A Different Approach to the ADN vs. BSN Debate

[Sheri257]

Over and over again, we read the same things on these threads. Pay BSN's more at the bedside, and mandate a BSN for all entry level nurses. There is widespread assumption that a BSN mandate would limit the labor supply even further and increase nursing wages.

I'm not sure that would actually happen but, for the sake of argument, let's assume that it would. Ok: so now you're making more money but, since I live in California where we have mandated staffing ratios ... it got me thinking. What's going to happen in the other 49 states where you don't have ratio laws? Isn't it possible that with a more limited labor pool the hospitals would give you even more unreasonable patient loads at the bedside than you have now?

A BSN mandate could very well limit supply and increase wages but it does nothing to improve working conditions. This is where, IMO, a ratio law is a better alternative because it does both. While a ratio law doesn't limit the supply, it does increase the demand and wages by limiting the number of assigned patients to each RN and forcing the hospitals to create more nursing positions.

Plus, it has the added benefit of making your life a hellava lot easier at the bedside which a BSN mandate doesn't do. By limiting supply even further, a BSN mandate could very well thwart attempts to mandate ratios in other states if there aren't enough nurses to staff mandated ratios.

Now ... this may not satisfy BSN nurses who want more consideration for your degrees but, this is where I don't understand you guys. I'm a recent ADN grad and I'll be spending the next two years working on my BSN. You BSN nurses are already way ahead of me.

You definitely qualify for more jobs than I do. There are, at least, some jobs where you can make more money than me at the bedside and, there are other jobs where your BSN counts as additional experience, etc. for promotion. In my area, at least, the BSN career opportunities are tremendous because there aren't that many BSN nurses to begin with. You're also way ahead of me in getting your master's, which increases your job prospects even further.

I see plenty of benefits with the BSN as it is. If I didn't ... I wouldn't bother with the time and expense of furthering my education.

And I wonder if any of the BSN nurses have considered the flip side of all of this? If everyone had a BSN then, everyone would also qualify for those other job opportunities that only you qualify for now. For nurses who don't want to work at the bedside, you already have a huge advantage over the rest of us.

Do you really want every nurse to qualify for the jobs that only you qualify for now? In some ways, this could actually be detrimental to BSN nurses who, IMO, have a huge advantage over the rest of us as it is.

As the old saying goes ... be careful what you wish for.

Just some food for thought.

:typing

[Protoadn]

Its a classic thing here. Someone will always be threatened and annoyed by someone else that is getting the same pay and doing the same work, but hasn't earned either right in their mind. Its why anesthesiologists dislike CRNAs. Nursing sure is difficult, but most of it is common sense. You can't teach common sense, it comes naturally for some and for others it comes with time and experience. Because you are hearing here that many, many people that have graduated from or are currently in ADN programs bring lots of different levels of experience to the table, I believe you should take a minute to reconsider those negative experiences you have had with ADN's. People should be evaluated on a case by case basis. I speculate that no matter what program you came from its variations of the amount of clinical hours, the level of comfort the student has with the basics of physiology, and previous life-experiences that will make them seem to be better RN's at first. I speculate even further that if you took ten RN's, five with BSN's and Five with ADN's that in five years of working in the same unit you wouldnt be able to tell the difference between them as far as on the job performance. To me this argument for more money for BSN's is short sided and only rewards the already lop sided education system that we have here in the US.

[ByTheLake]

The fact is this: your child's teacher has to have a BS or BA. Why don't we?

No, they don't. Mine learn at home, from me. And study after study has shown that "professional" teachers don't produce better results than mom-teachers with *only* a high school diploma. You should also do a little research on what a university education really means today. A previous poster nailed it: a BS/BA is nearly meaningless now. That is not only because so many people have them. Do some research.

A degree does not equal well-educated. There are many people in this country who are becoming or are currently well-educated without the aid of any institutes of higher education, or the help of any formal institutions of learning at all. Do not ever be duped into thinking that a degree is anything more than a piece of paper. It is good that we require them for entry into nursing, but do not think that one piece of paper will make you a better nurse than someone else's piece of paper. Just as one BSN nurse is better than another BSN nurse, and one ADN nurse is better than another ADN nurse, some nurses are just better than others. Not all of us graduated with 4.0's no matter our program! And not all those who graduate with good grades will make good bedside nurses. There's that extra je ne sais quoi that some nurses have that makes them fabulous, and it's just not something you can get from *any* nursing program or textbook.

