BSN as entry into practice; why we decided against it. - page 17

by MunoRN 26,792 Views | 240 Comments

While hopefully avoiding stoking the ADN - BSN debate unnecessarily, I thought I'd share my experience with my state's consideration of BSN as entry into practice, as well as the BSN-in-10 initiative. About 3 years ago I sat... Read More


  1. 1
    Quote from MunoRN

    In terms of clinical experience, there's a reason my hospital stopped hiring BSN new grads for two years. While all RN graduates in state need the same number of clinical hours, not all clinical hours are equal. BSN programs often struggle with limited clinical placement opportunities as compared to more dispersed ADN programs, as a result it's not unusual for ADN grads to come out of school closer to being able to take a full load. That's not an observation specific to my Hospital, from an online article "Diploma and Associate Degree RNs will clearly tell you that they can run rings around BSN program graduates when it comes to patient care. Theyll explain that they have more actual clinical experience and patient care know how in their little finger than a new BSN grad, and 99% of the time theyre right about that!" It may just be a myth, but it's a frequently stated myth. As an aside, I don't think time-to-full-load is all that important, potential to progress should be more important.
    *** Here in Wisconsin the public ADN programs are 1 plus 1. That means that after a student finishes the first year of the ADN program they are eligible to take the NCLEX-LPN. Most will do so and then work full time over the summer as LPNs and then continue part time LPN during the last two semesters of the nursing program. So it is not unusual at all for a brand new ADN RN to have nearly a year of LPN experience. There are plenty of LPN jobs around here. Mostly in LTCs, but also med-surg jobs in rural critical access hospitals. Many already worked in these small hospitals and LTCs as CNAs, continued for a year of LPN work and are then hired as RNs in the same hospital. The oppertunity to gain valuable nursing experience working as an LPN is not an option for the BSN program students. There are several small hospitals and LTCs in the area that offer Scholarships for their CNAs & LPNs to attend the very inexpensive ADN programs (around $6-7K total) at the public schools.
    Not hard to see who is going to initially be the more competent bedside RN,though I suspect that a couple years out there may be little difference between them.
    I serve as an instructor in my hospitals nurse residency program. These new grads who have a year of LPN experience have got their priortization and time managment down pat the first week of residency clinical and are ready to hit the ground running. They have already called physicians in the middle of the night to report changes in patient condition, the know the meds (at least the PO ones) well, they have given and taken report hundreds of times, the have preformed chart checks, signed off orders, dealt with lab and pharmacy, dealt with patients, their families and physicians, they have managed a full patient assingment , honed their assessment skills, likely had a chance to at least observe a code, maybe have preformed CPR and a thousand other basic nursing tasks.
    I am sitting here with the local weekly shopper covering a 4 county area and count 7 listings for LPNs. 2 at a hospital, 4 at nursing homes, and one at aclinic. Many of these places would love to hire an LPN knowing s/he will soon be an RN.
    Last edit by PMFB-RN on Nov 21, '12
    tewdles likes this.
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    There were a limited number of these 1 plus 1 programs in my state until a few years ago. The problem became that these programs required usually more than 1000 hours of experience as an LPN prior to starting the RN portion of the program. As LPN jobs became scarce many of these students were unable to get their 1000 hours in and were having to start over in a direct ADN or BSN program.
  3. 2
    Quote from Esme12
    ...I actually yearn for the day that this argument ends and there is finally a consistent entry level into nursing. I miss the days of respect for the kind of nurse you are and not the kind of nurse that has many degrees...
    I think it's unfortunate that there's essentially a civil war among RN's, particularly since most of it seems to be based on a concerning lack of knowledge about what the differences actually are.

    I think we're already pretty close to a standardized level of entry when you look at curriculum, the name itself of the degree is becoming the main difference. There are two consortiums in my state where ADN and BSN programs have combined, you can take your BSN OB Nursing class at the CC with ADN students, and ADN students can take the same class at the University campus, it's all interchangeable. I'm not convinced that a BSN student and an ADN student are getting significantly different educations when they're sitting next to each other the same classes.

