BSN vs ADN or Program vs Program

phuretrotr · Jul 22, 2013

All programs differ in the number of hours, BSN or ADN, so there is really no difference or advantage to the number of hours. There is a slight difference in the level of preparation for nursing in BSN and ADN. Both programs will provide what is necessary to be a competent nurse and to pass the NCLEX, the BSN just includes an array of more intellectual stimulating classes that ADN's don't both with. Such classes are research, ethics, cultural/religion. I guess you could say more rounded...

I don't really care who has what anymore. I just slipped in a BSN program so that is what I will be getting. The only advantage that I have heard about a BSN is that many places hire BSN's only or over ADN's because of the extra classes. But you can always to back to school to get your BSN while even working as an RN with an ADN.

Do what you will, we all get to the same place sooner or later.

classicdame, MSN, EdD · Jul 22, 2013

Actually, the new health care programs call for BSN as entry level to all hospitals in USA by 2020. That is a goal, not a law, but the writing is on the wall.

We hire BSN over ADN when possible. And in our state the clinical hours are the same for each program.

Guests · Jul 22, 2013

Do you think that there is really that much of a difference in level of prep or is it more dependent on the school?

In terms of preparation, I think it's mostly program dependent... though I believe that a BS program results in a broader, more well-rounded education.

In my state, we have a variety of clinical requirements. I've found that some ADN programs require more clinical hours than the traditional BSN programs.

Again, though, it's program dependent. For example, many of the local ADN programs do not permit their students to perform IVs; neither on patients nor on each other. My DEMSN program did.

Ultimately, though, I think it doesn't add up to a hill of beans. Using my IV example: While I had done some IVs in school (and some Foleys and some NGs and some wound care), I did not become competent at any of them until I began doing them on a regular basis.

Personally, I think the biggest predictor of the quality of a program's graduates is: The rigor of its admissions process.

THELIVINGWORST, ASN, RN · Jul 22, 2013

It depends on what your hospitals hire really. As far as nursing goes, can YOU tell a BSN nurse from an ADN nurse? I can't.

HouTx, BSN, MSN, EdD · Jul 22, 2013

It depends on what your hospitals hire really. As far as nursing goes, can YOU tell a BSN nurse from an ADN nurse? I can't.

Yes, actually I can. While technical skills may be equal, the BSN students are more aware of the 'big picture' and have a much better understanding of non-clinical issues that have a huge impact on patient care. They are better prepared to delegation and leadership. They have a greater depth of understanding related to complex physiological problems. They also are much more apt to volunteer to participate in professional activities that are not linked to additional pay..... but that has been my experience, your mileage may vary.

Esme12, ASN, BSN, RN · Jul 22, 2013

I have to disagree....my mileage does vary......all new grads struggle with delegation and "the big picture" having worked with both....it is the quality of the school that makes on new grad superior over another. I have found new grads in general missing essential basics or critical thinking and assessment in the pursuit of advancing the education with a dumbing down of the bedside nurses role and na ever increasing removal of skills from the bedside nurse under the umbrella that it is an "advance" concept. We are going to educate ourselves out of the bedside and patients will suffer....for we are the last line of defense for errors and intervention.

I think the ability to delegate and have leadership come with experience...and not in a degree. I will admit that the ADN grads education will vary greatly according to the school with some for profits maintaining an inferior curriculum and a lack of concurrent theory....which affect the quality of the education.

The truth is both programs will mkae you an RN. One will cost a significantly less amount over all (ADN to BSN) however...the BSN is getting hiring preference by those in power to promote the BSN in 10 agenda....but these are the same that believe there is still a nursing shortage.

kittycat123 · Jul 22, 2013

Honestly, the higher the education, the more future proof you are in your job. A BSN will probably be a requirement in the near future (a decade or so). I'm sure in a few more decades a masters might be required. Always push for the most education you can afford. It will open doors for you later in life.

nurseprnRN, BSN, RN · Jul 23, 2013

Time for my periodic opinion piece on this issue.

This is one of the most contentious issues in nursing: the level of education needed for a profession. As many of the NN'rs know, I come down squarely on the side of a BS in Nursing or BSN (not a BA or "BAS," whatever that is) as entry-level educational preparation. When I had smaller kids and they asked me a question, I always asked them, "Do you want the short answer or the long one?" Since I can count on the fingers of one hand the number of times they ever said, "Short" and still have enough left over for the Boy Scout salute, here it is again.