[jjjoy, LPN]

I am an RN with an ADN degree from a 2 year program at a local college. As for Bridging from "RN" to "BSN"... the way I understand it, once you "bridge" to the BSN you are still an RN.

rags

I was using the common terminology you see out there, such as programs for those with RNs to earn a BSN. Instead of having to take every class in a BSN program, the RN can skip many of the nursing courses and "bridge" to the other coursework for that degree. I wasn't saying that one trades in their RN for a BSN.

And I do think it bears repeating that almost no one is saying that ASNs aren't good RNs or even that BSNs are better nurses. The question is about the often arbitrary educational requirements to be qualified to apply for certain jobs. For example, should nurses be taught IV skills in nursing school? Many programs don't teach this skill. Yet many people think it should be taught in school. Should it or shouldn't it? It depends on many factors, not just on "well, my school did/didn't teach it, therefore other schools should/needn't teach it."

[jjjoy, LPN]

No, they don't. Mine learn at home, from me. And study after study has shown that "professional" teachers don't produce better results than mom-teachers with *only* a high school diploma.

MOST teachers DO need a college degree to be qualified to teach. That doesn't mean they are better. It's just a reality in the job market. Can you see where someone might dismiss the knowledge and skill of nurse when a kindergarten teacher seems to have more education? Notice I say seems. I'm talking about people who are looking from the outside.

A degree does not equal well-educated... There's that extra je ne sais quoi that some nurses have that makes them fabulous, and it's just not something you can get from *any* nursing program or textbook.

Very true. Still, do you then just get rid of all training and let anyone who wants to give it a try? You still need some kind of basic foundation and screening out process. The question is how much foundation is enough foundation? What criteria must be met to allow someone to hold the title of "nurse" or "practical nurse" or "registered nurse"? The criteria can and do change over time, sometimes for better, sometimes for worse.

[SpaceshuttleRN]

First of all when it comes to the idea of patients not having as much respect for or confidence in ADN RNs as they have for BSN RNs, let me ask you this," Do you walk around with your degree listed on your name tag? "

You get the respect and confidence that you deserve based on what you project through your actions. Your name on a degree does not prove you can function, only that you managed to pass a course based on book knowledge. Getting a BSN doesn't make you a good nurse anymore than recognizing numbers makes you an expert mathmatician.

[81Bubbles, BSN, RN]

Here's some food for thought. I hold a bachelors degree in another field and I will have my ADN at the end of the semester. And guess what I can go directly to a nursing masters program without taking any additional nursing classes..... Just a bit of Info

[jjjoy, LPN]

First of all when it comes to the idea of patients not having as much respect for or confidence in ADN RNs as they have for BSN RNs, let me ask you this," Do you walk around with your degree listed on your name tag? "

I don't know who said that patients don't have as much for or confidence in ADN RNs. There's just an assumption that many people have that nursing can't be THAT difficult or demanding if you "only" need a two-year degree.

And why are they promoting all of these accelerated BSN and direct-entry MSN programs? Because a whole set of potential nurses weren't considering nursing because they already have a bachelor's degrees and going back to school for an associate's degree in order to practice nursing feels like going backwards.

You get the respect and confidence that you deserve based on what you project through your actions. Your name on a degree does not prove you can function, only that you managed to pass a course based on book knowledge. Getting a BSN doesn't make you a good nurse anymore than recognizing numbers makes you an expert mathmatician.

Absolutely. I don't think anyone is arguing otherwise.

[rags]

In Wyoming there is one University and it is in the South Eastern part of the state. There are 7 ADN programs scattered throughout the state. Many nursing students are non-traditional in the ADN programs and would not be able to relocate to attend the University so would not have found Nursing to be an option if the ADN programs were not there.

In 2005 there were a total of 213 new nurse graduate students from in State Nursing programs that sat for Boards (for Wyoming License) and out of that 213, 40 were from the BSN program. I think there would definitely be a hardship in the already stressed work place if the remaining 173 had not had the opportunity to attend an ADN program.