    I had a BS in Biology before getting my BSN, so I'm all for upping our educational requirements if for no other reason than to justify my time and money spent on 2 BS degrees. Although I think we've failed to control our own destiny in this regard and as a result we've been taken advantage of to some degree. There's little difference in curriculum between an accelerated BSN and an ADN, except the BSN might cost $85,000 while the ADN is usually less than $10,000. If we figure the average career of a Nurse is 25 years (which is generous considering more than half of Nurses are now "second career"), that's a pay cut of $3,000 per year for the BSN. I really don't believe the idea that we'll get paid more since we already have both ADNs and BSNs in the marketplace, if employers were going to pay BSNs more then we'd already being seeing that, instead employers might pay another $1 an hour and often pay nothing more at all.
    PMFB-RN and Esme12 like this.
  4. 0
    Quote from MunoRN
    There were a limited number of these 1 plus 1 programs in my state until a few years ago. The problem became that these programs required usually more than 1000 hours of experience as an LPN prior to starting the RN portion of the program. As LPN jobs became scarce many of these students were unable to get their 1000 hours in and were having to start over in a direct ADN or BSN program.
    *** Not the case here. There is no requirement for the students to take the NCLEX-LPN but it is encouraged, if for no other reason than as practice for the NCLEX-RN. I am under the impression that the majoriety do take it and work as LPNs.
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    Of the 18 people in my CRNA graduating class 12 (including me) started their nursing career as associates degree RNs. A number of them decided to do an associated degree program since it can be a faster path to CRNA school as compaired to traditional BSN programs.
  6. 2
    Quote from MunoRN
    We also have 3 year BSN programs, Chaplain college offers one, it's 1 year of pre-reqs (A&P, micro, Psych, math, etc) and 2 years of the program. Of course this is completely different from an ADN program, which is 1 year of pre-reqs and 2 years of program.

    Saying a BSN is better than an ADN doesn't make as much sense when you put it another way; 1 year of pre-reqs and 2 years of program is better than 1 year of pre-reqs and 2 years of program.

    Of course Chamberlain's program isn't exactly the same as ADN programs; it costs $85,000.
    $85,000 HOLY CRAP!!!
    IndiCRNA and PMFB-RN like this.
  7. 0
    Quote from MunoRN
    I think it's unfortunate that there's essentially a civil war among RN's, particularly since most of it seems to be based on a concerning lack of knowledge about what the differences actually are.

    I think we're already pretty close to a standardized level of entry when you look at curriculum, the name itself of the degree is becoming the main difference. There are two consortiums in my state where ADN and BSN programs have combined, you can take your BSN OB Nursing class at the CC with ADN students, and ADN students can take the same class at the University campus, it's all interchangeable. I'm not convinced that a BSN student and an ADN student are getting significantly different educations when they're sitting next to each other the same classes.

    I had a BS in Biology before getting my BSN, so I'm all for upping our educational requirements if for no other reason than to justify my time and money spent on 2 BS degrees. Although I think we've failed to control our own destiny in this regard and as a result we've been taken advantage of to some degree. There's little difference in curriculum between an accelerated BSN and an ADN, except the BSN might cost $85,000 while the ADN is usually less than $10,000. If we figure the average career of a Nurse is 25 years (which is generous considering more than half of Nurses are now "second career"), that's a pay cut of $3,000 per year for the BSN. I really don't believe the idea that we'll get paid more since we already have both ADNs and BSNs in the marketplace, if employers were going to pay BSNs more then we'd already being seeing that, instead employers might pay another $1 an hour and often pay nothing more at all.

    The average career of a nurse is 25 years????!!!!! Is that why us who have been a nurse for 32 years can't get a job? Munro, where did you hear this???Is this true???
    I knew it- it's soup kitchens and homeless shelters for us What are we supposed to do when we aren't near 65 yet? those of us who had our RN's at age 23and it's 32 years late?
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  9. 0
    Quote from kcmylorn
    The average career of a nurse is 25 years????!!!!! Is that why us who have been a nurse for 32 years can't get a job? Munro, where did you hear this???Is this true???
    I knew it- it's soup kitchens and homeless shelters for us What are we supposed to do when we aren't near 65 yet? those of us who had our RN's at age 23and it's 32 years late?
    I think 25 years is actually a pretty high estimate for the average Nurse career span. These two sites put it at 5-7 years. The average age of a new grad is 31 years old. A sizable chunk of those new grads won't make it more than 2 or 3 years. If we use a 6 year average in my previous example then getting a BSN can be a 12,500 pay cut per year compared to an ADN.
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    Or more than double what CRNA school cost. Holy crap is right........
    kcmylorn likes this.


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