administrators don't want to pay nurses more and they practice the "divide and conquer" routine. They stroke the egos of the diploma and ADN's and say, "See, the BSN's want more money and they do the same job the you do!!." Nurses fall for it hook line and sinker and it gets voted down in unon contracts every time. Instead of insisting that nurses who have higher degrees be rewarded, our own peers need to validate their self worth and self inportance by dumping on those of us who improve ourselves through education and earning and maintaining professional certifications. We are looked down on and made fun of for attempting to improve the image of nursing. And it will not improve until we do. We will forever be the disposable interchangeable widgets who can be replaced by cheaper, and less educated personnel. Our lack of higher education leads the public and the adminstrators to think that, if a nurse with only 2 or 1 years of education can do this job, surely a nurse's aid with a GED can do the same. Make no mistake about it- that is what the train of thought is with the pubic and the people who arre paying for our services think. Unfortunately, we do to. We are forever apologizing and making excuses for our lack of education. We are not paid and treated like professionals because most of us are not.

We need to make the BSN as entry into practice, phase out diploma and ADN programs, eliminate the career track of LPN's, and improve the education of nursing assistants. PT assistants and OT assistants do a fraction of what nursing assistants do, and have a 2 year associates degree to become PT and OT assistants. That is ridiculous. As it stands now, nurses with less than a BSN are indentured servants in the hospital. They have minimal career mobility to better paying jobs. Work in a doctors' office is notoriously low paying, as is home health, and clinics.

Nurses have educated themselves they have moved away from the bedside, not because they don't want to do patient care, but because they are not rewarded or appreciated for their education. The individuals with the motivation and the desire for better paying jobs attain the higher education that is needed and required for the better paying jobs and career fields. Nursing is losing these individuals with motivation and who have the most to offer, to other career fields that don't look down on higher education- a "brain drain".

That is my 0.02 cents on the subject. I hope that I have given people who deride BSN's some food for thought. We will never be cohesive and a power to be reckoned with until we unite under a a common educational background that is commensurate with other health care prodesionals- give the diplomas and ADN's a grandfather clause to allow them to continue practicing, as pharmacists did. Make it easier for them to earn a BSN- give them credit for their diploma and ADN classes. As it stands now, the colleges make you jump through hoops to get your classes approved for a BSN- it should not be. We have to do this soon before we lose our entire practice to technicians. We are giving away our professional practice and make it easier for the hospitals to replace us, and we have never learned to how fight at the bargaining table, or beat them at their own game. We have a long way to go.

Linda, RN, BSN, CCRN

(yes, I use my college degree in my title as well as my specialty certification- I earned the right to use them)

LeesieBug · Aug 11, 2003

The most interesting thing I have noticed about this type of thread is that usually the origonal question is from someone who simply wants advice from "professionals".

Then there seems to be a few who want to prove just how UNPROFESSIONAL they are by bashing one degree or another, or taking one tiny remark that is NOT meant to be insulting, and blow it way out of proportion. Sheesh......

goingCOASTAL · Aug 11, 2003

Originally posted by lindarn

We educate ourselves like blue collar trailer trash and then wonder why we are payed, compensated, and treated as such. We get what we ask for.

Linda;

Finally, someone who can point out all the benefits of obtaining a higher education in nursing without incinuating that everyone below a BSN is an ignoramus. I am contemplating going back for -- at least -- a BSN, and for all the reasons you mentioned -- not because I want "ascend" into management.

The above quote is the only one that raised my collar, which is pretty good, since it is only one paragraph out of a well-thought out essay. I am an ADN prepared RN, and I don't really mind the "blue-collar" label attached to it. I knew that when I got in the job that I actually would be working, sweating, pulling, picking up -- and to incinuate that "working" is somehow less noble than -- I suppose -- pencil pushing, is elitist BS. If I decide to obtain my BSN or higher, it will be promote professionalism within our industry, to obtain more clinical knowledge, but never, NEVER to escape the "work" that defines nursing.

And if that "work" makes me blue collar trash, then so be it.

Pride of July28 · Aug 11, 2003

I have a twist for the board

This may be available in an older thread but--

If you already have a degree in management (BBus Admin- Mgmt 2001) and are looking to enter nursing school with the eventual goal of a NP or CNS-- do you need to get a BSN or ADN?

I have been told by numerous sources that most of the addtl classes in in a BSN are management and comm health related. If have a mgmt degree w/ conctration in Health Care -- I was not looking to get another BS-- can I get my ADN and still do an Rn-MSN bridge?

If those that know can pass on the info or direct me to a former post-- I would most appreciate it!

Nila

goingCOASTAL · Aug 11, 2003

Originally posted by Pride of July28
I have a twist for the board
This may be available in an older thread but--
If you already have a degree in management (BBus Admin- Mgmt 2001) and are looking to enter nursing school with the eventual goal of a NP or CNS-- do you need to get a BSN or ADN?

I have been told by numerous sources that most of the addtl classes in in a BSN are management and comm health related. If have a mgmt degree w/ conctration in Health Care -- I was not looking to get another BS-- can I get my ADN and still do an Rn-MSN bridge?

If those that know can pass on the info or direct me to a former post-- I would most appreciate it!

Nila

If you are looking to advance yourself up a clinical ladder (Nurse Practitioner or other Advanced Practice Nurse, or Nurse Anesthetist

Some universities are offering MSN bridge programs for people with non-nursing bachelor's, but these are very rare. I know that at one time Vanderbilt had such a program. You will just have to search these out through schools you might attend.

What's more common is the RN-MSN program, where ADN nurses can get their BSN and MSN at the same time, though in most cases, entry into these programs are more competitive than doing it "the old fashioned way." A particular school close to me requires a higher grade standard from ADN work to do the bridge program than they require for those entering their BSN (and eventual MSN) programs.

If you are wanting a "management" ladder, advanced nursing degrees are not necessary. In fact, in an increasingly corporatized industry, an MBA is preferred. In some states, an MSN is required for the final nursing executive in the facility, so many colleges offer a joint MSN/MBA track for those wanting to advance the corporate ladder. I have known nurses who've completely advanced out of nursing and into the corporate (business) structure with such degrees.

If you wanted to teach nursing, BSN & MSN would be required, and in many places, so would a PhD (or it's equivalent) in Nursing.

At one time, one could easily switch back and forth on these career ladders, but they are increasingly becoming more specialized -- each with their own educational requirements and preferences.