ADN vs. BSN for Entry Level Nursing

Nursing Students ADN/BSN

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The new push is for all nurses to be baccalaureate prepared, eliminating the 2 year associate degree program. Given the current and future nursing shortage, what is your opinion?

What happens to people who have a BS in another field and opted for the ADN or AS because it was the only option available due to the extremely long waiting lists for BSN slots? Is it okay to go for the ADN or AS with a BS in another subject and then earn a second Bachelor's (BSN) later?

It's most definitely ok as BSN minimum entry most likely would not happen in any of our lifetimes, so that's not an issue. Nothing is going to happen to people with a Bachelors in another field and this is the way it should be, IMHO.

ADN nursing is here to stay for at least a very long time (past my retirement I would predict), regardless of what degrees ADN nurses hold in other fields.

Having said that, I have to chime in here because I see comments like this a lot and it bothers me to see comments about people having bachelors degrees in other fields who have an associates degree in nursing and the idea that the two combined degrees are the equivalent of a BSN.

As an ADN grad myself who is currently a BSN student, I have to say that having an ADN along with a bachelors in journalism, English literature, biology, or what have you is most definitely not the equivalent of having a BSN.

There is more to a BSN than extra general ed. classes compared to an ADN and the idea that a liberal arts bachelors degree substitutes for a BSN basically reduces a BSN to extra science, psych, or humanities courses which of course is way off base.

If a bachelors in another field really was the equivalent to a BSN as long as you have an ADN, I would most definitely have pursued a degree in a field other than nursing after my ADN because I'm way burned out on studying any more nursing subjects at this point.

Diploma hospital based programs are closing in my area (PA). I currently work at Children's Hospital of Philadelphia and have been told in 2 years the hospital will only hire BSN prepared nurses. Well since I want to work here I am now waiting on acceptance to a BSN program. I was also told BSN nurses make more money. I'll have to check into that.

Specializes in Critical Care.
Diploma hospital based programs are closing in my area (PA). I currently work at Children's Hospital of Philadelphia and have been told in 2 years the hospital will only hire BSN prepared nurses. Well since I want to work here I am now waiting on acceptance to a BSN program. I was also told BSN nurses make more money. I'll have to check into that.

Wrong on both accounts. 60% of RNs are ADN RNs. Hospitals are not about to move to 'BSN only'. For one thing, it is a mistake to think that hospitals even WANT this distinction. The major argument in favor of BSN entry is more pay and respect. Where exactly, would that come from? Our employers. Do you think they have a vested interest in forwarding that goal?

As a result, salaries are about the same for ADN and BSN. Look, if hospitals REALLY wanted more BSN employees, they'd simply pay for it. The fact that they do not speaks volumes.

If you are waiting for BSN to be mandated from the outside of nursing, keep waiting another 40 yrs. In fact, the reason WHY BSN hasn't already BEEN mandated is lobbying pressure to gov't from corporate interests, such as hospitals, that do NOT want this distinction.

Ask N. Dakota why it repealed BSN entry. I suspect that if you look at campaign contributions, you'd find a pervasive lobbying effort that was in play.

Your employers might WANT BSN nurses, but they certainly do NOT want to pay for it. As a result, they WILL studiously avoid pressures that would make BSN cost more money - for THEM.

Many hospitals have indeed begun to advertise, "BSN-preferred". That is far different from 'required'. By using this method, they can yield more BSN applicants for positions WITHOUT the requirement that would require more pay. When you see 'bsn preferred', read between the lines, "We PREFER BSNs but only if they are willing to work in the same salary ranges and under the same working conditions as our ADNs." Yes, I fully agree that hospitals DO prefer this option.

The supposition that BSN will ultimately lead to better salaries and respect is putting the cart before the horse. If you want a move to BSN, then better salary and more respect needs to be a direct result of attaining BSN, not some far away idea. Indeed, hospitals are banking on the difference between those two concepts: BSN first, and THEN we'll discuss what that means in terms of salary and respect. That is a losing proposition for nurses, whether it leads to more BSNs, or not.