At my place of employment RN jobs are always open. There is a shortage now that cannot be filled and last June alone there were 13 new grads hired from both ADN and BSN programs. I know my hospital would be in a real pickle if the ADN's had not been available for hire. The University BSN program already has a waiting list so it would not have been able to accommodate the overflow of applications. The 7 ADN programs have on average >120 applications each year and each accepts from 24-48 students each year.

rags

[81Bubbles, BSN, RN]

Quote: MOST teachers DO need a college degree to be qualified to teach. That doesn't mean they are better. It's just a reality in the job market. Can you see where someone might dismiss the knowledge and skill of nurse when a kindergarten teacher seems to have more education? Notice I say seems. I'm talking about people who are looking from the outside.

Well around here a teacher could get a degree in ANYTHING they choose then teach. That's scarry in my book. Someone with a bachelors in mountian management could be your childs teacher.

[jjjoy, LPN]

Well around here a teacher could get a degree in ANYTHING they choose then teach. That's scarry in my book. Someone with a bachelors in mountian management could be your childs teacher.

Where I am, a teaching credential is also required on top of the bachelor's. That's a year-long program full-time. Some local places when desparate will hire someone who is enrolled in a part-time credential program. To teach secondary level, the teacher must also have a related degree or have taken relevant coursework and passed the appropriate single subject test. Perhaps less than ideal, but there are requirements beyond any college degree. Maybe it's different in your state.

But back to nursing... I think it's scary that current nursing education tends to only introduce nursing students to nursing and the wide variety of health conditions they might come across and the rest is learned "on the job." Even still on orientation, the new grad is immediately asked to use their "nursing judgement" in assessing patient status and in critically reviewing physician orders - even though judgement is honed through experience and many nursing programs just don't have THAT much of that kind of clinical experience.

[sddlnscp]

Jjjoy, I agree with you. My father is a teacher and he had to have a Bachelor's Degree in education, which included what we would consider "clinicals" while he served his time as a student teacher. Then he had to become certified to teach in this state and, after he moved, he had to become certified to teach in that state as well. I wonder if it does vary in the different states, but I know ours is very strict as is the one he is currently teaching in.

Anyway, I also agree with your second statement as well. Perhaps I will feel more prepared after my second year, but being a first-year student, I feel nervous about the idea of putting LPN after my name in June - it's just not that far away and I feel I still have so much more to learn. I don't have any solutions though or know how things could be done differently, but I do wish I felt more prepared. This is in no way a reflection of the type of education I am getting either, I am lucky to be in one of the best programs in the state and am learning a ton, I just know that there are still vast amounts of knowledge out there yet for me to explore. :)

[EmerNurse, BSN, RN]

This is a hard debate, but I think the OP's questions are very important. First off, I am an ADN RN and yes, I am starting my BSN classes this month. Not because I don't think I'm a good nurse, but because I want to someday teach and I need my degrees for that.

I believe wholeheartedly that a nurse (ADN or BSN) improves his/her practice by education but not necessarily by advanced degree. I would prefer an ADN RN who goes out of his/her way to keep up to date on practice, looks for important CEUs, certifications etc, that directly impact the nurses' work at the bedside, rather than a BSN grad who does the minimum required of his/her facility and that's it.

I agree that it would be very difficult to mandate a BSN for entry-level nursing. It would put a severe burden on areas, such as those mentioned above, that do not have local university settings. Areas that are typically underserved would remain so, and that problem would worsen.

It would put a severe burden on 2nd career students who are entering nursing in their late 30's and 40's, as well. When one has a family and a full-time job to contend with, there is much to be considered. Would I have decided to become a nurse (starting back to school at age 36) had I been required to do a 4 year degree? Probably not. The money simply wasn't there for that kind of commitment and I had 4 kids at home. That would have been one less nurse in the work force, and I'm sure the same applies to many others.

Perhaps one day, when most RNs ARE BSNs, it could be mandated, but I just don't see how we can do it now and keep the working nurse force we have (let alone address the working conditions and shortages).

Personally, I'd like to see nurses of ALL degrees band together and stand up for better working conditions, fair pay and ratios and respect for the work we do. After we can ALL stand up together, then maybe we can talk about the details.

My 2 cents.