(Disclaimer: Have worked as a staff nurse, inservice/staff development, instructor, NCLEX prep course instructor, case manager in multiple settings, and other stuff too numerous to mention. In short, been around, seen that, done that.)

What's a profession? Is nursing a profession? What's the basic educational prep for people you think of as professionals? Would you want your chemistry research done by someone with an associate degree? Your child taught high school math or English? Your income tax advising? Sure, there are good people with lower level education who succeed in life, but don't let that "we all have the same license and sit for the same exam" fool you. Better education makes you better at what you do. There are any number of people who can give you examples of BSNs or MNs who don't know how to take a rectal temp (why does everyone focus on that and bedpans when they think of nursing, anyway?) and marvelous crusty old LPNs who saved the resident's butt one dark and stormy night, but for every single one of those I will see your anecdote and raise you half a dozen godawful errors or commission or omission made by nurses who didn't take the coursework and didn't get exposed to the idea of autonomy in school.

Time: The bachelor's degree takes four years. The associate's degree (AS or ASN) takes ... three and a half, once you count all the prerequisites you're going to have to take before they admit you into the nursing program. And those who say you can work on your BSN while you are working as an RN with an AS don't tell you (and maybe don't know, to be charitable) that many of your course hours from the AS program may not be transferrable, so it won't just be a matter of a semester or two or three. AND working as a nurse is HARD, almost as hard as nursing school ... think you'll have the mental, physical, social, and financial energy for more education at the same time? Oh, and in most jurisdictions you can't sit for the LPN exam and work as one while partway thru a AS or BSN program anymore, either.

Job opportunities: Although the old a-nurse-is-a-nurse-is-a-nurse attitude is fortunately fading away, at entry level for new grads, about the same, and I realize that people who are just starting out have a very incomplete idea of what it means to be a nurse. However, look around the place and see who's working. Are you planning to be older some day? Do you see older nurses working in those entry-level staff or charge positions? If not, where did they all go? Why do you care? Well, suppose you work on a general medical floor and get entranced by cardiac rehabilitation after following a patient who did it. A job comes up in the department, hooray! Oops, BSN only. Or you find your heart drawn to helping underserved women in a public health clinic for high-risk pregnancy. Sorry, BSN only in public health. After five or six years as a staff nurse you have become a resource to new hires and your peers and you realize you have a gift for teaching. You see that a position in staff development has come open, and you are first in line at HR to apply. You got it.... BSN is the minimum. School nursing? BSN. Hurt your back and want to go for a job in case management? BSN. You discover you have a gift for asking, "Why do we do it this way?" and are amazed to find you want to look into jobs in management or nursing research.....BSN minimum. And if you look at the regular old want ads for nurses in the paper, you will see more and more and more of them say "BSN preferred/ required." And if so, then exactly how is getting the BSN later going to help you now? You are starting to get the picture. Also, many, many practice settings give you a differential for BSN. No, I know, not all, but hey. One more factor.

Growth: The questions in the licensure exams (NCLEX) are developed from errors made in the first year of practice by new grads, and regardless of pass rates from different level programs, anyone in practice can confirm the research: In the first year of work all new grads perform at about the same level as they get their feet under them and get used to the idea of working as an RN. But after that year, the BSNs pull ahead in ways that are related to their higher level of education. Why? Because what we call in the ed biz "psychomotor skills," the things you do with your hands, can be done by anyone with enough practice. Hell, we teach lay people how to do peritoneal dialysis at home or suction tracheostomies. But the understanding of WHY some things are as they are is something you get in better education: more science, more sociology, more psychology, more history, a basic statistics class, exposure to more clinical settings (I doubt if you'll get a full semester in peds, psych, OB, or any public health at all in most AS programs) give you the insight to ask better questions and make better decisions.

Well, if you really want to be a NURSE, don't you want to find yourself in the camp of folks who are grateful they learned more, rather than the ones who find they had to for advancement or competence and wish they'd done it in the first place? My answer is clear.

THELIVINGWORST, ASN, RN · Jul 23, 2013

This is my problem. Is the fact that I have taken those classes required for a BSN irrelevant? Or that my program gives me two med surg clinicals and all the other classes you mentioned as well? My ADN program may be the exception rather than the rule but I will be proud of my degree come December. I hate that nothing is ever good enough anymore. That's what it seems like to me when comparing degrees, people always ask about upwards mobility. Because my school is one of the best in the state, I will have no problems going anywhere I want and I will have a job waiting for me.

This argument is frustrating. More so because where you live makes such a difference. At my hospital most of the administrative nurses are ADNs