A question for BSN proponents: Is there an advantage to moving to BSN entry IF there is no corresponding increase in salary or respect? Deep within this fundamental question is another question: HOW do we move to BSN entry in a way that DOES lead to higher salary and respect? It's not a matter of if such a move could lead to those ideal goals, but how. How, i suspect, involves making that higher pay and respect the result of individual conversion and acquisition of BSN along the way and NOT by putting forward some far off, lofty goal of such a move. That means demanding more from your employers than merely, 'BSN-preferred'. It means you hold them accountable to that preference by demanding that they put their money where their mouth is.

If you apply for a 'bsn-preferred' position, you SHOULD be asking by what means they support that preference. What exactly are the differences in salary and position? Be specific: how much MORE starting salary is this BSN-preferred position over and above what you would pay an ADN in the same tier of experience? What benefits, besides salary, accrue to BSN candidates over ADN candidates? (Don't take 'more management opportunity' as an answer. That does NOT answer this question for bedside nurses. If that answer is given, it should be immediately followed up by, "Yes, but what advantages do you extend to the BEDSIDE NURSE for BSN?") It's a valid question: IF you actually DO prefer BSN, by what methods do you do so? Talk is cheap.

I'll make a deal with you BSN proponents. You begin to actually bargain your BSN degree to your employers, so that they actually provide an incentive (as opposed to mere desire) for BSN, and I'll go back to school. Make the market place recognize a significant difference, and I'll pursue that difference. That's fair.

Upwards of 40% of RNs are at least BSN now. You don't NEED 100% participation to bargain for this, you are already a sufficiently vested 'minority'. If those of you that are already BSN raised your voices collectively, the market would be required to listen.

On the other hand, if we stumble towards BSN, without raising a voice to the differences, why should the market CARE about such differences? The fact that such a difference isn't routinely offered to 40% of the workforce speaks volumes about how 100% of a future workforce will be treated.

~faith,

Timothy.

I have no idea how it is done in States that neighbor yours. But your dismissal of ALL State college programs shows that either you don't know of which you speak before you speak, or don't wish to because it doesn't support your argument

I didn't see the comment being referred to here as including a "dismissal of ALL state college programs."

Community colleges may offer coursework that is fully transferrable to and of equal quality to a university (some CC's surpass uni's in quality of courses), but they are not universities. They do not offer all of the coursework required to earn a bachelor's degree. That is why you have to transfer from the CC (apply and be accepted to the uni) in order to earn a bachelor's degree. Thus, the poster you are referring is not incorrect to state that "two year colleges are not part of a state university system."

If you apply for a 'bsn-preferred' position, you SHOULD be asking by what means they support that preference. What exactly are the differences in salary and position? Be specific: how much MORE starting salary is this BSN-preferred position over and above what you would pay an ADN in the same tier of experience? What benefits, besides salary, accrue to BSN candidates over ADN candidates? (Don't take 'more management opportunity' as an answer. That does NOT answer this question for bedside nurses. If that answer is given, it should be immediately followed up by, "Yes, but what advantages do you extend to the BEDSIDE NURSE for BSN?") It's a valid question: IF you actually DO prefer BSN, by what methods do you do so? Talk is cheap.

You make a good point here.

Specializes in Oncology/Haemetology/HIV.

Actually Tim, Hospital at UPenn (which includes CHOP) I believe has pushed for an all BSN or higher nursing staff. If it isn't already, I would be surprised. I also do not know whether ADN/Diplomas that had been long standing employees were "parented" in. It was a big controversy when I left my assignment at HUPenn.

On the unit that I worked, the staff ate new nurses, med students and interns with a vengence. But notably throughout the facility, nurses did hold "greater" nursing power than in many places...certainly more than your standard "customer service" oriented community facility.

However, three of the best facilities at which I have been, it has been made clear that a nurse is valued for her skills and knowledge, and degree differences were not an issue. All three ranked higher in the national ratings of hospitals. One was Johns Hopkins. And in those, there was substantially less "nurse eating" going on. Probably it paid better, but thestaff did not seem to note degree differences despite BSN being on the name tag.

Actually Tim, Hospital at UPenn (which includes CHOP) I believe has pushed for an all BSN or higher nursing staff. If it isn't already, I would be surprised. I also do not know whether ADN/Diplomas that had been long standing employees were "parented" in. It was a big controversy when I left my assignment at HUPenn.

On the unit that I worked, the staff ate new nurses, med students and interns with a vengence. But notably throughout the facility, nurses did hold "greater" nursing power than in many places...certainly more than your standard "customer service" oriented community facility.

However, three of the best facilities at which I have been, it has been made clear that a nurse is valued for her skills and knowledge, and degree differences were not an issue. All three ranked higher in the national ratings of hospitals. One was Johns Hopkins. And in those, there was substantially less "nurse eating" going on. Probably it paid better, but thestaff did not seem to note degree differences despite BSN being on the name tag.

You know , I remember the days that there was a ginormous discussion about Osteopathic Dr's and MD. Was one better then the other, were DO's just MD flunkies, DO's arn't trained like MD's. DO's , do weird medicine, I wouldn't send a dog to a DO. Heck, I remember that our intensivist at a major level 1 trauma center in Ohio didn't put his title on his lab coat because it would cause him more greif than it was worth. (he was a DO). Now , in Ohio at least, every one is equal, I havn't heard a pt ask if their DR is a MD of DO. It was the same debate as this nursing BS. Now hospitals do not differentiate between the two. DO's go to what used to be primarily MD hospitals and MD's go to what used to be DO hospitals. The real question is how well are pt's cared for, if a DO has manipualtion courses and an MD has some other sort of class, who cares. They both get paid the same do the same job and are both respected. Don't know about you, I don't care if an cardiac surg. had a class in why tulips are red or yellow. I want to know how his pt out comes are and how many ssurg's he did before he opens my chest. That's the bottom line for most pt's as well.

I didn't see the comment being referred to here as including a "dismissal of ALL state college programs."

Ok, but apparently I did, which is why I made the comment.

Community colleges may offer coursework that is fully transferrable to and of equal quality to a university (some CC's surpass uni's in quality of courses), but they are not universities. They do not offer all of the coursework required to earn a bachelor's degree. That is why you have to transfer from the CC (apply and be accepted to the uni) in order to earn a bachelor's degree. Thus, the poster you are referring is not incorrect to state that "two year colleges are not part of a state university system."

Guess it depends on the State. That assertion is quite incorrect when discussing NYS, as I said previously. The letterhead, public handouts and miscellaneous materials that go with advertising on my alma mater say distinctly "SUNY _____ Community College, a Unit of the State University of New York". One must apply to transfer credits to one of the 4-year schools, but one must also do the same if requesting transfer from one 4-year school to another 4-year school. Applications are required in either case, and frankly may be rejected in either case. Simply having an application process to move one's credits from one "unit" to another does not eliminate it from the State university system. It is part of the same, at least in THIS State, which is why I told the quoted poster that I didn't know how her neighboring States did it, but it WAS an incorrect blanket assumption.

You know , I remember the days that there was a ginormous discussion about Osteopathic Dr's and MD. Was one better then the other, were DO's just MD flunkies, DO's arn't trained like MD's. DO's , do weird medicine, I wouldn't send a dog to a DO. Heck, I remember that our intensivist at a major level 1 trauma center in Ohio didn't put his title on his lab coat because it would cause him more greif than it was worth. (he was a DO). Now , in Ohio at least, every one is equal, I havn't heard a pt ask if their DR is a MD of DO. It was the same debate as this nursing BS. Now hospitals do not differentiate between the two. DO's go to what used to be primarily MD hospitals and MD's go to what used to be DO hospitals. The real question is how well are pt's cared for, if a DO has manipualtion courses and an MD has some other sort of class, who cares. They both get paid the same do the same job and are both respected. Don't know about you, I don't care if an cardiac surg. had a class in why tulips are red or yellow. I want to know how his pt out comes are and how many ssurg's he did before he opens my chest. That's the bottom line for most pt's as well.

But ALL DOCTORS AND OSTEOPATHS GRADUATED FROM A FOUR YEAR UNDERGRAD PROGRAM PROGRAM AND A FOUR YEAR MEDICAL OR OSTEOPATH SCHOOL. That is the difference. Nurses graduate from two year ADN programs, 2-3 year diploma programs, or four year BSN programs. The length of the programs are the make education difference, so you are comparing apples to oranges.

Lindarn, RN, BSN, CCRN

Spokane, Washingto

Not so, DO's actually go to school longer than MD's . If you actually sit atnd look at class time , internship etc,,, DO's do more time. But, they get payed the same. Besides, all I was really saying was that this discussion is getting old. The physicians are able to work for a solution better than nurses seem to. Who would of thunk ! ADN's go almost 3 years unless they really do some cramming, Diploma go almost 4 years (usually 1 quarter short of), and 4 years get summers off so talk about comparing fruit. There are so many programs out there, we all take the same federal exam, we all do the same job. I'm a diploma nurse, was just offered a job that presents pros, improv. to hospitals, talks to ER directors ,CEO"S and Admin , travel around the state 4-5 days a week , high profile job, lots involved, sounded soooo... interesting. They said my qualifacations exceeded anyone they had found yet. I was going to take the job but my husband and I decided we couldn't afford a 23 thou. $/yr. pay cut. because our daughters are in school. So someone else took the job, a MSN nurse. Her pay is the same. She has done nursing education, research. The company said they wish they could have hired me because she has book work experience but little true clinical experience. They wanted to know if I would re-consider to come on board and help her. I guess when she presents to CEO's and Dr's they make mince meat of her. I'm just saying when are we going to look at job preformance rather than what looks good on paper.

Community colleges are

part of the same, at least in THIS State, which is why I told the quoted poster that I didn't know how her neighboring States did it, but it WAS an incorrect blanket assumption.

It's interesting how NYS structures their public higher education. It looks like it all post-high school programs are administered under the State University of New York, including technical colleges and certificate programs. So I think we're all correct. Community colleges aren't universities as the term is generally understood and in New York, community colleges are part of the SUNY system.

http://www.suny.edu/Student/academic_degree_certs.cfm

I'm sure my post will sound like many others since this is a topic that is discussed over and over again..and doesn't seem like the debate will simmer anytime soon! But I feel like I have to put my two cents in;)

I don't understand why people seem to get so angry and heated over "which degree is better". We are all nurses and it's really more important that we band together and try to change the things we can about nursing. Our profession is not going to get the respect it deserves if we can't manange to get along.

I think the question of who comes out better prepared for entry level nursing has a great deal more to do with the institution of learning in question rather than the length of time of the program.

I am about to graduate from an ADN program in a few weeks. I am not of the position that ADN programs are better than BSN programs. The school I go to has an excellent reputation and we've been told time and time again from recruiters and educators at our clinical sites that they love hiring new grads from our school because our grads are so well-prepared.

I fully intend on continuing on with school once I decide where I want to specialize. I will go on for my MSN ultimately. I believe that continuing education is critical.

There is only so much nursing school can teach about each area of nursing. A large part of nursing I think is learned through experience, something that can't be taught in lecture nor gained through limited clinical experiences. There is such a difference between "textbook nursing" and "real-world nursing". For the sake of lecture exams and boards we have to be taught textbook nursing and instructors hesistate to teach the real-world nursing component in fear of confusing us when it comes time for boards. Makes for a rough transition one we're out in the real world!

Anyway, I don't see any evidence that either degree is so superior to the other or that one has such major deficits that it needs to be such a huge issue. It almost seems to me that this topic is a scapegoat for the real causes for the huge mess nursing is in today.

I don't mean to nor do I intend to offend anyone. Just want to put that out there. We all work hard for our degrees and we all deserve respect and recognition as nurses.

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